Are Smartphones Starving Adolescent Brains?

15 mei · Just the Facts with Gerald Posner

There has been a lot of news recently about the deleterious effects on the developing brains of children and adolescents who spend too much time online. Social psychologist Jonathan Haidt (@afterbabel) and many others who have studied it pin most of the blame for spiraling rates of poor adolescent and teen mental health — including depression, anxiety, and suicidal ideation — on social media. “The costs of using social media, in particular, are high for adolescents, compared with adults, while the benefits are minimal,” Haidt writes in his latest bestseller, The Anxious Generation.

Social media is unquestionably an irresistible magnet for kids, but Dr. James Winston, a Miami Beach-based psychologist with 30 years of experience in the field of addiction, says putting the blame on social media is too simplistic. Winston believes that the culprit is the device itself — the smartphone — and that extensive use during the crucial years of childhood brain development creates a neurological nutritional deficiency for users fourteen and younger.

“Smartphones are starving the brain,” he says.

While Winston’s smartphone-induced nutritional deficiency seems initially a revolutionary idea, it provides a straightforward, organic answer as to how digital technology has created and fed a mental health crisis among kids.

The theory certainly drew a lot of attention and excitement after a presentation Winston made at a program last week in Miami Beach, “The Effects of Screen Time on Adolescent Brain Development.” After the event, when I spoke to academics, researchers, local politicians, and parents, all thought it might be the next big step in figuring out how to protect children when it comes to the harms of digital addiction.

Margarita Louis-Dreyfus, the Swiss billionaire businesswoman and philanthropist, had flown in from Switzerland to co-host the event. She had created Human Change last year, “a coalition of parents, advocates, educators, psychologists, pediatricians, clinicians, and researchers who are raising the alarm about the dangers of digital devices and social media to children’s health and development.” This past January, Winston had joined Louis-Dreyfus and Human Change at the World Economic Forum, trying to raise awareness of the issue among the global leaders that gathered in Davos.

Winston has no social media accounts and uses an AOL email address. But, as the single father of teen sons, he is no newcomer to the subject of technology and kids. I wrote about Winston two years ago in Forbes - '“This Family Foundation Is Quietly Going To War With Facebook Over How It Affects Kids’ Brains” - regarding how he and four relatives of a family foundation left by his father were spearheading scientific research at the University of North Carolina into how social media platforms affected young brains. The family’s $10 million gift in 2022 created an eponymously named National Center on Technology Use, Brain, and Psychological Development. That UNC research center is the only one in the country that does not accept money from tech companies.

Last year the center published the results of a groundbreaking 3-year study in JAMA Pediatrics. It utilized functional MRIs to monitor the brains of middle school students. The results showed that the brains of teens who frequently checked their social media developed differently than those who did not check social media very much. The heavy social media users were far more hypersensitive to feedback than their less connected peers.

For Winston, a UNC and Oxford alum, who worked with drug addicts at a federal prison and later as clinical supervisor at an adolescent sex offender treatment program before going into private practice, his initial interest in the field came about unexpectedly.

“I used to be one of those nerd dads who walked their kids into school every day,” he recounts. “And we would get bumped into by students coming the other way. Every day that happened. Very few of them even looked up from their phones. Professionally, I knew that was one of the critical variables in addictive dynamics, interference with basic self-care, thinking about survival. We've all supposed to be aware of our surroundings, simple things like avoiding potholes or hurting ourselves or others. These kids were bumping into each other because the magnetic pull of their devices was so powerful that they were oblivious to everyone around them.”

Winston talks animatedly about attachment theory, introduced by British psychologist John Bowlby in the 1950s and 1960s to understand the emotional bond between infants and their parents.

“We require sustained attachment to caretakers in order to develop into thriving human beings,” he says. “Where our sustained attention goes, so goes our attachment to that person, so in terms of human bonding, attention is the currency of value.”

“Smartphones are strategically designed to capture this exact attention. The tech companies know exactly what they're doing. They're developing a device that is architecturally constructed to be overstimulating. That gives it a huge addictive potential. And if you think about it, it's really a parallel universe, a digital parallel universe, and it's unlimited.”

The crux of the problem, says Winston, is that “adolescents are incapable of regulating hyper-arousing dynamics. That’s why we don’t let kids watch violence or allow them into a casino, because we know intuitively that they cannot integrate that in a healthy way.”

A parallel problem is that smartphones significantly impact neurobiological adolescent brain development.

“Our brains developed over tens of thousands of years to absorb visceral input,” says Winston, “eye contact, voice quality, touch, it is how we unfold in a healthy way.”

“Our brains learned to process if someone was sarcastic, affectionate, snarky, or what it's like when you say something, and they're hurt. If they're mad, you can discern all that. The richness and dimensionality of face-to-face contact is visceral nutrition for the brain.”

That is where the smartphone comes to play, and thousands of years of brain wiring starts to go haywire for kids.

Winston sees all the classic signs of addiction when it comes to adolescents and smartphones. There is increased self-centeredness, cravings and dependency for the device, externalization of responsibility, and withdrawal symptoms if the smartphone is taken away. “Ever try to take an iPad away from a six-year-old? We call that reaction a tantrum, and in addiction terminology that's called withdrawal.”

Some researchers have contended that tech is not a classical addiction since it does not cross the blood brain barrier. “Gambling doesn't either,” counters Winston. “But we all know gambling is an addictive disease. Cell phones don't cross your blood brain barrier but still ticks all the addiction boxes.”

“Access to a drug is a critical variable in the development of an addictive dynamic,” he adds. “Smartphones are not just another tech advancement; they are qualitatively different in that they can be carried around with us all the time. While that makes it easier for people, including adults, to get addicted, it is especially dangerous for adolescents, ages 9 -14. This is the second most critical time of brain development and is when the neural highway system that we carry into adulthood is established.”

The adolescent brain undergoes a massive restructuring process as kids near and enter puberty. The young brain is designed to prune itself of circuitry no longer needed from childhood.

“And it is during this time,” notes Winston, “when the need for adolescent social connection is as powerful an instinct as hunger. They are transitioning from family centric mother and father to a peer system. It is wired into our DNA as a transitional period when adolescents make friends, develop empathy, and learn their social skills needed for early adulthood. Tech companies know this and exploit it. If they can get a pathway system laid down, where kids are attached to their phones, and in particular social media, they've got a lifetime customer. It's no different, except in the quality of the substance, than cigarettes. They used to target kids so they would have them for life.”

Research shows adolescents spend on average eight hours a day behind a screen.

“That is four months a year,” Winston says, “half of their waking hours.”

He returns to attachment theory.

“Attention is going through a screen instead of a dimensional dynamic with face-to -face contact. It has profound implications both emotionally, psychologically, and neurobiologically.”

Why is he focused on the device as opposed to what it contains?

“As an addiction guy, a critical factor that facilitates an addictive dynamic is access to a drug,” he notes. “You can't really be an alcoholic if you can't get alcohol, for instance. The constant and easy access to smartphones amplifies the addictive process.”

He cites a recent study that shows kids pick up their phones roughly 100 times a day. “That is pretty extraordinary,” he says. “So, there's some magnetic pull that keeps them going.”

What is good news for tech companies — that kids want to stay on their devices more than ever — is, for Winston, “horrifying in terms of adolescence. I've witnessed kids interacting with one another. Then, one kid gets kind of anxious. Instead of staying connected with the other kids, they pick up their phone. So, phones have become a medicator, which is a powerful ingredient in any addictive process. And it allows kids to avoid the hard work of really having to learn how to manage their feelings, the uncomfortable ones in particular, to work it out face to face. They go to the phone and the anxiety goes away.”

That is no different in Winston’s view than an alcoholic who takes a drink to offset anxiety.

Where Winston’s theory goes beyond the work of Haidt and others is in his belief that the tech addiction for kids creates a measurable nutritional deficiency.

“Both fruits and candy contain sugar,” says Winston, “but they are otherwise nothing alike. There is a big difference between having a banana for a snack or a snickers bar. The simple sugars in candy spike blood sugar, are void of nutrients, and since they are calorie dense, people need to eat a lot to feel full. It is no coincidence that the brains of cocaine addicts and sugar addicts looks basically the same. You can never get enough of what you don’t need. That is smartphones.”

What are the results of Winston’s nutritional deficiency? “If it was one hour a day, it might not have such bad effects on things like depression and anxiety. But the mental and psychological problems spike as it becomes a nutritional deficiency at scale with more and more hours stuck on a phone.”

There are huge ramifications if Winston is right about smartphones creating a nutritional brain deficiency at a particularly critical development period for adolescent brains. It would open the door for the Surgeon General and other government health officials and institutions to get involved. Winston’s dream scenario is a ban on smartphones for kids younger than 14, the age he set for his own sons to get their phones. “It would protects adolescents’ neurobiological vulnerabilities, allowing kids a longer runway to feed on vital social ‘visceral nutrition’ which facilitates healthy brain and psychological development.”

“I know everybody laughs But I think that was probably true in the 1940s if someone said that about cigarettes.” He believes that society is in the middle of the same historical process as played out with cigarettes. “Cigarettes used to be cool. Then science proved they were not only addictive but caused cancer. Legislation banned sales to minors.”

At the very least, Winston hopes to get state by state or national legislation to ban smartphones at schools. Research shows a 6% increase in academic performance when phones are removed. “It is a no cost enhancement of one of schools’ primary functions.”

Another ambitious goal is warning labels outlining the addictive potential of smartphones, “the equivalent of ‘cigarettes will kill you’”.

“I think this still sounds radical to some people and they will think it will never happen. Interestingly, in Chile, a few months ago, they put little warning labels on processed food, and it really had a huge impact on the amount of processed food that was bought. So much so that it began to shift Chile’s obesity rate.”

There is significant correlational research documenting the dangers of too much social media and smartphone use. What is missing is the hard science data. It is needed to force government action that could bolster his provocative theory with incontrovertible facts. That is why he and his family, and other activists like Margarita Louis-Dreyfus, are funding research studies.

“It is why I jumped at the opportunity to get some funding to the UNC center,” says Winston. “The science must stand on its own. Whether you're Republican or Democrat or what, it doesn't matter, this is the science. In every historical social change movement, the tipping point at a national level has come after the accumulation of apolitical science.”

The sooner the hard science comes, the better. The mental health of our children is what is at stake.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.justthefacts.media

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The ICC minus 1
24 mei· Just the Facts with Gerald Posner
I joined the International Criminal Court in 2012. It was only ten years old and had been tarred by controversy over its credibility and independence. Still, I believed in its stated mission of providing a legal forum for bringing to justice those guilty of genocide, war crimes, crimes against humanity and the crime of aggression.
Being an ICC member did not mean I agreed with everything it did. In 2018, for instance, it undermined its own principles when its appeal chamber unexpectedly overturned the conviction of Jean-Pierre Bemba, a Central African Republic politician found guilty of allowing war crimes under his command. And there were many instances in which I was concerned about apparent bias, had questions about fairness over the cases it pursued, and was frustrated by its glacial pace. Still, I stuck with the ICC.
Today, I submit my resignation and cancel my membership.
The May 21 decision to pursue arrest warrants against Israeli Prime Minister Benjamin Netanyahu and Defense Minister Yoav Gallant on war crimes charges, was a bridge too far. Those warrants, the first ever against any Western leaders, were an assault on the state of Israel and its right to defend itself against a terrorist enemy who violates the Geneva Convention by using its civilian population as human shields. The very suggestion of a moral or legal equivalence between a democratic country fighting an enemy that threatens its elimination and Hamas’s mass murderers is itself preposterous.
The ICC prosecutor, British lawyer Karim Kahn, relied on experts versed in human rights law, not the laws of conflict. This was all about feeding a feverish anti-Israel sentiment, particularly an anti-Netanyahu virus. There is no other way to explain why the ICC so blatantly violated its key rule about its own jurisdiction. The ICC only has jurisdiction when local courts are unwilling or unable to act. When the ICC issued arrest warrants last year for Vladimir Putin, and Maria Lvova-Belova, the Russian Commissioner for Children's Rights, it was confident that if it did not act, there was no independent Russian legal tribunal that would pursue those charges. The same is true with the arrest warrant request this week for three Hamas officials -- Yahya Sinwar, Ismail Haniyeh and Mohammed Deif — for war crimes including extermination and murder, the taking of civilian hostages, torture, rape and sanctioned acts of sexual violence. Even the ICC understands that Hamas has no intention of investigating its own atrocities.
“Israel, on the other hand,” noted the Israeli ambassador to the EU, Haim Regev, “has a rigorous legal system that has proven itself willing and able to investigate and prosecute violations of international law.”
President Biden, who has tried straddling an impossible middle in the conflict by arming Israel while criticizing the humanitarian response in Gaza, had no doubt the ICC move was beyond the pale. “Let me be clear,” he said, “we reject the ICC’s application for arrest warrants against Israeli leaders. Whatever these warrants may imply, there’s no equivalence between Israel and Hamas.”
Not all U.S. allies agree. France and Germany, most notably, have said they would arrest Netanyahu and extradite him to The Hague for trial. Germany, of course, has had some practice in arresting Jews, although I personally was surprised by their quick embrace of such an outlier warrant.
I understand that the cancellation of my ICC membership is symbolic only. I hope, however, that I am not the only one to throw in the towel on a troubled tribunal whose ingrained biases have destroyed any last vestiges of authority and impartiality.
This ICC — the one that wants to draw parallels between the IDF and Hamas terrorists — is destroying itself in real time.
By the way, for any subscriber who also does Wiki editing, I would appreciate if someone could remove the ICC reference in my Wikipedia page, or at least update it with this Substack. I will correct my own Linkedin profile.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.justthefacts.media
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Are Smartphones Starving Adolescent Brains?
15 mei· Just the Facts with Gerald Posner
There has been a lot of news recently about the deleterious effects on the developing brains of children and adolescents who spend too much time online. Social psychologist Jonathan Haidt (@afterbabel) and many others who have studied it pin most of the blame for spiraling rates of poor adolescent and teen mental health — including depression, anxiety, and suicidal ideation — on social media. “The costs of using social media, in particular, are high for adolescents, compared with adults, while the benefits are minimal,” Haidt writes in his latest bestseller, The Anxious Generation.
Social media is unquestionably an irresistible magnet for kids, but Dr. James Winston, a Miami Beach-based psychologist with 30 years of experience in the field of addiction, says putting the blame on social media is too simplistic. Winston believes that the culprit is the device itself — the smartphone — and that extensive use during the crucial years of childhood brain development creates a neurological nutritional deficiency for users fourteen and younger.
“Smartphones are starving the brain,” he says.
While Winston’s smartphone-induced nutritional deficiency seems initially a revolutionary idea, it provides a straightforward, organic answer as to how digital technology has created and fed a mental health crisis among kids.
The theory certainly drew a lot of attention and excitement after a presentation Winston made at a program last week in Miami Beach, “The Effects of Screen Time on Adolescent Brain Development.” After the event, when I spoke to academics, researchers, local politicians, and parents, all thought it might be the next big step in figuring out how to protect children when it comes to the harms of digital addiction.
Margarita Louis-Dreyfus, the Swiss billionaire businesswoman and philanthropist, had flown in from Switzerland to co-host the event. She had created Human Change last year, “a coalition of parents, advocates, educators, psychologists, pediatricians, clinicians, and researchers who are raising the alarm about the dangers of digital devices and social media to children’s health and development.” This past January, Winston had joined Louis-Dreyfus and Human Change at the World Economic Forum, trying to raise awareness of the issue among the global leaders that gathered in Davos.
Winston has no social media accounts and uses an AOL email address. But, as the single father of teen sons, he is no newcomer to the subject of technology and kids. I wrote about Winston two years ago in Forbes - '“This Family Foundation Is Quietly Going To War With Facebook Over How It Affects Kids’ Brains” - regarding how he and four relatives of a family foundation left by his father were spearheading scientific research at the University of North Carolina into how social media platforms affected young brains. The family’s $10 million gift in 2022 created an eponymously named National Center on Technology Use, Brain, and Psychological Development. That UNC research center is the only one in the country that does not accept money from tech companies.
Last year the center published the results of a groundbreaking 3-year study in JAMA Pediatrics. It utilized functional MRIs to monitor the brains of middle school students. The results showed that the brains of teens who frequently checked their social media developed differently than those who did not check social media very much. The heavy social media users were far more hypersensitive to feedback than their less connected peers.
For Winston, a UNC and Oxford alum, who worked with drug addicts at a federal prison and later as clinical supervisor at an adolescent sex offender treatment program before going into private practice, his initial interest in the field came about unexpectedly.
“I used to be one of those nerd dads who walked their kids into school every day,” he recounts. “And we would get bumped into by students coming the other way. Every day that happened. Very few of them even looked up from their phones. Professionally, I knew that was one of the critical variables in addictive dynamics, interference with basic self-care, thinking about survival. We've all supposed to be aware of our surroundings, simple things like avoiding potholes or hurting ourselves or others. These kids were bumping into each other because the magnetic pull of their devices was so powerful that they were oblivious to everyone around them.”
Winston talks animatedly about attachment theory, introduced by British psychologist John Bowlby in the 1950s and 1960s to understand the emotional bond between infants and their parents.
“We require sustained attachment to caretakers in order to develop into thriving human beings,” he says. “Where our sustained attention goes, so goes our attachment to that person, so in terms of human bonding, attention is the currency of value.”
“Smartphones are strategically designed to capture this exact attention. The tech companies know exactly what they're doing. They're developing a device that is architecturally constructed to be overstimulating. That gives it a huge addictive potential. And if you think about it, it's really a parallel universe, a digital parallel universe, and it's unlimited.”
The crux of the problem, says Winston, is that “adolescents are incapable of regulating hyper-arousing dynamics. That’s why we don’t let kids watch violence or allow them into a casino, because we know intuitively that they cannot integrate that in a healthy way.”
A parallel problem is that smartphones significantly impact neurobiological adolescent brain development.
“Our brains developed over tens of thousands of years to absorb visceral input,” says Winston, “eye contact, voice quality, touch, it is how we unfold in a healthy way.”
“Our brains learned to process if someone was sarcastic, affectionate, snarky, or what it's like when you say something, and they're hurt. If they're mad, you can discern all that. The richness and dimensionality of face-to-face contact is visceral nutrition for the brain.”
That is where the smartphone comes to play, and thousands of years of brain wiring starts to go haywire for kids.
Winston sees all the classic signs of addiction when it comes to adolescents and smartphones. There is increased self-centeredness, cravings and dependency for the device, externalization of responsibility, and withdrawal symptoms if the smartphone is taken away. “Ever try to take an iPad away from a six-year-old? We call that reaction a tantrum, and in addiction terminology that's called withdrawal.”
Some researchers have contended that tech is not a classical addiction since it does not cross the blood brain barrier. “Gambling doesn't either,” counters Winston. “But we all know gambling is an addictive disease. Cell phones don't cross your blood brain barrier but still ticks all the addiction boxes.”
“Access to a drug is a critical variable in the development of an addictive dynamic,” he adds. “Smartphones are not just another tech advancement; they are qualitatively different in that they can be carried around with us all the time. While that makes it easier for people, including adults, to get addicted, it is especially dangerous for adolescents, ages 9 -14. This is the second most critical time of brain development and is when the neural highway system that we carry into adulthood is established.”
The adolescent brain undergoes a massive restructuring process as kids near and enter puberty. The young brain is designed to prune itself of circuitry no longer needed from childhood.
“And it is during this time,” notes Winston, “when the need for adolescent social connection is as powerful an instinct as hunger. They are transitioning from family centric mother and father to a peer system. It is wired into our DNA as a transitional period when adolescents make friends, develop empathy, and learn their social skills needed for early adulthood. Tech companies know this and exploit it. If they can get a pathway system laid down, where kids are attached to their phones, and in particular social media, they've got a lifetime customer. It's no different, except in the quality of the substance, than cigarettes. They used to target kids so they would have them for life.”
Research shows adolescents spend on average eight hours a day behind a screen.
“That is four months a year,” Winston says, “half of their waking hours.”
He returns to attachment theory.
“Attention is going through a screen instead of a dimensional dynamic with face-to -face contact. It has profound implications both emotionally, psychologically, and neurobiologically.”
Why is he focused on the device as opposed to what it contains?
“As an addiction guy, a critical factor that facilitates an addictive dynamic is access to a drug,” he notes. “You can't really be an alcoholic if you can't get alcohol, for instance. The constant and easy access to smartphones amplifies the addictive process.”
He cites a recent study that shows kids pick up their phones roughly 100 times a day. “That is pretty extraordinary,” he says. “So, there's some magnetic pull that keeps them going.”
What is good news for tech companies — that kids want to stay on their devices more than ever — is, for Winston, “horrifying in terms of adolescence. I've witnessed kids interacting with one another. Then, one kid gets kind of anxious. Instead of staying connected with the other kids, they pick up their phone. So, phones have become a medicator, which is a powerful ingredient in any addictive process. And it allows kids to avoid the hard work of really having to learn how to manage their feelings, the uncomfortable ones in particular, to work it out face to face. They go to the phone and the anxiety goes away.”
That is no different in Winston’s view than an alcoholic who takes a drink to offset anxiety.
Where Winston’s theory goes beyond the work of Haidt and others is in his belief that the tech addiction for kids creates a measurable nutritional deficiency.
“Both fruits and candy contain sugar,” says Winston, “but they are otherwise nothing alike. There is a big difference between having a banana for a snack or a snickers bar. The simple sugars in candy spike blood sugar, are void of nutrients, and since they are calorie dense, people need to eat a lot to feel full. It is no coincidence that the brains of cocaine addicts and sugar addicts looks basically the same. You can never get enough of what you don’t need. That is smartphones.”
What are the results of Winston’s nutritional deficiency? “If it was one hour a day, it might not have such bad effects on things like depression and anxiety. But the mental and psychological problems spike as it becomes a nutritional deficiency at scale with more and more hours stuck on a phone.”
There are huge ramifications if Winston is right about smartphones creating a nutritional brain deficiency at a particularly critical development period for adolescent brains. It would open the door for the Surgeon General and other government health officials and institutions to get involved. Winston’s dream scenario is a ban on smartphones for kids younger than 14, the age he set for his own sons to get their phones. “It would protects adolescents’ neurobiological vulnerabilities, allowing kids a longer runway to feed on vital social ‘visceral nutrition’ which facilitates healthy brain and psychological development.”
“I know everybody laughs But I think that was probably true in the 1940s if someone said that about cigarettes.” He believes that society is in the middle of the same historical process as played out with cigarettes. “Cigarettes used to be cool. Then science proved they were not only addictive but caused cancer. Legislation banned sales to minors.”
At the very least, Winston hopes to get state by state or national legislation to ban smartphones at schools. Research shows a 6% increase in academic performance when phones are removed. “It is a no cost enhancement of one of schools’ primary functions.”
Another ambitious goal is warning labels outlining the addictive potential of smartphones, “the equivalent of ‘cigarettes will kill you’”.
“I think this still sounds radical to some people and they will think it will never happen. Interestingly, in Chile, a few months ago, they put little warning labels on processed food, and it really had a huge impact on the amount of processed food that was bought. So much so that it began to shift Chile’s obesity rate.”
There is significant correlational research documenting the dangers of too much social media and smartphone use. What is missing is the hard science data. It is needed to force government action that could bolster his provocative theory with incontrovertible facts. That is why he and his family, and other activists like Margarita Louis-Dreyfus, are funding research studies.
“It is why I jumped at the opportunity to get some funding to the UNC center,” says Winston. “The science must stand on its own. Whether you're Republican or Democrat or what, it doesn't matter, this is the science. In every historical social change movement, the tipping point at a national level has come after the accumulation of apolitical science.”
The sooner the hard science comes, the better. The mental health of our children is what is at stake.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.justthefacts.media
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A Transgender Roe v. Wade?
11 mei· Just the Facts with Gerald Posner
Gender activists are hailing an 8-6 decision by the U.S. Fourth Circuit as a Transgender Roe v. Wade. Their celebration is, however, premature. While Kadel v. Folwell is undoubtedly a landmark ruling that the Equal Rights Amendment bars state health plans from excluding medical coverage for transgender surgical procedures, one of the dissenting circuit court justices called it “imperial judging at its least defensible.” It will almost certainly be reviewed by the Supreme Court.
In the spotlight in the Fourth Circuit case were two states that had excluded covering costs “in connection with sex changes.” West Virginia’s Medicaid plan did not pay for transgender surgical procedures. North Carolina’s insurance plan for teachers and government staff did the same.
The die was cast in the appellate court when the majority concluded that the state plans “cover mastectomies to treat cancer, but not to treat gender dysphoria…and chest-reconstruction surgery for cisgender women post-mastectomy, but not for gender dysphoria in transgender women.” The majority considered “treatments for a diagnosis unique to transgender patients” as “medically necessary treatments” and that the Constitution prohibited any coverage exclusions for transgender patients. The court’s bottom line: “The North Carolina State Health Plan and the West Virginia Medicaid Program discriminate on the basis of gender identity and sex in violation of the Equal Protection.”
Just the Facts has subscribers in over 100 countries. Many may not be familiar with the much talked about 14th Amendment. It was ratified in 1868 in the wake of the Civil War and designed to stop states from discriminating against freed Black slaves. The Amendment gave all Blacks born in the United States citizenship as a matter of birthright. Courts have, in the 156 years since its ratification, expansively interpreted its broadly-worded second sentence: “No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.”
That language was the basis for the Supreme Court’s 1973 milestone 7-2 Roe v. Wade decision. The Roe court ruled there was a personal right to privacy implied in the 14th Amendment and that abortion was constitutionally protected.
In 2019, the same Fourth Circuit appeals court that made the Kadel ruling, had demonstrated its willingness to grant constitutional protection to gender identity. In deciding in Grimm v. Gloucester County School Board that a Virginia school district could not bar a transgender boy from using whatever bathroom he chose, the court concluded that “gender identity is a protected characteristic under the Equal Protection Clause.” The following year, the Supreme Court ruled 6-3 in its Bostock ruling that gay and transgender status was covered by the 1964 Civil Rights Act.
The Kadel ruling relies on Grimm and Bostock and expands their reach. A dissenting judge, J. Harvie Wilkinson III, summed up the potential impact of the new decision: “What plaintiffs propose is nothing less than to use the Constitution to establish a nationwide mandate that States pay for emerging gender dysphoria treatments.”
In reaching its sweeping ruling, the majority provided examples of what it concluded constitute sex discrimination in the state plans. It cited, for instance, that “women can receive coverage for a vaginoplasty to treat the congenital absence of a vagina, but transgender women cannot receive a vaginoplasty to treat gender dysphoria.”
The court did not further describe the birth condition that would require such surgery for women. It is Mayer-Rokitansky-Küster-Hauser syndrome, a rare congenital reproductive disorder defined by an underdeveloped or nonexistent uterus and vagina. When the condition affects the uterus, it means women are infertile.
The two state plans covered surgeries for genitals or breasts only if the patient had a congenital condition or there was injury or a disease. Women who were diagnosed with Mayer-Rokitansky-Küster-Hauser syndrome, would qualify for full coverage of a vaginoplasty. Men, however, who identified as the opposite gender, would not qualify for state coverage. For men, it involves the surgical removal of the penis, testicles and scrotum and uses a skin graft from the buttocks or bowel to create a nonfunctioning pseudo-vagina.
Patients did not qualify for coverage under the state plans, as one dissenting judge wrote, “to affirm a patient’s biological sex.”
The same is true in another example cited by the majority, when the state plan “covers chest surgery for men who experience gynecomastia, but not for transgender men who experience gender dysphoria.”
Men in either state only qualify for surgical correction of gynecomastia, a hormonal imbalance that results in a swelling of breast tissue, if “they have physical symptoms, like breast pain.” They are not covered to treat “gender dysphoria.”
The six dissenting justices understood it is not a violation of the Equal Protection Clause for state health plans to exclude coverage based on medical diagnoses.
“The Equal Protection Clause does not license judges to strike down any policy we disagree with,” said Judge Richardson, writing for the dissent. “North Carolina and West Virginia do not target members of either sex or transgender individuals by excluding coverage for certain services from their policies. They instead condition coverage on whether a patient has a qualifying diagnosis. Anyone—regardless of their sex, gender identity, or combination thereof—can obtain coverage for these services if they have a qualifying diagnosis. And no one—regardless of their sex, gender identity, or combination thereof—can obtain coverage if they lack one. There is therefore nothing about these policies that discriminate on the basis of sex or transgender status.”
The Kadel decision is dangerous for the breath of the constitutional protection it applies to gender medical procedures. It is also reckless in its embrace of the scientific certainty and safety about such procedures.
“The science behind gender dysphoria care is far from settled,” wrote Judge Wilkerson in his dissent. “Many European nations have questioned the wisdom of hormonal and surgical interventions, particularly when used to treat children…. Providing the best possible care to adults and youth struggling with gender dysphoria is a challenging task for our States. But it is one that they are entitled to perform without premature judicial interference.”
Still, the majority blew past amicus briefs that set out the extent to which the science about gender was in a state of rapidly changing flux and provided a list of recent studies that raised significant questions about the safety and long-term effects of the very surgeries the majority wants to constitutionally protect.
The Kadel ruling exposes the dangers of leaving to the courts matters that should be decided by biology and medicine. It is the latest example of the politicization of gender medicine. The Supreme Court will be the last resort for permitting state legislatures to have the power to set policies on gender dysphoria treatments. Putting it under the protection of the Constitution, as Kadel does, guarantees only that evolving evidence about gender medicine will be ignored at the peril of patients and the costs borne by taxpayers.

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Campus Insanity, Vol 83
6 mei· Just the Facts with Gerald Posner
Most readers are familiar with Sirius radio and CNN host Michael Smerconish. In an era of increasingly polarized politics, where the loudest voices on the far right and far left often garner the biggest ratings, Smerconish is an old-fashioned centrist, a lawyer by training who tries striking a reasoned balance on even the most contentious issues. Listeners to Smerconish filter him through their own world views. His effort to stay in the middle means he is not someone who would seem likely to get cancelled as a university commencement speaker.
But that is precisely what has happened at Dickinson College, a premier Pennsylvania-based liberal arts school, that has rescinded its invitation for Smerconish as the school’s 2024 commencement speaker. It also cancelled an honorary degree it had planned to give him.
What did he do wrong?
A Muslim-Arab first year student wrote an opinion piece in the student newspaper that Smerconish supported racial profiling of Muslims and Arab Americans. The evidence? In a book Smerconish authored 20 years ago, Flying Blind: How Political Correctness Continues to Compromise Airline Security Safety Post 9/11, he wrote: “The TSA should at least be paying extra attention to those who share characteristics – either racial or circumstantial – with those who have been known to commit terror acts in the past. Makes sense to me.”
That was, claimed the student, “as blatant as it could possibly be. In no uncertain terms, Smerconish advocates for racial profiling.”
The class of 2024, he wrote, “deserves better than Smerconish.”
That article sparked pro-Palestine student protestors to set up an encampment on campus with a key demand that Smerconish be cancelled from the commencement.
Smerconish, as is his style, offered an olive branch, saying on his radio show that he would reread Flying Blind. “Chances are, that given the acquired wisdom of the last 20 years and all the knowledge that I have gleaned, and you know, reflecting on my life’s experiences, my hunch is I will probably stand behind every single word in the book.”
How did that go over at Dickinson?
“His statements were not a sign of the times,” proclaimed the student newspaper editorial, “but remain his own enduring prejudices.”
“This should be a cautionary tale for anyone in America who believes in fairness, common sense, the free exchange of ideas, rational decision-making, and the importance of leadership in the face of hysteria,” Smerconish wrote in a public letter he shared today.
Nothing in Flying Blind was considered controversial when it was published in the wake of the 9/11 attacks. It still is not. However, activist students combed it looking for some sentence, anything at all that they might use to cancel him. It was not really about something they thought was objectionable from two decades ago, it is because they have disdain for someone who is not an advocate for their current anti-Israel/pro-Palestine passion.
This past Saturday, the same College President, John Jones, who had invited Smerconish this past January — “On a personal note, and as a long-time acquaintance and admirer of your career, I am excited to welcome you to campus” — wrote and withdrew the invitation.
Schools cancelling a speaker is nothing new. But those speakers are usually themselves firebrands whose hard-edged views run counter to the progressive ideologies that are the permitted “one think” at many schools.
That even a moderate like Smerconish can run afoul of the censorial mob is evidence of both the closed mindedness of the protestors and the cowardice of school administrations to stand up to them. Those in power at many universities have abdicated their decision making to a tiny minority with the loudest megaphone.
Dickinson was founded in 1783 by Dr. Benjamin Rush, a slavery abolitionist who was also one of the original signers of the Declaration of Independence. “Rush believed in freedom — freedom of thought and freedom of action,” the school proclaims on its website.
It appears the school has modified the concept of “freedom of thought.” Unless someone objects, of course, and especially if that objection is couched in the modern language of racial or gender victimhood. Such a complaint does not need to be true. It just needs to be voiced and then craven school administrators race to placate the aggrieved students. Throw in a few radicalized professors, and you have the perfect storm in which a moderate like Smerconish becomes someone the student newspaper concludes is “undeserving of the honor of commencement speaker.”
Smerconish, in his public letter, summed up the danger of judging a 20-year book through the prism of today’s political filters: “Times change, people change, circumstances change. Statements in books written decades ago, if penned by the well-intentioned with a history of tolerance and advocacy of unity, cannot in a just and rational society be the basis for judging someone’s soul or determining their fitness to be part of the national conversation. And it certainly shouldn’t obliterate someone’s lifetime of reputation and performance. Those students who demanded I not speak had better hope that twenty years from now, when they are looking for a job, no one will look at everything they said and did two decades earlier, yanking it out of context and using it as a weapon of personal destruction.”
An oft-quoted thought from a German Lutheran pastor during World War II is,
“First they came for the socialists, and I did not speak out—because I was not a socialist.
Then they came for the trade unionists, and I did not speak out—because I was not a trade unionist.
Then they came for the Jews, and I did not speak out—because I was not a Jew.
Then they came for me—and there was no one left to speak for me.”
When cancel culture comes for middle-of-the-road commentators like Smerconish, it is strong evidence that no one is safe. At least no journalist who reaches conclusions based on facts and evidence that somehow is on the prohibited list at today’s college campuses.
I am not holding my breath for any commencement address invitation coming my way any time soon.

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Words Matter
5 mei· Just the Facts with Gerald Posner
The United States, European Union, United Kingdom, Canada, Australia, New Zealand, Japan, are among several dozen countries that have designated Hamas as a terrorist organization.
The New York Times, Washington Post, PBS, and all three major television news outlets, ABC, CBS, and NBC, and other legacy media outlets, will not use the word terrorist to describe Hamas.
The Black Panthers were militant. Hamas is a terror group.
That is not rocket science. It is straightforward, especially for news outlets reporting on the Middle East. The legacy media, however, avoids putting terror and Hamas in the same sentence.
The Associated Press style guide on the Israel-Hamas war, for example, says that the terms terrorism and terrorist have become too politicized and often are applied inconsistently. The AP made an exception after 9/11 and referred often to al Qaeda as terrorists. But not Hamas.
The world affairs editor for the BBC, John Simpson, said last October that terrorism "is a loaded word," and that "it's simply not the BBC's job to tell people who to support and who to condemn — who are the good guys and who are the bad guys."
Media bias is insidious on the big issues that dominate the news cycle. They can influence public opinion in something as simple as the words selected to report events. In this case, avoiding the word terror is meant to soft-pedal Hamas’s actions. The New York Times even managed to avoid the word terrorists in their initial report on the pillaging of rape, murder and abduction carried out by Hamas on October 7.
Shunning the words terror or terrorists normalizes Hamas and its atrocities. Lots of groups covering everything from climate change to social justice are correctly dubbed militant. Extinction Rebellion, for instance, the militant eco-warriors, chain themselves to one another to block traffic, and engage in high profile incidents of “environmentally themed graffiti” on some of the world’s great art works. Extinction Rebellion is undoubtedly a militant group. And the mainstream press refers to them as such, sometimes even as extremist. But Extremist Rebellion does not fire rockets and send suicide bombers into civilian gatherings, nor has it unleashed an attack in which rape, kidnapping and murder were its tools of ‘resistance.’ If they did, they would correctly be classified as a terror group. Same as Hamas, but likely without the political cover of the legacy press.
There should be no debate over October 7. It was a terror attack and those who carried it out were terrorists. By using militant when it comes to Hamas, the press is normalizing its horrific acts of terrorism.
Six months on from October 7 and I no longer know what it would take to get the legacy press to correctly call Hamas a terror organization. I know, unfortunately, that simple good journalism is not enough.

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Mercedes Maoists
28 apr· Just the Facts with Gerald Posner
There has been a recent wave of comparisons between the massive late sixties and early seventies antiwar protests and today’s campus Israel-Palestinian demonstrations. While these parallels are largely imperfect, they share a common element: activist professors and radicalized teaching assistants can significantly intensify campus unrest.
I experienced this first-hand growing up in San Francisco during the 1960s and attending UC Berkeley from 1972 to 1975—a period marked by significant protests against the war in Vietnam, Laos and Cambodia, the rise of the Black Power movement, and an anti-capitalism fever. As a political science major, I was surrounded by professors who were not just educators but also fervent advocates, with some quoting Mao’s Little Red Book and fostering a spirit of revolution over academic inquiry.
Those professors, whom we dubbed "Mercedes Maoists," seemed to lead comfortable lives in the affluent Berkeley Hills, driving vintage Mercedes, while preaching revolutionary ideals. This wasn't mere posturing; they genuinely believed America was fundamentally flawed, a sentiment echoed by a sizable contingent of radical university teachers who distort Middle East history into a victim narrative in which Israel and western colonialism are the root of all evil.
Students now arrive at college already steeped in an extreme mix of ideology and misinformation—many boasting a "history degree from TikTok." Unlike fifty years ago, we couldn't blame social media for our skewed world views.
By the time I entered the Berkeley freshman class, I had embraced Dr. Benjamin Spock’s views on Vietnam. Yes, that Dr. Spock. The pediatrician whose 1950s book about raising children was a bible for my parents and many millions of others. Spock had created a revolution of sorts by suggesting our parents use less discipline and instead encourage our instincts and reinforce our independent thinking.
Spock’s perspective was a precursor to the cultural revolution of the Free Speech/Haight Ashbury/Woodstock era in where cultural gurus such as psychologist Timothy Leary urged a “Human Be-In” crowd of 30,000 hippies in Golden Gate Park in 1967 to “Turn on, tune in, drop out.”
As adolescents, we quoted Leary as if it was some deep philosophical revelation, the 50-year-old version of ‘going viral.’
The tumultuous political climate in northern California made it seem to us as kids that the structured world of our parents was crumbling, and that society was on a precipice of some great but unknown change. Huey Newton and Bobby Seale had founded the Black Panther Party for Self-Defense (later mercifully shortened to the Black Panthers) across the Bay in Oakland. It was a Marxist revolutionary group that called for arming all Blacks, exempting them from the military draft, and releasing all incarcerated Black prisoners. The Panthers were ahead of their time by also demanding reparations for “centuries of white exploitation.” Martin Luther King’s activism was my parents’ style. That meant I wanted to be cutting-edge and oppositional by embracing the Panthers.
When the Ohio national guard shot at hundreds of student protestors at Kent State University and killed four and wounded eight, it shocked the country. For those of us who grew up in the Bay Area, however, the police shooting at demonstrators was not new.
A year before Kent State, Berkeley police had killed one and wounded dozens when they opened fire with buck and bird shot at demonstrators at a community garden called People’s Park. The city declared martial law and imposed a curfew. Ronald Reagan, who had run on a law-and-order platform when he was elected California’s governor in 1967, wasted no time sending in the national guard. Then troops arrived en masse with unsheathed bayonets and live ammunition. Military helicopters sprayed tear gas across the campus. Alameda county sheriffs, many of whom were Vietnam veterans, were let loose with truncheons on the crowds.
As I started my first semester at Berkeley, hundreds of thousands protested Nixon’s mining of North Vietnamese ports by taking to the streets nationwide for massive marches, silent vigils, traffic‐blocking sit‐ins, and often violent clashes with police. A few months earlier an all-white northern California jury had acquitted Angela Davis for her role in providing the guns used in a takeover of a Marin County courthouse in which four were killed.
All the political chaos meant that by the time I got to Berkeley I was primed to be receptive to the leftwing propaganda that my teachers passed for scholarship.
One professor hung his favorite Mao quote in a placard over his classroom doorway: “A revolution is not a dinner party, or writing an essay, or painting a picture, or doing embroidery; it cannot be so refined, so leisurely and gentle, so temperate, kind, courteous, restrained and magnanimous. A revolution is an insurrection, an act of violence by which one class overthrows another.”
An oversized Che Guevara poster greeted us at a “comparative economic systems” class. A different professor who taught about American imperialism in Central and South America encouraged us to write congratulatory letters to Chilean president Salvador Allende getting the 1973 Lenin Peace Prize. None of us were particularly bothered that the Soviet government appointed and controlled the panel who chose the winner. Allende shared the award that year with the Soviet leader, Leonid Brezhnev.
At Berkeley, professors often joined us in protests, providing solidarity with a revolutionary zeal. They also played on student fears that we would be drafted to fight an “unjust war.” Teachers helped feed a contagion that infected many students, one whose underlying philosophy was that resistance and revolution was far more important than worrying about good grades and some future job.
The culmination of insanity came in 1974, just before my 20th birthday, when heiress Patty Hearst, was kidnapped from her Berkeley apartment by the Symbionese Liberation Army, a self-described Marxist guerrilla group.
On an audiotape released to the media two months after her abduction, Hearst announced she had joined the SLA and adopted the name Tania as a tribute to one of Che Guevara's comrades. Two weeks later, she carried an M1 carbine into a San Francisco bank branch and announced to the stunned customers and employees, “I'm Tania. Up, up, up against the wall, motherfuckers!”
How did that play at Berkeley? Many students and faculty cheered her on. “We Love You Tania” posters sprouted up around campus. One teaching assistant on “political discourse” held a nightly vigil to show “solidarity” with the SLA.
When a campus environment reaches the extreme edges, what passes for the middle is still pretty far out. The middle at my Berkeley poly sci classes was represented by the small faction of pacifists who contended Hearst should not have been armed during the robbery.
Leaving Berkeley and going on to Law School at UC San Francisco was the time for detoxing from the political fervor. I came to realize how the writings of Spock and the lectures by many poly sci professors were riddled with errors and steeped in an ideology of anti-imperialism. Contract and criminal law discussions replaced lectures about the Bolshevik revolution and Mao’s Great Leap Forward. My law school years - 1975- 1978 - coincided with the end of the Vietnam war and the disintegration of the violent Weather Underground. The “revolution” preached by the tenured Mercedes Maoists had turned into a quickly fading memory of a period when the earth seemed slightly off its axis.
Today’s campus protestors might not be able forget their past so easily. Omnipresent technology allows outdated and sometimes vile ideas to retain some cachet on Tik Tok. I am forever grateful that social media did not exist during my time at Berkeley. Today’s students will learn the hard way that ignorance and hate live forever on the internet. There will always be online evidence of who called for the destruction of Israel, denied October 7 terrorism, proudly claimed their support for Hamas, and attacked Jews for nothing more than being Jews.
The university professors who have celebrated October 7 and urged “resistance at any cost” might eventually pay a price with their careers as schools investigate how tenured teachers can be dismissed for hate speech. If there is anything I learned from my Berkeley student days, it is that the influence of a radicalized faculty sets the framework by which students feel not only empowered but sanctioned by those in authority. Students should bear the ultimate responsibility for what they do. However, without taking effective action against the teachers who sanction and foment the extremist hate, I know from experience the craziness will never end.
_________________________
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Orwell's Latest Doublethink
28 mrt· Just the Facts with Gerald Posner
California has reaffirmed that convicted male sex predators who have declared themselves to be women can serve their sentences in all-female prisons. The state says it is following federal law by “expressly prohibit[ing] housing decisions based solely on an incarcerated person’s external genitalia.”
Mishandling this fundamental common sense issue was a key factor in Nicola Sturgeon’s resignation last year. (Check my December 2022 article, “Does Scotland’s New Gender Law Put Women at Risk.”)
California is pushing the progressive gender boundaries with the legislation, named by its proponents as The Transgender Respect, Agency and Dignity Act, and signed into law by Governor Gavin Newsom in 2021. Similar laws are also in Washington state, Rhode Island, Connecticut, Massachusetts, and New York City.
California does not require any medical diagnosis of "gender dysphoria." Anyone can declare on a Gender Identity Questionnaire that they are a different gender than their biological sex. The ease with which men can transfer to female prisons is set out in the portion of the law named, Housing and Searching Incarcerated People Consistent with their Gender Identity.
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Although the state has spent more than $3 million on medical procedures for inmates wanting to “transition” to a different gender, the California Department of Corrections and Rehabilitation (CDCR) does not require that the prisoners take any medications or have any medical procedures. The CDCR says it “does not determine an incarcerated person’s gender identity. Every incarcerated person self-identifies.”
Prisoners must serve their sentences at “an institution consistent with their gender identity.”
Of the 93,000 inmates in state prison, only 3,700 are women. A remarkable 90% of those female prisoners have a history of being beaten or battered. The state says that as of this month, there are “1,919 incarcerated people identified as transgender, non-binary and intersex.” All, of course, “based on incarcerated people who self-identify using the Gender Identity Questionnaire.” The vast majority of those are biological men.
What does California say about the safety of transferring men, even sex offenders, to female prisons? It flips the focus to the risk facing trans-identified prisoners. “Since transgender, non-binary and intersex people may be singled out for violent attacks by other incarcerated people and are at a higher risk for victimization, CDCR must make every effort to protect this vulnerable population. Housing transgender people according to their gender identity, when safe to do so, increases safety in prisons, upholds CDCR’s duty to protect all incarcerated people and promotes successful rehabilitation.”
Some commentators have suggested California convert a small prison into one exclusively for its 2,000 trans inmates. It cannot, the state claims, because a federal law, the Prison Rape Elimination Act, states, “The agency shall not place lesbian, gay, bisexual, transgender, or intersex inmates in dedicated facilities, units, or wings solely on the basis of such identification or status …”
Of the 363 prisoners who have asked as of March 2024 to be transferred for gender, 347 are biological men. They include murderers, kidnappers, rapists, and sexual abusers. A snapshot report from 2022 revealed that one-third of those asking for a transfer to an all-women’s prison were registered sex offenders. A quarter were serving their current sentence for some sex related crime. After that report, the state stopped providing the breakdown data. (A UK study by its Ministry of Justice reported that half of transgender prisoners were sex offenders or '“dangerous category A inmates [“those that pose the most threat to the public”] In Canada, a startling 85% of “gender diverse offenders” have a history of sex crimes as men.)
Although the California law has established a cursory review process for transgender transfer requests, it does not give authority to prevent a move based only on the man’s criminal record. Last year, a report from the California Office of the Inspector General, concluded that, “If a person with a history of raping women requests to transfer to a women’s prison, this [law] may prohibit the department from denying the person’s transfer request based solely on the prospective transferee’s history of raping women.”
With this background, my primary question for the Department of Corrections was whether there have been sexual assaults by men who have transferred to all female prisons?
That state’s answer is that its “reporting mechanisms do not track assaults by gender identity.” Which means they have no idea. That is evident in a March 2024 report in which the Department of Corrections gives lip service only to “proactive measures designed to prevent sexual violence.” To make it more difficult for anyone to discover the real numbers, California offers transgender men the option of a new prison identification number.
The Geneva Convention mandates that male and female prisoners should be housed in separate facilities. That is only an interesting historical footnote in California and other gender progressive states that have embraced the movement’s two core doctrines: gender always trumps sex and self-identification determines gender.
In the case of the California prison system, it is not transgender inmates who are suffering the greatest discrimination and risk of injury. It is women who are most at risk. Putting biological men, many of them convicted sex offenders, into women’s prisons, is a misogynistic policy that at first seems so ludicrous as to be impossible. The women there have no escape from a predator. But as demonstrated in California, where trends that spread to the rest of nation often hatch, it is all too real.
Amie Ichikawa, herself a former inmate in California, works with Woman II Woman, a faith-based nonprofit that was created by formerly incarcerated women to help those still in prison and others as they are released. Ichikawa believes that biological men who pretend to be transgender are exploiting female inmates in what amounts to “cruel and unusual punishment.” She is in daily contact with women serving their time across the Golden State. It is "like they're being erased and that they do not matter at all."
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Full Version: "The Frankenstein Files"
5 mrt· Just the Facts with Gerald Posner
Many Just the Facts subscribers requested the full OpEd published in the NY Post, not simply a link to the paper. It is below in full. I have included a voice over for those who prefer audio. It will also be available as a Just the Facts podcast.
Thanks to everyone for the overwhelmingly positive response.
Secret files show how international group pushes shocking experimental gender surgery for minors
Newly leaked files from the world’s leading transgender health-care organization reveal it is pushing hormonal and surgical transitions for minors, including stomach-wrenching experimental procedures designed to create sexless bodies that resemble department-store mannequins.
The World Professional Association for Transgender Health documents demonstrate it’s controlled by gender ideologues who push aside concerns about whether children and adolescents can consent to medical treatments that WPATH members privately acknowledge often have devastating and permanent side effects.
Yet the US government, American doctors and prominent organizations nonetheless rely on WPATH guidelines for advice on treating our youth.
The files — jaw-dropping conversations from a WPATH internal messaging board and a video of an Identity Evolution Workshop panel — were provided to journalist Michael Shellenberger, who shared the documents with me.
Shellenberger’s nonprofit Environmental Progress will release a scathing summary report, comparing the WPATH promotion of “the pseudoscientific surgical destruction of healthy genitals in vulnerable people” to the mid-20th-century use of lobotomies, “the pseudoscientific surgical destruction of healthy brains.”
The comparison to one of history’s greatest medical scandals is not hyperbole.
It is particularly true, as the files show repeatedly, when it involves WPATH’s radical approach to minors.
When the organization adopted in 2022 its current Standards of Care — relied on by the National Institutes of Health, the World Health Organization and every major American medical and psychiatric association — it scrapped a draft chapter about ethics and removed minimum-age requirements for children starting puberty blockers or undergoing sexual-modification surgeries.
It had previously recommended 16 to start hormones and 17 for surgery.
Not surprisingly, age comes up frequently in the WPATH files, from concerns about whether a developmentally delayed 13-year-old can start on puberty blockers to whether the growth of a 10-year-old girl will be stunted by hormones.
During one conversation, a member asked for advice about a 14-year-old patient, a boy who identified as a girl and had begun transitioning at 4.
The child insisted on a vaginoplasty, a surgery that removes the penis, testicles and scrotum and repositions tissue to create a nonfunctioning pseudo-vagina. It requires a lifetime of dilation. Was he too young at 14?
Marci Bowers, WPATH’s president and a California-based pelvic and gynecologic surgeon who is herself transgender, said she considered any age limit “arbitrary.”
But she would not do it. Why?
“The tissue is too immature, dilation routine too critical.”
In lay terms, that means boys who are too young do not have enough penal tissue for the surgery and the surgeon must harvest intestinal lining to build the faux vagina. Even Bowers admits that can lead to “problematic surgical outcomes.”
She would know since she has performed more than 2,000 vaginoplasties. Her highest-profile patient is 17-year-old Jazz Jennings, the transgender star of reality TV show “I Am Jazz.”
Three corrective surgeries were required to fix problems from the original vaginoplasty.
“She had a very difficult surgical course,” Bowers admitted in a 2022 appearance on the show. “We knew it would be tough — it turned out tougher than any of us imagined.”
Still, Bowers told her colleagues in the internal discussion forum of the best age for an adolescent to undergo surgery: “sometime before the end of high school does make some sense in that they are under the watch of parents in the home they grew up in.”
Christine McGinn, a Pennsylvania plastic surgeon and herself transgender, agreed. McGinn has performed “about 20 vaginoplasties in patients under 18” and thinks the “ideal time in the U.S. is surgery the summer before the last year of high school. I have heard many other surgeons echo this.”
Waiting until teens are older than 18 and in college is problematic, she said: “there are too many stressors in college that limit patients’ ability to dilate.”
WPATH assures patients that surgical and hormonal interventions are tested and safe. It is a different matter in private.
President Bowers, for instance, said publicly in 2022 that puberty blockers are “completely reversible,” although in the internal forum she conceded it is “in its infancy.”
What about children who are infertile for life since they started hormone blockers before they reached puberty?
Bowers told her colleagues the “fertility question has no research.”
At other stages, members talk frankly about the complications for the transition surgery for girls, a phalloplasty in which a nonfunctioning pseudo-penis is fashioned from either forearm or thigh tissue.
It requires a full hysterectomy and surgical removal of the vagina. They also discuss other serious consequences, including pelvic inflammatory disease, vaginal atrophy, abnormal pap tests and incontinence.
A 16-year-old girl who had been on puberty blockers for several years before she was put on testosterone for a year had developed two liver tumors that an oncologist concluded the hormones had caused. Another member described “a young patient on testosterone for 3 years” who had developed “vaginal/pelvic pain/spotting . . . [and] atrophy with the persistent yellow discharge.”
Several colleagues described patients with similar conditions, some with debilitating bowel problems or bleeding and excruciating pain during sex (“feeling like broken glass”).
Vaginal estrogen creams and moisturizers as well as hyaluronic acid suppositories “can be helpful.”
One WPATH member seemed surprised: “The transgender people under my surveillance do not complain about this matter. However, I confess that I have never asked them about it.”
The litany of transition surgery’s side effects did not stop WPATH from endorsing far more radical “nullification” surgeries for patients who do not feel either male or female and identify only as nonbinary.
Several dozen so-called “de-gendering” surgeries are designed to create a sexless, smooth cosmetic appearance that is unknown in nature. There is even an experimental “bi-genital” surgery that attempts to construct a second set of genitals.
In 2017, when tabloids reported a 22-year-old man had spent $50,000 to surgically remove his sex organs so he could “transform into a genderless extra-terrestrial,” it seemed a one-off oddity.
But WPATH has enshrined that concept in its Standard of Care — the same document in which the group endorsed for the time first time chemical or surgical castration for patients who identify as eunuchs. (WPATH even linked to the Eunuch Archives, where men anonymously share castration fetishes.)
These science-fiction-like surgeries are not only reserved for adults.
“How do we come up with appropriate standards for non-binary patients?” asked Thomas Satterwhite, a San Francisco-based plastic surgeon who has operated on dozens of patients younger than 18 since 2014. “I’ve found more and more patients recently requesting ‘non-standard’ procedures.”
What are nonstandard procedures? They include “non-binary top surgery,” a mastectomy without nipples. There are brutal procedures for girls that eliminate all or part of the vagina and for boys that amputate the penis, scrotum and testicles.
The goal, as one San Francisco surgical clinic proclaims on its website, “is a smooth, neutral body that is cosmetically free of sexual identification.” On TikTok the trend is called a “flat front.”
A particularly intense subject of discussion was whether minors could understand the lifelong consequences of their gender treatments. Minors are presumed by law to be incapable of making an informed decision about having a vasectomy or tubal ligation.
Gender surgeries are an exception, however.
WPATH’s Standard of Care allows all procedures so long as the minor “demonstrates the emotional and cognitive maturity required to provide informed consent/assent for the treatment.”
In a May 2022 internal workshop, “Identity Evolution,” WPATH members conceded that was all but impossible.
Daniel Metzger, the British Columbia endocrinologist who cowrote the Canadian Pediatric Society’s position paper on health care for trans minors, said, “I think the thing you have to remember about kids is that we’re often explaining these sorts of things to people who haven’t even had biology in high school yet.”
Metzger noted adolescents are incapable of appreciating the lifelong consequence of infertility. “It’s always a good theory that you talk about fertility preservation with a 14-year-old,” he said, “but I know I’m talking to a blank wall. They’d be like, ‘ew, kids, babies, gross.’ Or, the usual answer is, ‘I’m just going to adopt.’ And then you ask them, ‘Well, what does that involve? Like, how much does it cost?’ ‘Oh, I thought you just like went to the orphanage, and they gave you a baby.’ . . . I think now that I follow a lot of kids into their mid-twenties, I’m always like, ‘Oh, the dog isn’t doing it for you, right?’”
There is extensive research showing adolescent brains are wired to have little control over rash behavior and are not capable of grasping the magnitude of decisions with lifelong consequences. It is why society doesn’t allow teens to get tattoos or buy guns. Car-rental agencies set 25 as the minimum age for renting a car, and Sweden sets the same limit for deciding on sterilization.
Although many WPATH members privately doubt that adolescents can give truly informed consent to life-altering procedures, they must affirm whatever children say about their gender.
Unless, the WPATH files disclose, the patient wants to reverse course and become a so-called detransitioner.
WPATH members mostly dismiss those cases as insignificant or overblown by the media and question whether minors who want to revert to their birth sex really understand what they are doing.
It’s a question that would never be asked for minors who declared themselves to be gender dysphoric.
One case involved a 17-year-old boy, just graduated from high school, who had been on testosterone for two years. He was reported to be “very distraught and angry. He reports he feels he was brainwashed and is upset by the permanent changes to his body.”
A self-described “queer therapist” did not believe any young person could be brainwashed. “In my experience, those stories come from people who have an active agenda against the rights of trans people.”
WPATH President Bowers said that “I do see talk of the phenomenon [detransitioners] as distracting from the many challenges we face.”
The leaked files put a spotlight on the danger of mixing ideological activism with medicine and science. They should serve as an urgent wakeup call for the medical associations and government agencies that rely on WPATH guidance for transgender health.
The files might even prompt investigations into how those with distorted personal agendas seized control of the organization at the expense of science and patients.
Investigating what has gone wrong at WPATH might prove uncomfortable for some gender progressives in the Biden administration, none more so than Adm.
Rachel Levine, the assistant secretary for health. Levine, the first transgender four-star military officer, is a WPATH member and has lavished praise on the organization.
She says it “assesses the full state of the science and provides substantive, rigorously analyzed, peer-reviewed recommendations to the medical community on how best to care for patients who are transgender or gender non-binary. It is free of any agenda other than to ensure that medical decisions are informed by science.”
Either Levine is unaware of the hormonal and surgical experimentation the group promotes or refuses to acknowledge it.
“The Frankenstein files.”
That is how a pediatrician described the leaked documents after I shared them with her.
Unfortunately, this is no horror novel.
It is a medical travesty playing out in real time, and the casualties are our children.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.justthefacts.media
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Who Put the Kids in Charge?
5 feb· Just the Facts with Gerald Posner
This is another in my occasional series on the trans industry.
The United States has one of the world’s most progressive standards of gender affirming care for minors. It requires that professionals, including physicians, therapists, and teachers, must confirm the self-diagnosis of children and young teenagers who believe they are a different gender than their birth sex. The judgment of children cannot be challenged. How did we get here?
It starts with a couple of words that are tossed about without most people knowing what they mean: Gender Dysphoria.
The term is only ten years old.
It was introduced as a treatable psychological condition in 2013 in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Healthcare professionals worldwide rely on the DSM as the authoritative guide to diagnose mental disorders. A dozen leading psychiatrists and mental health professionals worked for a year on developing the gender dysphoria diagnosis.
How was gender dealt with before 2013?
The first DSM published in 1952 did not mention the word gender. It did not appear until the 1968 second edition. That listed mental distress associated with gender identity as a “sexual deviation” in adults. The condition did not apply to children or adolescents.
Twelve years later (1980), the DSM third edition introduced transsexualism as a psychological disorder. That was defined as “a desire to live and be accepted as a member of the opposite sex…and a wish to have surgery and hormonal treatment to make one's body as congruent as possible with the opposite sex.” Patients had to exhibit the desire to be the opposite sex for two years before psychiatrists could make a conclusive diagnosis.
A revised DSM in 1987 (DSM-III-R), changed the disorder’s name from transsexualism to gender identity disorder (GID). It expanded the disorder to include people who did not want hormones or surgery.
The fourth major DSM published in 1994 kept gender identity disorder but again expanded the eligibility criteria to patients who exhibited “discomfort” with their birth sex and demonstrated “clinically significant distress or impairment in social, occupational, or other areas of functioning.”
When the fifth edition replaced gender identity disorder with gender dysphoria in 2013, it liberalized the criteria to include patients who exhibited a “marked incongruence between one's experienced/expressed gender and one's assigned gender.” The previous requirement for at least two years of symptoms before a diagnosis could be confirmed was slashed to six months.
And most importantly, in 2013, the disorder was applied for the first time to minors.
To make a diagnosis that an adolescent (ages 10 to 19) had gender dysphoria, in addition to the feelings of “marked incongruence” over gender, there had to be at least two from a list of ten symptoms:
A strong desire to be treated as the opposite gender or a desire to get rid of one's own sex characteristics
A strong preference for wearing clothes typical of the opposite gender
A strong preference for cross-gender roles in make-believe play or fantasies
A strong preference for the toys, games, or activities stereotypically associated with the opposite gender
A strong preference for playmates of the opposite gender
A strong rejection of toys, games, and activities typical of one's assigned gender
A strong dislike of one's own sexual anatomy
A strong desire for the primary and/or secondary sex characteristics of the opposite gender
A strong belief that one will grow up to have the primary and/or secondary sex characteristics of the opposite gender.
A strong desire to participate in the stereotypical games and pastimes of the opposite gender
As for children younger than 10, the DSM said they had to exhibit six of those symptoms.
While gender dysphoria was a frequently changing diagnosis in the psychiatric world, most professionals agreed that even in the instances in which it might be a correct diagnosis, it was a very rare occurrence. As little as .001 percent of the population had gender dysphoria that was accompanied with a desire for hormonal and surgical treatments.
The missing standard of care for adolescents and children
The 2013 DSM’s introduction of gender dysphoria — and its extension to adolescents and children — created a new world in medicine and psychiatry.
What should the standard of care be for the small number of cases in which doctors, therapists, or other professionals confirmed a diagnosis of gender dysphoria in children or young teens?
There were no guidelines for minors in 2013
A German-born endocrinologist who practiced in New York City, Dr. Harry Benjamin, had developed a protocol for cross-sex hormone therapy and for surgery for transgender adults who felt trapped in the wrong biological body. Benjamin is often called the father of modern transgender medicine [in a future article, I will write about the four endocrinologists and psychiatrists I call the Gods of Gender; Benjamin, John Money, Robert Stoller and Richard Green].
Benjamin was a strong advocate not just for international medical standards but also for gender affirming care for adults (also called “gender confirmation care”). He thought that in most instances, medical professionals should confirm the diagnosis as quickly as they could responsibly do so and then proceed to hormones and surgery.
Benjamin founded a medical association in 1979 to promote the treatment of gender dysphoria (it was called the Harry Benjamin International Gender Dysphoria Association (HBIGDA), renamed later the World Professional Association for Transgender Health (WPATH))
However, Benjamin had not addressed the issue of affirming care for minors in his professional writings. He did not treat minors in his clinical practice. Benjamin died in 1986, 27 years before the DSM introduced gender dysphoria and applied it to children and teens.
Still, many gender advocates contended that the same standards — gender affirming care for adults — should be applied to minors.
The organization Benjamin founded is today at the progressive forefront of interpreting gender affirming care and is essentially an advocacy group operating under the veneer of a medical guidelines association. Dozens of medical groups rely on the WPATH gender-affirming care guidelines, which have been updated eight times over twenty years. WPATH wields outsized influence on trans policies for adults and minors on the WHO, the American Pediatric Association, and the American Association of Clinical Endocrinology. LGBT advocacy groups rely on WPATH’s pronouncements on trans policies to lobby policy makers and the public that the science is settled.
That is false.
The science is anything but settled.
There has never been a double-blind clinical trial, medicine’s gold standard, for determining the short-term safety and long-term consequences of puberty blockers or cross-sex hormones for minors. There are no large-scale studies tracking patients who were given puberty blockers, or cross-sex hormones, or surgical interventions as children to determine if they were satisfied or unhappy with their gender decision.
The Dutch Model and the Introduction of Puberty Blockers
Although gender dysphoria was not a recognized condition that might apply to minors until 2013, the Netherlands had pioneered the concept of hormone blockers to what it called “juvenile transsexuals” in 1998 (many doctors still call it the Dutch Model.) It was developed by three Dutch clinicians based on observations of a handful of patients (only 7 children under the age of 16 had been put on puberty blockers by 2000). The researchers subjectively concluded hormone blockers reduced gender dysphoria agitation (they omitted that one teen died after puberty suppression and a vaginoplasty). Without any clinical research to support their conclusions, the trio claimed that puberty blockers were “completely reversible….in other words, no lasting undesired effects are to be expected.”
A later British study designed to confirm the Dutch results was withheld for years from publication because it did not show psychological improvement and enhanced mental health for the minors. American studies that have attempted to reinforce the Dutch Model have been of poor quality and produced mixed and poor results.
The Drug Industry Money behind the Dutch Model
Two of the original Dutch researchers in 2006 published a paper in the European Journal of Endocrinology. They concluded that puberty blocker “treatment appears to be an important contribution to the clinical management of gender identity disorder in transsexual adolescents.”
Largely ignored in a footnote in their acknowledgments was: “The authors are very grateful to Ferring Pharmaceuticals for the financial support of studies on the treatment of adolescents with gender identity disorders.” The study’s authors had presented their paper in Paris at the 2006 Ferring Pharmaceuticals International Pediatric Endocrinology Symposium.
Why did Ferring pay for the study? It had a patent on Triptorelin, one of the most expensive puberty blockers, used under the brand names Gonapeptyl and Diphereline. The study recommended puberty blockers for gender dysphoric children identified “by the first growth of pubic hair and for girls by budding breasts and for boys by growing testicles—as long as they had reached the age of 12…” The study recommended that cross-sex hormones not be dispensed before the age of 16.
Two of the Dutch researchers were leading advocates for expanded transgender treatment and served as directors of the Harry Benjamin International Gender Dysphoria Association (HBIGDA). When HBIGDA adopted puberty suppression as a recommended standard of care for minors in 2006, it copied it from the Dutch protocol, with the exception that it did not specify a minimum age.
Puberty blockers were prescribed to 111 minors between 2000 and 2008 (70 of them were the subjects of a much-challenged study published by the Dutch researchers, again confirming their own hypothesis.
Not very many clinicians adhered to the liberal Dutch rules. Some children were given endocrinological exams as young as ten. Cross-sex hormones were dispensed to children as young as thirteen.
America’s Permissive Gender Guidelines for Children
The Gender Management Service at Boston Children’s Hospital, founded in 2007, was the first dedicated clinic for transgender minors in America. Its co-founder, Norman Spack, was an endocrinologist who once said he was “salivating” at the possibility of treating his minor patients with puberty blockers. The Boston clinic followed the Dutch protocol, although it did not set a minimum age under which it would not prescribe the drugs. One of the Boston psychologists was dispatched to Amsterdam to be trained by the Dutch lead author.
When the Endocrine Society leadership decided it was necessary to address the first clinical guidelines for “transsexual persons,” it tapped the two primary Dutch authors and Boston’s Spack to lead the committee. It is not surprising that their recommendation was an endorsement of puberty blockers for gender dysphoric children. This formal endorsement by a leading medical society moved the medicalization of children forward.
Within a year of the DSM listing gender dysphoria as a treatable diagnosis for adolescents, the number of clinics specializing in “gender-nonconforming children and adolescents” had skyrocketed from the single Boston clinic to 32 (as of 2023, there are 60 clinics dedicated solely to gender affirming care for minors, and about 350 more that are clinics or medical offices that offer hormonal interventions for children and adolescents).
The U.S. clinics have adopted the most permissive interpretations of the Dutch protocol, everything from the starting ages to the duration of treatment. An international advocacy organization, the Gender Identity Research and Education Society, told parents who lived in Europe that if they wanted their gender dysphoric children to receive puberty blockers, that they should “consider taking their children to the USA.”
American gender clinics have expanded the boundaries of gender affirming care for minors. Children as young as 3 have been treated at Yale’s Pediatric Gender Program. U.S. clinics sharply downplay the role of psychotherapy that had been suggested by the Dutch as a parallel standard of treatment. The Dutch clinicians had also tried reducing the number of false positives, those children whose desire to change their birth sex was a “transient phase” that would pass before they reached 18. To avoid putting those children for whom gender dysphoria was a fleeting stage of adolescence, the Dutch discouraged early social transitioning of minors (such as using the child’s new pronouns and names). However, American clinics, and many U.S. school districts have instead made social transitioning the accepted standard.
The American approach is to put children on hormone blockers at ever younger ages, preferably before they start puberty. That is the only guarantee, contend advocates, for a less complicated series of surgeries for those who ultimately decide to cosmetically transition. It turns out that putting children on puberty blockers assures they will at least move on to cross-sex hormones. Ninety-five percent of minors on puberty blockers go on to further cross-sex hormones or surgeries. However, a study shows that upwards of 90% not taking puberty blockers change their minds and remain with their birth sex. A Canadian study by a psychologist running a gender dysphoria clinic, meanwhile, showed that without pharmacological or surgical treatment, approximately 80% of trans patients went on to identify as having a same-sex attraction.
The liberal U.S. approach has had a stunning effect on the number of minors put on hormones. A review of data at 43 major children’s hospitals shows that puberty blockers were never dispensed to minors from 2004 to 2009; from 2010 to 2016, 92 children were put on them. A larger study of all insurance claims filed for patients aged 6 to 17 in the U.S from 2017 and through 2021, reveals that almost 5,000 were put on puberty blockers, and another 15,000 skipped puberty blockers and went directly to cross-sex hormones.
Even one of the original Dutch clinicians who helped develop the protocol for giving puberty blockers to children, Dr. Thomas Steensma, expressed his concern in 2021 that the “rest of the world is blindly adopting our research….We just don’t know. Little research has yet been done on the treatment with puberty inhibitors and hormones in young people. That is why it also seen as experimental.”
What is Gender Affirming Care for Minors?
Gender affirmation is the standard of care adopted in 2018 by the American Academy of Pediatrics, the world’s largest association of doctors who treat children and adolescents. The American Psychological Association has similarly embraced “culturally competent, affirmative care for transgender and gender nonconforming people, including adolescents.” The Human Rights Campaign, one of America’s most influential LGBTQ+ lobbying groups, with 3,000,000 members, declares that gender affirming care is a medical necessity when it comes to gender dysphoria.
Gender affirming care covers a broad range of treatment options but always involves a confirmation of gender dysphoria by doctors, psychiatrists, and other medical and mental health professionals.
A pediatrician who prefers to stay anonymous shared with me guidelines he received from the large urban hospital with which he is affiliated: “Gender identity is a deeply personal and subjective experience, and individuals should be respected and believed whenever they reveal their gender identity. Therefore, it is generally considered best practice for healthcare professionals to validate and affirm the gender identity of their patients who are seeking gender affirming care. Your role is not to invalidate or question a patient's gender identity but instead to provide compassionate and respectful care that addresses the patient's individual goals. While a formal diagnosis of gender dysphoria is helpful for the patient’s access to full medical services, it should not be a prerequisite for patients who wish to obtain gender affirming care. The decision to seek gender affirming care should therefore be made by the individual based on their own life experience and needs.”
A particular problem with gender affirming care is that it is at odds with therapeutic exploration. It requires that therapists only confirm a minor’s self-diagnosis of transgender and facilitate their access to hormones and surgeries. The professionals cannot question whether the gender dysphoria is a “transient phase” or possibly the result of an underlying mental disorder. To do so would be to question the self-diagnosis, and that is forbidden. In lay talk, that means that professional discretion is eliminated.
This is one issue when it concerns adults, but quite another when children and teens are involved.
When minors self-diagnose with gender dysphoria, however, there is a unique preliminary medical intervention: the dispensing of hormones that block puberty. The idea is that if the birth sex hormones of a prepubescent child are blocked before a child later begins cross-sex hormones, any full transition to the opposite sex will supposedly be easier (no long-term studies have been done, it is a theory that has been put into standard practice).
Administering puberty blocking hormones is problematic because the process has evolved in America so that in many cases, children are making decisions about starting a process with lifelong consequences.
Who Put the Kids in Charge?
All this might be written off as another contagion from social media that affects teens at their most vulnerable time of lack of self-confidence and in a state of brain development where they have little control over impulsive behavior or are not fully appreciating the magnitude of decisions that have life-long consequences.
In interviews with several psychologists who have studied the field, I learned that adolescents cannot fathom risk. They cannot digest long-term consequences; they can only appreciate the gratification from something immediate. Children, especially adolescents, are susceptible to the pressure and influence of their peers, and the outside world has a huge, overdetermined impact on their development.
Social media and internet chatrooms that target children and teens who think they might have gender dysphoria have created a confusion matrix. With more than 100 genders available from which to choose, adolescents and children seem particularly susceptible to the contagion of believing they might be trapped in the wrong body. Experts who visit schools and study trends among minors have observed startling increases, especially among teen girls. Ten years ago, one percent might have talked about gender, now, in some schools upwards of 20 percent of teen girls identify as being the opposite gender.
The social media influence creates a false sense that the child has made a reasoned decision.
“If you're Johnny and you want to be Julie,” a Miami Beach-based psychologist told me, “and parents say, ‘Oh, okay,’ the child gets a charge from that response. Forget the content for a moment. The charge of that response is what kids will react to; hang on to it, it becomes an artificial structure. It's no different than being fed all the increasingly lurid and damaging YouTube or TikTok videos. Children are hypersensitive to external stimuli, and it pulls kids out of themselves, and then they're doing it just to again get the attention that their parents gave them when they said, ‘I want to be Julie.’ Many parents and professionals go along because it is, like a cult phenomenon. They are being bombarded with a particular type of narrative over and over and over again.”
These are the reasons society does not allow teens to get tattoos or buy guns. That is why car rental agencies make twenty-five the minimum age for renting a car; Sweden has twenty-five as the minimum age to decide on sterilization. The brain doesn’t stop its pruning and settle into something that has a degree of reliability before then.
Gender dysphoria is the only area of mental health in which patients are allowed to diagnose themselves, and physicians and psychologists are barred from making any independent medical judgment.
Those who present themselves to doctors or psychiatrists and announce they have depression, anxiety, or schizophrenia are never accepted at their word. But that is precisely what happens under gender affirming care for children and teens.
Failing to fully “affirm” in some countries will land a doctor in professional disciplinary proceedings. In some instances, doctors who refuse to go along with a process they believe is not in the best interests of the children because it is contradicted by science have been dismissed from their jobs and professionally ostracized as transphobic.
Doctors, psychiatrists, and psychologists are not the only ones who can get into trouble if they do not affirm the gender dysphoria presented by a minor. Parents who say no to their children are at risk in some places, such as Sweden, of losing their children to state control. Sweden’s Board of Health and Welfare can place a child into state custody if any third party reports the parents for refusing to approve puberty blocker treatment. Until recently, Karolinska Hospital, Sweden’s medical clinic for treating those aged 17 and younger who self-diagnose with gender dysphoria, had an online, pre-printed template for a report to be filed against resistant parents. A hospital official told reporters that “We refuse to see any children without their guardian’s approval.” That guardian can be the government.
The state of Washington has not let Sweden get too far ahead of the progressive gender trend. Parents who do not affirm and provide treatment for their child's gender choice will be legally at risk of losing custody due to “neglect.”
Oregon bypasses parents. A 2015 law permits 15-year-olds to get puberty blockers or start gender reassignment surgery without parental consent. Fifteen is the same age in Oregon where teens do not need parental consent to get birth control, have a pregnancy test, and get an abortion. Oregon does, however, ban teens until they are 18 from buying cigarettes and marijuana, voting, getting a tattoo, or using a tanning bed.
“It is the greatest medical scandal since lobotomies”
The United States has moved far beyond the Dutch standard of care, in which no surgeries were offered to patients younger than age 18. In contrast, an NIH-funded study reveals that minors as young as 13 can get mastectomies in the U.S. There are instances in which children as young as 12 have started crowdfunding to raise money for surgery. A recent US-based study shows that the average age for mastectomy in minors — dubbed “masculinizing chest surgery” — is 16, with a range of 14-18. A recent Vanderbilt University study found that the number of radical mastectomies performed on teen girls had surged fivefold in recent years.
At Vanderbilt itself, double mastectomies were performed on girls from 16 to 17 years of age. The clinic also provided cross-sex hormones, which can lead in some instances to lifelong sterilization, to kids as young as 13.
California’s Kaiser Permanente Oakland recorded 70 “top surgeries” in 2019 on teenagers between the ages of 13 and 18. Before that, it had only performed five in total since 2013, according to a study.
Until a recent Florida law banned it, Dr. Sidhbh Gallagher, a Miami-based plastic surgeon, performed 40 “top surgeries” per month, including on minors, according to The New York Times. Most patients, she told the Times, were 15 or older, but she admitted she had done the procedure on children aged 13 and 14. Since the Florida law came into effect, she has moved on to so-called bottom surgeries, such as vaginoplasties and phalloplasties.
“It is the greatest medical scandal since lobotomies,” a British physician told me.
It is worth noting that in the last couple of years, the U.K., Finland, and Sweden have all stopped or radically cut back on medical transition of minors. Their retrenchment is the result of a spate of recent studies that have concluded that while the medical interventions have little demonstrable benefit, the potential for lasting harm is not fully known.
When will United States medical associations responsible for treating children follow the lead of progressive European nations and stop embracing the cult of transgender ideology? How many more thousands of children will suffer from getting hooked on the trans contagion will depend on that answer.

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Weapons in the Wrong Hands. US Arms to Ukraine Diverted to Criminal Gangs?
12 jan· Just the Facts with Gerald Posner
An alarming report released Wednesday by the Defense Department Inspector General reveals that the U.S. has lost track of nearly all of the 40,000 sophisticated weapons sent to Ukraine’s front lines since February 2022.
The redacted report underscores that the advanced technology and compact size of these untracked weapons — including more than $1 billion in kamikaze and switchblade drones, Javelin anti-tank missiles, Stinger shoulder-fired missiles, and night vision goggles — make them particularly appealing for arms smugglers and black market dealers.
Approximately 60 percent of the weapons were “delinquent,” meaning they were neither initially logged into a tracking database, nor added after shipment from American stockpiles.
Over a year ago, the Biden administration tried fixing this problem by providing Ukrainian troops with handheld bar code scanners to instantly upload weapon serial numbers into U.S. databases. However, this effort has had a minimal impact. Only ten scanners were sent to Ukraine and none reached the front lines, where the weapons are deployed.
The Inspector General said that determining whether any weapons were illegally diverted “was beyond the scope of our evaluation.”
The issue is a significant behind-the-scenes concern for American officials, particularly given Ukraine’s history of arms smuggling.
A senior Interpol official, on the condition of anonymity, told Just the Facts that the international crime fighting organization believes that “some undetermined number of U.S. weaponry intended for Ukraine has gotten to criminals.” Albanian crime syndicates are at the top of Interpol’s suspect list.
Interpol has no public comment. It will not even acknowledge that it is officially investigating the diversion of the U.S. arms. However, last June, Interpol chief Jürgen Stock warned publicly that “Once the guns fall silent [in Ukraine], the illegal weapons will come. We know this from many other theaters of conflict. The criminals are even now, as we speak, focusing on them. Criminal groups try to exploit these chaotic situations and the availability of weapons, even those used by the military and including heavy weapons. These will be available on the criminal market and will create a challenge. No country or region can deal with it in isolation because these groups operate at a global level.”
The Interpol official who spoke to Just the Facts said that Stock’s concerns had materialized earlier than thought likely.
“We anticipated that the conflict would end before we confronted weapons of war finding their way to the illicit market. The sheer volume of weapons, coupled with the difficulty in tracking them, has presented a challenge for law enforcement problem sooner than we had expected.”
The report, and news of Interpol’s apprehension about some American weapons entering the black market, comes at a bad time for the Biden administration. It is likely to fuel increasing Republican congressional opposition to further aid to Ukraine.

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A Brief End of Year Thanks from Just the Facts
29 dec 2023· Just the Facts with Gerald Posner
Thank you to the 5000 loyal subscribers to Just the Facts.
This Substack is somewhat unorthodox. It does not adhere to the typical model of focusing on a single subject. Some of you discovered my work from articles about OxyContin or Fentanyl, only to find the next piece discussing the dangers of puberty blockers for minors or the risks posed to free expression by increasing censorship. Just when you think you spot a theme, I am sure to deliver something unexpected; how Sweden became a gangland paradise, the latest news from those still-sealed JFK assassination files, or the emergence of an October 7 denial movement. Just the Facts tries to break some news while also delivering a view of a topic that is fresh from the mainstream media coverage.
The nature of investigative journalism means Just the Facts has no set publication schedule. It depends on when I finish my reporting on a story. Sometimes a promising lead takes much longer than expected or ends up in a dead end. And many times, I am pulled away from Substack — which I keep free of charge — to fulfill commitments for books, articles, and documentaries.
Currently, there are several Just the Facts projects in progress. A couple have the potential for groundbreaking revelations. Additionally, next year, I plan to feature occasional articles by guest investigate reporters.
Remember, some of the stories I am chasing come from your tips. I encourage whistleblowers to contact me through my Swiss-based, encrypted email, [email protected], or via Signal at 917-300-9834. Response times may vary due to deadline pressures, but rest assured, I will get back to you.
For those wanting to send general feedback, or suggest a future topic, please write to me via Substack or at [email protected].
Outside of Just the Facts, you can follow my daily updates on X (formerly known as Twitter). Finally, my wife and reporting collaborator, Trisha — the author of the international bestselling The Pharmacist of Auschwitz, and the founder of the non-profit Antisemitism Watch — also shares her daily insights on X. Trisha has a much less frequently updated Substack, No More Nice Jewish Girl.
Thanks once again for your steady support and encouragement.
Wishing everyone a good New Year and start to 2024.
Gerald Posner

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Don’t Let The Sacklers Get Away With It
3 dec 2023· Just the Facts with Gerald Posner
The Supreme Court will hear oral arguments tomorrow morning about whether it should invalidate Purdue Pharma’s approved bankruptcy plan, the largest and most consequential in legal history. The elaborate $10 billion bankruptcy was approved in 2021 but is on hold at the request of the U.S. Trustee, the Department of Justice division that oversees bankruptcy cases.
The question the Supreme Court must decide is whether the Sackler family, owners of the company that sold $35 billion of its narcotic painkiller, OxyContin, should be granted full immunity from all civil litigation because they contributed several billion dollars to the settlement.
The Sacklers are one of America’s richest families. As directors of the privately owned Purdue, they carefully orchestrated and oversaw the aggressive marketing campaign that made OxyContin into a lethal blockbuster. No Sackler has ever gone bankrupt. So why did the bankruptcy judge, Robert Drain, give them a free pass from all litigation, something meant to be available only to those who have filed for bankruptcy? The Sacklers’ blue-chip law firms successfully argued that bankruptcy courts have expansive powers for creative outcomes (Judge Drain retired from the bench shortly after approving the Sackler deal in Purdue Pharma and went to work for Skadden Arps, a firm that was Purdue’s “special counsel” before and during the bankruptcy).
Purdue’s lawyers cited the precedent of a 1985 case in which A.H. Robins, the manufacturer of the Dalkon Shield contraceptive device, filed for bankruptcy. Plaintiffs had sued the Robins family owners, charging they had deceptively concealed evidence that the Dalkon Shield was dangerous. None of the Robins family had filed for bankruptcy. The court still discharged them from all liability.
Proponents of the Purdue settlement contend that the court had to impose a global resolution, as unfair as it might seem, or otherwise litigation would drag on for years. That does not persuade any of the families of the victims of OxyContin overdoses, a crisis that has taken over half a million lives. I have spoken with dozens of them in the lead up to the Supreme Court hearing. Several advocacy organizations, and individual victims, will hold a “Last Chance for Justice” rally in front of the court tomorrow morning. Others plan to line up overnight to get seats in the Court’s public gallery in order to hear the hour-long oral arguments.
The families whose lives have been upended by OxyContin believe that if the Supreme Court approves the Purdue bankruptcy, the Sacklers will benefit at the expense of all victims.
Upholding the legality of the Purdue bankruptcy plan will reinforce the common perception that individuals rich enough to take advantage of the legal system’s loopholes, can get away with the most appalling conduct. The Purdue bankruptcy will be the only major one in which no principal has faced criminal charges. Ed Bisch, a father whose son died from OxyContin twenty-two years ago, summed up the feeling of many others: “It was a bankruptcy scam from day one.”
At stake before the Supreme Court is much more than whether so-called “third party releases” are permissible under bankruptcy law. What is at stake is determining whether there will ever be an equitable accounting of responsibility for America’s prescription opioid epidemic. Justice requires at the very least that the Sackler family not be allowed to keep billions in OxyContin profits while walking away free from all legal liability.
The Supreme Court has a chance to do the right thing by the millions of Americans who have suffered a personal loss from the Sacklers’ addictive drug. There is still time for a measure of real justice for those responsible for creating the most deadly prescription drug crisis in American history.
A Note to Readers: I have written editorials about the Sackler/Purdue bankruptcy fiasco in the Los Angeles Times, and twice in The New York Times. Here are the links for those interested in more information.
“The Sacklers’ Last Poison Pill,” The New York Times, with Jonathan Lipson, December 5, 2020
“The Sacklers Could Get Away With It,” The New York Times, with Ralph Brubaker, July 22, 2020
“How to Hold Purdue Pharma Accountable for its Role in the Opioid Epidemic,” Los Angeles Times, May 17, 2020

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Let’s Annihilate Israel
2 nov 2023· Just the Facts with Gerald Posner
There has been a lot of talk from the Biden administration and European allies since October 7 about the need for a two state solution.
OK, let’s find out what the moderates in Gaza think about that.
Ghazi Hamad is widely considered a Hamas moderate. He was a Deputy Foreign Minister in the Hamas government, and the chairman of the Border Crossing Authority in Gaza. He holds a veterinary medical degree, speaks Hebrew and English in addition to his native Arabic, and was the editor of Al Watan, the Hamas newspaper. This week he gave an interview to Lebanese TV.
Here is a one minute clip.
Some of the highlights:
“Does that mean the annihilation of Israel?” “Yes, of course”
“We are the victims…therefore no one should blame us for what we do.”
“On October 7, October 10, October 1,000,000, everything we do is justified.”

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Why Didn't One Presidential Candidate Stop Purdue Pharma's OxyContin Express in 2002?
21 aug 2023· Just the Facts with Gerald Posner
The discussions at Wednesday’s Republican presidential debate in Milwaukee will largely be about the absent Donald Trump and subjects important to Republican primary voters. Opinion polls list one of the top issues as the lethal opioid crisis, especially that fentanyl is now the #1 killer of Americans and is pouring over the southern border.
The fentanyl epidemic, however, might not have existed if the groundwork had not been set with Purdue Pharma’s blockbuster opioid painkiller, OxyContin, and the lethal opioid crisis it triggered.
Asa Hutchinson is the only candidate who once had a chance early on to possibly stop the opioid crisis in its tracks. And he did not. I hope one of the FOX debate hosts, or his fellow contenders, will finally confront him about that missed opportunity.
I reported the background to this in my book, PHARMA. For those not familiar with it, in December 2001, Asa Hutchinson was the head of the DEA. The drug agency had just begun to focus on the problem of OxyContin being diverted to the black market. There were reports of rising abuse and overdose deaths.
The DEA’s point person was Laura Nagel, a 22-year veteran who was the second in charge of the Office of Diversion Control (the Edie character, played by Uzi Aduba, in Netflix’s Painkiller, is loosely based on Nagel).
Nagel was convinced that Purdue Pharma was not doing nearly enough to stop OxyContin reaching the black market. Purdue could not account for batches of pills made at a manufacturing plant in Totowa, New Jersey.
In April 2002, Nagel and some of her DEA team, met with Richard Sackler, as well as Purdue’s Chief Financial Officer, its general counsel, and the company’s medical director. Nagel presented evidence that abuse of OxyContin had spiraled since the drug had gone on sale in 1996.
At one stage, Nagel told Richard Sackler: “People are dying. Do you understand that?”
That meeting ended in a stalemate.
Later that month, Nagel again met with Purdue executives and this time was joined by Deborah Leiderman, the FDA’s director for controlled substances in the Center for Drug Evaluation and Research.
Nagel hoped the FDA would use its authority as the nation’s drug regulator to restrict how OxyContin was dispensed. The FDA had previously done that for barbiturates, amphetamines, and benzodiazepines; the diversion of each of those had led to widespread drug abuse. Leiderman had no interest in recommending that the FDA put any restrictions on OxyContin prescriptions.
As I report in PHARMA, “A retired DEA officer familiar with what transpired next told the author that Nagel and Gauvin [a DEA pharmacologist] were so incensed by Leiderman’s intervention on the side of Purdue that they discussed whether she might have sabotaged their investigation. They had no evidence of any wrongdoing and did not think she was in Purdue’s pocket. Instead, they wondered if it was Leiderman’s way of pushing back against the DEA for overreaching its authority by seeking prescription restrictions.”
A month later, the Sackler family hired “America’s mayor” to represent Purdue Pharma. Rudy Giuliani had opened Giuliani Partners, a consulting firm, only a few months earlier. He was riding high from his two terms as New York’s mayor. He had been widely praised for his calm leadership after the 9/11 terror attacks; Time had named him Man of the Year and Britain’s Queen Elizabeth had given him an honorary knighthood.
As a former United States attorney for the prestigious Southern District of New York, Giuliani offered high-level access and influence. He was friendly with many top-ranking Justice Department officials. As for Asa Hutchinson, the Drug Enforcement Administration director, the duo had known each other for twenty years.
Maybe, thought the Sacklers, Giuliani might find a way to put a check on an investigation opened recently by a West Virginia U.S. Attorney. And, Purdue told him, it wanted him to extinguish the brewing DEA firestorm in Washington.
Purdue Pharma was the ex-mayor’s first major client. (While the fee agreement remains a secret since both Purdue and Giuliani Partners refuse to disclose it, litigation documents produced later by Purdue reveal it was paying about $3 million a month to its team of high-powered attorneys). It could certainly afford it. OxyContin was bringing in $30 million a week, about 90 percent of Purdue’s profits.
When Laura Nagel heard the news about Giuliani’s retainer, she said, “My reaction was that they went around me. They went and got Rudy.… They thought they were buying access and insight into how to manage things politically.”
Giuliani assigned New York’s former police commissioner, Bernard Kerik, who had joined Giuliani Partners, to conduct a security appraisal of the New Jersey manufacturing plant where unaccounted-for Oxy had attracted Nagel’s attention.
Giuliani set an August meeting with the DEA.
“The mayor and I met with Asa Hutchinson, the director of the DEA; his staff; and people from Purdue [general counsel Udell],” Kerik told New York Magazine. Karen Tandy, the associate attorney general responsible for Drug Enforcement oversight, also attended.
“We don’t want Purdue put in a position where it winds up being taken over by the courts,” said Kerik. “Or they get put out of business. What I’d like to see come out of this is we set model security standards for the industry.”
A week before the first 9/11 anniversary, Giuliani joined Asa Hutchinson and Attorney General John Ashcroft at the opening of a DEA exhibit about terrorism and drug trafficking. Giuliani gave a short speech that raised $20,000 for the DEA’s Museum Foundation. When he finished, Hutchinson asked Laura Nagel to set a meeting with the ex-mayor.
A week later, Asa Hutchinson and Laura Nagel were in Giuliani’s twenty-fourth-floor office overlooking Times Square. A Purdue OxyContin team Giuliani had created ran through a thirty-minute PowerPoint designed “to keep OxyContin out of the wrong hands.” They emphasized that Oxy was “a good drug” and claimed they were doing all they could to spot abuse and diversion.
The DEA pair said little. “We were receivers of the information,” Hutchinson later said.
Nagel was anxious to return to headquarters. When she did, colleagues recall that she railed against that “dog and pony show.”
Laura Nagel had built a damning case against the cavalier way Purdue Pharma handled the manufacturing of a controlled substance. Over two years, she initiated several hundred OxyContin abuse and diversion cases connected to Purdue. Giuliani, however, had managed to make certain Purdue faced only civil charges. Purdue ultimately paid a $2 million civil penalty for its security lapses that allowed the drug to be diverted to the black market. By then, OxyContin sales were up twentyfold since its 1996 introduction; it was on its way to $2 billion that year in sales. Two million dollars was not an insignificant amount, but it was, as one Purdue executive boasted, “less than a day’s [OxyContin] revenue.”
Why didn’t Asa Hutchinson listen to Laura Nagel and use the DEA’s full enforcement power against Purdue and Oxy? It is a question never satisfactorily answered by Hutchinson or Giuliani. Maybe Wednesday, somebody can finally put Hutchinson on the spot and get an answer in front of millions of viewers on live television. It’s about time.

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A Quick Thanks
2 aug 2023· Just the Facts with Gerald Posner
Just the Facts reached 3,000 subscribers today. I am grateful to all of you. Some have been with me since the start and others subscribed only today. The growth has been slow and steady.
One of the first bits of advice another writer offered when I set up my Substack was to stick to a single topic.
“Carve out a niche on one subject and you will get a following fast,” he assured me.
Those of you who have stuck around for a while know I never did that.
On Just the Facts you get something about the gender wars one week, then opioids, maybe a condemnation of censorship before moving on next to the JFK assassination, or Nazi loot, possibly Big Pharma, maybe The Four Tops, or antisemitism, questions about Princess Di’s death, Afghan officials’ corruption, FBI mistakes in the Oklahoma City bombing or the Anthrax investigation, even how Sweden became a gangland paradise.
From the messages I get from readers, I know some of you subscribed hoping I’d always write about only one of those topics. I am thankful you stayed the course. And, sometimes, my favorite notes are those that say, “I never thought I’d be interested in that, but you hooked me.”
Just the Facts will remain an eclectic mix of news and reports from the frontlines of the culture wars.
And it will remain free. Paid Substack subscriptions is not how Trisha Posner and I pay our bills. We do that through books, articles for traditional media, and documentaries (I do not have an air date yet for the R. J. Cutler-produced 6-hour documentary made from my last book, Pharma, but when I do, I will blast it out).
I also want to thank some of the other great Substacks — among others, , , , — that have generated subscribers by recommending me. Substack is a community of writers. Supporting one another seems an indispensable element toward growing readers for all of us.
Share Just the Facts with your friends. I’ll let you know when it reaches another subscriber milestone. And in the meantime, thanks again for sticking around and spreading the word about this writing habit of mine.

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Sensitivity Language Police Strike Again
28 mrt 2023· Just the Facts with Gerald Posner
There was an outcry recently over hundreds of changes made to Roald Dahl’s books and Ian Fleming’s James Bond novels, all intended to make them “inclusive and accessible” through today’s progressive lens on issues such as gender, race, misogyny, weight, mental health, and violence. Author Salmon Rushdie condemned the publishers then for their “absurd censorship.” In a Substack I wrote last month about the Dahl alterations, “’Ugly’ and ‘Fat’ No Longer,” I concluded, “Words matter. The problem is that the Dahl sensitivity censorship sets a template for other hugely successful author franchises. Readers should know that the words they read are no longer the words the author wrote.”
The template of woke censorship has now been used by Harper Collins, one of the “Big Five” English-language publishers, to make wholesale changes in Agatha Christie’s classic detective novels. The publisher hired “sensitivity readers” to highlight what they considered offensive in the 12 novels and 20 short stories in the Miss Marple series and some of the 33 Hercule Poirot novels. The result is hundreds of alterations, often just changing a few words, but all too frequently the deletion of entire paragraphs.
These are not the first changes to Christie’s works. Use of the N-word was removed years ago from earlier editions. Her hit novel, The Little Indians, which was also a successful play on Broadway with that name, was changed in 1977 to And Then There Were None. “Little Indians” was judged to be a “racist term.”
The new changes, however, are a much broader effort to recast Christie’s writings so they satisfy modern sensitives. That results in characters mostly stripped of any racial or religious identity. A “black servant” is no longer black. A “gypsy type” woman is now just “a young woman.” A judge loses the “Indian” in a scene about his temper, Poirot no longer says that another character is “a Jew, of course.” Natives are replaced everywhere by locals. Most references to Nubians — an ethnic group indigenous to northern Sudan and southern Egypt — are deleted from the 1937 Death on the Nile. “Nubian boatman,” for instance, is now just “the boatman.”
All references to Oriental are gone (Harper Collins is reportedly even considering changing the title of one of Christie’s best-known novels, Murder on the Orient Express, to the one used in 1934 on the U.S. edition, Murder in the Calais Coach).
Sensitivity readers evidently are triggered by inexplicable passages. The publisher does not explain why it made any of the changes. In the 1964 novel, A Caribbean Mystery, a character does not see a black woman in the bushes as he returns to his hotel room. That passage is deleted in the cleansed edition. In the same book, Christie describes a character with “a torso of black marble such as a sculptor would have enjoyed.” That is also removed. At another point in the original, Miss Marple admires a West Indian hotel worker’s “lovely white teeth.” That is gone too. Even other references to “beautiful teeth” are deleted. What could be the preposterous reason to scrub references to “beautiful teeth?” Does it trigger readers with poor dental hygiene?
Insulting language is no longer allowed. In Death on the Nile, when a group of children annoy and harass a character, she muses, “they come back and stare, and stare, and their eyes are simply disgusting, and so are their noses, and I don’t believe I really like children.” In the cleansed edition it is simply, “They come back and stare, and stare. And I don’t believe I really like children.”
Harper Collins does not deserve all the blame. As with the previous cases of Roald Dahl’s books and Ian Flemings Bond series, descendants of the authors own the rights. They must sign off on the wholesale changes that supposedly make the books “more inclusive and accessible for modern readers.”
Shame on both the publishers and the family rights holders.
Good literature should not be judged through a modern-day prism that goes out of its way to correct for perceived slights. By reading the uncensored originals, readers can react to books as written. The most talented authors provide an essential lens into the era about which they write. In censoring and changing those books, publishers are invariably diluting the power of great storytelling.
Christie is only the latest author, but she will certainly not be the last, to have her books scrubbed of all language that might potentially offend today’s readers.
Dahl. Fleming. Christie. Who’s next?
Personally, I can’t wait for the public ruckus after sensitivity readers comb through the Old Testament.

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How the Word Police affect the news you get
18 mrt 2023· Just the Facts with Gerald Posner
The World Obesity Federation issued a grim 232-page report earlier this month that predicted more than half the world’s population will be obese by 2035. Childhood obesity will more than double. Scorecards on 187 countries ranked each by their ability to address the epidemic. An independent advisory committee estimated the economic impact to the global economy will be $4.32 trillion in lost productivity and additional health care costs for diabetes, blood pressure, heart disease and other obesity-related byproducts. That is about 3% of global GDP, the same impact as COVID-19 produced through worldwide lockdowns in 2020.
And the $4 trillion figure might be low. Some researchers not involved in preparing the report believe it will be substantially higher since the forecast did not take into account inevitable costs from long term disability caused by obesity.
The London-based World Obesity Federation is no rightwing organization attempting to stigmatize people with high body mass indexes (over 25 is overweight, more than 35 classifies as obese). It is a prestigious nonprofit whose work is supported by the World Health Organization and the United Nations Population Division. The British Medical Journal publishes an extended version of its conclusions.
The World Obesity Federation’s credentials, however, do not impress some progressive public health advocates who believe that such reports only add to “weight stigma and fatphobia in public health.” The woke resistance has been building for years.
A physician writing in Harvard Medical School’s Health Blog warned “weight bias is pervasive in medicine.” Terms such as “obese person” or “morbid” are “stigmatizing.” The U.K’s national health service has urged doctors for a decade to stop using “obese” and “overweight",” and instead try to find “weight-neutral language.” The AMA’s Journal of Ethics blames doctors who “exhibit weight bias” for “helping to perpetuate our nation’s obesity crisis.”
The word obesity should be banned in healthcare, concluded a licensed dietician writing last year for the University of Illinois at Chicago’s School of Public Health.
Buzzfeed’s copyediting desk joined the fray. The word obesity “is best avoided,” it declared. Why? It is based on BMI, a measurement that “simply looks at height and weight and is based on a Belgian scientist’s idea of ‘the average man’ 200 years ago. It’s racist and served as a steppingstone to the creation of eugenics.”
“The focus on body size is rooted in racism,” concurred the University of Chicago’s School of Public Health.
“Around 81 percent of societies historically have favored people in larger bodies. Larger bodies signified wealth and prosperity while thinness signified poverty and weakness. However, this began to change due to racism and eugenics. Charles Darwin and other race scientists created a hierarchy of civilization, placing whitemen on top and people of color, specifically black people, at the bottom, considering them to be ‘less civilized.’ Fatness and differing body characteristics were used to justify lack of civilization: fatness used as a marker of ‘uncivilized behavior’ while thinness was ‘more evolved.’ This idea was maintained throughout the United States in the 19th and 20th centuries, as a way to justify slavery, racism and classism, and control women through ‘temperance.’ This ideology has perpetuated Desirability Politics - where thinness and whiteness are given more access to social, political and cultural capital.”
The World Obesity Federation report, however, demonstrates that obesity is a mostly equal opportunity disease for all races. Where there are statistically significant variations, it is usually in favor of people of color. For instance, the increased rates for obesity predicted by 2035 for Sub-Saharan African men and women are expected to be about half that of men and women in Central, South and North America.
A lot of Substack readers know that facts alone are not always the most important elements as to whether something gets widely covered today in the MSM. A lot rides on whether the news checks the right boxes for progressive causes. Imagine if a UN and WHO-backed group issued a report that predicted a rapid rise in worldwide temperatures by 2035, and a $4 trillion impact on global economies. It would likely be front page news in most major papers and news sites.
What about the World Obesity Federation report? Google it. It was covered by medical journals such as STAT, Healthline, and the Medical Press. A Reuters story was picked up by CNN Online and CBS online. WebMD carried it, as did FOX News online. The only newspapers that put the story into their print editions were the New York Post and The Alaska Dispatch News. Big names in legacy media, including The New York Times, Washington Post, and NBC, totally ignored the alarming report. Covering it meant using repeatedly the much disfavored word obesity.
I wrote last month in Substack about “The Assault on Freedom of Speech.” It is not always, however, about direct censorship, cancellations, and the refusal to debate ideas in the public square. As the ghosting of the World Obesity Federation warnings illustrate, news is sometimes filtered and stories that do not fit certain political narratives are omitted. Only the Word Police can be satisfied that their assault on some language means the public is less informed on important issues.

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ChatGPT tackles the JFK Assassination
25 feb 2023· Just the Facts with Gerald Posner
Most of us have been deluged by prognosticators warning that the first widely available artificial-intelligence tool, ChatGPT, is either “a major threat to society’s well-being” or the start of an unchartered era in which machine intelligence will be “used for everything from customer service and sales to education and entertainment…. [and] will be able to hold more complex and nuanced conversations, and may even be able to understand and respond to more subtle emotional cues.”
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Elon Musk, one of the founders of OpenAI before he left, tweeted “ChatGPT is scary good. We are not far from dangerously strong AI.”
Pretty impressive for a product launched less than ninety days ago.
The truth between “end of times” and “the next enlightened era” is probably somewhere in between.
ChatGPT is the first generation of AI for the masses. Whatever it can do now will seem rudimentary in a few years. It is like the first generation of the iPhone. We know what it looks like but have trouble imagining how fast it will progress and change.
A lot of worry is that AI is too smart. It made its debut in scientific literature by producing four published papers. It passed three medical school admission tests “without any specialized training or reinforcement.” More than 200 books on Amazon are now listed with ChatGPT as a co-author. There is certain to be a lot more handwringing about AI’s implications. Dozens of competitive AI chatbots are in development, from tech giants such as Google to small, never-heard-of-before startups with a handful of coders.
Good writing will survive, however. And I am not personally worried until they invent an AI model that can reliably persuade whistleblowers to provide secrets about public or corporate malfeasance and somehow be capable of reviewing non-digitized archives stashed away in government and private vaults worldwide.
My goal this weekend was small in scope; a few questions about the JFK assassination seems to be a modest request for the AI chatbot that seems to have taken the world by storm.
I asked ChatGPT seven questions, in this order. Who killed JFK? Why did Jack Ruby murder Lee Harvey Oswald? What is the connection between Lee Harvey Oswald and General Edwin Walker? How many shots were fired at JFK and how many hit the president? Did Oswald work for the CIA? Is Oliver Stone’s film “JFK” good history or disinformation? and “What will be learned when the JFK files are finally made public?”
The answers below to each question are ChatGPT’s first responses. I did not request it to regenerate any answer. I did not correct any factual errors and it had some. For instance, it has Oswald coming to the attention of authorities after he tried to kill the retired Army general, Edwin Walker. In fact, no one knew that Oswald was the Walker shooter until Oswald’s wife, Marina, told the FBI after the president was killed.
At another point, it credits the Warren Commission with a shooting sequence in which the assassin’s first shot missed, the second hit the president and Governor Connally, and the third was the fatal head shot. One of the Warren Commission’s biggest errors was its belief that the first shot hit the president and the second shot missed. That compressed the time for the assassin to get off the three shots to about 5.5 seconds. It was in my 1993 book, Case Closed: Lee Harvey Oswald and the Assassination of JFK, that the evidence was presented for the first shot missing, nearly doubling the time the assassin had to fire three .
Also, when it came to why Jack Ruby killed Oswald, it mentions several possible motivations but omits entirely any of Ruby’s anger over his unfounded belief that the assassination was part of an antisemitic plot to unfairly blame Jews for the president’s death.
Still, overall, I’m mildly impressed with ChatGPT when it comes to some broad JFK assassination queries. That is especially true given that so much of its database includes millions and millions of pages of conspiracy speculation as compared to a much smaller subset of data concluding Oswald alone killed JFK.
Below are the verbatim questions and answers. I have put the questions in bold, so they are easier to see, and emphasized some portions of the answers. I’ve also attached a PDF of screenshots of my Q&As. That is to satisfy the eternally suspicious who won’t trust it unless they see it.
who killed JFK?
The assassination of President John F. Kennedy on November 22, 1963, in Dallas, Texas, remains a subject of controversy and speculation. The official investigation by the Warren Commission concluded that Lee Harvey Oswald acted alone in shooting President Kennedy from a sixth-floor window of the Texas School Book Depository building, using a Mannlicher-Carcano rifle. However, various conspiracy theories have emerged over the years, suggesting that other individuals or groups were involved in the assassination.
Despite numerous investigations and inquiries over the years, no definitive evidence has emerged to support any of the conspiracy theories. The assassination remains a subject of intense interest and debate, but it is generally accepted that Lee Harvey Oswald was the person who fired the shots that killed President Kennedy.
Why did Jack Ruby murder Lee Harvey Oswald?
Jack Ruby, a Dallas nightclub owner, shot and killed Lee Harvey Oswald, the man who had been charged with assassinating President John F. Kennedy, on November 24, 1963, two days after the assassination. Ruby's motive for killing Oswald is a matter of much speculation and debate.
Ruby himself gave various explanations for his actions. He claimed that he killed Oswald to spare Jacqueline Kennedy the pain of a trial, to avenge Kennedy's death, or to show that Dallas was not a city of hate. However, none of these explanations were consistent with the evidence, and it is likely that Ruby's true motive was more personal.
Some theories suggest that Ruby was part of a larger conspiracy to silence Oswald and prevent him from revealing any other conspirators in the assassination of Kennedy. However, no definitive evidence has emerged to support this theory.
The official explanation for Ruby's actions is that he acted alone, and that his motive was simply to become famous. Ruby had a history of erratic behavior and had expressed a desire to be a hero. He may have believed that killing Oswald would earn him the admiration of the public and a place in history.
In any case, Ruby was found guilty of murdering Oswald and sentenced to death, but the conviction was later overturned on the grounds that Ruby had not received a fair trial. Ruby died of cancer in prison in 1967 before a new trial could be held.
What is the connection between Lee Harvey Oswald and General Edwin Walker?
Lee Harvey Oswald and General Edwin Walker had a connection in the sense that Oswald attempted to assassinate Walker before he later assassinated President John F. Kennedy.
In April 1963, Oswald attempted to shoot General Edwin Walker, who was a right-wing activist and a former Army officer known for his opposition to the Civil Rights Movement. Walker had been relieved of his command by President Kennedy after disobeying orders during the integration of the University of Mississippi in 1962. Oswald, who had recently become politically radicalized and was sympathetic to Marxist ideology, saw Walker as a symbol of right-wing oppression and decided to kill him.
Oswald fired a shot at Walker's home from a distance, but missed and only shattered a window. However, the incident brought Oswald to the attention of the authorities, who investigated him but ultimately failed to connect him to the attempted assassination.
Later that same year, on November 22, 1963, Oswald assassinated President Kennedy while the president was traveling in a motorcade in Dallas, Texas. Oswald was arrested and charged with the murder, but was himself assassinated two days later by Jack Ruby. The connection between Oswald and General Walker has been the subject of much speculation and debate, with some suggesting that the two incidents were related or that Walker was somehow involved in the assassination of Kennedy, but there is no conclusive evidence to support these theories.
How many shots were fired at JFK and how many hit the president?
According to the official investigation by the Warren Commission, three shots were fired at President John F. Kennedy during the assassination on November 22, 1963, in Dallas, Texas. The first shot missed, the second shot struck Kennedy in the upper back and exited through his throat, and the third shot hit Kennedy in the head, causing a fatal wound.
The Warren Commission concluded that all three shots were fired by Lee Harvey Oswald from a sixth-floor window of the Texas School Book Depository building using a Mannlicher-Carcano rifle. However, the number of shots and their trajectory have been the subject of much controversy and debate over the years, with various conspiracy theories suggesting that there may have been additional shooters or that the shots may have come from a different direction.
Nevertheless, based on the official investigation, it is generally accepted that three shots were fired, with two hitting President Kennedy, and that Lee Harvey Oswald was the person who fired those shots.
Did Oswald work for the CIA?
There is no conclusive evidence to suggest that Lee Harvey Oswald worked for the Central Intelligence Agency (CIA) or was directly involved in any CIA operations.
However, there have been various conspiracy theories and allegations over the years that have suggested that Oswald had connections to the CIA or was involved in CIA operations. Some theorists have pointed to Oswald's brief defection to the Soviet Union in 1959 and his subsequent return to the United States as evidence of a possible CIA affiliation. Others have suggested that Oswald's military background and his language skills made him an attractive candidate for intelligence work.
Despite these theories and allegations, there is no hard evidence to support the claim that Oswald was an agent of the CIA or that the CIA was involved in the assassination of President Kennedy. Several official investigations, including the Warren Commission and the House Select Committee on Assassinations, found no evidence of a CIA conspiracy, and no direct link between Oswald and the CIA has been definitively established.
Is Oliver Stone's film "JFK" good history or disinformation?
Oliver Stone's film "JFK" is a dramatized version of events surrounding the assassination of President John F. Kennedy and the subsequent investigations. While the film is highly regarded for its artistic qualities, it has been criticized by many historians and experts as presenting a distorted and misleading account of the assassination and the investigations.
The film includes many conspiracy theories and allegations that have been widely discredited by official investigations and other studies. For example, the film suggests that there was a large-scale cover-up involving government officials and intelligence agencies, that there were multiple shooters involved in the assassination, and that there were connections between Oswald and various other individuals and organizations.
While these claims have been popularized by various conspiracy theorists, there is no conclusive evidence to support them, and most mainstream historians and experts reject them. Moreover, the film takes significant liberties with the historical record and conflates various events and characters for dramatic effect.
In summary, while "JFK" is a powerful and entertaining film, it should not be taken as an accurate or reliable account of the assassination and the investigations. Students of history should consult more credible and trustworthy sources to learn about this important event in American history.
What will be learned when the JFK files are finally made public?
In 1992, the U.S. Congress passed the President John F. Kennedy Assassination Records Collection Act, which required that all assassination-related records held by federal agencies be publicly disclosed no later than 25 years after the passage of the law, which would have been 2017. However, due to concerns about national security and the potential impact on U.S. foreign relations, some of the records have been withheld or redacted, and the full release of the records has been postponed.
In 2018, President Trump ordered that the remaining classified files related to the assassination be released by October 26 of that year. However, some documents were held back at the request of the FBI and CIA, and the full release has not yet occurred.
It is difficult to predict exactly what will be learned when the JFK files are finally made public, as the content of the files has not been fully disclosed. However, it is possible that the files could shed new light on the circumstances surrounding the assassination and the subsequent investigations, and possibly answer some of the lingering questions and controversies.
For example, the files may provide further information about the activities of Lee Harvey Oswald and his possible connections to other individuals or organizations, including the CIA or organized crime. The files may also provide new information about the investigations conducted by the FBI and other agencies, and shed light on the motives of the various parties involved.
It is also possible that the files may not provide any significant new information or may even raise more questions and controversies, depending on their contents and the interpretations of those who study them.
The bottom line?
If you are waiting for AI to solve the Kennedy assassination, you are out of luck.
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How did Sweden Become a Gangland Paradise?
17 feb 2023· Just the Facts with Gerald Posner
Sweden passed a milestone this month, but the dubious achievement was mostly lost under a deluge of news and commentary about Chinese spy balloons and the war in Ukraine. Crime statistics from last year revealed that the nation that once had one of Europe’s lowest rates of gun violence was closing in fast on Croatia for the continent’s highest per capita rate of fatal shootings.
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The news was celebrated in a Stockholm suburb when a hooded gunman fired 15 rounds from an AK47 into the home of a mother and her infant child. Police arrested 13 and 14-year-old suspects after the getaway car crashed during a high-speed chase.
Such a brazen assault would have been front pages news in Sweden a few years ago. Today, however, it is another in a long litany of gangland violence that plagues the country. There were 388 shootings last year, with 61 fatalities. That was more than double the 2021 number, which itself had set a record and moved Sweden ahead of Italy and eastern European countries. In fact, since 2000, Sweden is the only one of 22 European nations that has recorded “a significant rise in gun deaths.” While the number of shootings and fatalities might seem modest to Americans inured to mass shootings, it is alarming to Europeans who are accustomed to a fraction of the U.S.’s violent gun culture.
Rapes and sexual assaults are also at record levels. Every year during the past decade, the country averaged between 62 and 78 rapes per 100,000, about three times the number reported in 35 other European nations. The government claims that is because in 2013 it instituted a more liberal definition of rape by eliminating a requirement for the use of violence, threats or coercion and including cases where the victim did not physically resist. Sweden’s is not unique, however, since many of its EU neighbors have similarly broadened the definition of rape but have not seen a jump in the number of reported assaults.
Sweden’s socially liberal and tolerant Nordic neighbors, Denmark, Finland and Norway, match or exceed Sweden’s progressive laws about rapes and sexual assaults. Yet, they have 60% to 80% fewer rapes per capita. Sweden has six times as many shootings per capita than their combined figure.
While the crime stats are bad, many Swedes suspect the numbers are underreported. That belief was so widespread that the government was forced to issue a report denying it was “covering up crime statistics,” claiming it had “nothing to gain” from underreporting the numbers.
What is behind the Swedish surge in crime?
A recent report put most of the blame on 52 criminal gangs concentrated in huge immigrant suburbs of Stockholm, Malmo, and Gothenburg.
They are in a cut-throat competition to control a booming and lucrative narcotics trade. The violence has skyrocketed because the gangs are heavily armed despite Sweden long boasting some of the strictest gun laws on the planet. All guns are licensed by the government, buyers have to take training courses that can last a year, and firearms are seldom stored at homes but usually in a lock box at a registered gun club. What the Swedes did not envision was the birth of sophisticated criminal enterprises with cross-border reach. Swedish police and border agents have failed to stop the gangs from arming themselves with millions of dollars in surplus weapons smuggled from the Balkans. The gangs also have developed a penchant for using explosives, either bought on the black market or stolen from local construction sites. Some gangs produce their own IEDS or use ex-Yugoslavian M75 hand grenades. It is no longer shocking to hear about a gang blowing up a restaurant or shop that refuses to pay protection money. Swedish police created a new crime category in 2017 to monitor the number of explosives and grenade attacks. (The only other country that tracks grenade attacks is Mexico; the two nations have a similar rate per capita).
The intelligence chief of the National Police, Sweden’s FBI, admitted to a reporter, “It’s not normal to see these kinds of explosions in a country without a war.”
The turf wars for control of drug distribution that play out across the country are depressingly similar, but the names change depending on the city. In Gothenburg it is likely to include the Ali Kahn and Backa gangs; in Stockholm it is usually a Turkish and Iraqi gang, Asir, battling with the Gambian-led Chosen Ones; Malmo is split between a Bosnian gang, M-Falangen and its Albanian rivals, K-Falangen. While the police describe the gangs as extended mafia-like families, immigrants call them ‘clans,’ and often resort to them to resolve problems that they do not want to report to the government authorities.
Anyone who has followed Sweden’s spiraling descent into violence will not be surprised that in recent years almost half the suspects arrested for gun crimes are younger than 18. The gang lords exploit what they see as a loophole in the Swedish justice system. Sweden sets 15 as the age of criminal responsibility; anyone younger is considered incapable of committing a crime. In the U.S., where it is set by states, it is often 10. In Sweden, those under 15 are never prosecuted but if the crime is terrible enough, they can get counseling. The worst punishment for anyone between 15 and 18 is to undergo a rehabilitation program at homes that more closely resemble an American boarding school than a juvenile detention center. The rooms are comfortable and there is television, video games, sports, and internet access.
The problem of gangs using adolescent assailants was highlighted last month in a murder that attracted nationwide attention. A fifteen-year-old Afghan boy, who had escaped the Taliban in 2019, was shot execution style at a sushi restaurant outside Stockholm. Hundreds attended his memorial. Police later arrested a 15-year-old as the shooter; his two accomplices were 16 and 17.
“Many of them that we talk to don’t expect to be old, they don’t expect to reach 30,” says Johan Olsson, chief of the police’s national operation division in Stockholm. “The life of these young men is short, nasty and brutish. It’s a very, very grim environment.”
Sweden’s crime epidemic is not simply the result of a too-lenient criminal justice system. It has been fueled also by a surge in immigrants during the past decade, most from war-ravaged Syria, Iraq, and Afghanistan. Two million immigrants live in Sweden, about 20% of the population (25% of the country if those who have at least one immigrant parent are included). The largest group are Syrian refuges.
Sweden has long prided itself as having one of the world’s most generous and protective immigration policies. It passed groundbreaking legislation in 1989, the Aliens Act, and the 1994 Reception of Asylum Seekers. Those laws established the framework to welcome anyone fleeing persecution, war, or other forms of violence. All seeking safety from conflict zones or escaping oppression were allowed to enter the country without background checks or any questioning that the government thought might add to the stress and anxiety of the incoming refugees. Sweden also provided for state support of the new arrivals, with welfare subsides for housing, medical needs, and education. Eligibility for citizenship was automatic after four years, and that sometimes was expedited. Before Covid slowed migration to the EU, Sweden ranked first per capita in its number of asylum seekers and refugees.
When the country had a record influx in 2015, Swedish Prime Minister Stefan Lofven, said at the time, “My Europe takes in refugees. My Europe doesn’t build walls.”
The problem was that Sweden had significantly underestimated the immense difficulties of integrating such huge numbers into society. Tens of thousands were put into so-called Million Programme estates, enormous 1960s era housing projects. Newcomers faced many hurdles in assimilating into Swedish culture, adopting its values, and learning its language, exacerbating the problems in what had become immigrant ghettos. Children in large families slept on the floor as the inventory of apartments ran low. Nearby schools were woefully substandard. The unemployment rate for young immigrants was double that of native Swedes. And, while the country is proud of its generous welfare system, many new arrivals were quickly mired in a cycle of poverty.
The perfect storm created a rare opportunity for the criminal gangs inside the housing estates. There seemed to be an inverse relationship between the growth in power and influence of the gangs and the reduced level of police patrols and enforcement. Opposition politicians criticized the Million Programme estates as a Nordic version of Paris’s banlieues, places like Seine-Saint-Denis and Clichy-sous-Bois that had become so-called “no-go zones” in which criminal gangs exerted such control that the police no longer patrolled them. (The government admits that hundreds of thousands of immigrants, most from Muslim countries, live in 61 sprawling neighborhoods it defines as “vulnerable.” Those neighborhoods, according to an official report, “are characterized by a low socioeconomic status, in which criminals exert influence on the local community…. working [as police] in these vulnerable areas is challenging.”)
As the police pulled back and the government struggled to assimilate the large number of the new arrivals, the gangs — Kurdish, Turkish, Bosnian, Syrian and Somali — moved in. They offered many vulnerable, young people a promise of fast money and a quick way out of the ghettos. And the problem was not limited to the latest arrivals. David Jones, a journalist who has written about crime and immigration in Scandinavia, says, the children of those migrants who arrived in the 1990s “have morphed dangerously into a lost generation who are effectively stateless. Though they were born here, many don’t feel remotely Swedish, yet have no allegiance to their parents’ homelands, either. Their alienation and discontentment smoldered for several years.”
Has the government’s failed integration of migrants led to surging gang and gun violence? News accounts and websites sometimes report that immigrants are the perpetrators in a majority of serious, violent crimes. Those are often anecdotal. The real number is impossible to determine. That is because Swedish law enforcement agencies are forbidden to register an individual's ethnicity or nationality, and that information is omitted from official crime statistics. Websites that have reported court information revealing that a criminal was foreign-born have sometimes been censored by the government. An internal investigation was opened on one police officer, after he told a journalist that “ethnic Swedes [are] engaged in group violence, but not in the same numbers as foreign-born offenders.”
The strict policy of secrecy around the nationality or ethnicity of those arrested and convicted of violent crimes is an exceptional standout in a nation that otherwise prides itself on transparency and a progressive and open access records policy. Sweden is one of three Nordic countries that makes even personal tax returns public.
Information leaked by prison officials reveal that over half of those serving long prison sentences for violent crimes are foreign-born. It is closer to 70% if Swedish born, second-generation immigrants, are included. Crime reporters calculate that immigrants are suspects in 90% of public shootings.
There is some evidence that Swedish leaders are finally running out of patience. The national police commissioner admitted that unchecked criminal gangs threatened the very democracy that Sweden so greatly valued. The Gothenburg police chief told a reporter in 2020 that, “We need more police to deal with this situation urgently. Otherwise we will turn into a gangsters' paradise.”
Last April, Magdalena Andersson, then Prime Minister, said, “Segregation has been allowed to go so far that we have parallel societies in Sweden. We live in the same country but in completely different realities.” It was a rather remarkable admission considering that her party, the Social Democrats, had been in power for 28 of the last 40 years.
Public opinion polls before last September’s national election consistently showed that gang crime topped the list of concerns for the average Swede. The new Prime Minister, the Moderate Party’s Ulf Kristersson, managed to get a parliamentary majority by promising to tackle crime and winning the backing of the far-right Sweden Democrats.
Kristersson committed to a “paradigm shift” in criminal justice and said he would work for longer prison sentences to go after gang members and deter recruits. “These people who shoot each other on the street aren’t going to stop because we tell them to; they need to be locked up.”
His far-right partners want him to go further. One proposal is to permit the police to set up temporary zones in neighborhoods where they can search for guns, explosives, and drugs, even if they do not suspect wrongdoing. Another idea is to use anonymous witnesses at criminal trials, something now forbidden.
The new government is talking up its anti-crime program, dubbing it “the biggest offensive in Swedish history against organized crime.”
Given the failure of previous governments to acknowledge or concentrate on the problem, the “biggest offensive” might be a low bar. Criminals know that no matter what the politicians promise, the police are still hobbled by a nation that often puts privacy protection above police powers. Detectives are frequently denied access to the CCTV network, traffic cameras or automatic license-plate recognition technology. Only recently have they been able to tap telephones.
The only way to measure progress will be a steady drop in the sky-high crime rates. That will not be easy. It has taken years of neglect for Sweden to reach such a low point, it might take a long time to return any semblance of safety. As one Swedish cop assigned to the gang beat told a reporter in 2021, “There’s no quick fix, this will take at least one generation.”
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The Assault on Freedom of Speech
4 feb 2023· Just the Facts with Gerald Posner
Note: This is the first in an occasional series of short essays about the perils of what I call one think, a pernicious type of censorship in which voices and opinions that veer outside the guard rails of what is deemed “acceptable speech” are themselves banned, canceled, humiliated in the public square, and often branded as some form of bigotry.
I made my first trip to London in 1981 to visit the family of my soon-to-be wife, author Patricia Posner. One day, while walking in Hyde Park, near Marble Arch and Oxford Street, I came across a few dozen people listening to a speaker ranting that the “illuminati are the masterminds” of a recently failed assassination on the Pope.
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“I wonder what’s going on?” I asked Trisha.
“Oh, that is Speakers’ Corner. People are free to turn up and talk about whatever they want.”
She gave me the capsule history. For 600 years the British had hanged criminals there before huge crowds, some of whom bought tickets for the best seats. The more than 50,000 who were executed got a couple of minutes to say their final words. A century after the executions had moved from London, Parliament passed an act setting aside Speakers’ Corner. It was a safe haven used by suffragettes in their campaign for the right to vote, as well as by political firebrands such as Karl Marx, Vladimir Lenin and black-nationalist, Marcus Garvey. 1984 author, George Orwell, himself an occasional speaker, called it “one of the minor wonders of the world….Freedom is the right to tell people what they do not want to hear.”
For me, as an American, raised in liberal San Francisco on principles of free speech and vigorous debate, I thought Speakers’ Corner simply unnecessary.
“I guess the whole of America,” I told Trisha, “is the equivalent of Speakers’ Corner.”
I returned there many times in subsequent London visits. There was always something interesting going on. A Muslim preacher adamant that Jesus was a fiction. A Christian cleric scolding young Muslims that Islam was a faith of demons. An atheist calling out Catholics to demand they implore the Pope to stop “counting his money and smoking his dope.” An apoplectic man screaming that feminism was a fraud and that women were more violent than men.
Some could be dismissed as religious fanatics or slightly unhinged. Others, however, pressed a rational and persuasive case for Western intervention to stop the Serbian slaughter of Bosnian Muslims or against a British military role in the war in Iraq. Those gatherings, some of them huge, provoked vigorous and often heated arguments. Although few people left with their minds changed, they had at least engaged in the debate.
In all my visits I never saw any effort to silence the speakers, who at times relished expressing views that others found shocking and disturbing.
No one called the often offensive speeches a smokescreen for hate.
There was no movement to close Speakers’ Corner over charges it subjected marginalized groups to harmful prejudice.
I never once heard anyone say that speech, by itself, could sometimes be violence.
Speakers’ Corner showed me why the English were proud they did not need a “first amendment” to enjoy freedom of speech. A British high court judge summed it up when he overturned in 2009 the conviction of a bible-thumping, evangelical minister who had become a near public nuisance: “Freedom only to speak inoffensively is not worth having. Free speech includes not only the inoffensive but the irritating, the contentious, the eccentric, the heretical, the unwelcome and the provocative, provided it does not tend to provoke violence.”
Fast forward to 2023 America.
Imagine a Speakers’ Corner, an unrestricted bastion of “say whatever you like, no matter how many people you offend,” in New York’s Central Park or San Francisco’s Golden Gate Park. A free-flowing discussion about today’s hot button issues, such as abortion, bail reform, climate activism, puberty blockers for adolescents, and race reparations, would quickly devolve into shouting and possibly violence.
Too many people have become accustomed to having their opinions amplified in an echo chamber of social media and cable news. Most follow those who reinforce what they already believe. Few like having their opinions challenged. Fewer yet have an open mind to changing what they think if presented with alternative evidence and arguments.
For those who do have independent opinions, fear of the consequences of speaking out has created a tsunami of self-censorship. Little wonder that people stop themselves from saying or writing something that they believe will produce some blowback.
That became abundantly clear when my wife, Patricia, wrote a Wall Street Journal Op-Ed in May 2022, “When Did ‘Woman’ Become a Dirty Word?” She put a spotlight on the trend in medicine to degender language. While trans rights, she wrote, were important to protect, so were women’s rights. Defending the rights of men identifying or transitioning to change their gender should not be at the expense of women. Trisha got almost a thousand direct messages and emails, mostly from women who overwhelmingly thanked her for saying what they felt unable to express in their workplace since they feared it meant they could be tagged as “transphobic.” That risk forced them to stay quiet.
Heated discussions today abruptly end when someone charges racism or some phobic bias (transphobic, homophobic, Islamophobic), or interprets and condemns an opinion as the product of ableism, the patriarchy, or misogyny.
All those biases and prejudices undoubtedly exist and should be condemned when publicly exposed. But in many instances, they have been reduced to empty labels used as cudgels by which to end immediately uncomfortable discussions or unpopular ideas. Evidence to the contrary is never welcome. One think has replaced divergent points of view. Fit in or get canceled. Afraid of losing your thousands of followers on Twitter or Facebook? Do not post or like anything too controversial.
This is the opposite of what I was taught in school. I was on the debate team at a San Francisco high school and then later at UC Berkeley. That instilled in me the concept that societies that evolve the best are those that do so through a battle of ideas. Let the nastiest opinions be expressed, my first debate coach said, and then destroy them with logic and evidence. I grew up on the idea that a consensus on divisive topics could only be had after a robust public discussion in which different views were constantly criticized and questioned.
For school debates, a single controversial issue was assigned every year. To be a champion debater, one had to at different times persuasively argue both sides. The challenge was to understand so thoroughly what the advocates on each side believed that it was possible to credibly present their case.
Imagine that today? More likely that both sides would be intent only in making their own points, not in listening to what the other said. Intellectually stimulating debate is a relic of a quickly fading past.
The growing shadow of censorship has also fallen across college campuses, which should be bastions of free speech. There are dozens and dozens of examples in the past few years in which protestors have insisted their schools withdraw an invitation to a speaker they judge as controversial. When that fails there are efforts to block the entrance to lecture halls, shout down the speaker, and even storm the stage.
At my alma mater, UC Berkeley, conservative speakers were shouted down even during the school’s much touted Free Speech Week. That is right, you read it correctly. Berkeley devotes a week a year to “free speech,” seven days when opposing points of view can be expressed. Except, of course, it is a façade. Only points of view that are sanctioned by the one think police are allowed. This is the same school that in 1964 ignited the Free Speech Movement. A 21-year-old student, Mario Savio, led 500 fellow students demanding an end to the numerous restrictions on political speech that were leftovers at public universities of the rabid 1950s Red Scare of McCarthyism.
Most of the canceled speakers are conservatives; however, progressives are also sometimes canceled if they step on some unidentified one think land mine. “Protests against liberal speakers have drawn less media attention and appear to be less frequent,” concluded two constitutional law professors in a review of free speech problems on American campuses. The College of William and Mary sponsored a “Free Speech Event” a few years ago in which the ACLU’s Executive Director for Virginia was invited to talk about “Students and the First Amendment.” BLM protestors interfered, chanting “ACLU, you protect Hitler, too,” until it was canceled. Why? “Liberalism is white supremacy,” said one organizer.
Protestors also blocked a “Stand Against Fascism” speech by the very progressive University of Oregon President, Michael Schill. Demonstrators chanting he was a “white leader,” who ran the university as a “business firm,” forced him to cancel.
At UCLA, a panel discussion, “What Is Civil Discourse? Challenging Hate Speech in a Free Society,” was hosted by the university, the Los Angeles Times, and the U.S. Holocaust Memorial Museum. Protestors shut it down by shouting that the panel was “normalizing fascism.” One demonstrator said, “This is what the people in Nazi Germany were facing.”
Colleges should be the places where the most repellant views are sometimes presented so that students can learn how to demolish those with logic and evidence as opposed to protesting and screaming the loudest. Administrations are craven, however, buckling often to the shrillest voices.
Times are changing fast and not for the better. A few years ago, the fabled Oxford Union debating society refused to withdraw the invite it had extended to France’s right-wing politician Marie Le Pen. In the ensuing debate, Oxford published a paper that argued that it would have even been in the best interests of free speech to have invited Hitler to speak there in 1933: “It seems to me that freedom of speech, particularly in the context of politics and democracy, is a fundamental moral principle and shouldn’t be abandoned based on our feelings of whether we like the speaker or not.”
In sharp contrast to that defense of offensive speech, this month the UK’s University of Derby added trigger warnings to Shakespearean and Greek tragedies because it is “a genre obsessed with violence and suffering, often of a sexual or graphic kind.”
There is not a lot of good news beyond campuses when it comes to the protection of free speech in modern America.
For me as a journalist, one of the most sobering instances that demonstrated how quickly the protections for speech can be lost, transpired at The New York Times in June 2020. One of the paper’s opinion editors invited Republican Senator Tom Cotton to write an Op-Ed about the protests sweeping the nation in the aftermath of George Floyd’s murder. Although its title, “Send in the Troops,” made it seem as if Cotton were calling for military force against the demonstrators, his piece suggested the military be available as a backup only if the police were overwhelmed and there was no other way to stop the riots.
“The column immediately drew fierce backlash, dozens of Times journalists voicing their opposition, tweeting the headline, caption and a form of the phrase “Running this puts Black @NYTimes staff in danger,” according to Politico.
What did the Times do?
The day after Cotton’s Op-Ed, James Bennet, the paper’s editorial page editor, wrote “Why We Published the Tom Cotton Op-Ed,” an unprecedented defense of his decision. Bennet emphasized that he “strongly oppose[d] the idea of using federal troops.” However, he said, “We published Cotton’s argument in part because we’ve committed to Times readers to provide a debate on important questions like this. It would undermine the integrity and independence of The New York Times if we only published views that editors like me agreed with, and it would betray what I think of as our fundamental purpose — not to tell you what to think, but to help you think for yourself.”
At a long and tense internal meeting the following day, Bennett and other top editors apologized to the paper’s staff. While the Times publisher, A. G. Sulzberger, said the paper’s leadership regretted publishing Cotton’s opinion piece, he nevertheless backed Bennett, who he said had “as tough a job as anyone I can imagine in any newsroom.”
Two days later, June 7, Bennet resigned, saying he was “proud of the work my colleagues and I have done to focus attention on injustice and threats to freedom…” The paper issued a statement that the Cotton Op-Ed had not met its “editorial standards.”
The Times leadership may have ultimately had little choice because a fair percentage of its newsroom was in open revolt, mostly on Twitter, after the Cotton Op-Ed. Bennett’s departure, and the reassignment of James Dao, the editor who personally oversaw the Cotton piece, was likely the fastest way to quell the staff uprising. It was also, however, a sign of how one of the country’s most influential papers had itself come up short when it came to protecting speech.
The express purpose of an opinion page is to run a mix of opposing viewpoints on the important issues of the day. I have written nine New York Times Op-Eds (all available here). The most recent three were on the drug industry and vaccines, and two about how the billionaire Sackler family were using the bankruptcy courts to avoid personal liability for the lethal opioid crisis they had ignited and fed with their blockbuster hit drug, OxyContin.
Those who disagreed with me could write an opposing opinion piece. The Washington Post, for instance, published Jillian Sackler’s Op-Ed “Stop blaming my late husband, Arthur Sackler, for the opioid crisis.”
That is how Op-Ed pages should work. Opinions presented on both sides of tough issues and the readers can make up their own minds. There were many good arguments against the case Cotton made, but not wanting it printed was not the right approach.
A month after Bennet left, Times opinion writer and editorsubmitted her resignation. While Bennett had left with a statement that talked about how he “was honored to be part of it [the Times],” Weiss left with a stinging resignation letter that she published on her website. Central to her disillusionment was that at the Times “truth isn’t a process of collective discovery, but an orthodoxy already known to an enlightened few whose job is to inform everyone else.” Weiss concluded, “And I’ve always comforted myself with the notion that the best ideas win out. But ideas cannot win on their own. They need a voice. They need a hearing. Above all, they must be backed by people willing to live by them.”
Weiss nailed it.
It is great to champion free speech. If, however, the guardians of such speech are frightened every time a tweet in opposition goes viral, there will be little room indeed for an energetic and lively exchange of ideas. Those heated discussions might often be uncomfortable and trigger a lot of sensitive people, but they are also the only way to reach a consensus on key issues in our fragile democracy. The alternative, one think, an inflexible orthodoxy in which only sanctioned opinions and beliefs are championed, is already changing the definition of free speech in America. If we allow it to become an insufferable and permanent form of censorship, we will only have ourselves to blame for not speaking out earlier and forcefully.
For now, I would settle for a Speakers’ Corner in Central Park as a starter.
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