#Pediatric Health Risk

[huntquinlan]

every once and a while i remember the wing pregnancy plot and i vibrate with rage for a good minute. star wars revenge of the sith ass plot (derogatory). if she wanted to create drama around it, it shouldn’t have been the wings. it literally could have been anything but the wings. pregnancy is incredibly dangerous in general. elain could have had a vision of something going wrong. nyx simply could have been born prematurely due to the stress of feyre having to find out nesta was kidnapped and is stuck in a death tournament. or he could have just been premature. sometimes babies are. ugh.

[kids-worldfun]

Childhood Obesity: Tips for Parents and Caregivers

by Dr. Shanthi Thomas Shane hardly spoke to anyone at school. At recess time, what did she do? She did not go to the playground. She sat alone at her desk, reading a book. Often, she would long to talk, but it looked as though no one was interested in talking to her. She hated looking at the mirror. Shane had childhood obesity. If you have a child who was obese, what do you do? Important tips…

[surinderbhalla]

Snoring: Hidden Dangers and Health Risks

Snoring might seem harmless, even amusing to some, but the truth is far more serious. Beyond just being a nuisance to your bed partner, snoring could be a red flag for underlying health issues. In this article, we delve into the hidden dangers and health risks associated with snoring, shedding light on why addressing this seemingly innocuous habit is essential. Snoring: Hidden Dangers and Health…

[iatrophilosophos]

Hey I'm hearing uh. More, and more, and more buzz about GLP-1 agonists like ozempic from random ppl and healthcare providers alike and there's like a terrifying lack of lucidity abt it so I just wanna say, if you've heard some stuff and are curious:

Ozempic is a chemically-aided crash diet. That's it.

Like metformin, an older diabetes medication used off-label for weight loss, it's functioning as an appetite suppressant in this use-case. It's not magic; it's not changing how your body makes or uses fat; it just makes it less miserable to eat less. It is contraindicated by histories of disordered eating and should absolutely not be prescribed without a full screening for above-adequate food intake and nutrition *and* ongoing screening for adequate nourishment/malnutrition: this is broadly not happening.

I've also seen no indication that ozempic/GLP-1 agonists are any less likely to lead to weight cycling (w/o constant use) than a straight crash diet, or do anything meaningful to limit the known, significant health risks of weight cycling.

Nothing has changed:

The main things we know from a western scientific perspective about weight and weight loss are that 1) almost all people who lose significant weight gain it back and 2) weight cycling causes cardiovascular and metabolic health complications. Yall we aint even have strong evidence to suggest that weight loss is beneficial to health conditions associated with higher weights. This *should* point to Dr's never ever reccomending weight loss (we do know it can hurt, don't know it can help) but yknow we live in uhhhh fucking world.

We are possibly ripe for an aggressive intensification of anti-fat medical rhetoric, especially in pediatrics

Among the projections for an RFK FDA that ive gotten from folks i know in these fields is a renewed focus on childhood obseity and general military-style fitness. As the ozempic fad has already been ramping up, I'm kinda! concerned! about this being a major point of focus for the oncoming administration--i figure we're ripe for another mass diet craze associated with a wide variety of deaths anyway and that existing cultural+market inertia added to it being literally on the agenda spells some not great things. I really seriously reccomend paying extra attention to this area.

Clinics love ozempic because it's extremely popular and extremely profitable--i even know someone who's job was threatened for refusing to prescribe it. We already know that we cant trust doctors to be informed around weight or for the system to sound public alarms.

Obviously, people have the right to do whatever they want--but the disclosure just isn't there and people are being sold this stuff based on the idea it'll make them *healthier* and prevent disease. It can't and it won't.

If the claims here about weight in general are new to you, start here: (Don't love the title of the article, second the exasperation)

If you want to understand more about glp-1 agonists specifically, like, start with the Wikipedia article and do some googling it lays out the pharmacology in relatively plain language. Sry i ain't doing a buncha work to find citations ppl won't click; there's not a lot of good critical stuff out there that's actually published but it doesn't actually take a lot of reading up on critical weight science to form a critical take on the sources singing ozempics praises.

Peace, good luck, do whatever you want forever, maybe tell ur mom that this isn't any different from the disastrous weight loss fads of the 90s.

[sayruq]

Dr. Tanya Haj-Hassan, a pediatric intensive care physician who works with Médecins Sans Frontières and co-founded @GazaMedicVoices, has emerged as one of the most prominent voices raising the alarm about the hell Israel has created for Gaza’s healthcare workers. Mary Turfah: Yesterday, I came across a report of a third mass grave unearthed at Al-Shifa Hospital. One month ago, as the first mass graves there were being uncovered, you were interviewed by Sky News. The anchor cited Israeli military sources saying that they had detained “hundreds of Hamas militants” within the complex, then asked you what you thought of that. Could you speak to your response to him, and to this persistent obsession with “militants at Al-Shifa,” when not a single hospital in Gaza has been spared, and when there have been mass graves [seven in total to date] uncovered at multiple hospitals in Gaza? Tanya Haj-Hassan: Yeah. I think my response was something to the effect of, I can’t believe we’re still having this conversation. Everybody from a medical or humanitarian background is so sick of having to respond to these atrocious, preposterous justifications that are being provided for things that are never justifiable. I thought the Hamas and Al-Shifa question was buried a long time ago. There were several weeks where that’s all we were asked about in interviews. There were multiple investigations done that concluded no credible evidence existed to justify the attacks on Al-Shifa. And then, Al-Shifa was targeted again, besieged again. Then, eventually, Al-Shifa started functioning again. The staff were so proud of the fact that they got it functioning again. That second time, the hospital was again besieged and targeted. A lot of the staff were taken out into the courtyard of the hospital, where the male staff were stripped. Israeli soldiers beat several of the healthcare providers. A very, very senior person at Al Shifa, an older doctor, was eventually released and came on foot to Al-Aqsa Hospital. And immediately, he went back to work. I was at Al-Aqsa Hospital when he turned up disheveled, beard down to here, exhausted, having lost I don’t know how many kilos, hadn’t seen his family for five months, didn’t have a phone, didn’t have proper shoes, didn’t have proper clothes. They fled with basically nothing. And many of the other healthcare providers who were taken outside with him were abducted. I think his testimonies of what happened and the amount of work they had put into getting Al-Shifa functioning again made the question of the Sky News anchor even more infuriating. Because that’s the reality I had just come out of, and to hear him then ask a health professional who had spent the last few weeks resuscitating dead and dying children that have been maimed to an extent that I don’t think I’ll ever be able to forget—even though I think for my own well-being, it would probably be good if I would forget some of those images—I found it so insulting. Insulting to me, to the healthcare providers who had risked their lives to stay at Al-Shifa, who had lost 25 percent of their body weight, who were exhausted. Insulting to the health care providers who had been killed at Al-Shifa, fleeing from Al-Shifa, to the civilians who were executed there. It’s insulting to our intellect. It’s insulting to humanity

MT: Last week, it was revealed that Dr. Adnan Al-Bursh, a renowned orthopedic surgeon in Gaza, was tortured to death inside of Israeli prisons, according to eyewitness testimony, after he had been abducted from the hospital where he was providing life-saving care, back in December. Hundreds of medical workers have been killed to date, and many more injured. You said in one interview that doctors and healthcare workers are changing out of their scrubs before leaving the hospital so that they’re not targeted. On top of this, the doctors in Gaza have been working basically nonstop for 215 days. As someone who has worked in Gaza, I was wondering if you could say a bit about what your colleagues are facing day-to-day. THH: I want to start with the abduction of healthcare workers, because it’s so underreported, to the point where myself and my colleagues, medical providers working our own jobs, are doing the investigative work. They’re systematic. There have been at least 240 abductions documented by our group— MT: 240?! THH: At least 240, and I’m not talking about what’s reported by the Ministry of Health, which I believe is an even higher number. We documented that at least 240 healthcare workers have been abducted and detained by Israeli forces, the majority of whom have not been released. And the ones who have been released are providing testimonies of torture, of themselves but also the torture that they’ve witnessed. I’ve taken testimonies. One, a three-hour-long testimony about the torture inflicted on [my friend,] a nurse, for 53 days in custody, accusing him of being part of Hamas, of his family being part of Hamas, even though the fact that he was released tells you he wasn’t part of Hamas. Given the extent to which he was tortured, I’m surprised that he survived. And he has not survived with his physical and mental health intact. He has scars, he has nightmares. He had hematuria, so bleeding when he urinated, for weeks after he was released.

Please read this interview as it sheds light on the horrors doctors, nurses, and other medical workers in Gaza have endured

[covid-safer-hotties]

Also preserved in our archive

Something y'all may need with family get-togethers for the winter hollidays coming up. Several studies have shown 500% increase in risk for cardiovascular episodes after a covid 19 infection, but not for vaccination. Call people out if they spread this bs.

By Chris Mueller

The claim: Studies show COVID-19 vaccine recipients are 500% more likely to die from a heart attack A Nov. 29 Threads post (direct link, archive link) makes a claim about the COVID-19 vaccine and its effect on the heart.

“Your chance of dying from a heart attack from that ‘vaccine,’ according to their own studies, is 500% greater than if you were unvaccinated,” reads the post. “This is state-sanctioned murder.”

It was liked more than 500 times in four days.

Our rating: False There are no studies that show COVID-19 vaccine recipients have a 500% greater chance of having a heart attack. Some studies show the opposite − that the shot is associated with a lower risk of heart attack.

COVID-19 virus linked to heart attack risk, not vaccine There are no credible news reports about a study saying COVID-19 vaccine recipients have a 500% greater chance of having a heart attack. The American Heart Association even recommends the COVID-19 vaccine to people with a history of heart disease and stroke, saying they are "at much greater risk from the virus than they are from the vaccine."

There are several studies that show the vaccine is associated with a lower risk of cardiovascular events, including heart attacks and strokes.

A study of nearly 46 million adults in England found that people who received the COVID-19 vaccine had fewer heart attacks and strokes than those who had yet to be vaccinated. The researchers examined medical records from the two years between December 2020 and January 2022.

“This England-wide study offers reassurance regarding the cardiovascular safety of COVID-19 vaccines, with lower incidence of common cardiovascular events outweighing the higher incidence of their known rare cardiovascular complications,” the study says.

Erin Faherty, a pediatric cardiologist at Yale Medicine, previously told USA TODAY that vaccination for COVID-19 is associated with a lower risk of heart attack.

"We have no evidence to suggest that the COVID-19 vaccine shuts down the heart or is associated with widespread heart failure," she said in February. "From the data we have, the risks of COVID-19 infection far outweigh the minor cardiac risk of vaccination."

Some studies have linked the virus – not the vaccine – to a higher risk of cardiovascular events. People who caught the disease early in the pandemic had double the risk, while others with severe cases had nearly four times the risk, according to a study supported by the National Institutes of Health published in October.

But a study of more than 8 million adults in Sweden found “full vaccination significantly reduced the risk of several more severe cardiovascular outcomes linked to COVID-19, such as heart attack, stroke, and heart failure,” said Fredrik Nyberg, an epidemiology professor and one of the study’s authors, in a news release.

There is a “causal association between mRNA COVID-19 vaccines and myocarditis,” which is inflammation of the heart muscle, but cases are rare, according to the Centers for Disease Control and Prevention.

USA TODAY reached out to the user who shared the post for comment but did not immediately receive a response.

Our fact-check sources Nature, July 31, Cohort study of cardiovascular safety of different COVID-19 vaccination doses among 46 million adults in England University of Cambridge, July 31, Incidence of heart attacks and strokes was lower after COVID-19 vaccination American Heart Association, Oct. 9, COVID-19 Is a Coronary Artery Disease Risk Equivalent and Exhibits a Genetic Interaction With ABO Blood Type American Heart Association, Oct. 6, 2023, What people with heart disease should know about vaccines today National Institutes of Health, Oct. 10, First wave of COVID-19 increased risk of heart attack, stroke up to three years later USA TODAY, Feb. 14, No evidence COVID-19 vaccine 'shuts off' the heart, contrary to anti-Kelce post | Fact check Centers for Disease Control and Prevention, accessed Dec. 4, Clinical Considerations: Myocarditis and Pericarditis after Receipt of COVID-19 Vaccines Among Adolescents and Young Adults

[macgyvermedical]

Safe States: Trans Youth Health and School Update

This is an updated version of my recent post about safe states. If you are trans and a minor, or are a parent of a trans minor, here is some information you may want to have if you are considering moving from an unsafe state. Please spread this around if you can!

Maps created by Erin Reed at https://www.erininthemorning.com/

The following is general information about states marked “safest states with strong protections”. All states listed have expanded medicaid, which means even if you don't yet have a job in your target state you and your family will still have health coverage (call Job and Family Services in the area you are going to get set up). I always recommend getting a 90 day supply of all medications, including gender-affirming medications, plus an emergency PAPER prescription for all medications before making any move. That way, if you can't get in to see a clinician quickly, you will not run out of medications.

Added to this list is the Gender Identity Policy Tally (how many categories of protection policy a state covers), the number of WPATH pediatric Gender-Affirming Care providers, and whether the state has free online education available, which may be an easier transition for students who may have to switch schools midyear or move around several times prior to living in a permanent location.

State: California

*Cost of Living: 134.5% of US average

Climate Risk: Moderate

Median Rent: $1,856

Minimum Wage: $16/hr (116 hours to make rent)

2020vs2024 Politics: Blue, went 8 points redder

**Gender Identity Policy Tally: 23.25/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 36

Free Online K-12 School Available?: Yes

State: Colorado

*Cost of Living: 105.5% of US average

Climate Risk: Low

Median Rent: $1,594

Minimum Wage: $14.42/hr (110.5 hours to make rent)

2020vs2024 Politics: Blue, went 2 points redder

**Gender Identity Policy Tally: 23.25/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 7

Free Online K-12 School Available?: Yes

State: Connecticut

*Cost of Living: 113.1% of US average

Climate Risk: Low

Median Rent: $1,374

Minimum Wage: $15.69 (87.5 hours to make rent)

2020vs2024 Politics: Blue, went 5 points redder

**Gender Identity Policy Tally: 22.25/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 3

Free Online K-12 School Available?: No (tuition-based schools available)

State: Hawaii

*Cost of Living: 179% of US average

Climate Risk: Low

Median Rent: $1,868

Minimum Wage: $14/hr (133 hours to make rent)

2020vs2024 Politics: Blue, went 6 points redder

**Gender Identity Policy Tally: 17.75/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 1

Free Online K-12 School Available?: No (tuition-based schools available)

State: Illinois

*Cost of Living: 90.8% of US average

Climate Risk: Moderate

Median Rent: $1,179

Minimum Wage: $14/hr (84 hours to make rent)

2020vs2024 Politics: Blue, went 7 points redder

**Gender Identity Policy Tally: 22.5/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 5

Free Online K-12 School Available?: No (tuition-based schools available)

State: Maine

*Cost of Living: 111.5% of US average

Climate Risk: Low

Median Rent: $1,009

Minimum Wage: $14.15/hr (71 hours to make rent)

2020vs2024 Politics: Blue, went 2 points redder

**Gender Identity Policy Tally: 23.5/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 0

Free Online K-12 School Available?: Grades 7-12 only (tuition-based schools available for lower grades)

State: Maryland

*Cost of Living: 119.5% of US average

Climate Risk: Low

Median Rent: $1,598

Minimum Wage: $15/hr (106 hours to make rent)

2020vs2024 Politics: Blue, went 6 points redder

**Gender Identity Policy Tally: 22.75/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 6

Free Online K-12 School Available?: Kent County only (tuition-based schools available elsewhere)

State: Massachusetts

*Cost of Living: 148.4% of US average

Climate Risk: Moderate

Median Rent: $1,588

Minimum Wage: $15/hr (106 hours to make rent)

2020vs2024 Politics: Blue, went 8 points redder

**Gender Identity Policy Tally: 20.25/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 4

Free Online K-12 School Available?: Yes 

State: Minnesota

*Cost of Living: 94.1% of US average

Climate Risk: Low

Median Rent: $1,178

Minimum Wage: $10.85/hr (108 hours to make rent)

2020vs2024 Politics: Blue, went 3 points redder

**Gender Identity Policy Tally: 21/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 6

Free Online K-12 School Available?: Yes

State: New Jersey

*Cost of Living: 114.1% of US average

Climate Risk: Moderate

Median Rent: $1,577

Minimum Wage: $15.13/hr (104 hours to make rent)

2020vs2024 Politics: Blue, went 10 points redder

**Gender Identity Policy Tally: 23.25/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 3

Free Online K-12 School Available?: No (tuition-based schools available)

State: New Mexico

*Cost of Living: 94.2% of US average

Climate Risk: High

Median Rent: $966

Minimum Wage: $12/hr (80.5 hours to make rent)

2020vs2024 Politics: Blue, went 5 points redder

**Gender Identity Policy Tally: 19/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 2

Free Online K-12 School Available?: Yes

State: New York

*Cost of Living: 125.1% of US average

Climate Risk: Moderate

Median Rent: $1,507

Minimum Wage: $15/hr (16/hr for NYC, Long Island, and Westchester), (100.5 hours to make rent)

2020vs2024 Politics: Blue, went 11 points redder

**Gender Identity Policy Tally: 24/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 13

Free Online K-12 School Available?: No (tuition-based schools available)

State: Oregon

*Cost of Living: 115.1% of US average

Climate Risk: Low

Median Rent: $1,373

Minimum Wage: $16.70/hr (but it's complicated) (82 hours to make rent)

2020vs2024 Politics: Blue, went 2 points redder

**Gender Identity Policy Tally: 21/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 9

Free Online K-12 School Available?: Yes

State: Rhode Island

*Cost of Living: 110.5% of US average

Climate Risk: Moderate

Median Rent: $1,195

Minimum Wage: $14/hr (85 hours to make rent)

2020vs2024 Politics: Blue, went 7 points redder

**Gender Identity Policy Tally: 20.25/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 1

Free Online K-12 School Available?: No (tuition-based schools available)

State: Vermont

*Cost of Living: 114.9% of US average

Climate Risk: Low

Median Rent: $1,149

Minimum Wage: $13.67 (84 hours to make rent)

2020vs2024 Politics: Blue, went 3 points redder

**Gender Identity Policy Tally: 20.5/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 0

Free Online K-12 School Available?: No (tuition-based schools available)

State: Washington

*Cost of Living: 115.1% of US average

Climate Risk: Low

Median Rent: $1,592

Minimum Wage: $16.28 (97 hours to make rent)

2020vs2024 Politics: Blue, went 0 points redder

**Gender Identity Policy Tally: 22/26

Number of Pediatric Gender-affirming Care Providers (WPATH): 13

Free Online K-12 School Available?: Yes

*On this scale, 100% is the average COL across the USA. Numbers above 100% mean the state is more expensive than average. Numbers below 100% mean the state is less expensive to live in than average. Pennsylvania, Utah, and Nevada are the states closest to average. Hawaii, at 179% is the most expensive state. Mississippi, at 85.3% is the least expensive state to live in.

**The Gender Identity Policy Tally is a tally by the Movement Advancement Project of 26 different areas in which there can be policy protecting trans and gender nonconforming individuals. The score is a count of how many of these pieces of policy are present in a state. 

References: COL CR MR MW POL PT WPATH K12

[evidence-based-activism]

Is male circumcision as harmful as female circumcision? I have had multiple discussions about this, but someone said that certain types of FGM are equally or less invasive than MGM

Hi! No, no it is not.

Male circumcision

So, the big question about male circumcisions is if it's ethical or not. A while ago, I would have said, no definitely not, since it's a violation of bodily autonomy. However, someone has since pointed out to me that we do a lot of things to infants (and children) that are technically violations of bodily autonomy.

We consider this morally acceptable because we are providing some intervention that they (the children) are not capable of either requesting or refusing on the basis of it's benefits outweighing the harms. The best example of this, in my opinion, is vaccines. We give children a lot of vaccines because we know that they have (and do) substantially lower the chance of the child getting sick and/or dying from a preventable disease. In this case, the minor violation of bodily autonomy (vaccination of a child) is permitted because waiting until they are able to give their consent would introduce a substantially larger risk of harm.

How does this relate to male circumcision? Given this framework, we could accept male circumcision if (1) there are benefits to the procedure, (2) the benefits outweigh any risk of harm, (3) waiting until the child is able to consent to the procedure is not feasible (i.e., some significant portion of the benefits would be lost).

There is some mixed evidence for these three claims. Evidence in favor includes:

There are a number of reviews [1-3] by the same team that provide support for all three points. In particular this review [3] directly reviews the evidence of "arguments opposing male circumcision", debunking each one in detail. However, the fact that they are all by the same team is less encouraging. The evidence here is substantial, but there's a potential for bias.

That being said, the American Academy of Pediatric [4] also concludes that the "health benefits of newborn male circumcision outweigh the risks".

This Cochrane Review (essentially the highest quality evidence) [5] found male circumcision substantially reduces acquisition risk of HIV by heterosexual men and that incidence of adverse events is very low.

And this review and meta-analysis [6] found the same reduction for HPV.

Evidence against:

This review [7] suggests the benefits of male circumcision may not apply in North American countries

This article [8] claims the same for developed countries in general

This commentary [9] claims the same, suggesting that "from the perspective of the individual boy, there is no medical justification for performing a circumcision prior to an age that he can ... choose to give or withhold informed consent himself"

That being said these papers have also been challenged by advocates for male circumcision [10] and even opponents [9, 11] recognize that the rates of complications are very low, and the rates of serious complications even lower. In addition to that, complication rate was greater for older children [11], which provides support for the third point I highlighted above (i.e., waiting until they are older may introduce more harms than benefits).

And all of that being said, if the procedure is done, it should absolutely be done with some form of pain relief. Thankfully, it appears that the vast majority are performed in this fashion [11].

In the end, there is strong evidence supporting male circumcision for infants in developing countries. There are research gaps concerning if these benefits apply to developed countries (i.e., little work has examined this population specifically), which indicates a need for such research. That being said, with the extremely low complication rate and moderate evidence of benefits, there also isn't a strong argument against the procedure.

---

Female Genital Mutilation

Comparing this to female genital mutilation (FGM) will highlight just how egregious such equivalencies are.

First, a brief detour into biology. Men and women have various embryological precursors that develop into either male or female sex organs. These are called biological homologues, and they are roughly (although not perfectly) comparable. For example, an embryo has the gonad which, during sex differentiation, develops into the ovary in women and the testicle in men [12].

This framework allows us to make some rough comparisons between male circumcision and FGM. For example, it's likely that the "less invasive" form of FGM you were referred to is type 1A [13]. In this type, only the clitoral hood is removed. Both the clitoral hood and the foreskin develop from the prepuce, as they are homologous structures. Notably, even here, male circumcision and FGM type 1A would still only be homologous if (1) FGM type 1A has a similarly low risk profile as male circumcision and (2) male circumcision actually provides no benefits to the infant.

For the first point, we have little to no data on the complication rate of type 1A FGM, specifically because it is essentially never performed in isolation [14]. This is – almost entirely – a theoretical form of FGM. Despite this, even if it were more common it doesn't necessarily follow that the procedures would have a similar adverse effect profile. In fact, one of the most common arguments against male circumcision involves the numerous nerve endings in the glans (head of the) penis, generally in reference to how the foreskin "protects" the penis head or "preserves sensitization" (neither of which are proven assertions). But while the glans penis and glans clitoris have a similar number of nerve endings in absolute terms, the clitoral head is much smaller and therefore much more densely innervated [15]. As a result, it would be much more likely for the removal of the clitoral hood to result in irritation than the removal of the foreskin.

And for the second point, I've discussed the mixed literature on the topic in developed countries. However, most FGM is performed in developing countries (although certainly not exclusively so) [14], and in this context there is strong evidence of a health benefit to male circumcision and absolutely no health benefit to FGM.

To complete the comparisons between FGM and male circumcision in terms of homologous structures [12, 13]:

Type 1B involves the removal of the clitoris with the prepuce (clitoridectomy). This, anatomically speaking, would be similar to removal of (minimally) the penis head.*

Type 2 involves partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora. This would be roughly comparable to the removal of the penis head, mutilation/cutting/removal of penile raphe (underside of the penis) with or without mutilation/cutting/removal of the scrotum.*

Type 3 is infibulation, or the narrowing of the vaginal orifice with creation of a covering seal by cutting and apposition the labia minora and/or the labia majora, with or without excision of the clitoris. There is no direct comparison for men, as they do not have a vaginal orifice or any similar structure.

Type 4 is all other mutilation/anything that cannot be categorized as above.

*Note: these comparisons aren't perfect due to differences in how the homologous structures are arranged. For example, removal of the penis head would also impact the urethra, whereas removal of the clitoris would not. That being said, these comparisons are far more accurate than between FGM types 1B - 4 and male circumcision.

To further drive home the differences, FGM results in substantial, severe health complications (unlike male circumcision) and has absolutely no known health benefits (possibly unlike male circumcision). These articles [16-21] go into great detail on this; the complications range from: infection, incontinence, infertility, severe and sometimes chronic pain, pregnancy complications, PTSD and post-traumatic symptoms, other psychiatric disorders, greater risk of STDs, and death.

There is no evidence of any benefits.

---

Conclusion

Hopefully, it's clear that male circumcision and female genital mutilation are in no way comparable.

The opponents of male circumcision often suggest that any violation of the bodily autonomy of infants is morally wrong, but this fails to consider the nuanced situation inherent to infant-hood and early childhood. They are physically and mentally unable of consenting to or refusing any medical procedure, which is why we have a – generally recognized – moral caveat to this principle that allows caregivers to act in the best interests of the child, particularly when waiting for the child to grow older before allowing any intervention would increase the risk of harm. (Childhood vaccinations and, really, any other medical procedure done on children, are other examples of this.)

It's possible that future research may indicate that male circumcision is not associated with benefits in developed countries. (This would remove male circumcision from the category of procedures described above.) Even then, however, it would not be comparable to FGM due to the vastly different complication rates.

I hope this helps you!

References under the cut:

Morris, B. J., & Krieger, J. N. (2013). Does male circumcision affect sexual function, sensitivity, or satisfaction?—a systematic review. The journal of sexual medicine, 10(11), 2644-2657.

Morris, B. J., Kennedy, S. E., Wodak, A. D., Mindel, A., Golovsky, D., Schrieber, L., ... & Ziegler, J. B. (2017). Early infant male circumcision: systematic review, risk-benefit analysis, and progress in policy. World journal of clinical pediatrics, 6(1), 89.

Morris, B. J., Moreton, S., & Krieger, J. N. (2019). Critical evaluation of arguments opposing male circumcision: A systematic review. Journal of Evidence‐based Medicine, 12(4), 263-290.

Task Force on Circumcision, Blank, S., Brady, M., Buerk, E., Carlo, W., Diekema, D., ... & Wegner, S. (2012). Male circumcision. Pediatrics, 130(3), e756-e785.

Siegfried, N., Muller, M., Deeks, J. J., & Volmink, J. (2009). Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane database of systematic reviews, (2).

Shapiro, S. B., Laurie, C., El-Zein, M., & Franco, E. L. (2023). Association between male circumcision and human papillomavirus infection in males and females: a systematic review, meta-analysis, and meta-regression. Clinical Microbiology and Infection, 29(8), 968-978.

Bossio, J. A., Pukall, C. F., & Steele, S. (2014). A review of the current state of the male circumcision literature. The Journal of Sexual Medicine, 11(12), 2847-2864.

Frisch, M., & Earp, B. D. (2018). Circumcision of male infants and children as a public health measure in developed countries: a critical assessment of recent evidence. Global public health, 13(5), 626-641.

Deacon, M., & Muir, G. (2023). What is the medical evidence on non-therapeutic child circumcision?. International journal of impotence research, 35(3), 256-263.

Moreton, S., Cox, G., Sheldon, M., Bailis, S. A., Klausner, J. D., & Morris, B. J. (2023). Comments by opponents on the British Medical Association’s guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health. World Journal of Clinical Pediatrics, 12(5), 244.

Shabanzadeh, D. M., Clausen, S., Maigaard, K., & Fode, M. (2021). Male circumcision complications–a systematic review, meta-analysis and meta-regression. Urology, 152, 25-34.

26: The Reproductive System . (n.d.). In Anatomy and Physiology (Boundless) . LibreTexts. https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Anatomy_and_Physiology_(Boundless)/26%3A_The_Reproductive_System

Abdulcadir, J., Catania, L., Hindin, M. J., Say, L., Petignat, P., & Abdulcadir, O. (2016). Female genital mutilation: a visual reference and learning tool for health care professionals. Obstetrics & Gynecology, 128(5), 958-963.

WHO, U. O. (2008). Eliminating female genital mutilation: An interagency statement. World Health Organization.

Shih, C., Cold, C. J., & Yang, C. C. (2013). Cutaneous corpuscular receptors of the human glans clitoris: descriptive characteristics and comparison with the glans penis. The Journal of Sexual Medicine, 10(7), 1783-1789.

Utz-Billing, I., & Kentenich, H. (2008). Female genital mutilation: an injury, physical and mental harm. Journal of Psychosomatic Obstetrics & Gynecology, 29(4), 225-229.

Klein, E., Helzner, E., Shayowitz, M., Kohlhoff, S., & Smith-Norowitz, T. A. (2018). Female genital mutilation: health consequences and complications—a short literature review. Obstetrics and gynecology international, 2018(1), 7365715.

Iavazzo, C., Sardi, T. A., & Gkegkes, I. D. (2013). Female genital mutilation and infections: a systematic review of the clinical evidence. Archives of gynecology and obstetrics, 287, 1137-1149.

Berg, R. C., & Underland, V. (2018). Immediate Health Consequences of Female Genital Mutilation/Cutting (FGM/C).

Sarayloo, K., Roudsari, R. L., & Elhadi, A. (2019). Health consequences of the female genital mutilation: a systematic review. Galen medical journal, 8, e1336.

Reisel, D., & Creighton, S. M. (2015). Long term health consequences of Female Genital Mutilation (FGM). Maturitas, 80(1), 48-51.

[she-is-ovarit]

Trans research and scientific consensus

(2020) - Study of 139,829 students finds that in comparison to other students, transgender identity, especially non-binary identity, is associated more with perpetrating bullying than being bullied. Non-binary identity was most strongly associated with involvement in bullying, followed by [transgender] opposite sex identity and cisgender identity. 

(2023) 21 leading experts on pediatric gender medicine from 8 countries wrote a letter to Wall Street Journal expressing disagreement over how gender dysphoria in youth is treated, voicing concerns against things such as the affirmative model and research conducted outside of the US has found hormonal interventions for gender dysphoria to be without reliable evidence. Among these international experts is Dr. Rita Kaltiala, chief psychiatrist at Tampere university gender clinic and author of several peer-reviewed studies on trans medicine and Finland's top authority on pediatric gender care.

(2023) Landmark study from Denmark on 3,800 transgender patients pulled data from hospital records and applications from legal gender changes and discovered 43% of this group had a psychiatric illness compared with 7% of non-trans group, and despite "gender affirming care" and legal gender changes, still had 7.7 the rate of suicide attempts and 3.5 times the rate of suicide deaths. Researchers state this rate is likely even higher due to missing data.

(2016) Study finds association with increased risk of multiple sclerosis for trans women taking estrogen/reducing testosterone levels.

(2023) Metadata study shows, at best, no improvement for patients in gender-affirming care. "The conclusions of the systematic reviews of evidence for adolescents are consistent with long-term adult studies, which failed to show credible improvements in mental health and suggested a pattern of treatment-associated harms. Three recent papers examined the studies that underpin the practice of youth gender transition and found the research to be deeply flawed. Evidence does not support the notion that “affirmative care” of today’s adolescents is net beneficial."

(2011) Long term follow up of 324 transgender people having undergone sex reassignment surgery in Sweden, found that trans women retained male patterned incidents and rates of violence and had a greater significance and rate of rape and sexual violence than cisgender men. The study also found, "Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group."

(2020) Largest study to date on 641,860 people finds association with autism and "gender diversity", "Gender-diverse people also report, on average, more traits associated with autism, such as sensory difficulties, pattern-recognition skills and lower rates of empathy — or accurately understanding and responding to another person’s emotional state".

(2022) US study examining 10 years of data on 952 people finds large percentages of young adults prescribed hormones for trans identity no longer getting the drugs 4 years later. Discontinuation rate for both sexes combined = 30%. Female discontinuation rate as high as 44%. The standard disinformation pushed is that only 1-2% of people who begin medical transition end up desisting. But these figures show that in this cohort of young adults, the overall rate of discontinuing hormone treatment ranged from a low of 10% to a high of 44% within a space of just 4 years.

Abruzzese et al. 2023 'The Myth of “Reliable Research” in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies—and research that has followed'

More to come.

[probablyasocialecologist]

While the Cass Review has been presented by the U.K. media, politicians and some prominent doctors as a triumph of objective inquiry, its most controversial recommendations are based on prejudice rather than evidence. Instead of helping young people, the review has caused enormous harm to children and their families, to democratic discourse and to wider principles of scientific endeavour. There is an urgent need to critically examine the actual context and findings of the report. Since its 2020 inception, the Cass Review’s anti-trans credentials have been clear. It explicitly excluded trans people from key roles in research, analysis and oversight of the project, while sidelining most practitioners with experience in trans health care. The project centered and sympathized with anti-trans voices, including professionals who deny the very existence of trans children. Former U.K. minister for women and equalities Kemi Badenoch, who has a history of hostility toward trans people even though her role was to promote equality within the government, boasted that the Cass Review was only possible because of her active involvement. The methodology underpinning the Cass Review has been extensively criticized by medical experts and academics from a range of disciplines. Criticism has focused especially on the effect of bias on the Cass approach, double standards in the interpretation of data, substandard scientific rigor, methodological flaws and a failure to properly substantiate claims. For example, although the existing literature reports a wide range of important benefits of social transition and no credible evidence of harm, the Cass Review cautions against it. The review also dismisses substantial documented benefits of adolescent medical transition as underevidenced while highlighting risks based on evidence of significantly worse quality. A warning about impaired brain maturation, for instance, cites a single, very short speculative paper that in turn rests on one experimental study with female mice. Meanwhile extensive qualitative data and clinical consensus are almost entirely ignored. These issues help explain why the Cass recommendations differ from previous academic reviews and expert guidance from major medical organisations such as the World Professional Association for Transgender Health (WPATH) and the American Academy of Pediatrics. WPATH’s experts themselves highlight the Cass report’s “selective and inconsistent use of evidence,” with recommendations that “often do not follow from the data presented in the systematic reviews.” Leading specialists in transgender medical care from the U.S. and Australia emphasize that “the Review obscures key findings, misrepresents its own data, and is rife with misapplications of the scientific method.” For instance, the Cass report warns that an “exponential change in referrals” to England’s child and adolescent gender clinic during the 2010s is “very much faster than would be expected.” But this increase has not been exponential, and the maximum 5,000 referrals it notes in 2021 represents a very small proportion of the 44,000 trans adolescents in the U.K. estimated from 2021 census data.

7 August 2024

[theconstitutionisgayculture]

This isn't science, it's public relations. Thankfully, Trump's executive order cuts off WPATH.

Trump’s executive order directs federally funded institutions to stop reliance on WPATH, calling its recommendations “junk science.” Cut off from what Abbruzzese calls WPATH’s “evidence laundering,” insurers will be forced to evaluate the gender medical evidence and issue policies on their own. Systematic reviews and investigations already undertaken in England, Finland, and Sweden indicate it’s not likely they will find the evidence for medically transitioning children to be terribly impressive.

The same order also says that no medical group which received federal money can provide pediatric gender transitions. Those that do risk losing Medicare and Medicaid contracts. Shrier says that some boutique medical practices that don't received federal money will still be able to pursue gender-affirming care for kids but in her view it was the omnipresence of gender-affirming care that was its chief strength. If it is now limited to a few fringe places it will be a lot less able to bully people into line.

God, we can only hope this is right and things are changing. One day history will look back on this period of transing kids with the same horror we have now when we look back on things like lobotomies and the Tuskegee Experiments, but that's a cold comfort to the children who were coerced into irreversibly altering or mutilating their bodies by adults with an agenda to push or serious mental health problems.

Give the whole article a read, as well as the articled linked. There's a great argument for why this current trans nonsense is directly linked to Obamacare.

[mariacallous]

Yesterday, health officials in Louisiana announced that a patient who was hospitalized with severe bird flu in December has died. The individual contracted bird flu after exposure to a backyard flock and wild birds. It is the first death recorded in the United States attributed to H5N1, or avian influenza.

The person was over the age of 65 and reportedly had underlying medical conditions. The Louisiana Health Department has not released any more details about the patient.

A total of 66 people in the US tested positive for bird flu in 2024, according to the Centers for Disease Control and Prevention. In all of the other cases, people developed mild symptoms and made a full recovery. But the Louisiana case is a stark reminder that avian flu can be dangerous. And as the number of human infections rises, health experts worry about more cases of severe illness—and potentially more deaths.

“This is an ongoing game of Russian roulette,” says physician Nahid Bhadelia, founding director of the Center on Emerging Infectious Diseases at Boston University. “The more virus there is in our environment, the more chances there are for it to come into contact with humans.” It was only a matter of time before bird flu turned deadly, she says.

The US is in the middle of an H5N1 outbreak that shows no signs of stopping. The virus has infected more than 130 million birds, including commercial poultry, since January 2022. In April 2024 it spilled into dairy cows for the first time. Though not fatal for cows, the virus has sickened more than 900 dairy herds in 16 states.

Most people who come down with bird flu are farm workers or others who have direct contact with sick animals. Of the 66 confirmed infections in the US last year, 40 had exposure to dairy cows, while 23 had exposure to poultry and culling operations. In the three other cases, the exact source of exposure is unknown.

Since 2003, more than 850 human cases of H5N1 bird flu have been reported outside the United States, and about half of those have resulted in death. In a statement released Monday, the CDC said a death from H5N1 bird flu “is not unexpected because of the known potential for infection with these viruses to cause severe illness and death.” Federal health officials say the risk of getting bird flu remains low for the general public, and there is no evidence that the virus is spreading from person to person anywhere in the country.

One of the puzzling aspects of the current US outbreak is why all the human infections until now have resulted in mild illness. “It could be that they're young, healthy people,” says Jennifer Nuzzo, director of the Pandemic Center and a professor of epidemiology at Brown University. “It could be that the way they're being exposed is different from how we've historically seen people get infected. There are a number of hypotheses, but at this point they're all just guesses.”

Nuzzo says it’s very possible that the Louisiana patient’s preexisting health conditions contributed to the severity of their illness, but also points to the case of a teenager in Canada who was hospitalized with bird flu in November.

The 13-year-old girl was initially seen at an emergency department in British Columbia for a fever and conjunctivitis in both eyes. She was discharged home without treatment and later developed a cough, vomiting, and diarrhea. She wound up back in the emergency department in respiratory distress a few days later. She was admitted to the pediatric intensive care unit and went into respiratory failure but eventually recovered after treatment. According to a case report published in the New England Journal of Medicine, the girl had a history of mild asthma and an elevated body-mass index. It’s unknown how she caught the virus.

“What that tells us is that we have no idea who is going to develop mild illness and who is going to develop severe illness, and because of that we have to take these infections very seriously,” Nuzzo says. “We should not assume that all future infections will be mild.”

There’s another clue that could explain the severity of the Louisiana and British Columbia cases. Virus samples from both patients showed some similarities. For one, both were infected with the same subtype of H5N1 called D1.1, which is the same kind of virus found in wild birds and poultry. It’s different from the B3.13 subtype, which is dominant in dairy cows.

“Right now, the question is, is this a more severe strain than the dairy cattle strain?” says Benjamin Anderson, assistant professor of environmental and global health at the University of Florida. So far, scientists don’t have enough data to know for sure. A handful of poultry farm workers in Washington have tested positive for the D1.1 subtype, but those individuals had mild symptoms and did not require hospitalization.

“In the case of the Louisiana infection, we know that person had comorbidities. We know that person was an older individual. These are factors that contribute to more severe outcomes already when it comes to respiratory infections,” Anderson says.

In the Louisiana and British Columbia cases, there’s evidence that the virus may have evolved in both patients to produce more severe illness.

A CDC report from late December found genetic mutations in the virus taken from the Louisiana patient that may have allowed it to enhance its ability to infect the upper airways of humans. The report says the changes observed were likely generated by replication of the virus throughout the patient’s illness rather than transmitted at the time of infection, meaning that the mutations weren’t present in the birds the person was exposed to.

Writing in the New England Journal of Medicine, the team that cared for the Canadian teen also described “worrisome” mutations found in her viral samples. These changes could have allowed the virus to more easily bind to and enter cells in the human respiratory tract.

In the past, bird flu has rarely been transmitted from person to person, but scientists worry about a scenario where the virus would acquire mutations that would make human transmission more likely.

For now, people who work with birds, poultry, or cows, or have recreational exposure to them, are at higher risk of getting bird flu. To prevent illness, health officials recommend avoiding direct contact with wild birds and other animals infected with or suspected to be infected with bird flu viruses.

[darkmaga-returns]

As undeniable evidence mounts that fluoride harms children’s brains, a historic ruling by a federal judge—and a report the government tried desperately to bury—may finally end the practice of adding this toxin to America’s drinking water.

For over two decades, scientists have warned about the harmful effects of fluoride exposure on the developing brain. Since 63% of the U.S. has fluoride in its drinking water, this is a critical issue affecting millions of Americans! Unfortunately, government agencies like CDC—along with the American Dental Association and the American Academy of Pediatrics—dismissed concerns and stubbornly continued to champion water fluoridation.

This all changed last month with a pivotal court ruling. But, first, some background: In 2016, the NIH’s National Toxicology Program (NTP) was charged with analyzing the large volume of studies on fluoride’s neurotoxicity. Shortly after, an advocacy group sued the EPA in a bid to force it to remove fluoride from drinking water. Knowing that a report from NTP was forthcoming, U.S. District Judge Edward Chen stayed the case until the report’s release. Little did he know how long he would have to wait.

Not only did it take NTP six years to complete the report, but when it was ready to publish in May 2022, officials at CDC and HHS betrayed their duty to the American people by trying to suppress the report! Ultimately, it took another year and a court order from Judge Chen for the report to be released. As HighWire viewers may have suspected, the report did not bode well for water fluoridation.

This September, with the NTP report finally in hand, Judge Chen made his historic ruling: “[T]he Court finds that fluoridation of water at 0.7 milligrams per liter (‘mg/L’) – the level presently considered ‘optimal’ in the United States – poses an unreasonable risk of reduced IQ in children.” He concluded:

[T]here is substantial and scientifically credible evidence establishing that fluoride poses a risk to human health; it is associated with a reduction in the IQ of children and is hazardous at dosages that are far too close to fluoride levels in the drinking water of the United States. And this risk is unreasonable under Amended TSCA.

The court then ordered the EPA to “to engage with a regulatory response,” but the even better news is that many townships aren’t waiting to protect their kids from this toxic exposure. Abilene (TX), Hillsboro (OR), Lebanon (OR), Yorktown (NY), and Winter Haven (FL) have already decided to end, or forego starting, fluoridation in the wake of the Court’s ruling, and many other communities, including Lyndon (WA), Monroe (WI), Naples (FL) and Tampa Bay (FL), are considering the same. Visit the Fluoride Action Network for materials you can use to demand action in your city.

Congratulations to the legal team, with a special kudos to current Siri & Glimstad partner Michael Connett who has focused on fighting the fluoride issue, and the plaintiffs, for this landmark win that will have a lasting impact on the health of all American children! For more details, watch The HighWire interview with Connett.

[justinspoliticalcorner]

Ryan Adamczeski at The Advocate:

After pressure from Kentucky Republicans, Democratic Gov. Andy Beshear is backtracking his support for gender-affirming care. The Republican Party of Kentucky said in a statement last week that Beshear's administration is "out of control" for trying “to force Kentucky taxpayers to pay for transgender surgeries for convicted criminals.” Beshear responded at a press conference Thursday, caving to conservatives' outrage by claiming he is against those incarcerated “receiving better coverage and health care than a law-abiding citizen.”

“I recognize that LGBTQ inmates may be at a higher risk for violence than other inmates," Beshear said. "However, convicted felons do not have the right to have any and all medical surgeries paid for entirely by tax dollars, especially when it would exceed the type of coverage available to law-abiding citizens in the private sector.” Beshear is incorrect — when the state incarcerates a person, it becomes legally responsible for their health care, according to the U.S. Marshals Service. Prisoners are legally entitled to health care, as the U.S. Supreme Court ruled in the 1976 case Estelle v. Gamble that ignoring a prisoner's medical needs violates the Eighth Amendment, which forbids cruel and unusual punishment.

Gender-affirming care sometimes and sometimes doesn't include affirmation surgery. While such surgery can seem cosmetic, it can be crucial to its recipients' mental health and overall well-being. The American Medical Association, the American Psychiatric Association, the American Academy of Pediatrics, the American Academy of Child & Adolescent Psychiatry, the World Medical Association, and the World Health Organization all agree that gender-affirming care is evidence-based and medically necessary. Beshear also said at the conference that "the Department of Corrections is just trying to get this right under federal law, and it appears at least a little unclear to me what’s required under federal law." This is also incorrect — even the official policy of the first Trump administration was to provide inmates with gender-affirming care, in compliance with U.S. law. Several states have also upheld the right of inmates to receive gender-affirming care in recent years.

Ugh. Kentucky Gov. Beshear caving into a bad faith debate about gender-affirming care for prisoners by expressing its opposition.

[robertreich]

The GOP’s Attack on LGBTQ Americans, Revealed 

Republicans don’t seem to care that Ronald Reagan once starred in a film that featured a prominent drag scene or that Rudy Giuliani did a skit in drag with Donald Trump.

Suddenly, they’re trying to ban or restrict drag performances in at least 15 states, with bills so broadly worded that advocates warn they could be used not only to prosecute drag performers, but also transgender people who dare to simply exist in public.

These bans are part of a cynical campaign to demonize the LGBTQ+ community. MAGA politicians are stoking fear over imaginary dangers to distract from how their policies only help themselves and their wealthy donors.

In the first half of 2023 alone, Republicans across the nation introduced a record number of bills to strip away freedoms and civil rights from LGBTQ+ Americans, largely targeting transgender and gender-nonconforming people.

By banning gender affirming care for minors, GOP lawmakers are effectively practicing medicine without a license — overruling the guidance of doctors, the American Medical Association, and the American Academy of Pediatrics. And they’re lying about what gender affirming care even is.

Genital surgery, for instance, is rarely, if ever, done under the age of 18. It’s not even all that common for adults. Politicians like Ron DeSantis are lying about it to scare people.

And the Republican presidential frontrunner has made it clear that trans people have no place in his vision of America.

MAGA lawmakers and pundits falsely claim trans people and drag performers are a danger to children and the public at large, when there is no evidence at all to support that. None. Trans people are in fact four times more likely to be the victims of violent crime.

These scare tactics are dangerous. Recent analysis found a 70% increase in hate crimes against LGBTQ+ Americans between 2020 and 2021, as the surge of these bills began. And that’s only counting hate crimes that get reported. 2020 and 2021 each set a new record for the number of trans people murdered in America.

The cruelest irony is that these Republican bills pretending to protect children actually put some of the most vulnerable children at greater risk. LGBTQ+ kids are more than four times as likely to attempt suicide, especially transgender children. Gender-affirming care reduces that risk. That is why it is life-saving.

Don’t Say Gay laws strip away potentially life-saving support. A teacher discussing sexual orientation and gender identity won’t turn a straight kid gay. But it will make an LGBTQ+ student 23% less likely to attempt suicide.

The tragic truth is that Don’t Say Gay Laws and health care bans will cause more young lives to be needlessly lost.

If Republicans really cared about protecting kids, they’d focus on gun violence, now the leading cause of death for American children. If they were really worried about children undergoing life-altering medical procedures, they wouldn’t pass abortion bans that force teens to give birth or risk back-alley procedures.

What the GOP’s vendetta against the LGBTQ+ community really is, is a classic authoritarian tactic to vilify already marginalized people. They’re trying to stoke so much paranoia and hatred that we don’t notice how they are consolidating power and wealth into the hands of a ruling few.

We need to see this attack on LGBTQ+ Americans for what it is: a threat to all of our human rights.