#Vanderbilt University Medical Center

[free-air-for-fish]

[20] Chapter 16 Review Syndicate: All That Moves Us

This is another review that came out and then was re-released again because the author appeared at the Southern Festival of Books in Nashville. Jay Wellons is head of pediatric neurosurgery at Vanderbilt University Medical Center, and All That Moves Us is a memoir of his time as a doctor thus far as well as his life in general. I was hesitant to read this book, since I was worried it would…

[nando161mando]

"Transgender patients are suing Vanderbilt University Medical Center

It’s the hospital that gave away their records to Tennessee's AG via bogus legal request

The same bogus request that other red state AGs are using to gain more records

If there is a political party that targets a minority, puts them on a list, tracks their every movement, and uses them as a scapegoat—

what would you say about that political party?"

[pwrn51]

What Patients Teach their Doctors about Life, Death

  Today’s guest is Dr. David Alfery Writer and Author of “SAVING GRACE, “What Patients Teach their Doctors about Life, Death, and the Balance in Between. Dr. Alfery served as Chief of Anesthesia, President of the Tennessee State Society of Anesthesiologists, and was a founding member of Anesthesia Medical Group, one of the largest anesthesia practices in the United States. Also, Dr. Alfery worked…

[digitalcreationsllc]

Vanderbilt University Medical Center investigating cybersecurity incident

Vanderbilt University Medical Center said it is investigating a cybersecurity incident that led to the compromise of a database. VUMC runs seven hospitals and multiple healthcare facilities across Nashville, Tennessee — serving more than three million patients each year. The organization is one of the largest employers in the state with 40,000 employees and has more than 1,7000 beds across its…

[doyoulikethissong-poll]

Dolly Parton - Jolene 1973

Dolly Parton is an American singer-songwriter, actress, and philanthropist. With a career spanning over fifty years, Parton has been described as a country legend and has sold more than 100 million records worldwide, making her one of the best-selling music artists of all time. She has had 25 singles reach no. 1 on the Billboard country music charts, a record for a female artist (tied with Reba McEntire). She has 44 career Top 10 country albums, a record for any artist, and she has 110 career-charted singles over the past 40 years. She has composed over 3,000 songs. She has founded a number of charitable and philanthropic organizations, chief among them is the Dollywood Foundation, which manages a number of projects to bring education and poverty relief to East Tennessee where she grew up. In response to the COVID-19 pandemic, Parton donated $1 million towards research at Vanderbilt University Medical Center, which funded the critical early stages of development of the Moderna vaccine.

"Jolene" was released on October 15, 1973, as the first single and title track from her the thirteenth solo studio album Jolene, and became Parton's second solo number one single on the country charts. "Jolene" became Parton's first top ten hit song in the UK, reaching number seven in the UK Singles Chart in 1976. It also re-entered the chart when Parton performed at the Glastonbury festival in 2014.

According to Parton, the song was inspired by a red-headed bank clerk who flirted with her husband, Carl Dean, at his local bank branch around the time they were newly married. In an interview, she also revealed that Jolene's name and appearance are based on that of a young fan who came on stage for her autograph.

During an interview on The Bobby Bones Show in 2018, Parton revealed that she wrote "Jolene" on the same day that she wrote "I Will Always Love You".

"Jolene" was nominated for the Grammy Awards for Best Female Country Vocal Performance twice, in 1975 and 1976. The first nomination was for the original recording, and the second was for a live recording from the TV series In Concert. It did not win either time, but in 2017, a cover by the a cappella group Pentatonix which featured Parton as a guest singer won the Grammy Award for Best Country Duo/Group Performance.

In 2023 she released her forty-ninth solo studio album, Rockstar, a collaborative project with a variety of rock musicians and where "Jolene" is sung by Italian rockband Måneskin, listen to it here!

"Jolene" received a total of 94,3% yes votes!

[covid-safer-hotties]

Also preserved on our archive

An astonishingly simple and comprehensive guide to avoiding airborne illness while traveling. Many of these tips work for trips to the pharmacy or grocery store too. Stay safe out there!

By Korin Miller

Whether you’re traveling domestically or heading abroad, feeling your best at your destination means you’ll get the most out of your trip. Unfortunately, COVID-19 is still out there, and cases are expected to climb again as we head into the winter months. By now you’re likely aware of basic COVID prevention strategies, but air travel presents unique challenges that can be tricky to navigate.

Luckily, you can take steps to lower the odds of picking up the illness on your next flight. To help you do just that, we asked doctors and health policy researchers how they lower their COVID risk while flying. Here’s what they recommend.

Wear a mask—before you’re even on the plane Many of us know this already, but it’s worth recalling: Research has found that wearing a well-fitting, high-quality mask like an N95 or KN95 lowers your chances of picking up COVID-19 by 83%, according to the Centers for Disease Control and Prevention. But when you wear a mask during your travels matters, says William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine.

“You really want to use your mask consistently around others, whether you’re in the airport or on that plane,” he says. Thomas A. Russo, MD, professor and chief of the Division of Infectious Diseases at the University at Buffalo’s medical school, agrees. “Think about the whole process when you fly—going through the airport, checking in, boarding the plane, and being on the plane—you’re going to interact with people from all parts of the world… There’s a risk you might get COVID,” he says.

You can help protect yourself by always keeping your mask on—and wearing a relatively new one. Compared to a mask that’s gotten a lot of use, a fresh one will fit more snugly around the nose, cheeks, and chin and, in turn, catch particles more effectively.

Put the air vent to good use If you prefer not to wear a mask, you should take steps to protect yourself in other ways. For example, after you get to your seat, adjust the vent so the air blows over your face, suggests Sheldon H. Jacobson, PhD, a University of Illinois Urbana-Champaign professor and researcher whose work includes using data-driven risk assessments to inform public health policy.

Dr. Jacobson says most airplanes use high-efficiency particulate air (HEPA) filters that catch microbes. Plus, cabin air is refreshed every few minutes, and a good portion comes from outside the aircraft. As a result, what blows out of the vents is pretty fresh. This strategy also keeps the air around you moving faster, meaning there’s less time for you to inhale any possible germs in the cabin, according to Dr. Jacobson. Still, if the person sitting next to you is coughing and sneezing, it’s best to wear a mask if you have one, he says. The filtration system can only do so much in that instance—and it’s not always on before takeoff and after landing.

Be mindful about how you eat and drink If you can, Dr. Russo suggests eating before you get to the airport to lessen the number of times you’ll need to remove your mask when you’re around other people. If you need to dine at the airport, Dr. Schaffner recommends looking for seating away from crowded areas.

When masks were still required for air travel, the suggested strategy for eating and drinking on board was to wait until your fellow fliers finished their snacks and refreshments. But now, Dr. Russo points out, the people around you may not mask up at all. Instead, he suggests dropping your mask, taking a sip or bite, and immediately pulling it back up. This lowers the odds you’ll breathe in viral particles that may be floating around, he explains.

Plan your vaccine around your trip Dr. Schaffner and Dr. Russo recommend getting the updated COVID-19 vaccine about two weeks before your trip. “It’s a good strategy,” Dr. Russo says. It usually takes 14 days or so for your body to build up immunity to COVID after getting vaccinated, according to the World Health Organization. This means your body should be ready to fight the virus by the time you fly, Dr. Russo says. Immunity also fades over time, making the timing of your shot important, he says.

Wash your hands…a lot Experts say you’re more likely to get COVID-19 from breathing in infectious droplets and particles than from touching things. But there’s still a chance you could get sick if you happen to touch a contaminated surface and then your eyes, nose, or mouth.

“What we’ve learned is that transmission from this virus from inanimate objects is very low, but it’s not zero,” Dr. Russo says. That’s why he recommends good hand hygiene while flying. You should wash your hands with soap and water, making sure to scrub for at least 20 seconds, and do so often: before and after security, whenever you use the bathroom, and before eating or touching your face. Hand sanitizer is also a good option in a pinch, Dr. Russo says. But he stresses that keeping your hands clean shouldn’t replace masking up. “It’s much, much less helpful than wearing a mask,” he says.

[meret118]

MSNBC's Rachel Maddow sounded the alarm about Vanderbilt University, which willingly turned over the private medical records of families whose children were getting gender-affirming care at the University's medical center. But on Monday, Maddow points out that it isn't about LGBTQ issues anymore.

. . .

"It turns out that once you've convinced yourself that you have the right to go take the private medical records of people you've decided are bad people, once you've decided you have the right the take the private medical records of people because you think they don't actually have the right to make their own decisions for their own lives and their own health care, so they don't have any legitimate expectation of privacy — they don't have any legitimate expectation of protection from you," she slammed.

. . .

A week ago, she covered the Vanderbilt story, but now Tennessee's AG wants the private medical records of women who live in their states, if they travel to another state for an abortion.

. . .

It isn't only Tennessee, 19 other states signed a letter demanding that the private medical records of women who get abortions out of state be sent to their state of residence. The states that want the medical records are: Mississippi, Alabama, Alaska, Arkansas, Georgia, Idaho, Indiana, Kentucky, Louisiana, Missouri, Montana, Nebraska, North Dakota, Ohio, South Carolina, South Dakota, Tennessee, Texas, and Utah.

[religion-is-a-mental-illness]

By: John Sailer

Published: Jul 5, 2024

In Students for Fair Admissions v. Harvard (2023), the Supreme Court held that colleges and universities couldn’t engage in racial discrimination in the name of diversity. The 45-year-old dispensation from civil-rights law that the court effectively overturned had never applied to employment decisions. But its end ought to provoke institutions to scale back “diversity, equity and inclusion” initiatives more broadly. Some appear to be doing so: The Massachusetts Institute of Technology and the Faculty of Arts and Sciences at Harvard said recently they would no longer require “diversity statements” from prospective hires.

Yet there is evidence that many universities have engaged in outright racial preferences under the aegis of DEI. Hundreds of documents that I acquired through public-records requests provide a rare paper trail of universities closely scrutinizing the race of faculty job applicants. The practice not only appears widespread; it is encouraged and funded by the federal government.

At Vanderbilt University Medical Center, a large hiring initiative targets specific racial groups—promising to hire 18 to 20 scientists “who are Black, Latinx, American Indian, and Pacific Islander.” Discussing a related University of New Mexico program, one professor quipped in an email, “I don’t want to hire white men for sure.”

Both initiatives are supported by the National Institutes of Health through its Faculty Institutional Recruitment for Sustainable Transformation program, or First. The program gives grants for DEI-focused “cluster hiring” at universities and medical schools, promising eventually to spend about a quarter-billion dollars.

A key requirement is that recipient institutions heavily value diversity statements while selecting faculty. The creators of the program reasoned that by heavily weighing commitment to DEI, they could prompt schools to hire more minorities but without direct racial preferences. That’s the rationale behind DEI-focused “cluster hiring,” an increasingly common practice in academia. The documents—which include emails, grant proposals, progress reports and hiring records—suggest that many NIH First grant recipients restrict hiring on the basis of race or “underrepresented” status, violating NIH’s stated policies and possibly civil-rights law.

In grant proposals, several recipients openly state their intention to restrict whom they hire by demographic category. Vanderbilt’s NIH First grant proposal states that it will “focus on the cluster hiring of faculty from minoritized racial and ethnic groups, specifically Black, Latinx, American Indian, and Pacific Islander scientists.” The University of Texas Southwestern Medical Center and the University of Texas at Dallas jointly proposed hiring 10 scholars “from underrepresented groups,” noting that the NIH First program specifically identifies racial minorities and women as underrepresented.

Emails reveal candid discussions about the perceived aim of the program. In April 2023, a professor running the University of New Mexico’s cluster hire emailed Jessica Calzola, the NIH program official overseeing the First program, to ask whether Asian-Americans count as underrepresented. The professor later wrote, “I really need a response at least by tomorrow, because it is now holding up our search teams.”

In reply, Ms. Calzola reiterated the program’s official policy: “My confusion is how this information can hold up search teams since candidates are to be evaluated and considered based on their credentials and not race/ethnicity/gender, etc.—all hiring decisions are to be made following the law and avoiding any type of bias (as you have stated and acknowledged).”

Ms. Calzola’s seemingly straightforward response confused her correspondent. “I am now wondering if I am missing something in terms of what we are supposed to be doing,” the professor emailed other members of the leadership team. She wondered if she placed too much emphasis on minority status.

Yet she hesitated to take Ms. Calzola’s word at face value, citing earlier remarks: “My first thought is that Jessica has to write about hires in this manner (she’s hinted at that before on zoom).” (Ms. Calzola referred my inquiry to an NIH spokeswoman, who said in a statement: “Consistent with NIH practice and U.S. federal law, funded programs may not use the race, ethnicity, or sex . . . of a prospective candidate as an eligibility or selection criteria.”)

A colleague responded: “For me as long as we are diversifying our departments and go with what we wrote in the proposal I am happy.” She then made clear her intention to keep one specific group out of consideration: “I don’t want to hire white men for sure, we did a very good job in the grant with the tables and numbers and that’s what we should follow in my opinion.”

Yet the confusion at UNM makes sense. Records show a repeated tension between the NIH First program’s official nondiscrimination policy and how the funded projects have played out—which at times looks a lot like discrimination.

At its inception, NIH First was widely understood not to involve racial preferences. In 2020, shortly after the program was announced, Science magazine published an explanation: “Not all of the 120 new hires would need to belong to groups now underrepresented in academic medicine, which include women, black people, Hispanics, Native Americans, and those with disabilities, says Hannah Valantine, NIH’s chief diversity officer. In fact, she told the Council of Councils at its 24 January meeting, any such restriction would be illegal and also run counter to the program’s goal of attracting world-class talent.”

Yet multiple programs have stated their intention to limit hires to those with “underrepresented” status. One job advertisement, for a First role at Mount Sinai’s Icahn School of Medicine, notes: “Successful candidates will be early stage investigators who are Black, Latinx, or from a disadvantaged background (as defined by NIH).”

Some grantees even admit such preferences in documents sent to and reviewed by the NIH. A joint proposal from the University of Maryland School of Medicine and the university’s Baltimore County campus states that all scientists hired through the program will meet the NIH’s definition of “underrepresented populations in science.” Drexel University’s program, which focuses on nursing and public health, provides its evaluation rubric in a progress report. Among its four criteria: “Candidate is a member of a group that is underrepresented in health research.”

This raises questions about compliance with Title VII of the Civil Rights Act of 1964, which prohibits race discrimination in employment. The First program’s website highlights regulations requiring that federal agencies ensure grant recipients comply with nondiscrimination law. The most basic implication is that universities can’t refuse to hire someone, or prefer one candidate over another, because of race or sex. But emails show that this has been happening.

At the University of New Mexico, the First leadership team heavily scrutinized the race and sex of applicants. “Just to be sure: what was the ethnicity of Speech and Hearing’s first-choice candidate?” a UNM team member asked in an email.

“She identified as URM in her application, right? I am confused, maybe I am misremembering,” a team member wrote of a different candidate. Another responded, “It looks like she said she was a ‘native New Mexican.’ We checked, and she said she’s white.”

Another team member wrote about a third candidate: “He is LGBTQ so should fit NIHs definition of URM. In my opinion, women are more underrepresented in our department when you consider demographics.”

The team had veto power over the program’s job searches, which it took seriously. In one email, a math-and-statistics search committee sent a list of proposed finalists. The first candidate, a woman, was recommended without qualification, while the second candidate, a South Asian man, was recommended if the leadership team decided he was a “good fit for the program.” A third candidate, a woman, was recommended as a backup.

One leadership team member emailed her colleagues about the South Asian candidate, citing the NIH’s priorities: “Is this a second look person that NIH would like?” UNM’s grant proposal explains that “at each point in which the applicant pool is narrowed, all applicants from underrepresented groups are given a ‘second-look’ before they are eliminated.” The question, in other words, was whether the South Asian candidate counted as underrepresented. (A UNM spokeswoman said “the second look procedure is a longstanding UNM hiring process.”)

The team agreed the answer was no and nixed him. As one pointed out, “We’ve said that Math is really low on women.” Another chimed in, excited to interview the two remaining candidates, noting “their DEI statements are strong.”

UNM appears to have violated NIH First policy, which states that programs “may not discriminate against any group in the hiring process.” The UNM spokeswoman said in a statement that “the email correspondence among members of the UNM FIRST Leadership Team do [sic] not represent the University of New Mexico’s values nor does it comport with the expectations we have of our faculty” and that “as a result of this unfortunate circumstance,” the university is instituting a required “faculty search training/workshop for all . . . faculty search committee members.”

Yet other universities signaled to NIH that they also intended to engage in race and sex preferences. Northwestern University’s program, which focuses on areas like cancer and cardiovascular health, promises to hire faculty from “underrepresented groups.” Its grant proposal suggests this excludes one particular group: “Our faculty development programming intentionally seeks to elevate URG”—underrepresented group—“faculty to equal privilege with white men in academia.”

Records repeatedly show NIH First grantees following through on their promises. In a letter of support for Florida State University’s project, that university’s associate vice president for human resources declared, “I firmly believe in and reaffirm this project’s mission to create an under-represented minority faculty cohort.”

Hiring documents show that special attention was paid to job candidates’ minority status. In a survey on job finalists, one Florida State faculty member wrote, “Is the applicant a URM, as defined by the NIH? Relatedly, I’m not saying this is happening, but I believe consideration of self-reported sexuality in the hiring process would go against official FSU nondiscrimination policy.” An FSU spokeswoman said in an email that “the Florida FIRST program followed the guidelines set forth by the NIH.”

That search took place as the Florida legislature was beginning to curtail DEI at public universities. Other programs raise similar red flags regarding state law. California’s Proposition 209 prohibits preferential treatment by race in admissions, hiring and “the operation of public employment.” A San Diego State University proposal says nonetheless that it will require shortlists “to include at least 25% of applications from historically underrepresented groups.” The San Diego program even divvies up certain faculty duties by race: “Whenever possible, the chair of the hiring committees should be a faculty member of color”; “the hiring committees will be required to have at least two (50% recommended) faculty of color”; and so on.

A university spokesman said in an email that “SDSU relies on the Building on Inclusive Excellence (BIE) faculty hiring program,” that “BIE is compliant with both civil rights law and California Proposition 209,” and that “it is incorrect to state that ‘the SDSU program . . . divides certain faculty duties by race.’ ”

Taken as a whole, these documents shed new light on the practice of cluster hiring. They explain why some in academia seem to treat the practice as a form of legal racial quotas. In addition to the responses already noted, representatives of the University of Maryland, UT Dallas and UT Southwestern said that their institutions comply with civil-rights laws and don’t discriminate on the basis of race. Drexel, Northwestern, Mount Sinai and Vanderbilt didn’t reply to inquiries.

The documents I reviewed point to a large-scale sleight-of-hand in the application of the NIH First program. They give all the more reason to reconsider one of the most controversial practices in higher education, mandatory diversity statements, which provide a convenient smokescreen for discrimination. Lawmakers would be wise to investigate this practice closely—especially the NIH First program.

In a comment on her decision to end mandatory diversity statements, MIT president Sally Kornbluth noted that such statements “impinge on freedom of expression.” That’s true, but fails to capture the full extent of the problem. Diversity statements mask racial discrimination. The NIH has ensured that they’re widely used in medicine, where excellence should matter most.

Mr. Sailer is a senior fellow at the National Association of Scholars.

[ Via: https://archive.today/nZ42W ]

==

This is amazingly unethical, not to mention illegal.

DEI is cancer.

[mightyflamethrower]

The Supreme Court Is About To Hear A Major Child Gender Transition Case. Here’s What To Know.

The Supreme Court on December 4 will hear oral arguments in a case dealing with Tennessee’s law banning irreversible gender transition procedures for children — and it promises to be one of the most significant cases the court has looked at this term.

Tennessee Gov. Bill Lee (R.) signed the much-discussed Senate Bill 1 into law on March 22, 2023, which went into effect on July 1, 2023. The bill bans doctors or health care providers from performing so-called “gender-affirming” surgeries or hormonal procedures on minors, including surgery, puberty blockers, and hormones.

The bill followed a September 2022 investigation into Vanderbilt University Medical Center (VUMC) by the The Daily Wire’s Matt Walsh, who exposed VUMC’s gender transition procedures for children and shocking attitudes towards gender transitions in general. Walsh and The Daily Wire found that the hospital regarded transgender procedures as a “big money maker” and pressured employees to ignore their “religious beliefs” on transgender issues or face “consequences.”

“The people of Tennessee, through their elected representatives, took measured action with Senate Bill 1 to protect kids from irreversible, unproven medical procedures,” Tennessee Attorney General Jonathan Skrmetti said in an October statement. “Lawmakers recognized that there is little to no credible evidence to justify the serious risks these procedures present to youth and joined a growing number of European countries in restricting their use on minors with gender-identity issues.”

The ACLU led a variety of left-wing legal groups in suing Tennessee in April 2023 to block the law from going into effect, calling these transgender procedures “medically necessary gender-affirming care for Tennessee’s transgender youth.” That claim is based on activist assertions that young people suffering from gender dysphoria may commit suicide if they do not have access to transgender hormones or surgeries.

Recent research has shown that, contrary to such claims, these procedures actually increase the likelihood that minors will attempt suicide. According to an April study, “gender-affirming surgery is significantly associated with elevated suicide-attempt risks, underlining the necessity for comprehensive post-procedure psychiatric support.”

Yet the ACLU and their allies are suing Tennessee on behalf of a Nashville, Tennessee couple and their 15-year-old son, who identifies as a girl, as well as a doctor from Memphis, Tennessee, Dr. Susan Lacy.

“It was incredibly painful watching my child struggle before we were able to get her the life-saving healthcare she needed. We have a confident, happy daughter now, who is free to be herself and she is thriving,” the ACLU’s client, Samantha Williams, said earlier this year of her trans-identifying son.

“I am so afraid of what this law will mean for her,” she said. “We don’t want to leave Tennessee, but this legislation would force us to either routinely leave our state to get our daughter the medical care she desperately needs or to uproot our entire lives and leave Tennessee altogether. No family should have to make this kind of choice.”

Skrmetti’s office argues that states have governed the practice of medicine within their borders since the United States was founded, pointing out that it is states who license doctors and regulate medical practices, which includes restricting the administration of drugs. The Tennessee lawmakers who passed Senate Bill 1 used that power to stop the use of hormonal and surgical procedures for minor gender transition procedures, Skrmetti’s office said.

More than 20 other states have passed similar laws protecting children, they pointed out.

“The federal government, in its arguments to the Supreme Court, puts its faith in a false and manufactured consensus that ignores the many doctors, States, and countries who have looked at the evidence and determined these treatments are too risky for kids,” Skrmetti added. “The Constitution does not prevent the States from regulating the practice of medicine where hot-button social issues are concerned. People who disagree with restrictions on irreversible pediatric procedures for gender transition are free to advocate for change through state elections.”

The ACLU’s case will be argued by Chase Strangio, a woman who identifies as a transgender man. The ACLU has advertised that Strangio will be the first openly trans-identifying individual to argue a case before the Supreme Court, describing Strangio as “our nation’s leading legal expert on the rights of transgender people, bar none.”

[bpod-bpod]

Kidney Correction

Cellular enzyme RAC1 underlies repair of kidney collecting ducts damaged by prolonged ureteral obstruction by controlling the rebuilding of duct cells' actin cytoskeleton which is co-ordinated with cell division

Read the published research article here

Image from work by Fabian Bock and colleagues

Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

Image originally published with a Creative Commons Attribution 4.0 International (CC BY-NC 4.0)

Published in Science Advances, February 2024

You can also follow BPoD on Instagram, Twitter and Facebook

[morbidology]

The 10th of August, 2012, started just like any other day but by the following morning, Melanie Davis would be dead and her 15-year-old son, Zachary, would be in police custody.

Melanie was as Australian citizen who moved to Hendersonville, Tennessee, to marry Chris. The couple went on to have two sons – first born was Josh and second born was Zachary. They were your average all-American family that lived in a middle class neighbourhood. Melanie worked as a paralegal and in her free time, she partook in triathlons.

However, in 2007, tragedy struck when Chris died from amyotrophic lateral sclerosis. The death came as a blow to the whole family but it particularly had an impact on 10-year-old Zachary who fell into a deep depression. Within just a few months, Zachary would be sent for psychiatric treatment with Dr. Bradley Freeman at the Vanderbilt University Medical Center.

Zachary told his psychiatrist that he would very frequently hear disembodied voices. It was evident that he was suffering from some form of mental disease from the very first meeting. Nevertheless, Zachary’s case was terminated when Melanie stopped bringing her son to his appointments with Dr. Freeman.

Throughout his teenage years, Zachary was known to be an outcast by his peers at Station Camp High School. He possessed some bizarre quirks and characteristics. One student recalled how Zachary often refused to speak in his regular voice and almost always responded in a whisper when being spoken to. This same student added that Zachary would wear the same hoodie day in and day out.

At approximately 9PM on the 10th of August, 2012, 46-year-old Melanie went to bed just like usual. Earlier on in the evening, Melanie, 16-year-old Josh, and 15-year-old Zachary had attended a showing of the comedy film “The Campaign” at the local cinema before returning home together. As Melanie drifted off to sleep, she was completely unaware that her youngest son, Zachary, was planning something extremely sinister.

When Melanie and Josh were both asleep, Zachary crept into his mother’s bedroom. He was armed with a sledgehammer that he had retrieved from the basement....

𝐑𝐞𝐚𝐝 𝐌𝐨𝐫𝐞:

[intothewildsstuff]

Several attorneys general made ‘abusive legal demands’ to get trans patients’ medical records, senators allege

Tell me again that red states aren't like Nazis. Democrats are absolutely right on this one. And "mischaracterization" is just plain lying. Call it out.

[mariacallous]

Since 2018, conservative state legislatures across the country have proposed and passed laws targeting young transgender people’s freedom to to play on sports teams and use bathrooms that correspond with their gender, and to obtain gender-affirming health care. Advocates for trans rights argue that the increased interest in the subject has served to galvanize the energies of those who had fought an ultimately losing battle against gay marriage—and have observed how the anti-trans movement has used tactics that have proved successful in limiting abortion. As with much legislation of this type, amid the nationalized, culture-war politics, the effects are felt most acutely by the most vulnerable families and individuals.

In a startling piece of reporting in this week’s issue, Emily Witt follows a mother named Kristen Chapman who moves her family from Tennessee to Virginia, in order for her daughter Willow to continue receiving gender-affirming care. “I genuinely feel we are being run out of town on a rail,” Chapman says. “I am not being dramatic. It is not my imagination.” With nuance and compassionate precision, Witt captures the urgency of the family’s relocation, and the sense, as laws seem to change underfoot, of pursuit. As she writes, “Chapman had chosen Virginia for their new life, she said, because it was still in the South, but there would be ‘multiple avenues of escape.’ ”

On the last morning of July, Kristen Chapman was getting ready to leave Nashville. Chapman, who is in her early fifties and wears her silver hair short, sat on a camp chair next to a fire pit outside the rental duplex where her family had lived for twelve years. She was smoking an American Spirit and swatting at the mosquitoes that kept emerging from the dense green brush behind her. Her husband, Paul, who was wearing a T-shirt with the Guinness logo, carried boxes out to the front lawn. Their daughters, Saoirse and Willow, who were seventeen and fifteen, were inside, still asleep. Chapman looked down at the family’s beagle mix, Obi-Wan Kenobi, who was drinking rainwater out of a plastic bucket. “We got him when we moved in here for the kids,” she said. “He’s never lived anywhere else.”

Paul was planning to stay in town; Chapman was heading to Richmond, Virginia, with Saoirse and Willow. Chapman and Paul’s marriage was ending, but the decision to split their family apart had happened abruptly. Willow is trans, and had been on puberty blockers since 2021. In March, Tennessee’s governor, Bill Lee, had signed a bill that banned gender-transition treatment for minors across the state.

On paper, the law, which went into effect in early July, would allow trans teens like Willow to continue their medical care until March of 2024. But Chapman wasn’t sure they could count on that. Willow was determined to begin taking estrogen when she turned sixteen, in December of 2023, which would allow her to grow into adulthood with feminine characteristics. If she couldn’t continue taking puberty blockers until then, she would begin to go through male puberty, which could mean more surgeries and other procedures later in life.

At first, the family had hoped that the courts would declare the new law unconstitutional. Federal courts had already done so in at least four other states in 2023, finding that such bans violated the First Amendment and the equal-protection and due-process clauses of the Fourteenth Amendment. But that spring the Pediatric Transgender Clinic at Vanderbilt University Medical Center, where Willow had been receiving care, informed its patients that it was ceasing operations. Seeing this as a bad sign, Chapman set up a GoFundMe page in early May and began planning their departure.

Inside, the apartment was filled with abandoned objects—an old Wi-Fi router, trash bags of unwanted clothes. A Homer Simpson doll in a hula skirt lay forgotten on a windowsill. Chapman, an artist who supplements her income with social work, had recently quit her job as a caseworker. She would need their landlord as a reference to get an apartment, especially because she had bad credit, but the family still owed him back rent. She checked Venmo, waiting on a loan from a friend.

At six-thirty that morning, Chapman had gone out to her white Dodge S.U.V. and found her younger daughter asleep in the back seat. Willow had gone over to a friend’s house and stayed out late. When she got home, she realized that she had locked herself out. The Dodge’s window had been stuck open for months, so she got in. “Any other human being would have handled this totally differently,” Chapman said, shaking her head.

Willow had gone back to sleep in her room, which she once shared with her brother. (He was a sophomore in college and had already moved out.) The colorful scarves and lights that used to decorate the space had been taken down. When she woke up, she began sifting through what was left. “I feel like I’m ready to say goodbye to it,” she said, looking around. There were drawings scrawled on the wall, a desk spattered in paint. “Most of the stuff in here I’ve trashed.”

“It’s like getting a new haircut,” Chapman said. “A fresh palette.”

Chapman had chosen Virginia for their new life, she said, because it was still in the South, but there would be “multiple avenues of escape.” Paul worked nights for a large grocery-store chain; Richmond was among the northernmost cities where it had branches, and Chapman thought that at some point he might be able to transfer there. Earlier in the summer, she and Willow had driven to Richmond to see the city, and Chapman had lined up a marketing job. It didn’t pay well, but she knew she wouldn’t get a lease without a job. Willow, who had received her last puberty-blocker shot at the Vanderbilt clinic in late May, was supposed to receive her next one in late August. They didn’t have a lot of time.

Despite having taken puberty blockers for two years, Willow looks her age. She is tall and long-limbed and meticulous about her appearance. That morning, she had on Y2K-revival clothes: wide-legged jeans worn low on the hips with a belt, a patterned tank top, and furry pink Juicy Couture boots. Her blond hair was glossy and straight, her bangs held back with a barrette. She is committed to living her adolescence as a girl regardless of what medical treatment she is allowed to receive. At times she has used silicone prosthetic breasts; attaching them is an onerous process involving spray-on adhesive.

From a very young age, Willow wore dresses and gravitated toward friendships with girls. Her parents thought that she would likely grow up to be a gay man. As Chapman put it, “We knew she was in the fam.” When a homophobic shooter killed forty-nine people at Pulse, the gay night club in Orlando, in 2016, Willow, who was eight at the time, accompanied her mother to a vigil in Nashville. Willow wrote a long message on a banner in solidarity with the survivors. Chapman took a photo of her there. “It was like she was transfixed,” Chapman remembered. In the sixth grade, Willow went to an all-girl sleepover. A parent overheard the kids discussing gender and sexuality, and told Chapman. Willow says that it was around then that she began to think about her identity. “Pretty much as soon as I knew about, like, conceptualized gender, I knew I wanted to be a girl,” she said. She had been an A student, but her grades started going down. Looking back, Willow struggled to articulate what had happened. “It just got complicated, like with all my stuff physically, it just felt like a mess,” she said.

She came out to her friends first; then one day, in the spring of 2020, while she was upstairs on her laptop and Chapman was downstairs working, Willow sent her mother a three-word e-mail that said, “I am trans.” Willow told me, “I realized I have to do this sometime if I want to advocate for myself and get what I need to get.” She left it to her mother to inform the rest of the family. Chapman was accepting; Paul was more skeptical. “That’s him, you know—a man of science,” Chapman said. “It wasn’t overly positive or negative.”

Willow had already decided on her new name before coming out, and began using it with friends. She was again reluctant to tell her family. “I was, like, I’ll keep that secret,” she said—she had been named at birth for a brother of her father’s who had died, and knew the name was important to him. Her mother found out when another mom referred to Willow by her chosen name. Chapman started using it right away; it took Paul another year.

To figure out their next steps, Chapman took Willow, who was then twelve, to her regular pediatrician at Vanderbilt University Medical Center. She was referred to the center’s Pediatric Transgender Clinic. The clinic, which opened in 2018, was part of a broader expansion of gender-affirming care at flagship medical schools in the South that occurred around that time. (Clinics also opened at Duke University, the University of Mississippi, and Emory University, among other schools.) These places “attracted the kind of people who build very trusting relationships with patients and are able to establish not just the clinical competencies but also an inclusive environment,” Jasmine Beach-Ferrara, the executive director of the Campaign for Southern Equality, an advocacy group for L.G.B.T.Q. rights, told me. “All those things are nothing you can take for granted when seeking medical care in the South.” (Federal funding for health care is often funnelled through state governments, some of which have a history of withholding money from providers that offer abortion and other politicized health services.)

Care for patients who are experiencing gender dysphoria is highly individualized: some trans kids opt for a purely social transition, changing their names or pronouns; others, like Willow, seek a medical transition, which can be started at the onset of puberty. In Willow’s case, a diagnosis of gender dysphoria had to be verified before pharmaceutical treatment could begin. A course of psychotherapy was accompanied by a physical assessment at Vanderbilt, which included ultrasounds, X-rays, and blood tests. The clinic was following a protocol supported by the Endocrine Society and the World Professional Association for Transgender Health, whereby patients take puberty blockers—which have been used to treat children experiencing early-onset puberty since the nineteen-eighties—to delay the onset of secondary sex characteristics until they are ready to begin taking estrogen or testosterone.

“I’d always explain it to the families as a pause on puberty, allowing the youth to take a deep breath,” Kimberly Herrmann, a pediatrician and internist at Whitman-Walker Health, a provider in the Washington, D.C., area that offers gender-affirming care to patients aged thirteen and over, told me. (Some patients choose to go through their natal puberty.) “All of the data suggests that it is the correct thing to do for a patient with a clear diagnosis,” Izzy Lowell, a doctor who started a telehealth practice for gender-affirming care called QueerMed, said, of taking puberty blockers. “If they are going to develop the body of a grown man, it becomes difficult to undo those changes.”

Paul was worried about the blockers’ long-term effects on Willow’s health. (Studies have shown that they can affect bone density when used long term, and the protocol for hormone therapy advises doctors to discuss potential risks to fertility and options for fertility preservation.) Chapman thought the risks to Willow’s well-being would be worse if she developed male secondary sex characteristics. In one testimony against the Tennessee ban, an adult trans woman described her adolescence, in which she attempted to present as male, as “a disastrous and torturous experience.”

“Paul and I talked about it and came to the belief that we wanted her on them as quickly as possible for safety reasons,” Chapman said. “I hate that that’s true, but we know that’s the world that we live in, and that she is going to be a safer person for the rest of her life if she does not look male.” (A recent analysis of crime statistics from 2017 and 2018 found that transgender people are more than four times as likely as cisgender people to be the victims of a violent crime.)

The evaluation and diagnosis took almost a year. For Willow, the talk therapy was the most taxing part. Willow was insured through the state’s Medicaid program, TennCare, which meant that there were only a limited number of therapists she could see, none of whom were trans, or even queer. She went through three in a year. “We were in the lowest tier of care,” Chapman said, adding that at least one therapist dropped their health insurance. Willow told her mother that she wished she could just be left alone to be a “sad trans girl.”

At the age of thirteen, she was finally able to start puberty blockers. “You have an end goal,” Willow said of the experience. “And all the in-between doesn’t matter.”

In September, 2022, the conservative commentator and anti-trans activist Matt Walsh, who moved to Nashville in 2020 (along with his employer, the conservative news company the Daily Wire), posted a thread on Twitter. “Vanderbilt drugs, chemically castrates, and performs double mastectomies on minors,” it began. “But it gets worse.” Walsh—who is the author of books including “Church of Cowards: A Wake-Up Call to Complacent Christians” and “What Is a Woman?,” a polemic arguing that gender roles are biologically determined—worked in conservative talk radio before being hired by the Daily Wire as a writer, in 2017. Last year, the left-wing watchdog group Media Matters for America mapped Walsh’s origins as an aspiring radio shock jock in the early twenty-tens who once said, “We probably lost our republic after Reconstruction.” In 2022, he was one of several right-wing social-media pundits who began broadcasting misinformation about hospitals that provided gender-transition treatment for minors, which were then overwhelmed with phone and e-mail threats and online harassment. One study found that more than fifteen hospitals modified or took down Web sites about pediatric gender care after being named in these campaigns.

Walsh included in his thread about Vanderbilt a video clip of Shayne Taylor, the medical director of its Transgender Clinic, speaking of top and bottom surgeries as a potential “money-maker” for the hospital. Walsh did not specify that Taylor was mostly speaking about adults. (Vanderbilt never performed genital surgery on underage patients and did an average of five top surgeries a year on minors, with a minimum age of sixteen.) More than sixty Republican state legislators signed a letter to Vanderbilt describing the clinic’s practices “as nothing less than abuse.” In a statement calling for an investigation, Governor Lee, who was up for reëlection, said that “we should not allow permanent, life-altering decisions that hurt children.” Within days, Vanderbilt announced that it would put a pause on surgeries for minors. Jonathan Skrmetti, Tennessee’s Republican attorney general, began an inquiry into whether Vanderbilt had manipulated billing codes to avoid limitations on insurance coverage.

In October, Walsh and other anti-trans advocates held a “Rally to End Child Mutilation” in Nashville’s War Memorial Plaza. The speakers included the Tennessee senator Marsha Blackburn, the former Democratic Presidential candidate Tulsi Gabbard, and Chloe Cole, a nineteen-year-old self-described “former trans kid.” After identifying as male from the age of twelve, receiving testosterone, and getting top surgery, Cole de-transitioned to female at sixteen and is now one of the country’s foremost youth advocates of bans on gender-transition treatment for minors. “I was allowed to make an adult decision as a traumatized fifteen-year-old,” she said at the rally.

For the past four years, the number of anti-trans bills proposed throughout the United States has dramatically risen. The A.C.L.U. has counted some four hundred and ninety-six proposals in state legislatures in 2023, eighty-four of which have been signed into law. The first state ban on gender-transition treatment for minors was passed in Arkansas in 2021. It was permanently blocked by a federal judge this year, but more than twenty states have passed similar laws since then. As lawsuits filed by the A.C.L.U., Lambda Legal, and other organizations make their way through the courts, trans people are left to navigate a shifting legal landscape that activists say has affected clinical and pharmaceutical access. Lowell told me that she consults with six lawyers (including one she keeps on retainer) to best advise patients, who must frequently drive across state borders to receive care. “It’s literally a daily task to figure out what’s legal where,” she said.

In Tennessee, the Human Rights Campaign has counted the passage of at least nineteen anti-L.G.B.T.Q. laws since 2015, among the most in the nation. Some of these laws have been found unconstitutional, such as a ban on drag shows in public spaces and a law that would have required any business to post a warning if it let transgender people use their preferred rest room. But many others have gone into effect, such as laws that censor school curricula and ban transgender youth from playing on the sports teams that align with their identity.

Proposals to ban gender-transition treatment for minors were the first bills introduced in the opening legislative sessions of the Tennessee House and Senate in November, 2022. “It was Matt Walsh who lit a fire under the ultraconservative wing of the Republican Party this year,” Chris Sanders, the director of a Nashville-based L.G.B.T.Q. advocacy group called Tennessee Equality Project, told me. “It was lightning speed the way it all unfolded.” At hearings throughout the winter, parents of trans kids, trans adults, trans youth, and a Memphis pediatrician who provides gender-affirming care testified against the ban. Those who spoke in support of it included Walsh, Cole (who is from California), and a right-wing Tennessee physician named Omar Hamada, who compared such treatment to letting a minor who wanted to become a pirate get a limb and one eye removed.

L.G.B.T.Q. activists who attended described feeling disregarded by the Republican majority. Molly Quinn, the executive director of OUTMemphis, a nonprofit that helps trans youth navigate their health care, likened the experience to “being the only queer kid at a frat party.”

Three months after Governor Lee signed the ban, Vanderbilt University Medical Center informed patients that the previous November, at the attorney general’s request, it had shared non-anonymized patient records from the Pediatric Transgender Clinic, including photographic documentation and mental-health assessments. “I immediately started hearing from parents,” Sanders said. Their fear stemmed in part from attempts in states like Texas to have the parents of trans kids investigated by child-protective services. (The attorney general’s office said in a statement that it is “legally bound to maintain the medical records in the strictest confidence, which it does.”) Former patients have sued Vanderbilt, and a federal investigation by the Department of Health and Human Services is also under way. (A spokesperson for Vanderbilt declined to comment for this article.)

In July, the Sixth Circuit Court of Appeals became the first federal court in the country to allow a ban on gender-transition treatment for minors to take effect, with a final ruling planned for September. Chapman, who had spoken out for trans rights through local media outlets, and had been targeted with online threats and menacing phone calls in return, understood that Tennessee, where she had lived for most of the past thirty-five years, had become a hostile environment for her family. “I genuinely feel we are being run out of town on a rail,” she said. “I am not being dramatic. It is not my imagination.”

It was dusk by the time Paul had loaded the last of the boxes into three storage pods. Everything was ready, but the family was having trouble leaving. Someone would walk out of the house and get into the car, only to go back into the house five minutes later. Chapman suddenly remembered that she had forgotten to buy padlocks for the storage pods, which were scheduled to be picked up by U-Haul the next day. As she drove off to get them, Paul sat on the back steps and stared out at the lawn. Fireflies were winking on and off over the grass.

“Bollocks,” he said to himself, then stood up and went inside.

Although comprehensive demographic data on transgender youth are scarce, the American Academy of Pediatrics has reported that “research increasingly suggests that familial acceptance or rejection ultimately has little influence on the gender identity of youth.” But without parental consent most kids in America who wish to transition medically are legally unable to do so until they turn eighteen. Having a supportive parent or guardian as a trans child is more than a legal or practical advantage, though. A study of eighty-four youth in Ontario, aged sixteen to twenty-four, who identified as trans and had come out to their parents found that the rate of attempted suicide was four per cent among those whose parents were strongly supportive but that nearly sixty per cent of respondents who described their parents as not supportive had attempted suicide in the previous year.

Chapman’s decision to support her daughter grew in part out of her own experience as a black sheep in a deeply religious family. She was born in East Tennessee to a Baptist minister and his wife and had an itinerant upbringing, moving around the South. The last words her grandfather, who was also a Baptist minister, said to her were “I’m so sorry I’m not gonna see you in Heaven.”

Paul was raised in Dublin, Ireland, as the youngest of twelve children in a Catholic family. “We both came from communities that were super fundamentalist,” Chapman said. They agreed that they would raise their children outside of any religious tradition. If they had a doctrine, Chapman said, it was “critical thinking.” They brought their kids to Black Lives Matter demonstrations, and took them to hear the Georgia congressman and civil-rights activist John Lewis speak. But Paul and Kristen would also listen to the far-right radio host Rush Limbaugh, to know what the other side was saying. As the children got older, Paul and Kristen started to have different visions of the future—Kristen wanted to buy an R.V. and travel the country, and Paul wanted to buy a house. In 2019, they decided to separate, but they couldn’t afford to split their family into two households.

Paul at first had trouble understanding how Willow could decide about her gender so young. Kristen would argue, “If a person presents and says, ‘This is who I am,’ it is not your job to unpack that.” In the end, it was by talking to two trans women—a co-worker in her fifties and a twentysomething bartender at the pub he frequented—that Paul came to understand his daughter better. “Reading online was too much right-wing or left-wing,” he said. “I needed something more grounded.” The bartender told him that her father had rejected her, and that she had scars on her arms from self-harm. “I said, no matter what, I wasn’t doing that,” Paul recalled.

Willow had told me that one of the hardest parts of leaving town was doing so while her relationship to her father was still evolving. “I feel like my biggest unfinished business is that relationship,” she said the day before the move, over boba tea in a strip mall called Plaza Mariachi. “I think I’ve dealt with it. We’ll talk on the phone. Even if we don’t have an in-person connection, I think we’ll be O.K.”

Once they all managed to leave the house for the last time, Paul gave Chapman and each daughter a hundred dollars in cash as a parting gift. The family had dinner at Panera Bread, then sat for a while at a nearby park. Paul cancelled two Lyfts before finally getting in one and heading to the pub, where he would try to process the day. Chapman and the girls got in the white Dodge and took I-24 out of Nashville.

L.G.B.T.Q.-rights activists around the country have seen the sudden uptick in bills targeting transgender identity as a strategy to rally conservative voters after the legalization of gay marriage and the criminalization of abortion. “There was an inordinate amount of money and attention and huge far-right groups, many of which have been deemed hate groups, focussed on keeping us as L.G.B.T.Q. people from getting married, right?” Simone Chriss, a Florida-based lawyer, told me. Chriss is representing trans people in several lawsuits against the state over its restrictions on gender-affirming care. She observed that, after the Supreme Court legalized gay marriage, in 2015, “all of the people singularly focussed on that needed something else to focus on.”

She recalled watching as model legislation propagated by groups such as the Alliance Defending Freedom and the Family Research Council targeted trans people’s freedom to use bathrooms of their choice, and to play on their preferred sports teams. Health care came next. “All of a sudden, you see this surge in gender-affirming-care bills,” Chriss said. “And what’s bananas is there was not a single bill introduced in a single state legislature prior to 2018.”

The anti-trans rhetoric about protecting children mirrored that of the anti-gay-marriage movement, she continued, and new rules mandating waiting periods, for example, were familiar from the anti-abortion movement. “It’s like dipping a toe in by making it about trans children,” she said. “I think the goal is the erasure of trans people, in part by erasing the health care that allows them to live authentically.”

Beach-Ferrara, of the Campaign for Southern Equality, said her organization estimates that more than ninety per cent of transgender youth in the South live in states where bans have passed or will soon be in effect, and that between three and five thousand young people in the South will have ongoing medical care disrupted by the bans. (The Williams Institute at U.C.L.A. estimates that there are more than a hundred thousand thirteen-to-seventeen-year-olds who identify as trans living in the South, more than in any other region in the country.) Already, university hospitals such as the University of Mississippi Medical Center and the Medical University of South Carolina have discontinued their pediatric gender services before being legally required to do so.

Had Chapman stayed in Tennessee, Willow’s closest option for getting puberty-blocker shots would likely have required a four-hundred-and-fifty-mile trip to Peoria, Illinois. Willow’s TennCare insurance would not easily travel, and a single shot can cost twelve hundred dollars out of pocket. Paul had told Chapman not to be ashamed if the move didn’t work out and she changed her mind, but she already knew she would never go back to Nashville.

On their way east, the family stopped for a few days in Seneca, South Carolina, where Chapman has relatives. Back on the road, she tried not to focus on the uncertainty that awaited her and her daughters, but she had to pull over at least twice to breathe her way through anxiety attacks. There was a heat wave, and by the time they arrived in Richmond the back speakers of the S.U.V. were blown out, and everyone was in a bad mood. Willow had snapped at her mother and Saoirse for trying to sing along to the Cranberries; she had even yelled at the dog. “It was difficult?” Willow told me afterward, when I asked how the trip had been; then she added, “I’m still excited.” (Saoirse declined to be interviewed.)

Chapman had booked an Airbnb, a dusty-blue bungalow outside Richmond. It had good air-conditioning and a small back yard for the dog. She could afford only a week there before they would have to move to a motel. That night, Willow zoned out to old episodes of “RuPaul’s Drag Race” in the living room, while Chapman scrolled through real-estate listings on her phone. She asked for advice on the social-media feeds of local L.G.B.T.Q. groups, and the responses were heartening. She decided that, if she was able to find a place to live by the end of the week, she would not take the marketing job she had lined up. School wouldn’t start for a few weeks, and it was not the right moment to leave her daughters alone all day.

At eight the next morning, Chapman was sitting in an otherwise empty waiting room at the Southside Community Services Center, filling out forms to get the family food stamps and health insurance. She had put on makeup for the first time in days and was wearing wide-legged leopard-print pants and a black shirt. She had forgotten her reading glasses, however. “Do you have a spouse who does not live at home?” she read out loud, squinting her way through the questions. “Yes,” she answered to herself, checking a box. (She and Paul are not yet divorced.)

Chapman kept mistakenly writing “Willow” on the government forms—she had never officially changed her daughter’s name. (A 1977 Tennessee state law that prohibits amending one’s gender on a birth certificate will apply to Willow no matter where she moves; another Tennessee law, which went into effect this past July, bans people from changing the gender on their driver’s license.) Chapman picked up the next batch of forms, for Medicaid. “One down, one to go,” she said.

Later in the day, Chapman and her daughters went to see a house that was advertised on Craigslist, an affordable three-bedroom in the suburbs of Richmond. As they were driving, the owner texted Chapman that he had a flat tire and couldn’t meet them. But the place looked ideal from the outside, so she filled out an application and sent the landlord a thousand-dollar deposit. At five the next morning, she woke up and saw a text from the owner claiming that the money transfer had not gone through. She quickly realized she’d been scammed.

Chapman became weepy. She posted on social media about the con, then drove Saoirse to a thrift store she wanted to visit. At first, only one shopper noticed the woman crying uncontrollably in the furniture section. Then someone went to find some tissues, and someone else brought water. Soon, Chapman recalled, she was surrounded by women murmuring words of sympathy.

That evening at the Airbnb, Chapman and Willow sat at the kitchen table. “The emotional impact of the scam hit me way more than the money,” Chapman said, still tearing up at the thought of it. Willow nodded in sympathy. But for Chapman the experience was also a reminder of the advantages of talking about their situation—the women had told her that the schools near the house were not very good, anyway. “Thrift-store people will help you when you’re down and out. They’re used to broken shit,” she said, shaking her head. “If I had broke down in a Macy’s? Think how different the reaction would be.”

The next morning, Chapman was feeling a little less pessimistic. The humidity had broken, and the weather was good. People had responded to the news of the scam by donating money to replace what she had lost, and a local Facebook group had led her to a property-management company that was flexible toward tenants with bad credit.

She drove to see a three-bedroom apartment in a centrally situated part of Richmond. Though one of the bedrooms was windowless, the place was newly painted, and it had a wooden landing out back that could serve as a deck. It was also in a school district that people had recommended. “I can see this working,” Chapman said tentatively. Most of the utilities were included in the sixteen-hundred-and-fifty-dollar rent. Chapman didn’t have time to overthink it. She wrote the real-estate agent saying she would apply.

That afternoon, Chapman drove Willow to see the apartment. The door was locked, but Willow climbed through a window and opened the door so they could consider the space together. “We were, like, ‘Oh, this is nice,’ ” Willow said. She loved the neighborhood, which had vintage stores and coffee shops. “You can walk anywhere, you don’t need transportation—that’s really cool.”

The next day, Willow was sitting on a couch in the Airbnb watching a slasher film called “Terrifier.” Chapman was next to her, getting ready for a Zoom call with someone from a local trans-rights organization called He She Ze and We.

In the weeks leading up to the move, Chapman had taken time to research which schools were friendly to trans people. Willow estimated that maybe half the students in her middle school in Nashville were transphobic, and twenty per cent were explicit about it. She was bullied, but she says that it didn’t bother her. Her teachers were more supportive, such as the one who gave her an entire Lilith Fair-era wardrobe. “She was, like, ‘Do you want some of my old clothes? Because you’re so fashion,’ ” Willow said. “I had that black little bob.”

“She had Siouxsie Sioux hair for a while,” Chapman said, looking at her fondly.

The two of them agree that Willow’s personality shifted after transitioning. Once withdrawn and nonconfrontational, she began to develop a defiant attitude. “It was kind of fun to just mess with them,” she recalled of the bullies, who she said were not vicious but more into trying to get a laugh—“like, childish, immature stuff.” She would be coy; she would tell them to give her a kiss. “My only weapon, I guess, was how I chose to respond,” she said.

“She’s not a shrinking violet,” her mother added.

“I just don’t like the traditional way that you’re taught to stand up for yourself,” Willow said. “I think absurdism is the best way.” If she lets someone misgender her, she said, “it’s not because I don’t want to be the annoying trans person, it’s more like . . . you’re not gonna get to those people.”

In her freshman year, she attended a public arts high school, and began skipping class and smoking. She says there were at least ten other students who identified as trans, but she remained something of an outsider. When she was in school, she says, she almost thought of herself as a kind of character expected to perform.

Chapman is not a disciplinarian—she had enough of that growing up. But she had a conversation with her daughter after watching a video of an incident in which Willow was voguing in a school hallway, attempted to do a death drop, and ended up with a concussion. The students around Willow were clapping and egging her on even after she fell. “It’s great that you’re the kind of person who will do crazy things,” Chapman remembered saying, “but you need people around you who are not like that.” Both Chapman and Paul worry about Willow’s safety, in part because she is not easily scared herself.

“Will you turn that off?” Chapman said now about the horror film, as she logged on to Zoom. Willow took that as a cue to leave the room.

“You’re going to want to be on this thing,” Chapman said, calling her back.

Willow, who wore blue eyeshadow, a purple baby tee with a peace sign and the word “Smile!” on it, and magenta-pink shorts, plopped back down on the couch, then got up to retrieve supplies to disinfect her belly-button piercing, which she began to do with studiousness.

On Zoom, Chapman introduced herself to Shannon McKay, the co-founder of He She Ze and We, and gave a summary of their situation.

“Have you gotten connected with the medical piece yet?” McKay asked. She explained that, in Virginia, Willow might not have to wait until she turned sixteen to start estrogen. At this news, Willow looked up and made eye contact with her mother, who nodded back.

The conversation turned to politics. Earlier in the week, Glenn Youngkin, the Republican governor of Virginia, had held a town hall on parents’ rights at a school in Henrico County. A parent there had urged Youngkin to introduce a ban on gender-transition treatment for minors.

“Our governor, just to let you know, has not taken a stance,” McKay, who also has a trans daughter, explained to Chapman. “And I think he’s not conservative enough for the folks that wish he would be.”

In July, Youngkin had issued a series of rules that direct trans kids to use pronouns and bathrooms that accord with the gender they were assigned at birth, unless they have parental permission to do otherwise. Chapman asked McKay if that gave her some control over how Willow would be treated at school.

“The clincher here is, even if all parents involved do fill out the form and say, ‘We’re all on board,’ school personnel can still say, ‘I don’t believe in that. I’m not going to do it,’ ” McKay said. She did have some good news, however: if Willow learned to drive, she could determine the name and gender on her identification card.

“I’m not ready for it,” Chapman said, referring to the driving.

“Well, before this governor messes it up, I encourage people to go ahead and get these documents lined up,” McKay said.

Chapman got the apartment she and Willow had visited, and a few days later the family moved in. Willow started at her new school on Tuesday, August 22nd. She made friends with another trans girl in the first week. But, despite a letter from Chapman specifying Willow’s name and pronouns, school administrators told her they had to use the name on her registration. She was also told she should use the nurse’s bathroom instead of the girls’ bathroom, even though it was on a different floor and might cause her to be late to class. Willow ignored that rule, and asked her mother not to intervene on her behalf.

Before the school year had begun, Chapman told me that if school didn’t work out she would be fine with her daughter getting a G.E.D. When I asked Willow about the future, she said that she wants to move to New York City. She wants to go to the balls, “maybe be a model, I don’t know,” she continued. “I like doing art. I like meeting people. I don’t know how to connect all of those things and get paid.”

“You care more about personal freedom than hitting a milestone,” Chapman said. “You care less about the traditional high-school things, the traditional college things.”

“I feel like I should care about them,” Willow said.

“Oh!” Chapman said, looking surprised. “I like hearing that.”

“I’m open—like, I could potentially care about them, but if it’s not welcoming me then I won’t,” Willow said.

The day in August when Willow needed her puberty-blocker shot came and went. The family’s insurance still had not come through, and the earliest appointment Chapman could get at a clinic with tiered pricing was in mid-September. An administrator at the clinic assured her that there was a window with puberty blockers, and that Willow’s voice would not drop overnight.

I talked to Chapman the evening after the appointment. “We thought we were just going in for an intake, but they started Willow on estrogen today,” Chapman told me over the phone. “The doctor was in shock that Willow had been on puberty blockers for two years and that she was almost sixteen.” (“It’s really hard for cis people to fully appreciate the deep destabilizing physical betrayal that these kids are navigating on a day-to-day basis,” the doctor, Stephanie Arnold, told me. “It’s a period where you should be establishing confidence in yourself and your ability to interact with the outside world.”) Willow, Chapman added, “is over the moon.” They called Paul to let him know. “After every fucking thing . . . it just happened,” she said.

The following Monday, Chapman started a new job, counselling people on signing up for Medicaid. She was earning less than she had in Nashville, but hoped to rebuild her career as an artist and a community organizer.

The family was getting to know Richmond, with its restored Victorian row houses and stately parks. Using the hundred dollars from her father, Willow had bought herself a skateboard to get around town. Paul was planning a visit for October. “This city is just dang cute, let’s be honest,” Chapman said. They had found a leftist bookstore where she had bought Willow a book of poetry by trans writers. When I asked Willow how she felt on estrogen, she said that it was too early to discern any changes with clarity; what she felt, she said, was more vulnerable. A little more than a month in, Willow said that she was liking her new school and had even attended the homecoming dance. “And my grades are O.K.,” she added. “So that’s something.”

On September 28th, the Sixth Circuit Court of Appeals upheld the ban on gender-transition treatment for minors in Tennessee. The court found, among other things, that state legislatures can determine whether the risks of gender dysphoria are less significant than the risks of treating it before a patient turns eighteen. A dissenting opinion stated, “The statutes we consider today discriminate based on sex and gender conformity and intrude on the well-established province of parents to make medical decisions for their minor children.” Because the federal appeals courts have split in their findings, with other circuits finding such bans unconstitutional, the issue has the potential to proceed to the Supreme Court.

“I know what’s going on,” Willow had said, when I asked her about politics. She doesn’t see herself as an activist, though; she prefers to let the news filter through her mother rather than to consume it herself: “She’s my person on the inside.” 

[bostonfly]

Stop the time madness!!

I’ve studied the pros and cons of these twice-annual rituals for more than five years as a professor of neurology and pediatrics and the director of Vanderbilt University Medical Center’s sleep division. It’s become clear to me and many of my colleagues that the transition to daylight saving time each spring affects health immediately after the clock change and also for the nearly eight months that Americans remain on daylight saving time.