Even when Williams can find a specialist who is willing to see her son and accepts his insurance, there’s a long wait for appointments. At times that’s meant Marc has gone without medication to manage his seizures or been unable to see a speech therapist to help him learn to talk. When he was 2, he had to wait two years to see the various specialists needed to approve the removal of his breathing tube.

“Always they kept postponing it or it was hard to get an appointment to see the doctor,” Williams said. “Or we would see the doctor and then we would need to get a clearance from other doctors, and then it’s hard to get those appointments and all the appointments are always months down the line.”

California has a severe shortage of pediatric specialist doctors. The state has only one pediatric medical toxicologist for all 8.7 million children in California, for example, and one child abuse specialist for every 258,000 children, according to . The shortage spreads out over most disciplines, with one pediatric sleep medicine doctor for every 224,939 children, one sports medicine doctor for every 204,015 children and one hospice and palliative care doctor for every 190,709 children.

This shortfall puts medically fragile children at risk for worsening health and missed opportunities for life-changing treatment and support. Many families wait months—and in some cases a year or more—to get appointments. Sometimes they’re forced to drive halfway across the state to see a doctor. Sometimes by the time they see the specialist, the child’s condition has deteriorated or the window of opportunity for treatment that could halt or significantly reduce the progress of a disease or disorder has closed.

The shortage of specialists affects all children but is especially pronounced for children with disabilities and those from low-income families, because these children rely on the state’s health insurance program, Medi-Cal. Some specialists won’t accept the state health insurance plan and if the children’s families cannot afford to pay for private insurance or out-of-pocket care, then—despite having health coverage—they will not have access to doctors they need to see.

Pediatric specialists are pediatricians who undergo extra years of medical training so they can treat children with complex health care needs such as cerebral palsy, congenital heart disease, cystic fibrosis and cancer. Children’s hospitals and medical centers across California that it often takes a year or more to fill these positions—if they can fill them at all.

“It’s become a crisis,” said Dr. Carlos Lerner, a pediatrician who oversees a program providing specialty care for medically complex children at the Ronald Reagan UCLA Medical Center. “The fear is not just about today, but just projecting the current trend into the future, that’s where we really get worried.”

Children’s hospital leaders and pediatrician groups are calling on the state and federal government to increase the amount they pay these doctors for treating children and provide more training incentives, which are well below those of Medicare and private insurance. Without these actions, experts warned that shortages will only get worse.

Close to 360,000 children in California have medically complex conditions, according to the Children’s Specialty Care Coalition, an organization representing medical groups and hospitals treating children with special health care needs across California. That number is expected to double in the next decade as medical and technological advances reduce mortality rates for seriously ill children. Like Marc, these kids typically require care from multiple subspecialty physicians.

The American Board of Pediatrics report, using , found that the number of specialists varied widely across disciplines, ranging from the one pediatric medical toxicologist for the entire state to 606 neonatal-perinatal pediatricians in California, or one for every 14,476 children. A child will require a specific specialty based on their condition, and it’s common for children with complex health care needs to need treatment from a range of specialists. The wait times compound for these children, as they wait months for one appointment, and then months for another, often delaying their diagnoses or treatment.

While there are no defined ratios for how many specialists per child there should be, California ranked in the middle compared to other states when averaged across disciplines, although in some subspecialties such as sleep medicine, nephrology, emergency medicine and hospice and palliative care it ranked in the bottom half. Specialty shortages are a problem nationwide.

that children are more likely to survive when treated by pediatric specialists rather than those trained to treat adults.

To become a pediatric specialist, medical students typically train for 10 years—that’s an additional three years on top of completing four years of medical school and a three-year general pediatric residency. But that extra training doesn’t pay off financially. On average, pediatric specialists earn 25% percent less than adult medicine physicians trained in the same specialty. Many also earn less than general pediatricians, despite their extra years of training. This difference in compensation—exacerbated by rising levels of student medical school debt—is discouraging new doctors from entering pediatric specialty professions, even as the health care system faces a wave of older doctors retiring.

“It makes it very, very difficult to attract people to take this on as their life’s work, and to embark on this journey,” said Dr. Sherin Devaskar, executive chair of the Department of Pediatrics at UCLA. “They want to help children and their families. But they want to be in a situation where they can at least pay back their educational debt and at least be comfortable and have a life.”

The consequence is that medical students are increasingly shunning pediatric specialties. Hospitals and medical centers that train specialists report that they can’t fill their residency programs. In some specialties, such as pediatric infectious disease, nephrology and developmental pediatrics, there are only enough applicants to fill about half of the training slots nationwide.

Recruitment of experienced specialty pediatricians is also suffering as hospitals and medical centers compete for a shrinking pool of potential applicants. The problem is particularly acute in rural areas. Dr. Satyan Lakshminrusimha, the pediatrician-in-chief at UC Davis Children’s Hospital which treats children from northern California and Oregon, said he’s been trying to recruit a child abuse specialist for seven years. He’s also had unfilled openings for two genetic specialists for almost three years, and only just managed to fill a position for a pediatric gastroenterologist after a year-long search. California’s high cost of living and relatively low salaries for pediatric specialists are major factors, he and other physician leaders said.

The crux of the problem is low reimbursement rates, experts said. Upward of 70% of children with complex health care needs in California are covered by Medi-Cal, the state’s name for the federal health insurance program Medicaid, which serves people who qualify based on income or have certain disabilities. Many children also depend on a related program for children with disabilities called California Children’s Services. This means that compensation for doctors who treat children needing specialty care is usually heavily reliant on these programs.

But Medi-Cal doesn’t pay doctors as well as other health insurance programs. Medicare, the federal health insurance for people 65 or older and some younger adults with disabilities, for care than Medi-Cal, often for the same procedures. A comparison by the Kaiser Family Foundation found that Medi-Cal reimbursement rates amount to only about 70% of the rates paid by Medicare. Medi-Cal rates are set by the state, while the federal government sets Medicare rates.

“Medi-Cal in California compared to other states is generous in the range of services that it provides, but it’s near the bottom of the list in terms of how much [it] pays for each service,” Lerner said.  “As a predictable consequence, you may be eligible for a service, but the access to it is poor.”

Meanwhile, the average pediatric specialist nationwide is over 50 years old, and many are retiring. In a 2022 survey, over 90% of Children’s Specialty Care Coalition members said they expected a significant number of pediatrician specialists to retire within their organizations in the next five years. 

Impact on Families

Ultimately, the consequence is that families are having an increasingly hard time getting appointments with pediatric specialists. When they do find one, they must often travel further and wait longer for an appointment than they did in the past. This puts children at risk for more serious medical problems, emergency department visits, developmental setbacks, missed school, and delays in diagnoses that would allow them to get vital treatment and special education services. The delays also can create stress and anxiety for caregivers as they struggle to care for their child, sometimes without diagnoses or treatment. Some resort to paying out of pocket at considerable cost.

“Waiting for answers is not only stressful for families but is detrimental to that child’s health and wellbeing,” said Assemblymember Akilah Weber, an OBGYN who has pushed for the state to increase Medi-Cal reimbursement rates to pediatric specialists. “The earlier a child is diagnosed and treated, the better the potential outcome.”

Living in Adelanto, a desert community in San Bernardino County with fewer than 40,000 residents, has made finding specialists particularly difficult for Williams. The nearest children’s hospital, Loma Linda University Children’s Hospital, is more than an hour away. Sometimes she has to drive even further to Los Angeles or Orange County to take Marc to see the specialists he needs. Those drives are often a day-long ordeal.

“As a parent it’s a lot of drive time,” she said. “I’ve got to take hours to get ready, then drive in the traffic, and the appointment might only be 15 to 30 minutes to 45 minutes, and then hours of traffic coming back home. … It’s kind of draining.”

In of children and youth with special health care needs by the University of California San Francisco in 2023, a quarter of families reported waiting more than three months for new appointments. And in 75% of cases, wait times exceeded standards set by the state, which require that health plans ensure patients can get an appointment within 15 business days, or three business days if the matter is urgent.

Some families reported dire consequences because of the extended wait times, including failure to gain weight because of a faulty feeding tube, unsettling allergic reactions, and a child who fell behind with developing eating, communication and walking skills.

Williams said she had to wait over two years for her son to have a breathing tube removed from his neck that he was fitted with as a baby. She said she noticed he no longer seemed to need help with breathing when he was 2 years old. But it took so long to get appointments that Marc �徱���’t have the surgery until last summer. Marc now has difficulty swallowing because he had the tube in for so long, she said, and it’s interfered with his ability to get speech therapy.

“I just wish the health care was better out here,” she said. “… I wish I could afford better health care because then I could get better help.”

Solutions

Raising Medi-Cal reimbursement rates to equal or higher than those offered by Medicare is the top solution proposed by experts to ease the pediatric subspecialty recruitment crisis. Devaskar said rates should be set above those of Medicare because working with children and their families is often more complex and time consuming than treating adults, which also affects physician compensation.

So far, efforts in California to do this have been unsuccessful. A to increase Medi-Cal reimbursement rates to physicians serving children with special health care needs failed to advance in the legislature. The National Academies of Sciences, Engineering, and Medicine has also called on Congress to provide federal funds to states to increase Medicaid payment rates for pediatric services.

Additional proposed solutions from the National Academies and others include legislation to expand access to telehealth, improve collaboration between primary care and specialty pediatricians, increased funding for pediatric specialty residency programs and expanding loan forgiveness programs for those entering pediatric fields.

“It’s not just about the present,” said Devaskar. “20% of the country is children. They’ll be 100% of the future population. We’re investing in the health of the future of this country.” 

Williams, meanwhile, is still trying to find a pediatric pain specialist for Marc and has trouble getting timely appointments with his other specialists. She spends about four hours a week on the phone trying to secure appointments. Sometimes she can get some scheduled.

And sometimes, the calendar stays blank.

Having trouble getting a medical appointment? Here’s what to do:

California law requires health plans to provide timely access to care. In general, that means you should be able to get an appointment:

• Within 10 business days for non-urgent primary or mental health care
• Within 15 business days for non-urgent specialty or diagnostic care such as lab tests.
• Within 2 days for urgent care that doesn’t require prior authorization from your health plan.
• Within 4 days if urgent care requires prior authorization.

Urgent care is not the same as emergency care, which is for life- or limb-threatening conditions. For emergency care dial 911 or go to the nearest hospital.

Health providers may extend wait times for appointments if they determine that waiting longer will not affect a patient’s health, but they must note this in your medical record.

If you can’t get a timely appointment:

1. Contact your health plan and ask for help. They must help you get an appointment with another provider in or outside of your network.
2. If you don’t get the help you need from your health plan, call the Department of Managed Health Care’s Help Center at 1-888-466-2219 (TDD: 1-877-688-9891) or to file a complaint.   

��This story was produced in collaboration with the��.

CORRECTION: This story was updated at 2:32 p.m. Pacific on April 30, 2024, to provide more detailed information about California’s pediatric specialist shortage, using data from a 2023 American Board of Pediatrics report. Read our corrections policy here.

Then, inevitably, grief came knocking. Almost 12 years after Chavan’s departure, while she was sitting in her apartment in Winnipeg in early 2020, Chavan’s stomach dropped as her mom called with the news. Chavan’s grandmother, who lived in Sydney, Australia, had fallen sick, and over the course of a few weeks, had passed away. There was no way she could go to mourn in person for her grandmother, one of the most important people in her life. Flights to Australia were expensive, and she couldn’t afford to apply for the visa she would need to even get into the country. So instead, Chavan emotionally shut down. “I felt very frozen for a very long time,” she says.

Migrant researchers and psychologists call what Chavan was experiencing transnational grief, or transnational bereavement. It refers to the unique experience of losing someone you love while in another country. Although grief is already a difficult process, immigrants who experience transnational grief often go through additional layers of guilt, denial, and suffering since they are unable to attend the typical rituals associated with loss.

The inability to see their loved one in person makes it difficult to achieve closure, and the bereaved may be unable to process the loss and move forward. In recent years, this reality has become more apparent, as COVID-19 claimed millions of lives while simultaneously forcing border restrictions. The pandemic further highlighted the critical role of community support and immigration policy shifts to help those who grieve from afar.

The Toll of Long-Distance Loss

Experiencing grief from a distance has long been the reality of immigrants. Anyone who leaves their family behind also risks being apart from their loved ones during times of loss—and often this grief comes with a whirlwind of complicated emotions. 

“There is a strong sense of guilt. There is a strong sense of regret that they �ɱ�����’t able to be with their loved one as the loved one died,” says , a grief researcher at the University of Alberta. She recalls a conversation she had when she interviewed an Iranian-Canadian immigrant who had lost their brother during the lockdowns in the COVID pandemic. Because they were unable to travel back home, or even see his body before it was buried, they refused to accept that their brother’s death was real.

Chavan recalls similar experiences, being separated by borders. “I did not feel like I had permission to grieve, because I had not been there,” she says.

Without this space to mourn, grief can become difficult to move past—especially for immigrants who are undocumented., a sociologist at the University of Michigan’s Center of Racial Justice, works with these communities, and continuously hears about how grief affects everyday lives. “People described these experiences of grief and long-distance mourning as one of the most difficult parts of being undocumented in the United States,” she says.

For instance, while this phenomenon between 2017 and 2023, Fullerton Rico met a woman whom she calls Florencia (a pseudonym used to protect her privacy) who said, “When you experience grief [as an immigrant], your only option is to accept that you can’t do anything.” Fullerton Rico also shares a conversation she had with a man she calls Felipe: “Felipe told me grief changes you deeply.” The depth of that grief is exacerbated by distance when you can’t get closure from saying goodbye or attending a funeral, he told her. “It’s a chapter with no ending, and it remains unfinished.”

To make matters worse, the weight of transnational grief often remains a burden borne alone. “It isn’t something that people usually talk about,” Fullerton Rico says.

Bridging the Distance

Social rituals, in any culture, are an important part of the grieving process. Wakes and other celebrations of life can help people actively engage with memories of an individual, says, a neuroscientist who studies grief at the University of Colorado Boulder. “Thinking of these memories allows your brain to sort of remodel and think about how these memories now fit into your life,” she says. But for those who don’t witness deaths or funerals in person, this process may be disrupted or made more difficult.

, a psychologist who works with expats, helps clients construct their own rituals so that they can celebrate their relationship with their loved one. She walks them through the process of grieving from afar, through actions like letter-writing, eating a loved one’s favorite meal, or participating in a favorite shared activity. The process takes time. Several sessions of goodbyes and rituals are often necessary for someone to make peace with a sudden death, says Encina.

Similarly, during the pandemic, Chavan found her own turning point for bereavement in creative nonfiction. She had lost her job at the time and decided to attend a writing class, taking on a project that allowed her to dive into her experiences with transnational grief. , Chavan slowly broke the ice that had encased her for eight months. She sobbed as she remembered all the details about her grandmother: the spirited debates they would get into, how she commanded a room despite her small size, how she brought the family together with her love. 

“It was awful. It was devastating. It felt like losing her all over again,” Chavan says. 

But it was this act of writing and remembrance that allowed her to reconnect to her memories—and start to heal.

Systemic Solutions

Ultimately, making space for transnational grief requires the restructuring of how we think about immigration and loss. Currently, it takes years for an undocumented immigrant to become a legal, permanent resident in the U.S., and the few who are able to adjust their immigration status typically receive work authorization before the ability to travel back home, Fullerton Rico says. And so the opportunity of visiting loved ones becomes a waiting game, even as family members age or pass away. 

���� we pass laws that prioritize a fast path to citizenship, we could avoid having people go through these experiences,” Fullerton Rico says.

Many undocumented immigrants also have inflexible, low-wage jobs, which pressures them to make painful decisions, like watching their loved ones’ funeral on a smartphone in between helping customers or preparing meals at a restaurant. “Instead of being there in person, they had to sneak away to the bathroom, or hide in a walk-in refrigerator to get glimpses of one of the most significant rituals in somebody’s life,” Fullerton Rico says. 

Giving time and space for a person to grieve in the form of paid bereavement leave can help. This allows grievers to take time off work without facing the potential consequences of losing a paycheck or their job. Chavan recalls the pressure to continue to work in the midst of her grief because she �徱���’t have the financial flexibility to lose out on paid hourly work, which gradually degraded her mental health. Currently, only five states in the U.S. mandate employers to give bereavement leave, Fullerton Rico says, only two of which require the leave to be paid.

Most importantly, it’s crucial to “let people know that they’re not alone in this pain,” Fullerton Rico says. She urges more immigrants to recognize this reality and advocates for organizations to help immigrants get access to counseling, other mental health resources, or religious rituals so they’re less at risk of conditions like clinical depression. She shares the example of a Catholic priest she interviewed in New York City, who has helped perform memorial masses for transnational mourners since the 1990s. Today, these funeral ceremonies are held and streamed through Facebook Live, YouTube, or Zoom, helping families feel some sense of togetherness.

Experts agree that forming this social support is a key factor in the grieving process. “Grief is something of a social experience,” Bayatrizi says. “It’s an emotional experience that’s shaped through our social interactions.”

Chavan says that the only reason she finally felt ready to face the emotions was because her partner and her in-laws were supportive, giving her a small but strong community in an isolating time. After writing about the experience, she also started having more conversations with family and friends who had read the article, about the struggle of grieving from afar and how they coped. 

“It meant that I had this community, this global community that I could reach out to essentially,” she says. “Learning that you are not alone in something that you have gone through can be very powerful.”

In my little Italian village, the narrow streets climb into the hills where the meadows are still allowed to grow wild in the springtime.

Within two or three weeks, the stalks swell into a multitude of meadow-grasses and blossoms as tall as my waist, fragrant and enveloping. I think then: It might have been this way once, when the plenitude of existence could spread everywhere and it seemed unavoidable that every corner of this biosphere would fill to the brim with life. When it was only natural to think of this cosmos as living, as enlivened at its deepest core, and not as an optimized assemblage of dead matter. If you want to understand the extent to which your own existence results from the collective work of diverse organisms, you must go outside on nights such as this, when the moonlight on the diaphanous hillsides makes them seem almost translucent and fireflies tumble through the gloaming like tiny stars gone astray. Yes, it is still out there, even in Europe, if you go looking for it.

Such an experience of the harmony between a landscape and its life-forms is probably not the result of objective analysis. But this is precisely the point: If you let the calyxes and grasses slide through your hands amid the firefly flurries, celebrating the coming summer, you don’t just perceive a multitude of other beings—the hundred or so species of plants and countless insects that make up the meadow’s ecosystem. You also experience yourself as a part of this scene. And this is probably the most powerful effect of experiences in the natural world. When you immerse yourself in the natural world, you wander a little through the landscape of your soul.

For a long time now, such experiences have been considered not very reliable, certainly unscientific, and, if valid at all, deeply steeped in that pleasant state of mind known to us from fairy tales, novels, and poems. The moonlit night, for sure. Eichendorff! Is this supposedly where “the sky had silently kissed the earth”? And yet, in the interplay of the meadow’s plants, insects, and microorganisms, and in the night wanderer’s experience of this interplay and of his partaking in it, those familiar with recent biological research cannot fail to see a clearly tangible example of the principles upon which the world of life-forms is based. Seen in this light, the night wanderer’s sense of belonging, of deep investment, is��not a fallacy, but stands at the center of a realistic experience of what is actually meant by aliveness. Not theoretically, but practically, experienced from inside of a living being, which is what we are.

The principles made apparent by biological research show us that life is, at nearly every level, a collective concern, a shared enterprise under-taken by a wide variety of beings that arrive at a stable, functional, and thereby beautiful ecosystem by somehow putting up with one another and reaching agreements. Rivalry, competition, and selection in the Darwinian sense definitely play a role, but this is not the merciless final word; it is simply one force among many that living systems use to create and form themselves out of a multiplicity of participants. “Symbiosis” is the term often used for this cooperative process. But “symbiosis” has an overly pleasant ring to it that suppresses the fact that an ecosystem’s success produces not only the happiness of brotherhood but also the horrors of annihilation. Eating others and being eaten (which lies ahead for all of us) figure into the same living fabric, as processes necessary to maintaining the stability of the whole and allowing it to experience itself.

For that reason, it would be better to say that biologists understand that life is a phenomenon of absolute communality. Flourishing in a relationship of mutual benefit is as much a part of this as lustily consuming another in order to guarantee one’s own flourishing. The most astonishing thing about a meadow is not only the fact that the plants growing there create niches and a mutually beneficial micro-climate, but also that the stalks of those same plants have to be grazed in order for the meadow to remain a meadow. Their leaves and buds must be shredded by the mandibles of countless insects, to be crushed by rabbits, deer, and cows, so that they might perennially reemerge, variegated and placid.

The biosphere is full of such transformations. It is the continual product of them. There is no being, no life circumstance that does not result from contact, penetration, and conversion. The cells of our bodies result from “endosymbiosis,” from the contact between two different types of bacterial cells in which one of the cell types encloses the other. Only by this transformation into the body part of another could the enclosed bacteria further evolve into the organs necessary for the life of the enclosing cell. By infecting us throughout the course of our phylogeny, a multitude of viruses have infiltrated our genetic material with their DNA. The function of that DNA has transformed within our genetic matter such that it has become an indispensable part of our bodily processes. The living world is a constant conversion of one thing into another, leading to inexorable new growth.

In its incessantly renewing plenitude of life, the biosphere is no more “truthfully ‘symbiotic’” than it is “fundamentally ‘competitive.’” There is only one immutable truth: No being is purely individual; nothing comprises only itself. Everything is composed of foreign cells, foreign symbionts, foreign thoughts. This makes each life-form less like an individual warrior and more like a tiny universe, tumbling extravagantly through life like the fireflies orbiting one in the night. Being alive means participating in permanent community and continually reinventing oneself as part of an immeasurable network of relationships. This life network is knotted to all individuals. But just a single pull, a single slipup, is enough to loosen the ties.

If you walk through the evening meadow you experience all of this in a mysterious manner. Relief washes over you, because all at once your own struggle for life, the demand to somehow get yourself through the days, is poignantly and reassuringly echoed back to you. The burden is carried by an aliveness that vibrates everywhere, elevated above such troubles for the span of a springtime evening. If you hear the quiet rustle of the wind in the grass, you recall, deep within your body, that you are not a solid, constant individual. The grass seeds, scattered carelessly by the gentle breeze, pivot through the night like cells through the chamber of the self—the body’s dance of atoms, chaperoned by foreign microbes, amoeba, viruses, fungi.

This excerpt is adapted from Andreas Weber’s book��Matter and Desire: An Erotic Ecology��(Chelsea Green Publishing, 2017) and is reprinted with permission from the publisher��

In the decades since, the birth mother has become a paradox. According to mainstream media depictions, she is both brave and lazy, selfless and selfish, loving and careless, a heroine and a villain. She is a drug-addicted, abusive lay-about who makes the ultimate sacrifice–relinquishing her child to give them a better life.

And when her children are adopted into their “forever home,” she disappears. 

The term “birth mother*” is often used to refer to a woman whose biological child is adopted by another person, either voluntarily or forcibly. Often left out of happy adoption stories, villainized, or shamed into silence, these mothers are rarely given a platform. Now, three authors are aiming to change that.

The idea of the birth mother is the beating heart that connects three recent books: by Roxanna Asgarian, which explores the murder of six Black children by their adoptive white parents; by Gretchen Sisson, which spotlights mothers who relinquish their children through the private adoption industry; and by Jessica Pryce, which takes on the foster care system.

While the books examine foster care, adoption, and motherhood from different angles, they all surface and center the voices of the mothers who have (voluntarily or forcibly) relinquished their children. Their stories are at turns compelling, heartbreaking, rage-inducing, and sometimes—but rarely—hopeful. Together, they create a choral voice of pain and loss that cries out for a world in which their children could have remained theirs, and illuminate a path toward that world.

Mothers Who Are Missing, Martyrs, and Murderers

We Were Once a Family goes behind the headlines of a 2018 story that captured the country’s attention: , a white married couple, drove their six Black adoptive children off a cliff along the Pacific Coast Highway in what was ruled a murder-suicide. While news coverage of this tragedy often centered on what drove the Hart mothers to commit such a violent act, little was reported about the children other than the abuse they endured. Even less attention was paid to their birth families.

In fact, as Asgarian uncovers with dismay, neither Sherry Davis, birth mother of three of the children, Devonte, Jeremiah and Ciera, nor Tammy Scheurich, birth mother of the other three children, Markis, Hannah and Abigail, were informed by authorities of their deaths. Because their parental rights were terminated, there was no law that required this humane act.

���� [Shonda, my lawyer] hadn’t found out, I don’t even think they would have told me,” Davis told Asgarian.

Asgarian tells the story of these birth mothers and their family members who fought to keep the children with precision and care, interweaving their narratives with details and data about the Texas foster care system that ultimately tore these families apart. Asgarian does not ignore the Harts in this story, but her focus is more on why the Harts escaped CPS scrutiny despite multiple reports of abuse, while Davis and Scheurich did not.

In sharp contrast to the abuse the white, middle-class Harts were able to get away with for so long, Davis—who is Black and poor—and Scheurich—who is white, poor, and struggling with mental illness—did not receive the same benefit of the doubt. Importantly, both women did not lose their children due to charges of abuse; the impetus for the termination of their parental rights was Davis’ positive test for cocaine after giving birth to Ciera and Scheurich’s charge of medical neglect after she struggled to secure a ride to a hospital to treat Hannah’s pneumonia. 

“The children’s birth families were not beating their children or starving them,” writes Asgarian. “They were clearly struggling with substance use and mental illness, but instead of receiving help, the parents were punished.”

In Broken, Pryce, a Black woman who became a CPS caseworker after college to help ensure children were safe, explores the system from the inside. 

In the author’s note, Pryce explains that over the course of writing the book, she decided to focus on her own experiences as a case worker and the stories of women she knew or worked with personally. 

“My publisher and editor challenged me to dig deeper,” Pryce writes. “It required a level of vulnerability and culpability. But it also created an opportunity to get to the essence of how CPS plays out with families.”

The result is a deeply honest, intimate, and harrowing narrative. I desperately turned its pages to find out whether these women and their babies would be OK, and followed alongside Pryce as she slowly and painfully shifts from believing in the child welfare system to questioning it and ultimately aiming to dismantle it entirely. While never shying away from the brutal realities of the system, Pryce also shows deep compassion for her fellow case workers, many of whom are Black women, and her younger self.

“I saw humanity in my colleagues even in the face of difficult cases and complex circumstances,” Pryce writes.

The stories of the birth mothers threaded throughout this book are that much more fraught because of Pryce’s personal stake in them. One woman, Erica, takes in the 4-year-old daughter of a dear friend who is struggling to parent, only to find herself under investigation by CPS for abuse—and Erica also happens to be Pryce’s best friend. Pryce even admits to reporting her own sister to CPS over concerns of an abusive ex-partner. As these stories unfold, we watch Pryce evolve from an uncertain intern to an expert advocate as she realizes all the ways in which Black mothers bear the brunt of a system that, in Pryce’s words, requires not just an evolution but a revolution to truly serve the purpose it claims to.

Relinquished takes a look at another group of birth mothers—those who relinquish their children within the private adoption industry. Unlike the mothers from Asgarian’s and Pryce’s books, the mothers whose stories we hear, often firsthand, voluntarily gave up their parental rights, often just a few days or even hours after giving birth. Yet through these stories, we learn just how often the choice isn’t really the mother’s at all.

Many of the women in the book were preyed upon by for-profit adoption agencies or anti-abortion clinics and, in their words, coerced into giving up their children. Some would have chosen to parent if they felt they could. 

Taylor, who discovered she was pregnant when she was in her early 20s without a stable income or partner, received misinformation about birth control and abortions at an anti-abortion clinic. When she Googled “help for single moms,” she was flooded with ads for adoption agencies. She reached out to a large Christian adoption agency who connected her with a financially stable couple who she thought could provide for her son where she couldn’t.

“I was starting to feel unsure and I wasn’t ready,” Taylor said of her time in the hospital after giving birth. She was told she had already signed her termination of parental rights paperwork while she was on pain meds, something she �徱���’t remember doing. “I sobbed. [The agency worker] never told me I had a revocation period, nothing.” 

Common among the birth mothers’ stories is the expression that a small amount of money—as little as a few hundred dollars—could have allowed them to parent their child. Instead, they selected adoptive parents from a set of profiles of two-parent households with steady incomes and homes with yards. These profiles presented a life for their child they could not imagine themselves providing under their current circumstances.

The stories in Relinquished can feel repetitive in their similarities, but the ubiquitous nature of the experiences is also the point. One scene that is repeated over and over again: the sobs of the birth mothers that follow the moment when their child is taken from their arms forever.

Many of the women in Relinquished express feelings of regret, guilt, depression, and anger years after their child was adopted, but they also have ideas about how the industry could better support them: required waiting periods between birth and termination of parental rights, less money involved in the process, true options counseling that includes abortion, lifelong support for relinquishing mothers, and legally enforceable open adoption agreements. Some believe in adoption abolition, which means erasing the situations, like poverty or lack of housing, in which adoption becomes necessary.

“You just have to learn to find your voice,” says Erica, a birth mother. “That’s what the oppressed need to do: find their voice.”

A Radical Reimagining of Motherhood

That is ultimately what these three books do: give voice to the women who have been silenced, coerced, and shamed. “The stories we tell about adoption are part of both cultivated and incidental efforts to promote adoption as a social good,” Sisson says.

Giving visibility to these women is just one of the many steps these authors see toward a better, more just world for all mothers. Pryce argues that the incremental changes the child welfare system has undergone, such as mandates requiring foster children see a therapist or doctor within their first few weeks in state care, added funding for programs, or improved training for case workers, while positive, is not enough. “It’s time to dig into the foundational assumptions, mindsets, and biases that guide every policy and operational procedure within the system,” she says. “And yes, that digging will pull apart a system that we have always known—and it will take courage to create something new.”  

Asgarian presents similar calls to move beyond the current systems. She says that a true abolition of the system requires a “radical reimagining of what support for parents looks like.” This would include monetary, mental, and social support that prevent situations that require—or even suggest—the need for child removal.

In Relinquished, Sisson speaks with Renee Gelin, an advocate for family preservation who lost one of her own children to adoption. Gelin founded , a small collective of birth mothers who help women looking to parent but are feeling pressured into adoption. She spoke of a long-term dream in which a “commune of mothers who are all parenting without partners and can help each other.”

“It’s about being a village,” Gelin said.

At the core of all of these solutions is that village, one that reimagines what family and family support means. That village includes systems that don’t punish mothers for poverty or mental illness but provide the monetary and health support that allows them to be the best mothers they can be. Systems that elevate the importance of kinship when determining necessary temporary placements. Systems that do not abide the heteronormative, white-centered ideals of what a family should look like. That reimagining means a society that views motherhood not as a solitary role deserved by a select group, but as the foundation for the growth of the happy and healthy children we claim to want to see thrive.

*It’s important to note the language “birth mother” is offensive to some, while welcomed by others. Other terms with similarly mixed reactions include “first mother” and “natural mother.” Birth mother is primarily used in the texts we’re discussing so I chose to use it throughout this article.

Twenty-two hours later, he was assassinated.

King’s prophetic words express the virtue of hope amid hardship. He was not optimistic that he would reach the “Promised Land,” yet he was hopeful about the ultimate goal.

In conversation, “hope” and “optimism” can often be used as synonyms. But there’s an important gap between them, as psychology research suggests.

One of the most common tools to  asks people how much they agree with statements such as, “In uncertain times, I usually expect the best.” Those who strongly agree are regarded as highly optimistic.

But optimism can rely on a sense of luck over action. Self-help books on optimism are lined with hacks—like imagining your greatest possible self or focusing on the best-case scenario.

 studies how people perceive hope and justice. Long-term hope is not about looking on the bright side. It is a mindset that helps people endure challenges, tackle them head-on and keep their eyes on the goal—a virtue that Dr. King and other community leaders exemplify.

We, Not Me

Hope is often  as having strong will to succeed and plans to reach a goal.

Hope is stronger than optimism   and people’s ability to . Plenty of scientific evidence suggests that hope  and boosts their .

But branding hope as a self-improvement tool cheapens this long-established virtue. Hope has benefits . Thus, many psychologists are expanding the  beyond personal success. My research team defines this “” as striving toward a purposeful vision of the common good—a hope often shaped by hardship and strengthened through relationships.

Many leaders, including Dr. King, have channeled that lesson to inspire change. Centuries of spiritual and philosophical work describe hope  that, like love, is a decision, not a feeling.

The Myth of Time

Dr. King wasn’t known for looking on the bright side or expecting the best from others. He faced repeated waves of criticism, and, at the time of his death,  of him than of the .

In “,” Dr. King lamented the optimism of moderate white Americans who said they supported his goals but took little action. There is a “strangely irrational notion that there is something in the very flow of time that will inevitably cure all ills,” he wrote. “Actually, time itself is neutral; it can be used either destructively or constructively.”

He chastised society for believing that improvement would simply happen on its own. When he said, “The arc of the moral universe is long, ,” he was not describing its natural trajectory, but what people have the power to change. You cannot expect greener pastures if they are not tended today.

Dr. King was not alone in leveraging virtuous hope for justice. Brazilian educator Paulo Freire described hope as an “” that promotes action. Nelson Mandela, who spent 27 years in prison, called hope a “.”

Forged in Adversity

What makes hope a virtue is not its ability to promote happiness and success, but its commitment to a greater good beyond the self.

I study virtuous hope in a South African Zulu community, where there are few reasons for optimism. South Africa has . , and  is low. This is the part of the country where , with the percentage  in some communities.

We studied , based on their reputation and community suggestions. These individuals demonstrated an unwavering focus on striving for a better future, often unglued from expectations of personal success.

One local farmer nominated by his community struggled to buy seeds for his crops but still helped others apply for grants to buy them. Even when his own future was uncertain, he was not hoarding. He described his hope as a commitment to help others. His hope is not a positive expectation but a moral commitment.

Our interviewees did not describe hardship as a suppressor of hope but as its context to grow.

One unemployed young woman said she had applied for jobs for four years and would continue, though she was not naïve about the tough future. She said applying for jobs and reading to her child were her acts of hope. Her hope �徱���’t expect a quick improvement, yet it warded off paralysis.

Many of our interviewees anchored their hope in their Christian faith, as did Dr. King. Dr. King  St. Paul, one of the first Christian writers, , “Suffering produces endurance, endurance produces character, and character produces hope. Now this hope does not disappoint us.”

Hope, in other words, plays the long game: enduring suffering with integrity. Like Dr. King’s, it manifests in hardship and is refined in adversity. Hope enables communities to march for  even while tasting the danger of dictatorship, apartheid or oligarchy.

Hope knows it may take another generation to reach the Promised Land, but it acts today to  toward justice.

This article is republished from under a Creative Commons license. Read .

Woods, who is trans and nonbinary, works as a birth doula in the Seattle area. As part of their job, Woods extensively plans for a client’s post-labor recovery, and they wanted a similar level of care after their surgery. Top surgery was going to be vulnerable and challenging, Woods knew, and rather than rely solely on a partner or friends, they decided to hire an expert: a gender doula. 

Similar to birth doulas, gender doulas are non-clinical companions who provide advocacy, knowledge, and support. These days, you can count on two hands the number of people who have assumed the formal title of “gender doula,” but they have existed over the decades in other forms as “transgender transition coaches” or more informal word-of-mouth mentors. With exploration of becoming more common and , people are turning to gender doulas to navigate an often unwelcoming environment.

The gender doula could remind Woods to take their medication, supervise them on a walk in case they started feeling dizzy, or record how much fluid was draining into their post-surgical plastic bulbs to ensure they �ɱ�����’t at risk of infection. The doula could also act as an advocate at doctors’ appointments and ensure Woods’ correct pronouns were being used, given that they are often misgendered at the hospitals where their clients are giving birth, though “they/them” pronouns are clearly written on their badge.��

“When you’ve fought for so long, and have been silenced or not seen, and are finally stepping into your body, and then someone doesn’t see or acknowledge it … it’s just a dismissal of your existence,” Woods says. “And it’s crushing.” 

According to a , nearly half of the 1,500 transgender adults surveyed reported experiencing mistreatment or discrimination with a health provider. This includes misgendering, care refusal, and verbal or physical abuse. The rates are higher for transgender respondents of color, with 68% reporting a negative interaction. This in turn leads to health avoidance and delay, which can further exacerbate chronic health problems.

stef shuster, author of the 2021 book , says medical providers are often not trained as experts in gender, which means they bring in a lot of assumptions—sometimes bias—into their work about what they think a trans person should look or sound like.

“A�Բ�DzԱ� who doesn’t fit that mold, providers get really concerned about opening up access to care,” shuster says. “The structure of this system is flawed because it amplifies medical authority and minimizes trans people’s autonomy.”

Gender doulas help maintain autonomy, and sometimes, that looks like educating medical providers. Luigi Continenza, a gender doula in Tacoma, Washington, —like using the word “chest tissue” rather than “breast tissue,” or not asking patients about their top surgery scars when they’re seeking care for their ankle. 

Woods wanted a gender doula who could navigate the system, so they chose Ken McGee, a fellow birth doula who’d recently transitioned. He was also a physical therapist for a decade who’d seen how isolating gender-affirming surgeries can be and �徱���’t want people going through the process alone. McGee began pursuing gender doula work during the pandemic. He’s especially excited about educating clients and planning for rehabilitation post-surgery. “How are you going to be set up for sleeping? How do you think you’re going to wipe your bum? What’s showering going to be like?” he says. “I’ve never seen a surgeon’s office have a handout that covers all of that.”

For those who decide to medically transition—not a requirement for a transgender identity—a gender doula might offer guidance about how a patient can communicate with their doctor. But they won’t dish out medical advice. Gender exploration can be delicate, and many doulas are there to listen and help people process, though it’s important to note they are not trained therapists. 

, one of the first and only full-time gender doulas, says people often seek him out when they’re exploring their gender and feeling scared or confused. Like McGee, he started during the pandemic and much of his practice is online. He hosts virtual workshops such as “” and , but a bulk of his work is one-on-one consultations.

Lawliet holds a Ph.D. on the history of transgender medicine—one of his clients dubbed him the “trans librarian”—but he also has lived experience. “It took me a long time to realize that actually, I’m a gay man,” he says. ���� I had had somebody just talk it through with me, I feel like I could have saved eight years of consternation, you know?”

Lawliet says listening to Erica Livingston, a birth doula with Birdsong Brooklyn, on the podcast inspired him to pursue his current path. “She said this line: ‘We need a doula for every threshold.’ Of course, the threshold I was working with was transition,” Lawliet says. “I had a huge, thunderous, lightning moment.” Eventually, Livingston and her partner, Laura Interlandi, became his mentors, teaching him the skills to guide people through their most vulnerable and tender moments.

From his apartment in Los Angeles, surrounded by Dolly Parton art and tarot decks, Lawliet meets his clients over Zoom, which allows him to see people anywhere in the country—more than 115 of them so far with a growing waitlist. On a given day, it’s not uncommon for Lawliet to discuss everything from the spiritual aspects of transitioning and not feeling trans enough to the current political climate. Then there’s the logistics—insurance, clothing, name change—all the complex, moving parts of being trans, he says.

There’s currently no certification process. (Birth doulas have a certification process, though it isn’t a .) However, Lawliet is continually receiving requests for mentorship, so he is planning to offer a structured mentorship program in the future. For now, he has only taken on one mentee, who is Filipinx and Yaqui, which gives clients of color an option for someone with more shared experience.

Given the lack of official training, Lawliet strongly believes a deep interrogation of self needs to happen before someone assumes the title of gender doula. He’s always thinking about the ethical considerations of the role—confidentiality for one, or not trying to force people to grow or heal in a way that he thinks they need. He also created an online community with other gender doulas, including McGee, Luigi Continenza, Bowie Winnike, and Ro Rose, where they share resources, troubleshoot, and refer clients to one another.

In the end, McGee worked with Woods for a month. He taught them the signs of abnormal swelling and of course, made smoothies. When Woods wanted to step out into the world, McGee was right there alongside them, reminding them to take pauses when they felt winded, filling in the awkward silences, and stopping when they wanted to admire the exuberant branches of their favorite monkey puzzle tree. 

Eventually, Woods healed. The first time they slipped their favorite black hoodie over their head and looked in the mirror, they cried and thought:��“That’s how it’s supposed to look.” Woods and McGee are still in touch, and every now and then will go for a walk, together.��

In the summer of 2023, we at began to gather feminist changemakers from across the globe into an to tell the story of the future. We invited them to play with us and bring their hopes, love, and visions into our virtual circle in multiple sessions. Together, during one of the sessions, we wove a particular story, a fable—excerpted below—across time zones, cultures and generations: 

And so the other children asked, “Well, could we be visitors? Is there a way to share this place that wouldn’t intrude?” Ursula thought about it, and she looked to the trees and the path, and she asked Water. And Water said, “Yes, please bring the visitors. Remind them to bring their heart, make their offerings, and connect in their own ways. Yes, bring them.” So the children went to this place and they saw the beautiful little stream. As they sat, everybody was very quiet, until Ursula turned and asked, “Is everybody OK?” And Sister said, “Yes, but somehow it’s like we �徱���’t know Water before, and now we see her in a different way. We see more than we ever could.” And they thanked her for bringing them to this special place.

The deliciously nonlinear process of weaving this story together allowed us to feel, see, taste, and touch the world we long for—for our descendants, ancestors, and, yes, ourselves. 

Speculative, embodied storytelling is especially important now, given the level of uncertainty, conflict, and collective grief many of us are experiencing. Climate disruption has us literally navigating uncharted waters and unprecedented weather. Powerful new technologies, for healing and war, are evolving faster than we can grasp or govern them. Conflict is pervasive and escalating. Various anxieties haunt us and are amplified: disconnection, isolation, and loneliness; the specter of new deadly diseases; eco-anxiety; economic uncertainty; disregard for the life and well-being of the perceived “other”; displacement and lack of safe, consistent housing; concerns for our families’ and communities’ futures. 

Yet all is not lost. We need not brace ourselves and hold our collective breath. Instead, we can take low and slow breaths into our bellies, knowing that more people are remembering our right relationship to each other, to Water, Earth, Fire, and Air—sensing this is a crucial moment to leap into ways of being that foster repair, interconnection, and mutual thriving.  

The paradox of this time feels both new and ancient. What might it look like to belong—to ourselves, each other, and Earth—unconditionally? How might we remember what we’ve forgotten? How do we sit in paradox and use it to evolve together? 

Women leaders, organizers, and healers have helped their communities contend with these questions for generations. Root. Rise. Pollinate! started gathering such feminist changemakers—whom we call “pollinators”—early in the COVID-19 pandemic because we knew they could support mutual thriving in the middle of collapse. 

Now, years later, we find it even more important to commit to collective practices that generate hope, love, care, and community. Our current work in progress, , uses embodied storytelling to help pollinators be present in paradox, dream together, and apply those dreams daily in service of our collective evolution. Three core practices are emerging as essential to this evolution: Courageous Presence, Radical Imagination, and Embodied Adaptation. 

Practice 1: Courageous Presence

I don’t like the word “resistance.” I like the word “courageous presence.” What is courageous presence? It means you’ve really accepted the challenge given to you and you have developed through it … surrounded by people that understand the different parts that feed the whole soul and strengthen the body and mind for that challenge. —Elder Kathy Sanchez (Tewa Women United) 

The practice of speculative, embodied storytelling calls us to be present with the world as it is right now. This isn’t easy, but it’s powerful. As human beings, and activists, various habits protect us from seeing and experiencing the “muchness” of the world—repetitive unconscious behaviors like (but not limited to) retreating into or entrenching in that which is most familiar or (over)indulgence in any number of things. The unconsciousness with which we engage in these habits also separates us from our core power. We lose our ability to recognize and exercise our agency to face what is difficult and make choices to move away from the status quo toward something more hopeful, joyful, and rooted in love with courage.

In embodied storytelling we begin and end story circles with breath, body-based movement, and questions such as “How is your heart today?” By doing so, we bring our whole selves—heart, mind, body, spirit—forward in preparation for the stories we might weave. We practice courageous presence, rooted in love of ourselves, our people, and places, while opening to the complexity of our present conditions and the possibility to transform them. 

Practice 2: Visioning the Arc  

Our work as a movement is to create the conditions in which governance is loving. We don’t just want loving organizations, we want loving communities. We want the bloody state of the world to be loving … which is ultimately where we are trying to go with power. —Jessica Horn

Storytelling is the foundation of transformative strategy. It enables us to envision new, unexpected possibilities rooted in powerful, ancient truths. Pollinators weave a story together, generating ideas and energies that are hard to access when we are in more linear planning or evaluation modes. Through this playful practice we often surface key elements of vision, purpose, and strategies faster than when in those more linear modes. We connect the many layers of ourselves and our worlds with more ease. Some of the most powerful stories we created brought in the complexities of life, rather than a sanitized utopia. Through this practice we are seeding and growing power that is rooted in our imaginations, our interconnectedness, and the things we love.

Practice 3: Embodied Adaptation

The power of this work is as a driver of movement building … [so that] we do it in a way that fuels and strengthens the collective. —Shereen Essof

A revolution of being is about embodying the change we want to see in the world—without compartmentalizing the change. A revolution of being enables us to live wholeheartedly, with purpose as our imperfect selves in our imperfect world. Practice is the path.

As we engage in a revolution of being, we develop our capacity to keep our visions alive, to establish courageous presence, and to make choices and adjustments in response to inevitable change based on what is really important. We expect to learn and practice as we go. 

Stewards of the Future 

Each of us is trying to build a better future through collective learning. Each of us is both a learner and a teacher. —Pam Ki Mela

As stewards of the future, we are part of a longer arc, connected to our ancestors and descendants. A revolution of being will look different in each place and with each group of people, but it will share some similarities: the deep love for home, an unshakable sense of belonging, and an awareness of our interconnectedness with all living things. 

Join us in discovering a revolution of being!

MOTH

It isn’t in the wings or the flying 
where freedom takes place
it is in the quiet cosmos of 
your unbecoming.

In a case of silk 
your essence is protected 
while imaginal discs shift
molt into mystery, cave in.

May a song be an anchor 
while your body falls into itself. 
May you find beauty
in the reconstruction.

Do you remember 
your simultaneous
origin and conclusion?

Do you remember 
how once in a cocoon
you met yourself?

Care Coordination

Health care organizations such as hospitals, clinics, and managed care plans need to provide families of children with intensive medical needs with comprehensive care coordination that includes not just medical care but also social services, says Mona Patel, a pediatrician and chief integrated delivery systems officer at Children’s Hospital Los Angeles. That means going beyond just providing a list of resources and leaving caregivers to figure out the next steps. Families need personalized and well-organized support to connect them with resources in their community and help them navigate the challenges that come up.

Anna Leach-Proffer, managing attorney with Disability Rights California, says many programs such as Regional Centers and California Children’s Services do provide case managers for families of children with special health care needs. But this often results in families having multiple case managers who only work within one program and don’t coordinate among themselves. What’s needed is a super-coordinator who can oversee all aspects of a child’s care across all the programs.

A new benefit launched in July called Enhanced Care Management (ECM) aims to provide this for low-income children enrolled in Medi-Cal who have complex medical and social needs. However, the benefit has been slow to roll out and there is , including fears that it will simply add another layer of complication to the health care system for families.

Children’s Hospital Los Angeles is one of a few organizations already offering the benefit at scale. The hospital has hired 10 community health workers and provided ECM navigation to almost 300 families of medically fragile children since July. The workers meet with the families at clinics or in the community and walk them through obtaining the health and social services support they need, often going with them in-person to apply. This could range from getting a mental health appointment to an application for subsidized housing or for reduced-cost electricity. 

The system isn’t perfect—the hospital is contracting with several managed care plans that all have different administrative requirements, Patel says. She said it would help if the state Department of Health Care Services would standardize requirements across health plans. This needs to include standards designed for children, not just the adult population.

Nevertheless, families and medical providers working with the hospital’s program have so far offered positive feedback, she says.

“I think it could become the way of the future if it becomes much more streamlined,” Patel said, adding that the program could be “a wonderful opportunity to deliver the care and the depth of care that our patients and families deserve, especially in our vulnerable communities.”

Elizabeth Zirker, senior counsel for Disability Rights California, says managed care plans must also pay ECM providers adequately to ensure enough of them want to do the work. Another challenge with the care program is that it’s not available to children who qualify for Medi-Cal through a waiver program that exempts them from income-eligibility limits. It would make sense to change if those children aren’t receiving specific ECM-type services elsewhere, such as help transitioning out of an institution and coordination and referral to community and social supports, she says.

Closed Referral Loops

In 2025, Medi-Cal Managed Care Plans will be required to make sure that when members—including children and their families—are referred to a health or social service provider, someone follows up to make sure that referral went through. This “closed-loop referral” requirement encompasses referrals to ECM coordinators, local community organizations, dentists, regional centers, nutrition programs, and county mental health departments, among others.

Mike Odeh with the organization Children Now says, like ECM, this policy could really help families caring for children with disabilities, if done right. To ensure this, the state must fully detail what a closed-loop referral looks like, such as a maximum time a referral should take to complete and how they should be done. This is especially critical for young children for whom the speed of early intervention can have lifelong consequences.

“There needs to be training and resources (for providers) to make these systems work,” Odeh says. “At the end of the day it can’t be just giving the family a phone number and saying, ‘Good luck, hope it works for you.’”

Remove Limits on HCBA Waiver

The Home and Community-Based Alternatives (HCBA) waiver provides children and adults with disabilities who would otherwise be institutionalized to receive the services they need to live at home, including home nursing care. But the program has been full since July, leaving thousands of people on a waitlist. Disability rights advocates and members of Congress have to increase the number of waiver slots. The state did recently add an additional 7,200 slots over the next four years and implemented “triage” protocols to prioritize medically fragile children in the intake process, after a and other coverage of the issue. However, Zirker says the cap for medically fragile children should be lifted altogether.

Automatic Medi-Cal Reimbursement, Better Coordination With Other Plans

Some children with disabilities get health coverage from Medi-Cal and a statewide program called California Children’s Services (CCS). These programs don’t always agree on which entity should cover each service, and families get caught in the middle. If CCS denies a claim, Medi-Cal won’t pick it up until the family can prove it has exhausted the appeals process, said Leach-Proffer at Disability Rights California. That’s stressful and time consuming for families.

Leach-Proffer would like to see Medi-Cal coordinate with CCS to pay for denied claims, without families having to jump through hoops. In fact, Zirker believes that Medi-Cal should automatically pay all claims for its members so services can be provided in a timely fashion, and then figure out later if another program is responsible.

“Why should a medically fragile baby be placed at risk because these systems can’t communicate and are so lumbering?” she said.

Enforce Existing Regulations

Federal law requires Medi-Cal to for children under age 21 who are enrolled in the program. These services include dental, vision, hearing, home nursing, nutrition, and mental health services. But some California counties are not authorizing services according to these standards, said Nicholas Levenhagen, litigation counsel with Disability Rights California. He and Leach-Proffer said the Department of Health Care Services needs to provide better oversight of authorization processes among counties and Medi-Cal–managed care plans.

Enroll All Children in Medi-Cal

In October, the American Academy of Pediatrics—the largest professional association of pediatricians in the United States—proposed streamlining health care coverage for all children by automatically enrolling all newborns in a single, government-funded health insurance program. In California, this program would be Medi-Cal (a program that draws funding from two federal programs called Medicaid and the Children’s Health Insurance Program). The Academy proposed allowing all children to remain eligible for the program until they turn 26, regardless of income. Parents could choose to opt their child out of the program if they have another source of health insurance coverage. 

The Academy also proposed increasing federal funding to states to pay for this and increasing provider minimum reimbursement rates to make sure Medicaid providers are paid on par with Medicare—the health insurance program for people 65 and older.

“The existing patchwork of state Medicaid plans work well for some, but not all children, and leads to inequities and obstacles for families to obtain and keep their medical coverage,” said Jennifer Kusma, a co-author of proposal, in a statement. “Ultimately, all of society benefits when children and families are thriving and able to get their routine, preventive and urgent health care needs addressed.”

This story was produced in collaboration with the .

As her parents see it, caring for Claire is part of the job of being parents and something they do gladly, just as they care for her older brother, 7-year-old Xavier. Claire was born, apparently healthy, in December 2021 in Los Angeles, where the family still lives. Her parents never anticipated that four months later, after having brain swelling and open-heart surgery, their infant would be diagnosed with a condition so rare that only 20 people have been known to have it. Or that it would mean Claire’s mother, Vivian Vasquez, would become Claire’s full-time caregiver, and lose her job as a high school principal in the process, that the family would burn through their savings and need public assistance for health care, that they’d have to battle endless insurance program denials and paperwork to get care that doctors said Claire needed. Perhaps most shocking was that the health and social support system that’s supposed to help families like Claire’s would, instead, make it even more stressful to care for a child with intensive medical needs.

“When you are trying to care for a human baby and all you find are walls … it’s this stone-cold feeling,” Vasquez says. “How do I find the help I need? There’s no one to direct you.”

If Vasquez, who holds two master’s degrees, has struggled to figure out how to get health coverage and care for Claire, what happens to other, less-resourced families? California has multiple programs that provide support to children with complex medical needs and disabilities. Among them are Medi-Cal, the state’s safety-net health insurance program; a waiver program that allows kids with disabilities to qualify for Medi-Cal even if their parents earn too much; California Children’s Services, which provides treatment for children with certain medical conditions; In Home Supportive Services, which pays for caregiving of people with disabilities at home; and California’s Regional Center system, which serves kids and adults with developmental delays.

But accessing and making use of these programs is a minefield for many families. They often receive little guidance on how to apply for programs, must navigate complex paperwork and bureaucratic requirements, wait weeks or months to find out if they’re approved for a service, and—then, even if they do qualify—struggle to find providers that can offer the sanctioned care. The result is that children often don’t receive the care they need—which can lead to a need for even more care as they get older and increases the risk of the child requiring expensive visits to hospital emergency rooms. Some parents give up on trying to get services altogether and become emotionally or financially distressed. It’s common for at least one parent to have to stay home to care for the child, affecting the family’s income.

“I Can See Where People Would Give Up”

Claire is a vivacious child, with attentive brown eyes and the round cheeks of a toddler. Although she can’t talk, she babbles constantly, and flashes smiles at strangers and family members alike.

Born with a rare genetic condition that affects her heart, lungs, and brain function, Claire’s survival depends on a strict routine of alternating feeding, breathing, and medication treatments. These continue from the moment she wakes up until her bedtime around 9:30 p.m., when she sleeps attached to an oxygen machine.

An hour after Hernandez has given Claire her first supplements every morning, Vasquez steps into the little girl’s nursery.

“Hi, Claire bear,” Vasquez says. “Good morning, little honeybun.”

If she’s not too tired, the toddler stretches and greets her mom with a big smile. Vasquez props Claire up in bed or on the couch in the living room. She turns on The Wiggles—a children’s music show—on a tablet and uses a syringe to give her daughter the first of six meals of the day through her feeding tube. Claire likes to move along to the music and point and flex her toes when her favorite ballerina song comes on.

After making Xavier breakfast and driving him to school, Vasquez continues Claire’s feeding and treatment routine for the rest of the day and works with her on exercises to help physical and mental development, such as standing her against the wall, holding her head up, and putting toys in front of her. She balances this with taking Xavier to kung fu or piano lessons in the afternoon and helping him with homework.

But that’s just part of her responsibilities.

The stack of manila folders on the kitchen table is another story. Inside are papers related to health insurance programs, medical services, and social assistance Vasquez has sought to try to get Claire’s needs met and support her family financially.

“Everywhere I go, there’s something else to apply for,” Vasquez says, estimating that she spends two hours a day calling government agencies, health insurance officials, and doctor’s offices, often with little success. “I know the help is out there, it’s just hard to access it. … I can see where people would give up.”

“We have a very complex health care system,” says Apple Sepulveda, an occupational therapist with the in Los Angeles, who specializes in working with young children who have medically complex conditions, and is helping to teach Claire how to swallow. She says she’s constantly meeting parents like Vasquez who are struggling to get the support their child is entitled to, while trying to cope with the upheaval of caring for a child with intensive health needs. Because they don’t get enough help, parents can become overwhelmed or depressed, she says.

“Navigating all these services and appointments is time-consuming for families,” Sepulveda says. “We have to recognize that a lot of these parents are so overwhelmed because they bring their child home from the hospital or the NICU and they become their nurse, their care navigators, their advocates, their respiratory therapists. So, they wear a lot of hats.”

The Impact of Delays

Claire had open-heart surgery at 4 months old and shortly after was diagnosed with “chromosome deletion 4q21q22.” The condition impairs the body’s organs, delays growth, and affects feeding, speech, and mobility. Vasquez remembers how sad she felt when the doctors sat her and Hernandez down in a hospital office and told them that Claire might never walk or learn to speak. Vasquez’s dreams of taking her daughter to dance class and teaching her to read shattered. She wondered if Claire would ever learn to run, if she’d ever hold a balloon.

The doctors said Claire needed regular care from multiple specialists, occupational and speech therapy, tube feedings with specialized food, and oxygen equipment to help her breathe. 

She also needed more health insurance.

At the time, Vasquez was principal of an elementary school in Pomona, the culmination of a long career of teaching, founding a bilingual education program, and earning two bachelor’s and two master’s degrees. She had private health insurance for her family through her employer. But that insurance wasn’t enough to cover all the complex care that Claire required. Vasquez also needed a home nurse to care for Claire during the day while she worked. Although she and her husband made enough to live comfortably, these expenses were more than the family could afford. They also had a mortgage to pay, student loans, and two car loans, and were helping Vasquez’s elderly parents with utility bills. 

At first, Vasquez thought she had it figured out. A hospital social worker recommended she apply for the Medi-Cal and Home and Community-Base Alternatives (HCBA) waiver programs, which would cover Claire’s medical care. She also learned that, once Claire had Medi-Cal, she could apply for the state program that pays for a home nurse.

But it took months to get approved. First, Vasquez applied for standard Medi-Cal in June 2022, but was denied because her family’s income was too high. Then she applied for the waiver program, the other avenue to Medi-Cal coverage, which required gathering mountains of evidence for Claire’s condition. She waited three months for that to be approved. Then, upon receiving the approval, Vasquez had to reapply for Medi-Cal to get actual health coverage, which took effect  in January 2023. Because of the delay in getting insurance, during the eight-month process to obtain Medi-Cal Claire hadn’t seen most of the specialists she was entitled to see under , which requires that children enrolled in the safety-net health insurance program receive all medically necessary treatment.

Eight months is a long time when you are a toddler. It amounted to nearly half of Claire’s life that she had gone without the health care doctors said she needed. Early intervention is critically important for many children’s health and developmental conditions, increasing the likelihood that treatment will work.

Only when Claire had Medi-Cal could Vasquez apply for the home nurse program. Again, Vasquez waited about nine months for the application to be finalized. Eventually, she called the program’s customer service line in frustration, dialed through multiple prompts and waited two hours for someone to answer. She was told a form she had handed in was missing. It wasn’t until September that she received the first home nursing payment.

By that time, Vasquez had been fired from her job for missing too much work. She couldn’t juggle the demands of running a school with caring for Claire without the help of a nurse. With the loss of employment, Vasquez also lost the family’s main source of income, and her own and Xavier’s health insurance. She and Hernandez, whose job doesn’t offer family health coverage, began burning through their savings to stay afloat.

“I’ve never felt the amount of stress in my life as I have these last two years,” Vasquez says. “It just all crumbled down … I’ve had to reprioritize, readjust our lives.”

Ironically, Vasquez’s newly precarious financial situation made her and Xavier eligible for Medi-Cal. That application process took another three months, forcing Vasquez to burn through even more savings to pay for out-of-pocket medical bills for her and Xavier while she waited for their Medi-Cal cards.

“We �徱���’t qualify for Medi-Cal at first because we earned too much,” she noted. “It’s like you have to be reduced to low-income to get the help you need.”

All in all, the process of getting Claire the care she is entitled to—and needs—and health coverage for the rest of the family has taken more than a year and a half. And it’s not over yet. Vasquez is still trying to secure appointments with a developmental neurologist and speech therapist for Claire, and is trying to figure out how to apply for California Children Services, which she hopes will help cover some of the treatment.

“A Cloud Above My Head”

The Vasquez family’s worries �徱���’t end when they were finally enrolled in Medi-Cal and In Home Supportive Services, the home nursing program. Vasquez is compensated by Supportive Services for some of her caregiving hours, but at $17 an hour it’s only about half of her previous salary, and barely above minimum wage. Meanwhile, with Claire enrolled in Medi-Cal under the Home and Community-Based Alternatives waiver, Vasquez has struggled to find new specialists that take the insurance and don’t have a long waiting list.

Almost a year since having Medi-Cal, Vasquez is still working to get Claire all the doctor’s appointments and therapies she’s been told she needs. Provider shortages, particularly among those that accept Medi-Cal, make finding pediatric specialists difficult. And the doctors Vasquez used under her private plan don’t take Medi-Cal. Many doctors don’t accept Medi-Cal because it offers them a lower pay rate than private insurance, resulting in a tiered health care system that further exacerbates health disparities for Californians.  

Claire’s Medi-Cal plan sent referrals to at least 11 specialists, but most of them �ɱ�����’t taking appointments for months and still had to get final approval from Medi-Cal before they could see Claire. Vasquez had to pester them to try to ensure the referrals and approvals went through. This meant waiting months to see a primary-care physician, a pulmonologist, gastroenterologist, cardiologist, and other specialists. She’s still waiting for calls back for a developmental neurologist.

She’s also spent months fighting to get occupational and physical therapy, and now speech therapy for Claire. Vasquez applied for these services through the Eastern Los Angeles Regional Center in June 2022, but says she’s faced an uphill battle getting the therapies fully covered. She’s had to put in multiple requests to prove she couldn’t get coverage through her old health plan. Claire now has occupational and physical therapy twice a week, but Vasquez is frustrated that it took so long to get it. The Regional Center still hasn’t approved speech therapy, even though multiple providers have said Claire needs it. Vasquez is worried that the difficulty in getting these therapies and speech intervention has put her daughter’s development further behind.

To add to her to-do list, Vasquez now has to reapply for Claire’s Medi-Cal and HCBA waiver, because California has restarted its renewal process for health benefits after ending a three-year pause during the pandemic.

“When I think of the system, I feel like it’s just me and this cloud above my head with all these acronyms and bureaucracies and buildings and I’m like, ‘OK, which of them am I reaching for today?’” she says. “I’ve learned to take it one day at a time.”

Sepulveda says California needs to make it easier for families like Vasquez to get services. A new service under Medi-Cal called Enhanced Care Management that would provide care coordination for children like Claire could help, she says, but the benefit has been and many people are skeptical it will work. Vasquez says what she really needs is someone to walk through the system with her and provide ongoing support, rather than leaving her to figure everything out for herself. She wants it to be easy to call and get help, and to feel that those who answer the phone recognize her and her daughter as human beings, not just numbers and checkboxes.

Claire, meanwhile, is growing and gaining new skills, on her own timetable. She babbles, rolls over, and can pick up small items with her fingers like her pacifier and crackers. She recognizes people and smiles. The biggest smiles are for Vasquez, Hernandez, and Xavier.

But Claire doesn’t yet sit unassisted, crawl, or walk, as typically developing 3-year-olds would, and she hasn’t learned to speak.

Vasquez is holding out hope that Claire will eventually learn to do all these things. She dreams of using her education skills to one day teach her daughter to read. For now, she celebrates each small achievement, marveling at Claire’s determination.

“No one ever thinks they’re going to have a child with a condition,” Vasquez says. “It really does shatter hopes, but in a way it’s actually made me stronger. She’s taught me so much about what real courage is and what real beauty is. “

Sometimes, Vasquez and Hernandez get out the photo of Claire after her heart surgery at 4 months old, her tiny body covered in tape and stitches, her little face intent on breathing, on staying alive. She has done it. She is still doing it.

And her parents are helping her every step of the way.

This story was produced in collaboration with the .

We are afraid and yet we are obsessed, scaring ourselves with zombie movies, but the real undead/unalive, those of us who hang in a certain balance, are largely ignored. We elicit pity, guilt, and discomfort. Our stories are told for us, on our behalf. The half-dead, the near-dead, the undead: Our presence can be frightening. But say, where there is fear there is power. There is power in what we fear; there is a power we wield when we are feared. It is a time in the world where these sayings, these stories, and these worldviews must be shared widely again.

I developed ovarian cancer in my late 30s. kills the vast majority of its victims; there are few survivors. This is largely because there is , and it is almost always . Its symptoms are so generic (bloating, fatigue) that any tired woman would not notice them, and most poor and working-class women would simply endure them. 

In January 2021, while our world endured the isolation of COVID-19, I received a quick spiral of diagnoses that resulted in three cancer-related surgeries in less than three months. The winter of 2020 started with relief: Many of us had worked hard (and relatively well) together to defeat Trump. The previous four years of his presidency had brought me back to my organizing spirit and, while my peers and I were overworked and worn out, I felt some measure of calm when he was voted out.��

Alongside the battles of 2020, a small spirit had been warmly pestering me, like a child asking to be born. She brought me messages, bodily communiqués that doctors call “symptoms.” These resulted in a diagnosis of ovarian cancer, and one that disproportionately impacts , , , and older women. It feeds on those who can’t go to a doctor and those who convince ourselves we do not need to.

It is a cancer that lives and grows far inside the body. In my case, it came to me after years of terribly painful periods, with days of cramps and heavy bleeding. Continuous travel for work meant I rarely went to a doctor; I told myself that I ate alright and exercised. I had visited a gynecologist a few times, but they had not figured out what was wrong and only suggested birth control pills, which I politely would refuse. In retrospect, practically bleeding out and through my jeans in an airplane bathroom—several times over the years—was not normal. But the machine of overwork often convinces us our pain is normal, setting our standards of suffering to autopilot, set to run until we just fall down one day.

I have had six reproductive organs removed: each one died and went into the earth before the rest of my body. This was a sacrifice I made at men’s altar of blood and steel and science. A sacrifice I made to keep living in this wondrous body, to keep enjoying her purpose and pleasures.                                     

The (Goddesses and grandmother spirits of Central and Eastern Europe) and other spiritual forces in my life will, in time, tell me if this sacrifice was enough to save my life, but for now, it seems yes. I am told my diagnosis was quite unusual, that I was quite young for it. It has not served me to think of it this way. I refuse the idea it is unique—especially in the great cycle of loss and grief we all live in and through now. Instead, I felt it connecting me—as if on a threshold—to an array of spirits and humans. No saccharine optimism to be found, but such aliveness poured in and through me that I had moments of feeling dazzled.                                   

When I was in treatment, I felt I was nearly being killed to save my life. At that time, I searched the internet for books written by ovarian cancer survivors. There were few. I discovered why when I went to online ovarian cancer support groups: Everyone was slowly or quickly dying in those groups except me. Most of those suffering from this cancer likely simply died before they could consider writing anything.

Then I searched for any books by women who had any kind of cancer; I found some. Many felt like sugary, optimistic fairy tales bathed in Pepto-Bismol pink. They were also overwhelmingly the stories of Christian, wealthy, white, straight women. There were also many films, books, and articles written by people who loved people with cancer and who had lost people to cancer: lovers, parents, and siblings. The lives of cancer victims and survivors impact those around us deeply, and others are often moved to speak for us. This has advantages and disadvantages, of course. We also must reserve the space and support to speak for ourselves.

This made the few books I found that were completely different all the more precious—most notably, by Audre Lorde, which stands alone. She remains the only woman writer who lived with cancer I have ever read who wrote with raw truth about what it meant for her body, her sexuality, her mind, her relationships, and her children to suffer like this. She was taken from us far too soon. 

As I floated in my bed, during chemotherapy, high on opioids, I deeply wanted to read (when I could read) stories. Stories I could relate to: about the raw, the eternal, the visceral, the pessimistic, the women, the queers, the dead who talk to us when we are near their realm.

I �徱���’t want to hear the stories of praying to a God that was not mine. I was hungry to read about women grappling with cancer who were divorced, single moms, who came—as I did—from immigrant families, who had family far away, who were suffering through cancer on land that was not theirs and would never be. I did not feel the need to share every experience of these women; I just wanted to hear the pushed-out stories at the margins, which are really the stories of most of us. will deal with cancer at some point in their lives, and each year there are more cancer cases among . 

It seems to me some of us must chronicle the messy truths of it so that more of us can care for each other better in a time of profound alienation and isolation. Few have written about what it is to suffer cancer surgeries and treatment during a pandemic. This experience only underscored and deepened the solitude intrinsic to all of us who come close to death, all of us who must build a new life.

When I was a child, I was told one story about the history of the plant hemlock: one of the highest honors told in the stories of the witch burnings, was when one witch would smuggle hemlock to her tortured and imprisoned sisters. The ultimate sign of respect: allowing each to choose how much pain she wanted to take before ending her own life. At the heart of Slavic belief—indigenous to Eastern Europe and part of my heritage—are the ideas of immanence: that all things are alive and sacred. The love and the wrath of the earth are poured out upon us. Our deaths, our near deaths, our salvation, and our new lives are all catalysts for transformation in which we have some choice, some power, even when we feel we do not. There is no end, no beginning, and there never was.

I made choices in my near death. I made choices in my new life. My reasons were my own and would be different from anyone else. I owe a great deal to the legacy of feminist literature, particularly chronicling—the idea that it is inherently political and liberatory to chronicle painstakingly, in natural and raw time, the experiences of those who are often erased and silenced. “When we speak,” Lorde says, “we are afraid our words will not be heard or welcomed, but when we are silent we are still afraid, so it is better to speak remembering we were never meant to survive.”

I can only thank my ancestors here, and again and again eight times a year, for how they stayed close on this journey, ready for me if I were to cross over to their side. So many women in my lineage have suffered sorrow and regret silently; they urge me to speak. The honor of my life is to give voice in places they never could.               

These words are for all of us who know in our bones or seek a different way of being alive, nearing death, suffering, and even dying. They are for all of us who love someone going through these cycles. They are for all of us who want to reach beyond the numbing gauze of our times to know what suffering means, to be fully alive again, in order to be whole, again and always.

This excerpt from����by Caitlin Breedlove (AK Press, 2024) appears by permission of the publisher.

It takes a village to create a film. 

Many people think about filmmaking as just the people in front of and behind the camera—but there is a whole ecosystem of people who ensure that we can all safely participate in the process of creating a film that we can all be proud of. Inside this ecosystem, filmmakers can reshape community culture, iterating on how to live and lead in whatever villages we belong to. There is a role for everyone, and once the film village is created, everyone is essential. 

I am a film producer and director with , a film training program and production house designed to launch Black trans, gender-nonconforming, and intersex () storytellers into independent filmmaking and to tell stories woven at the intersection of being Black and TGNCI*. A lot of my work in film revolves around building film villages.

This beautiful, collective experiment is what continues to pull me into filmmaking. You get to be a part of a micro-society, practicing how another world could be constructed—and also how it can end. The film container can hold everything society holds, including violence and healing. And while the physical space of the village might end, the relationships created on set are transferable to our communities.

I’ve had the pleasure of writing, directing, and producing , a short film. Abandon is a story told from the perspective of a “barrel pickney” () reliving the moment she is abandoned by her mother at a bus stop, amidst the from Jamaica in the 1990s. This film was my way of working through a core childhood wound of abandonment and creating more possibilities for healing my youngest self. 

While directing this film, my focus was on the process and the people involved much more than on displaying the finished “product.” It was my first time experimenting intentionally with filmmaking rooted in healing justice, so I decided to start with my own story, my own wounds. Before we filmed a single scene, I brought in a healing justice practitioner who worked with everyone on set to explore their relationships with abandonment. It was essential to ensure everyone consented to be in this space where we would explore this rupture and violent theme over and over. Each person in this film village, cast and crew, had a defining experience with abandonment, and each of us had an opportunity to access healing together. Centering healing justice had a profound impact on me as an emerging film director and as a person using film and storytelling as a way to heal core wounds. 

One of the ways we centered healing justice was by experimenting with the autonomy and intuitive response of the characters. Though I wrote this script based on a specific experience of mine, on the film set we filmed a few different endings so that our cast could experiment with each character’s autonomy. In the film, a child experiences abandonment, so we experimented with different ways that this child might choose to respond. Do they cry while being understanding, throw a fit, make a scene, or are they completely unresponsive? 

We gave the child actor who played our lead role the autonomy and healing justice support to shape that role and the character’s experience. I was consistently and pleasantly surprised by the emotional range of our young actor, who had her own story to share about surviving abandonment. This production taught me that in moments of crisis we almost always revert to our youngest self. Witnessing this young person make choices for how to respond to abandonment opened deep healing possibilities for me while directing. What does it look like to get familiar with and develop trust with our child self ahead of crises? 

This production also allowed us to explore geography and place-based storytelling. The Abandon story is based on my experience of abandonment at a bus stop in Jamaica. Going back to the physical location as a sacred creative space and letting this location inform our new story more than two decades later unlocked something I don’t think I would have otherwise understood: The land holds our wounds—and it also holds the medicine for those wounds. 

When I initially experienced this abandonment at age 5, I dissociated completely. This film was an opportunity to reopen that wound in a sacred container and to be present with it. Across multiple takes, I was able to witness and direct one of my earliest experiences of abandonment. Making this film, so intimately based on one of my own core wounds, was one of my most difficult creative experiences. It was a process that triggered my abandonment wounds, and though I anticipated this and prepared for this, it was still emotionally taxing. Yet being present in the filmmaking process with all of these hard feelings is where I found my healing. Filmmaking is a great vehicle for healing precisely because of the village that surrounds each film. 

I knew that I needed the support of our remote somatic coach and our healing justice practitioner on the film set. But I also relied on the support of every person in this village—and I believe this magnified and created ripples of healing that everyone within this container could access. It wasn’t just a singular practitioner engaging folks’ healing on set. We all engaged with each other’s wounds and healing processes. I learned never to underestimate the power of the people in a community to heal each other. After all, harm happens in community, so there’s a particular kind of healing that also needs to happen in community. 

This sort of healing happened in the small moments, around the craft service tables, in the dressing rooms, and at the end of the night as we tried to make sense of all the worlds we experienced that day. Building film villages that are diverse and intergenerational is essential. Different bodies are conduits to different types of healing—and building this village offers more than what a singular practitioner could provide. Filmmaking and healing both require the support of a sturdy village. Combining both exponentially maximizes the potential for each. 

There is no one-size-fits-all for healing-justice-based filmmaking. Each film requires varied applications of healing justice. Some film sets require talk therapists and group debrief sessions, some require somatic bodyworkers, while others require group reiki and yoga to get our bodies limber before or after a long day. This is why, at Comfrey Films, we’ve created the role of the healing justice producer. This is a producer—or team of producers—who think through and prepare for the entire filmmaking process through a healing justice lens. They infuse our productions with opportunities for healing through all phases, from the film’s development through distribution. We invest in healing justice producers because we know this role is essential to creating culture-shifting films and embodying a culture of liberation in this work.

It takes a village to create a film. And it takes a village to heal.

Fast forward to the present, and there’s a different love-related equal-rights issue worth remedying this Valentine’s Day—orgasm inequality. This double standard often exists in heterosexual relationships where men feel entitled to get their orgasmic jollies in any and all encounters, while they consider a woman’s orgasm optional—a nice bonus if it happens, but not essential to feeling sexually satisfied. Given that orgasmic sex is a sublime source of human pleasure and has health and well-being benefits, both sexes should feel equally entitled to it. This should be especially true on Valentine’s Day, when sweethearts show the love they have for each other by making love.

Let’s start off with some data to get things straight (pun intended). Research shows the orgasm gap is real and largely unique to heterosexual, cisgender relationships. across sexual identities and discovered that heterosexual cisgender women were the least likely to say they usually or always orgasmed when sexually intimate (65%), especially compared to heterosexual cisgender men (95%). Both gay men (89%) and lesbian women (86%) reported higher frequencies of orgasms compared to their straight counterparts. These numbers hold firm across many studies, at least for women who are intimate with an ongoing, monogamous partner. Hook-up sex is less orgasm-friendly for both parties: that orgasm frequency for women having casual sex is about 32%, as opposed to about 82% for men.

Luckily, there’s nothing that categorically dooms straight women to less frequent orgasms than their male partners. Valentine’s Day provides a timely opportunity for straight couples to take up this issue in their own relationships. Here are some ideas on how to do that:

Embrace Equal Entitlement to Orgasm

The Golden Rule applies in bed every bit as much as it does in life: Treat others as you would have them treat you. If straight cisgender men feel entitled to an orgasm—meaning they believe they are inherently deserving of this form of delight—then it logically follows that so, too, do the women they’re sleeping with. If loving partners consensually agree to make love, there is a mutual healthy obligation to increase the pleasure that can be obtained from it, as receiving pleasure often ignites a desire to give pleasure in return. Not to mention, giving pleasure can itself be a pleasurable act that increases everyone’s enjoyment. But there is an important caveat: Cisgender male and female sexual arousal processes are not identical, and there are some distinct ways cis women need to be treated if orgasmic sex is in the cards.

������Ƶ Clitercourse With the Intercourse

Let’s toss out the tired stereotype that the female orgasm is some elusive mystery. that upward of 90% of cisgender women are able to climax while masturbating—and fast, ! This tells us that something about the bedroom dynamics of straight couples is resulting in legions of women getting shortchanged. Obviously, women need more than correct technique to get off. It’s common knowledge among sex researchers that female sexuality tends to be more “responsive” than the male variety—it’s tied to mood, restful sleep, feeling loved and wanted, and being treated kindly. Any deep dive into the orgasm gap would need to untangle these nuances. But at a surface level, what injustices are occurring in the bedroom that deny women their equal right to sublime sexual pleasure?��

Nowadays most men are diligent enough to get the mechanics of sex right as far as tending to their female partner’s clitoral desiderata. High numbers of straight men give oral sex to their female partners—79%, according to . A typical straight guy cares about women’s pleasure—so the orgasm gap is more a matter of him being misguided in how he doles that pleasure out. The problem is a phallocentric one. Many men turn what should be “clitercourse” into intercourse. Too many men approach foreplay as if it is a laborious step to prepare the vagina for penetration. They are either ignorant of or forget that for most women, clitoral stimulation—with tongue, fingers, or toys—is not the appetizer, but the main course. They confuse the time it takes for them to reach orgasm with what their female partner should need to get her goodies. what should be obvious, but somehow isn’t: “It takes women a lot longer to reach orgasm with a partner than men … 15 to 45 minutes versus two to 10 minutes.”

Quality sex is a labor of love that takes time. Female orgasms are not elusive. Heterosexual cisgender women are every bit as capable of experiencing orgasm through partnered sex as they are through self-pleasuring—that is, if their heterosexual cisgender male partners don’t fall into the trap of assuming that penis-in-vagina sex alone is the gateway to female orgasm. According to Mintz, only about 5% of women orgasm through thrusting alone, whereas 92% of women are able to orgasm when provided with 20 or more minutes of clitoral stimulation.

If pursuing orgasm equality this Valentine’s Day as a step toward equal rights isn’t compelling in itself, the proven health and well-being benefits of orgasmic sex might settle the score. Findings from the , which analyzed health outcomes of people first recruited as far back as the 1920s, showed that female participants with greater lifetime frequency of orgasmic sex tended to live longer than their less-gratified female counterparts. Frequent orgasms have even been linked to a more youthful appearance. A by Scottish psychologist David Weeks, who interviewed people over a 10-year span, discovered that both the males and females in his sample who had sex 50% more regularly looked anywhere between five and seven years younger in age. He credited this to how orgasms release a cascade of human growth hormones that elasticize and rejuvenate the skin.

So science tells us that orgasmic sex can not only make you quiver with delight, but also make you look younger and live longer—more reasons to embrace equal entitlement to sexual climax. Straight couples have an opportunity this Valentine’s Day to make the political very personal by focusing on what is a neglected woman’s rights issue—orgasm equality.  

While pop or hip-hop music are genres whose , this threatens to neglect other arenas of music making.

Some arts organizations in Canada have��, turned their platforms over to Black artists, or spotlighted their work. A recent virtual event, “,” featured acclaimed sopranos Measha Brueggergosman, Othalie Graham, and Audrey DuBois Harris, and was produced by��, a U.S. documentary film company. But what of a wider and cohesive community of Black classical instrumentalists in Canada today?

While there is a long history of professional classical musicianship in the Black community, there are gaps of knowledge about Black classical artistry in Canada.

Black classical artists might spend their careers in majority-White orchestras and small ensembles across Canada, without knowledge of others who share their experience. But this might be changing as , change the trajectory of their careers, , and step into leadership roles where they call for systemic change.

Black Classical Canada

In the United States, a  by the League of American Orchestras found that  of musicians in .

Similar data isn’t available in Canada. A study commissioned by Orchestras Canada  published in 2018 found that systemic inequity and coloniality underpinning Canadian classical music creates hierarchies reinforcing racism and cultural appropriation. Ethnomusicologist  authored the study with writer Soraya Peerbaye. Attariwala notes that because of Canada’s privacy laws, they could not compile race-related statistics about who is part of orchestras. She is now exploring the idea of orchestras taking voluntary statistical surveys.

Some prominent  have gained newfound attention through work by Black Canadians: Conductor  founded the  in 1998, honoring the . Classical singer and Nova Scotian  has been the subject of several Black artists  and became more commonly known in 1999, .

Although research has been broadly conducted into how , , and  have affected Black participation in classical music, we have yet to see a comprehensive study of Canadian Black contributions to Canadian classical music history.

Absence of Colleagues, Mentors

Canada has no comprehensive listing of contemporary Black classical instrumentalists. As the co-authors of this story, our shared interest in classical musicianship emerged through discussions, and an interest in reporting on Black classical instrumentalists came to the fore. Of the five Black classical instrumentalists whose work we were aware of, three were available to participate in interviews.

Black classical instrumentalists often experience their successes, as well as the  without the support of colleagues and mentors who might help navigate such terrain. All were pleased to have their experiences brought to light.

Negative experiences can start early.

Bassoonist Sheba Thibideau was told that her lips were “too big” to play the flute and that she was “not suitable” for violin by the principal of her elementary school in Vancouver.

Tanya Charles Iveniuk, who is on faculty at , the , and the , had an easier entry. Surrounded by the sounds of her older brother practicing the piano, she announced, at age 3, that she wanted to play the violin. And so it was.

In university, however, both musicians described impacts of . It often appeared as mysterious absence of access: to the appropriate performance-level student orchestra, to mentorship and information on how to navigate the  to professional life as a classical musician. They experienced microaggressions, at times, outright hostility or a lack of awareness of different economic circumstances.

Both question  if they hadn’t spent considerable energy navigating, explaining, and protecting themselves within the pressure cooker of predominantly White environments and power structures.

“I have a great career now,” says Iveniuk, “and yet, I’m haunted by that question.” This is psychic and emotional work that White (and   aren’t required to do.

Bartholomew-Poyser insists artists need to be able to talk about their experiences of microaggressions, “” and more overt harm, with each other and with their organizations. The  and  were recently called out by Black artists.

The Power of Many

Iveniuk relished experiences of working  and the opportunity to be . “Mind blown!” she laughs. “A whole orchestra of us?”

Thibideau has yet to have that experience. She’s dedicating 2020 to creating her  including a performance package to be used to entertain people in the prison system.

Iveniuk’s many projects include the  and planning to train as many BIPOC kids as she can.

Bartholomew-Poyser plans to catch young BIPOC players coming up. He says support looks like money, as well as mentorship, lessons, and transportation to and from concerts. It also looks like Black classical artists keeping in touch, he says, because “we need each other.”

In Canada’s already spread-out classical community, these vital connections will be the key to increasing the participation and visibility of Black instrumentalists.

This story was originally published by . It is reprinted here with permission.

In the fall of 2020, while sheltering in place during another surge of COVID-19 cases and after the summer racial justice uprising, Kirtrina Baxter knew she was ready for a change. She was traveling in Ghana on a seven-month healing journey to tend to burnout and a breakup when she remembered a conversation on a walk through the urban garden where she had worked with a fellow cooperative professional a year earlier. Her friend turned to her and said, “Kirtrina, you need to think about who you want to be in business with.” The pandemic put a pause on her earlier efforts to create a cooperative, but the pause and solitude of 2020 provided the clarity she needed to see a different path of opportunity. 

She took the time to answer the question for herself—and began to envision the roots of what would grow to become . Then, she went a step further to reach out to each person she wanted to build and connect with. All five of us—exhausted, struggling to care for ourselves and our families, care for sick loved ones, grieve losses, and remain employed during the pandemic—trusted and respected Kirtrina enough to say “YES!”

Today, three years later, we are a Black and Asian women–led cooperative and intergenerational community that leverages and shares our collective gifts, respect for the land, and our connection and wisdom of ancestors to build relationships and provide fiscal sponsorship, technical assistance, and resource generation to strengthen and sustain Black and Brown land stewards and food ecosystems.

During our early conversations, we acknowledged that we were yearning for something different than what any of us had experienced in our rich and varied work and lived experiences. We dreamed of creating a space steeped in love and care, one that welcomes and invites Black and Brown folks to heal, grow, learn, and share, and to receive the resources, support, and space to plant and nurture individual and collective dreams. We agreed to prioritize our relationship building and take the time to learn who we are, how best to connect, and what is most important to us. We understood that if we wanted to create something different intentionally, our “how” had to change. The way we come together and learn to adapt is an important practice for us, and our relationships are the core of all of this. Feeling seen and loved, as well as having the space to practice being loving in committed relationships with each other, enables us to transform culture, partnerships, work, and lives into what we have been dreaming of—and to become the women we have been dreaming of.

Change Is Constant, and Needed

As we focused on how we partnered with each other, we knew we would have to change our belief in what could be possible. We committed to stretching ourselves and sitting in discomfort, trying new ideas, and making mistakes—while releasing blame and shame connected to those mistakes. What we �徱���’t expect and were pleasantly surprised by was the adaptation that happened organically within each of us individually, as well as collectively. Our adaptation to open space for authentic check-ins at the beginning of every meeting enabled us to share how we were feeling honestly, what we were bringing to the space, and what our capacity looked like for the meeting and the work each week. Collectively, we made decisions to adapt our workflow and process based on the capacity and needs of our members. We were awestruck that our hypothesis of change proved correct! We prioritized care over production and relationship over checklists, and in so doing, strengthened our trust in each other and our commitment to our work.

Taking two years to focus on relationship building was different. It was challenging for us personally, for our funders, and our families. Some of our members were transitioning out of organizations and relationships, others were moving and traveling internationally, and some were raising children. Most of us had never been part of a collective before, and we were each trying to heal in our own way. It felt important to honor all of what we were holding and bringing into our space, while also holding fast to our commitment to expanding what could be possible for us collectively. 

We leaned into the lessons learned from Kirtrina’s leadership in and experience with , a Philadelphia-based collective of Black and Brown farmers and organizers working to ensure people of color regain community control of land and food. She shared with us how essential it is to value historically unnamed labor as work and see that work as worthy, especially when creating cooperatives. Taking the time to connect and heal is work—and is vital to how we learn, grow, and build together.

We have spent these first three years weaving together an understanding and alignment around values and ideologies—hard work that takes a lot of time, listening, trust building and rebuilding, frustration, and learning. Most of us had an idea of what a cooperative intergenerational space looked like before we began, but we quickly learned that the reality and practice of creating and sustaining such a space requires consistent work, commitment, communication, grace, forgiveness, and the ability to adapt and pivot to constant change. 

Now, we are continuing to build in ways that strengthen our relationships with each other and enable us to learn about ourselves in ways that impact how we show up in our families, communities, and other work. Our collective and individual ability to adapt, expand, and remain resilient and connected has been essential to our practice of revolutionary care. It has also helped us understand how we can adapt visions for ourselves that are full of abundance—and far more expansive than the limited versions presented to us in a society created in the imaginations of white men.

At 4DaSoil, we are committed to this revolutionary care practice for ourselves and our partners. We lead with who we are—our stories, and our intentions. We are mothers, small-business owners, recovering Wall Street workers, land and food industry workers, and activists. Our lived experiences reflect our identities, and we leverage our generational strengths as we struggle to make caregiving and life-sustaining decisions for ourselves and our families. We do all this while navigating white supremacist and oppressive systems that are designed to limit access to healthy food or full-service grocery stores in the predominantly Black and Brown neighborhoods in which we live.

4DaSoil is our intentional attempt and commitment to adapt and create ways of living, working, and loving—curated, defined, and held within our collective imagination. We are:

Kirtrina Baxter (U.S./Brazil) is a dedicated mother, spiritual drummer, returning generation farmer, food and land justice activist, community strategist, Afroecology educator, and a friend to Black women in the environmental justice movement and land workers internationally. Her work focuses on supporting collective development of Black and Brown growers. She is the reason 4DaSoil exists.

Robin Broughton-Smith (Philadelphia, PA, U.S.) is a former nonprofit executive director in the restaurant industry and business manager and accountant in the entertainment sector in New York City. She owned and operated two successful businesses in Philadelphia, her passion project was a successful bakery in Philadelphia called Sweet Nectar Dessert Kitchen, where she was the business owner and baker.

Hannah Chatterjee (London, U.K.) is the daughter of Asian immigrants with extensive experience in food systems planning, food policy, and public service in Philadelphia. She is a food industry worker who has cooked and served in kitchens, restaurants, and bakeries all over the world.

Nykisha Madison-Keita (Ghana) is an international agricultural business consultant who specializes in food safety and training for African farmers in and out of the African diaspora. She is an activist for land and has years of experience in business administration, community engagement, and urban farm and community market management. She offers food safety training and support that honors and aligns with practices that uplift cultural and ancestral wisdom.

Ebony Ross (Pittsburgh, PA, U.S.) is a capacity builder and coach for social justice leaders, organizers, and movement builders. She provides thought partnership, leadership development, and organizational development strategies that connect heart, vision, and strategy. She is a burgeoning farmer and doula in training.

Jasmin Washington (Brazil) is a descendant of farmers and small business owners. She is a former hedge fund and bank auditor with extensive experience in corporate, nonprofit, and small business settings. She is committed to providing healing and non-extractive fiscal management approaches and practices.

It was Musa who helped me realize the connection I was seeking could be found in my American homeland. In between posting herbal tea and tincture recipes, Musa uses her platform to call out popular herbalism texts for subtle and overt racism. She talks about how Black healing traditions are not just the foundation of White herbalism, but White Western medicine. She helps students reclaim herbs like turmeric and ashwagandha, which are typically attributed to Ayurvedic medicine but have been used by indigenous Africans for just as long and in similar ways.

At the center of Musa’s work is bodily autonomy. She says that “bodily autonomy is really key for anti-colonialism resistance, but particularly Black resistance. Whether we’re talking about emancipation from slavery or incarceration or medical apartheid, we’re talking about bodily autonomy. When we give people the skills to heal themselves as much as possible and connect that to how our ancestors would heal themselves as an act of resistance and self-determination, they gain the confidence to push back against the running narrative.”

Musa ended up with a career in herbalism despite that as an infant she nearly died because of herbal practices. Less than a year old and dangerously ill, Musa was taken to a Western doctor to be diagnosed, with plans to have her treated by a local healer. The problem came when Musa was misdiagnosed with mumps, so when her mother took her to a neighborhood medicine woman, the wrong treatment was administered.

As Sade explains it, “It’s a miracle I �徱���’t die. What did happen was it caused my neck to explode, and I had a hole in my neck. For years afterward my mom would massage vitamin E oil into my neck to reduce the scarring and to this day I still have huge scars on my neck. All because of lack of access to quality Western care and lack of follow-up.”

As Musa grew up, she couldn’t ignore how pervasive chronic illness plagued her community.

“I’m looking around and seeing all of these really sick people, a lot of cancer, diabetes, degenerative bones and tissue, so many things that were caused not just by personal behavior, but environmental racism and extreme stress. That’s how I realized that was an area that I wanted to work in.”

She began by studying pre-med, but switched direction just before entering medical school and became a medical researcher. She had hoped at the time to help diversify the medical research field, but was forced to leave due to a violently racist work environment. Biding time while she figured out her next step, Musa began teaching nutrition and herbalism classes in her community.

“Given that I was poor, I was also burdened with having to support my entire family, so I never even considered herbalism as a long-term option. Then as I began to get more serious in my studies and work with more people, I realized I could make a difference. It might not be as widespread as if I had done research in a lab, but teaching someone how to manage their diabetes or their blood pressure or take a few less pain pills per month or per week, that has a really big impact in their lives.”

From there, Roots of Resistance was born, breathing some much-needed color into an overwhelmingly White field. Plant medicine has been gaining popularity in tandem with spirituality over the last few years, but few herbalists are going to the same lengths as Musa to call attention to the contributions of the African diaspora.

She admits, “There are a small percentage of herbalists—including some White people—who are pushing back, but usually where they are pushing back is the appropriation of Native American medicine by White people or the appropriation of more ‘exotified’ Eastern healing traditions. In order for them to talk about how Black healing ways are appropriated, they’d have to talk about how they completely absorbed them and there is no discussion of that.”

I wondered how these uncomfortable subjects could be broached, given that her knowledge comes from years of intense study and is not easy to find, even online.

“I try to speak out and push back where I can, but generally it’s not well received, so I try to focus on how they would benefit from choosing to focus on plants that they have ties to. Everybody talks about how white sage has sacredness and how if you burn it you’ll have these spiritual effects, but I’m kind of like, yea, but how do you know that sacredness is going to transfer to you? I know personally, despite having some Native American blood, I don’t respond to white sage the way other people do. I respond to myrr, I respond to tamarind … I had to pay attention to what plants called to me, and I found that there were plants that could move me to tears. You don’t find this out if you’re just trying to steal other people’s sacred things. Find out what was sacred to your people and the land that you come from.”

“One of the things colonization did, and they even did this to White people, is it removed the spiritual component from all of the healing practices it touched. A lot of people nowadays are drawn to a holistic healing model because it involves the mind, body, and spirit, but all medicine used to be like this, even that which came from Europe. There was a strong connection to the Earth and plants were treated as spirits, not commodities. They were really big on approaching medicine with the right intention and believed that plants could enhance our innate power. You see a lot of people nowadays seeking this out with ayahuasca ceremonies, because they want to feel this spiritual enhancement and powerful connection to plants, but it doesn’t matter what you’re taking, whether it’s peyote or a plant that has no hallucinogenic effects, you can still have a powerful connection to that plant if you’re spiritually open to it. This was something that was inseparable from healing practice and that hasn’t been completely lost, but we definitely have a lot of work to do in reclaiming it, especially in the most colonized people.”

So where do we go from here? It seems like a lot of fourth-wave feminists want to dismantle current systems completely, but Musa clarifies why such thinking is ableist.

“The reality is, we can’t go back to before colonization. A lot of people feel like, ‘Oh, if we just eat like our ancestors, we’ll be fine,’ but we’re not in the same environment as them, we don’t breathe the same air that they breathed. We can’t just live off the land like we did before—there are people who are able to do that, but as a disabled person living with a chronic illness, I personally couldn’t imagine living in a place where there is not access to a hospital. I wish that we were able to do that, but the reality is that there is going to be a lot of people left behind.”

It boils down to Musa’s guiding mission of bodily autonomy. People who need pharmaceuticals should have reasonable access to them, but they should also have access to alternative modes of healing should they so choose.

The hard truth is we’re all going to get sick eventually, but we don’t have to wait until then to be compassionate toward the most vulnerable among us. They are the ones who need this work the most, and it is our responsibility to make sure it reaches them.

This article was originally published by . It has been edited for YES! Magazine. 

But that perception was challenged when my son, James, was born with medically intensive disabilities. I wanted my son to have a positive relationship with food, even though he is fed through a tube. To do that, I had to tackle my own emotional baggage about what it means to feed my family.

James’ relationship with food is complicated. He was tube fed for most of his early life, first with formula, and later with food processed in a blender. Now, at age 12, he gets about half of his calories from food and relies on Pediasure—vitamin-fortified formula—to get enough calories. For years, I felt guilty about the Pediasure. Every can made me feel like I was failing to give him “real” food. It took me years to accept that food doesn’t have a moral value. Feeding your child easily digestible food so they get adequate nutrition isn’t a weakness. Food doesn’t have to be a source of joy. It can simply be a source of nourishment.

This isn’t so much a story about how my son learned to eat as it is a story about how I came to terms with how he eats. The fact that my son hated food from a young age because his disabilities made the act of eating painful and scary made every mealtime hard. And for the longest time, I blamed myself.

Guilt in the NICU

In my rational mind, I know that I’m a good mother. But maternal guilt—especially around dietary choices—is common. My guilt around feeding started when my son was in the neonatal intensive care unit (NICU). I wanted to breastfeed. I’d memorized the adage “breast is best,” especially for the tiniest and sickest babies. I had breastfed my older child and easily transitioned to pumping when I went back to work. But the stress of pumping for a NICU baby was overwhelming. The hospital where my son spent most of his first year was a three-hour drive from our home. When I arrived at the hospital, I was desperate to see him, but I had to go to the pumping room instead. I couldn’t hold my own baby, and he couldn’t cry because of the tubes down his throat. So I played YouTube videos of babies crying to try and trigger the letdown reflex. It �徱���’t work. I could never release enough milk.

In my rational mind, I knew I wasn’t failing my son. All his medical needs were being met, and he was growing. But the decision to stop pumping and feed my son formula was hard. I felt so much pressure to keep pumping. It �徱���’t help that my son rejected every normal formula and had to be fed expensive specialty formula directly into his small intestines because of near-constant vomiting.

A Tube-Feeding Odyssey

During the early years, tube feeding solved a problem. My son was tiny and sick. To get better, he had to grow. To do that, he needed calories.

But tube feeding also created problems. My son had severe oral aversion—anything that touched his mouth triggered his gag reflex. He wouldn’t take a bottle or a pacifier or even put his fingers in his mouth. That meant he missed out on forming the neural-motor connections that pave the way for eating and speaking.

As a pathological overachiever, I �徱���’t want to just tube feed my child. I wanted to be the best at tube feeding. As we struggled to find a formula that worked, my son’s doctor suggested a blended-food diet but �徱���’t provide much guidance on how to do it. I started with baby food, then slowly started blending normal food and putting it through the tube. Through trial and error, I figured out the best, most calorically dense and nutritionally complete blended diet. The whole family worked to blend a month’s worth of food, made from bananas, carrots, spinach, eggs, and flax seed.

All the work I put into blending food was important for my son’s health—and my mental health. Having normal food in his stomach solved James’ constant vomiting and made the process of feeding him somewhat more normal. At a meal, everyone else would eat food from a plate and he would have blended food through the tube to his stomach. For me, making blended food instead of just opening a can and pouring it into the feeding pump made me feel like I was doing my job as a mom.

Learning to Eat

Swallowing involves about 50 tiny muscles in the mouth, tongue, and throat. Dysphagia is when something goes wrong in that process. Treating dysphagia in a medically fragile baby who’s never eaten and can’t understand detailed instructions is incredibly difficult.

There are formal therapy programs that are supposed to help children like my son learn to eat. But there aren’t enough speech-language pathologists and occupational therapists who specialize in children, especially those with special health care needs. Our local hospital had feeding therapists with special training in medically complex children. But their program had a years-long waitlist. Feeding therapy teaches children to overcome their aversion to tastes and textures by breaking down the process of chewing and swallowing food into small steps the child can practice.

There was another barrier to getting feeding therapy. My son needed to pass a swallow study (a medical test to make sure the things he swallowed went to his stomach and not his lungs). But he couldn’t pass a swallow study because he �徱���’t know how to swallow. The system wasn’t set up to work, so it fell to me to fix it.

To get my son to eat, I had to help him overcome his oral aversion. To do that, I tried to present him with different kinds of food to eat consistently and without pressure. I did OK with consistency, but I put pressure both on him and on myself. Our parent-child dynamic worked with mobility and speech because he wanted to move and communicate. The dynamic fell apart with food because he �徱���’t want to eat. The textures, tastes, and physical skills needed were overwhelming for him, and so was the pressure I put on him.

In the end, it was Pediasure that started my son’s journey toward enjoying food. One day, he discovered the taste of Pediasure from chewing a hole in his feeding pump line when he was teething. He became willing to eat vanilla Pediasure. He �徱���’t have the oral skills to suck on a bottle or drink from a cup, but the feeding pump could deliver a few drops of formula into his mouth at a time in a way that �徱���’t scare him.

Breakthroughs

As he grew, James alternated between hating food and wanting to participate in the thing everybody else was doing. He was particularly obsessed with frozen yogurt shops. He would be so excited to pull the yogurt handle and scoop the toppings that he would promise to eat it. Then he would get his perfect, beautiful frozen yogurt and cry. It was heartbreaking. Until one day, at age 4, he took his first bite of frozen yogurt. It was a single bite, and he �徱���’t like it, but it was a really big deal.

I pinned all my hopes on an inpatient feeding program at Children’s Hospital of Orange County, a five-hour drive from where we live in California’s Central Valley. The program is the only one of its kind in California and is created specifically for medically complex children who �徱���’t learn to eat as babies. My son went through the program the summer after kindergarten. Usually, kids stay with their parent in a special room that is set up to feel more like home than a hospital, but my son had to sleep in the ICU because of his ventilator. Those were the hardest three weeks of my life because it was all about food and it was all out of my control. In reality, it had always been out of my control.

The inpatient program worked enough to be considered a success. When my son entered the program he could only eat a single graham cracker. He left the program able to eat a white-bread-and-American-cheese sandwich with the crusts cut off. It took him about half an hour to do that. However, eating food was physically exhausting for the muscles in his jaws and he still needed to chug a Pediasure for concentrated calories.

I still felt like a failure. Now, instead of nutritionally and calorically perfect blended food in his tube, he was living on Pediasure and graham crackers.��He knew how to eat, but it was a Pyrrhic victory because now every mealtime was a battle of wills. He was willing to eat food, but he resented it and physically struggled with each bite. Meanwhile I was genuinely afraid that he wasn’t consuming enough calories to live. That fear wasn’t in my head. Medically fragile kids are frequently underweight, because being sick all the time burns a ton of calories. At every medical appointment, James was weighed and I was tasked with figuring out a way for him to eat more and gain more weight. ��

It turned out that vegetarian food was key to getting him to eat more.  Meat and other protein-dense foods are harder to chew and swallow than starchy foods. Vegetarian entrées like beans and tofu were easier for him to manage, with the side benefit of being healthy for the rest of the family. He started to enjoy trips to the farmers market, and could eat a few bites of whatever he chooses (and wash it down with Pediasure).

I wish I could say there was something I did that made him turn the corner, but I think it was just time. After a couple years of seeing eating as a chore, James got good enough at it to start actually enjoying some foods. That was always my goal: I �徱���’t want him to just eat food, I wanted him to love food.

The process was a learning experience for me. I had to relax and let him progress at his own pace. I had to understand that even when he loves a new food, he still needs to rely on “safe” and easy foods for most of his calories. Plain communication also helped. If James doesn’t like a lasagna I’ve made, for example, he’ll tell me.

These days, my son doesn’t love all the holiday foods, but he does eat the things he likes. He skips the Halloween candy because it has too many weird textures, but he enjoys trick-or-treating. For Thanksgiving he’ll eat a few bites of anything as long as it’s covered in gravy. During Christmas season, there is one dessert he adores: vanilla meringue cookies that are soft enough to melt in your mouth. His palate may not be expansive, but for me the most important thing is that he’s finally able to find joy in food. That’s all I ever wanted for him.

This story was produced in collaboration with the .

Since Oct. 7, 2023, I’ve spent my nights scrolling through videos of dead Palestinian children, etched in Instagram and backed by blue light. I scroll because as much as I cannot bear the gruesome brutality of missing infant arms, bloody 5-year-olds screaming for their mother, grandfathers on their knees holding their dead child in one arm and dead grandchild in the other—I also cannot bear to turn away. 

As a Black masc genderqueer lesbian, to turn away from this evidence of imperial violence would be to turn away from Sandra Bland, from Mike Brown, from Tamir Rice, from the anti-Black state violence that has, on digital display, taken hundreds of young Black lives over the last decade. 

To turn away from the supremacy and militarism wielded by Israel, that has been concentrated into a fascist regime financed by the United States, is to turn away from the politics of resentment that birthed the U.S. Immigration and Customs Enforcement’s policy of caging migrant children, many of whom are Black. 

To condemn the Palestinian movement against colonial occupation and for sovereignty would be to condemn the millions of Jewish people across the globe struggling for a new kind of peace and protection beyond Zionism. It would mean turning away from the Black radical tradition passed to me by my mother’s leadership in the Black Panther Party and my father’s work in the Black Liberation Army. It would be an act of self-recrimination, and I will not cosign my criminalization or the criminalization of our movements for peace, justice, and freedom.

I will not turn away from the American Indian Movement of the 1960’s, or the Landback movement of today. I will not turn away from the Arab Spring as it grows into a global summer of resistance. I will not turn away from the multigendered fight for control over our reproduction, or the workers’ fight for control over our production. Even though I am terrified that following the Cold War we have entered a fourth world war, terrified that we are too petty to build something popular and progressive; terrified that my wife, dead in my arms at the young age of 42, and my mother, dead in my arms at the young age of 59, simply join the ranks of the dozens of others I have personally lost in my lifetime, becoming a pain I cannot void—even still, I will not turn away.

Instead, my faith will reach out to touch your face sweetly, like my wife Alana once touched mine. Our terrorized bodies will find resonance in protest and will find armor in our congregational acts of public mourning. Together, in the millions and in every country, we will build a new demographic: the grievers. And we bereaved will remind those who seek to disenfranchise our loss, confiscate our hope, and weaponize our identity: We will rise from rubble, we will dance like the dust. Wherever our love is, there will be living, after all.

There Will Be Living After All

there are decades
that shatter everything you are
collapse it, stomach to back
till the three dimensions it once was
now fit, flat onto the page
maybe our children will read the story of us

maybe one day our children
those who survive the 21st century
will read that there were years littered with human longing
loss stretched across the memory 
exponential
a shadow over 3,650 afternoons
shade from an unbearable blinding, 
an unbearably binding truth

there will be living, after all.

there are decades sojourned like an open casket
Black Brown death on high rotation, 
on digital display
high-tech loss immortalized in ways 
found can never be
not when the air we breathe is saturated with
force and lies, the parents of an empirical grief
that partitions the memory 
its absence gnawing 
a desperate dementia 
the kind with pieces you don’t want to pick up
so you leave them where they fell
you let them be
familiar
breadcrumbs of a life
a marked trail
a masterful alchemy of moments 
a hidden transcript, love’s pidgin dialect
I speak you and remember how you 
rolled off the tongue
my God, I know this road too well 

this artery of land where my memory is sunless, hungry and alone 
or, a trial that always finds me guilty, 
insufficient
weaker than I meant to be
I follow it, then, through back streets and alleyways
back to the moon in your eyes
and am reminded, again

there will be living, after all

even though we walked, my love
I know
that it felt more like 
we shivered against a brutal night
crawled into and out of hospital beds 
more medical patient than person
a withered lonely 
one foot in love’s mass grave and 
one foot in its rebirth
I know it seems that way
like our bones are but rubbled stone
like death is all we have
like life is full of loopholes
like what we dreamed was just that, 
aspiration and holy grail
doomed to fail, but

if you’re like me 
grief may mark you
raise you keloid and braided
pockets and decades full of loss
a quilt of time pulled tight over a
buried past
stitched
across those broken moments
a whole life
spoken
in the parlance of tears

if you’re like me
grief might arm you
wield your open tumult
in full public view
until you are
a border of absence
a juggernaut of lonely
perpetually estivated in a burning
sorrow
the heart’s affliction militarized
a towering wall of
deep/cold/rage

if you’re like me
grief might crown you
in season
a solstice ordained by life’s forfeiture
if you are
willing to ascend to love’s trembling heights
like me
be an unwitting student
in a master class on meeting God with
every verdant breath
like, my beloved
do you remember
before life’s lambent afterglow?
how it was the sharp sweet sap of death that bled
you from each day
left you satisfied as worked land
sagacious
steaming
and threaded through my every/open/door
yes, remember
remember
I have loved
and been loved completely
grief
to the mirror
might say I am
love
if you’re lucky
like me, so

if you wondering what I been up to
if you came to ask after me
I been a crescent moon
defended against the soft night
I been a world war 
training for freedom
for that day when hope and history align
when dead languages let me speak to you again
alive 

on that day
they will probably call me crazy
redact my victories
tell me to get myself together

on that day
they will remind us of their charity
how they allowed some of us to breathe
gave some of us water and bread

but I will not pick up the parts of myself 
discarded by disease and distorted relations of power
I leave my loving on the ground
plant it like old seed in new earth
my memory will unpave the streets
my love will carry on the wind

as my wife is not lost to me
none of my dead are
as they leave no lack in me
I will leave nothing out nothing, because

after all is said
and after all is done
there will be living
after all

Blessed solstice loved ones. It is winter solstice in the northern hemisphere, and summer solstice in the southern hemisphere—but for my ancestors from the center of the surface of earth, my Caribbean community of the equator, we are always balancing darkness and bright, and other dualities. This solstice blessing is inspired by the , a person so deeply tied to the tides of how earth and moon and ocean interact that they became a star. This poem imagines Kuruman’s wish to us, the family members still here on earth. Take this meditation as an opportunity to reflect on these three questions in what is (depending on where you are) the darkest or brightest time of the year: 

What pulls you? 
What are you becoming?
What is your wish?

kuruman

this is what happened
from a wish to become
nothing

i became everything
i became pull

i became the only thing
we did not choose

i became gravity

*

this is what happened
in the dream where
i was everything

i became ocean
i became deep
i became heaven
i became sleep

i became what peace
you could imagine

*

this is what happened

i became star
i became morning

i emerged far
enough away��
that i could see you

*

this is the wish

a desert of salt
wide

and that you cross it

this is the wish

a sky 
black 

and that it holds you

this is the lesson

earth
was never still

As the events of this war unfolded over the next few days, I reached out to K., a journalist based in Kyiv, and D., an artist from St. Petersburg who opposes the war—each of whom I’d been in touch with only once online and had never met in person—to ask how they were. I was moved by the rawness of their responses, and I understood that, unlike most of what I had read about this war in the media, the personal accounts of these individuals might provide an emotional entry point to understanding the everyday reality of the war’s devastating impact in Ukraine for those of us not immediately affected. I asked K. and D. if I could interview them about their experiences to create a weekly illustrated diary that would juxtapose their individual, contrasting voices and raise immediate awareness of the war. Both of them instantly agreed.

Over the course of the next 12 months, I communicated with them individually via text message. Every week, I asked how they were feeling, what they were thinking about, and what they had experienced during the previous week. In addition to documenting their everyday experiences, I also posed questions that I hoped would shed light on how the war affected them on a deeper, more existential level: What impact did the war have on their minds and bodies? How did it change their relationship to their families and their sense of cultural belonging? Did it make them think differently about guilt, sacrifice, reparation, and retribution? Why do we wage wars, and will we ever learn from them?

Reprinted with permission from by Nora Krug, copyright 2023. Published by Ten Speed Graphic, an imprint of Penguin Random House.

I realized I wasn’t alone. The history of maternal liberation in communities of color runs deep. Stories of encouraged me—like and , a multicultural organization founded in Los Angeles in 1992 to protest mass incarceration and demand the liberation of the children and communities impacted by it. Scholars like , books like , and graduate coursework like my class on women of color in the United States revealed the parallels and interwoven experiences of mothers of color. 

That revelation helped inspire my own effort, , a virtual communal space and ethnographic movement encouraging Black mothers and other mothers of color to maintain their sense of self during motherhood. Central to FreeBlackMotherhood’s framework is the belief that “if we free ourselves, the children will follow.” That’s why we uplift the emotional vulnerability and self-reflection of Black mothers and others as crucial parts of building healing communities. 

I’ve witnessed the power of narratives of maternal liberation in Asian, Latinx, and communities both online and in traditional media. I feel curious and inspired about what we can learn if we engage in a cross-cultural dialogue that challenges the legacies of white supremacy with the pursuit of healing. In these spaces, parenthood—often specifically motherhood—is a site of resistance. We challenge one-dimensional narratives on kinship, achievement, and interconnectedness. 

Reclaiming Kinship and Connection 

“You can’t survive motherhood without kinship,” says , a postpartum healer, wellness coach, and doula who offers ancestral healing rooted in Mesoamerican traditional medicine through her practice Indigemama. “Western culture separates us. They tell us to live secluded in single-family homes, and it gives us the impression that if we ask for help and if we need support, then we’re weak. Then we’re not mothering material.”

She notes this perspective manipulates us to “struggle in silence” and view martyrdom as noble. Colonial views of mothering are individualist—but belonging and support help make mothering easier.

“I understand that all children are sacred, even if they’re not my children,” Panquetzani says. Ancient Mesoamerican worldviews believe children are borrowed, not owned, and reject “good or bad” behavior binaries for children. Instead this perspective considers a child to be “a being that is connected to nature, that is simply communicating their needs for survival.” 

Panquetzani notes that some elements of this tradition, like babywearing and , are practiced in white Western culture—albeit without reverence for the Indigenous cultures from which they come. “We have the ancient custom of carrying what is most sacred close to our hearts,” she says of her own ancestral traditions of babywearing. “I want my daughter to learn that she could trust to be held. I want my children to know that you are deserving; when you need to be supported, when life gets heavy, you can count on being held.” This communal care benefits the parents too, Panquetzani notes; she encourages us to see mothers’ shared plight and concerns everywhere, including Gaza and Palestine.

Where Western culture prioritizes independence in children even before it’s developmentally appropriate, Panquetzani believes in communicating unconditional love and ongoing care and support for the children in her life and community. “Because in community and kinship in Indigenous resistance, [the children are] always going to be taken care of, if not by me, [then] by the community. If not by the community, then by Mother Earth.” 

Challenging Perfection and Achievement 

Iris Chen, an Asian American woman of Chinese ancestry, says she sees a persistent awareness in her community of one-dimensional narratives of Asian parenting—often called “.” However, there is less recognition that this authoritarian, hierarchical type of parenting is based on trauma, scarcity, and fear. “I think that [type of parenting] has to do with historical, cultural trauma in our motherlands,” she explains. “Whether it’s colonization, war, poverty, things like that. … I think many of us—and the generations before us—came from a lot of struggle.”

She notes the energy of colonization and colonialism can unintentionally show up in parenting. “That is, in a more micro context, what happens with authoritarian parenting: You view your child as something to colonize. You have your values, and certain ideas of how things should go down, and you impose them onto your child.”

While she notes that Asian communities aren’t a monolith, Chen believes the themes of war, communism, migration/immigration, and pressure to assimilate surface consistently across these communities. That’s why the mission of her organization, , is to encourage parents to shift away from authoritarianism toward conscious, respectful parenting that is culturally accessible and relevant. Chen wants to empower Asian parents, reminding them they have agency over their narratives and parenting practices. She and Untigering envision a culture “where we’re not pressured to need to fulfill somebody else’s definition of who we need to be … [or] to fit into somebody else’s definition for us.”

She says this pressure manifests as feelings of otherness, alienation, pressure to leave cultural customs and languages, and overachieving. And Chen knows this firsthand: Despite meeting all the expectations of being the model minority—the good school, job, and salary—she still felt unfulfilled, and realized that tying her value and identity to her performance left little room for her to experience unconditional love.

So now Chen and Untigering offer that unconditional love, and work with Asian parents to help build a foundation rooted in “empowering them and supporting them to live the life that feels right for them instead of needing their success to feed my ego.”��

“I think we need to pull that apart a little bit and, again, recognize how a lot of tiger parenting is rooted in trauma, and it’s not inherent to who we are,” she says. She goes on to note that author Resmaa Menakem discusses trauma that’s decontextualized over time and looks like culture. “These are trauma-based responses, where we feel like … our only hope for survival and success [is] to climb the ladder, or we need to keep our children under control and obedient and compliant to survive. And to keep them safe.” 

Chen believes it’s possible to recognize the usefulness of these behaviors in a cultural context, and then assess whether they still serve us now. But she also denounces binary “all or none” approaches to culture and creates hybrid strategies that preserve health, like community, language, and tradition.

“It doesn’t have to be individualism versus collectivism,” she explains. “The community does thrive more when we can hold space for our individualism in a way that’s not coercive or conformist.” 

Challenging Anti-Blackness and Punitive Discipline

Leslie Priscilla founded after becoming certified as a parent coach, facilitating workshops with hundreds of Spanish-speaking parents in Orange County, California. The organization supports Latinx families in embracing trauma-informed, healing-centered, nonviolent, and culturally sustaining child-rearing.

Much of her work aims to end “chancla culture,” which she says survives through the use of oppressive strategies—including corporal punishment, shame, and fear—to manipulate children into behaving in ways that please adults. “La chancla is in reference to a sandal or flip-flop, and in Latinx culture, it is frequently referenced as having been used by our immigrant or Latina mothers to get children to change behavior—either threatening or actively using it to physically hurt us as children,” Latinx Parenting’s website explains.

“From the time I was very young, it was clear that there was a difference in my experience between the ways I was treated as a lighter-skinned child of immigrants, called ��ü�����, in comparison with my cousins who were more brown and called things like prieto,” says Priscilla. 

Growing up in Orange County, she says she remembers the overt suggestion that whiteness was beautiful, and she felt tremendous pride walking around in a body of lighter skin and fair hair. But while supporting parents in developing healthy discipline through Latinx Parenting, she also found harmful perspectives on colorism and race. 

“It was evident that I had to incorporate conversation around racism and discrimination, because not only were families continuing cycles that prioritized whiteness and white ways of being, but the stress from the racism and discrimination that people like my mom experienced in navigating the white gaze definitely affected parenting,” she says. She also adds that the constant stream of deadly police violence against Black men and boys, and Latino men and boys, shaped her understanding of how racism, discrimination, and colorism impacted parenting. In was having a mental health crisis and was reported by neighbors to be unarmed when Tustin Police shot him at an apartment complex neighboring Priscilla’s mother’s. “Trayvon Martin shares a birthday with my oldest daughter, and to this day, we honor him,” she adds. 

According to Priscilla, Latinx Parenting’s posts on colorism �徱���’t get engagement on social media early on. But within two years of starting Latinx Parenting, George Floyd was murdered, and she noted that it wasn’t only white cops who were killing Black and Brown people. “Officer Jeronimo Yanez shot Philando Castile as he was reaching for his wallet in 2016,” she says. “I knew that it wasn’t just white people who were raised to fear or be averted to Blackness. And I also knew all of that came from a white supremacist caste system that made our survival dependent on our alignment to whiteness.” 

Priscilla says this is why anti-racism is a core component of Latinx Parenting. “The way I’ve seen whiteness glorified as supreme embodiment via colorism and intracultural racism is not possible to ignore,” she says. “Because I can identify the channels through which those are passed on to the psyche of children, and because I was that child who had to unlearn my own internalized white supremacist tendencies, I place great importance on inviting parents and caregivers to reflect on how that shows up for themselves and in their relationship with children.”

These beliefs get internalized as anti-Blackness and anti-Indigeneity, she adds. “This is how I know our liberation is tied, and that despite what we were raised to believe, we are not each others’ enemies. There are many Afro-Latinx and Black Latinx individuals who resent the binary of ‘Brown vs. Black,’ because it excludes their identity,” she says, noting the complexities of exploring identity in Latinx communities. “Still, we as people who identify ourselves as belonging to the Latinx diaspora should also recognize what belief systems have been adapted into our families for survival purposes and what started that: colonization.”

CORRECTION: This article was updated at 12:18 p.m. PT on Dec. 8, 2023, to correct the a typo in the name of Chen’s organization, and to remove an incorrect reference to Chen’s ancestry. Read our corrections policy here.

���� This Is Us and Modern Family came together, it would be us,” Gasby told The Washington Post. Gasby’s daughter, Dana, agreed, telling The Washington Post that she’s glad her father met Lerner. “When he told me, I was like, Thank God. I’m happy,” she said.

Gasby’s admission ignited a , especially on he was shepherding for his wife’s lifestyle brand. “[Lerner’s] having her lifestyle funded by [this] Black woman, and this white woman �徱���’t have to build a thing with you,” that has accrued more than 215,000 views. When Gasby appeared on in 2019, the hosts pilloried him for moving Lerner into the home he shared with Smith. Co-host Sunny Hostin, who was friends with Smith and Gasby, said that moving Lerner in was “very disrespectful,” to which Gasby replied, “I am keeping my vows to protect and care for [Smith],” who he said encouraged him to move forward with his life after her diagnosis. “When we got the diagnosis at Mount Sinai … she stopped me, put her hand on my arm and … she said to me, ‘I want you to go on,’” Gasby said. “I’m not doing anything we �徱���’t [discuss].”

While many were upset that Lerner was helping Gasby care for Smith, who died in 2020, this complicated love story is an example of an extended family coming together to combat Alzheimer’s, of our time. It’s also a starting point for an honest conversation about the emotional needs of those caring for loved ones with incurable diseases.

I think about caregiving a lot. I’m a healthy 73-year-old African American woman, and my husband, Joe, is a 76-year-old diabetic and a cancer survivor. The aggressive chemotherapy and radiation that saved his life 25 years ago and . He exercises daily, takes all his meds, and remains mentally sharp—and he’s also at high risk of developing some form of dementia. I’m haunted by the possibility that I may one day have to be his full-time caregiver. 

At its best and most challenging, marriage is about spouses caring for one another, something Joe and I have done for 33 years. During Joe’s cancer journey, I insisted that his family recognize my need for emotional support. They eagerly responded to my call for help and buoyed my spirits: Joe’s relatives asked me how I was doing when they called to check on him, which had not happened before. And, in the last stages of Joe’s treatment, his parents opened their home to him so I could live in Richmond, Virginia, three days a week and teach at Virginia Commonwealth University. 

Though Joe’s cancer has been in remission since 1996, we’ve still talked about death, what we want, and what we don’t want. He has told me that if he declines beyond recognition he wants me to “move on.” Still, there’s nothing that can prepare you to watch the decline of your life partner while also being their administrator, appointment maker, chauffeur, cook, nurse, and doctor.

Over the past several years, I have watched my oldest friend care for her bedridden mother while also taking time for herself. Her mother worked for the federal government for 30 years, so my friend depended on the generous resources of her mother’s pension, Social Security, and Medicare to provide 24-hour care when needed. At the same time, I have seen another friend struggle with indifferent doctors and incompetent nursing staff as she tries to piece together support for her husband while he endures the final stages of Parkinson’s disease.

Caregivers are a national resource and a national treasure, but , , support groups, and time off that they deserve. They’re not recognized as individuals who have often quit their jobs, changed the direction of their lives, and given up their dreams to support someone else. 

The statistics are stark: According to , 53 million people in the United States are caregivers for someone who is chronically ill or disabled. Of those, have provided unpaid caregiving to an adult aged 50 or over. who are caregivers is increasing every year, , and 19% of adults over the age of 65 are caring for a friend or family member. All this caregiving, , takes place against the backdrop of a health care system that’s , difficult to manage, and does little to .

While nearly every state provides , it often isn’t enough to cover all the costs of care, including home health aides, health insurance, medical transport, and medications. , , and help to fill in the financial gap, but most older people age in their homes, because . In 2022, began attempting to address these concerns with its , which highlights nearly 350 actions various federal agencies can take to better support family caregivers and 150 additional actions that other levels of government can adopt.

Some of those actions include access to AmeriCorps Seniors, which offers short-term respite care to family caregivers in need of a break; updating rules for the Centers of Medicare and Medicaid Services to ensure family caregivers are involved in hospital discharge planning for their loved ones; and leveraging Medicaid funding to ensure caregivers receive better pay and the tax credits that are available to them. But as caregivers, particularly older caregivers caring for other aging people, wait for these actions to improve their lives, they’re taking respite care into their own hands.

There’s a saying among Black American Christians that “God never gives you more than you can handle.” Throughout my life, my acceptance of that assertion has waxed and waned, but 76-year-old Regina Wells, a retired case manager living in Washington, D.C., has an unshakable belief in that adage. And yet, her resilience, generous spirit, and deep religious faith were tested as she served as a full-time caregiver for her husband and her mother for more than a decade.

Given her career, Wells was accustomed to stress, but nothing could’ve prepared her for the rigors of being a full-time caregiver. Brough, her husband of 45 years, suffered a series of strokes over the course of three years. He also had high blood pressure and gout, for which he had resisted treatment, and over time, he developed congestive heart failure and sleep apnea. “He was a terrible patient,” Wells says. “He �徱���’t follow the doctor’s instructions. … He would insist that he was OK, that he �徱���’t need help, and then fall or slide off the bed.” 

After Brough’s last stroke in 2022, Wells realized she could no longer care for him on her own and that he would receive better care in a nursing home. The same year, Wells’ mother had several strokes and was diagnosed with breast cancer. Studies have shown that before those they’re caring for. That can be partially attributed to “,” a condition that can lead to physical, mental, and emotional exhaustion. As a result, caregivers are at risk for developing many chronic illnesses like diabetes, heart disease, and high blood pressure. Or, as told me, “Health problems often go unaddressed in caregivers.”

Wells beat those statistics. However, caretaking still took an enormous toll on her. While her friends, siblings, pastor, and children offered to help, she �徱���’t want to disrupt their lives by sharing the caregiving responsibilities. “People were telling me to take care of myself,” she says. “There were many offers of help that, looking back, I wish I had accepted. I cried a couple of times, but I wouldn’t break down. I felt that I couldn’t.”

Eventually, Wells reached a breaking point. “I remember one day when I felt so drained and tired and I did break down,” she says. “I told them both, ‘I can’t take care of you.’ I screamed in frustration and then I snapped out of it. I came back to reality.” For Wells, that reality included a diagnosis of B-cell lymphoma followed by six months of cancer treatments. “Luckily it was a nonaggressive cancer, and I �徱���’t have a bad reaction to the monthly chemotherapy treatments,” Wells says. “When I’d come home from the treatments, I’d take my nap when my mother napped. I adapted to her schedule.”

Wells developed cancer in 2021, a year before Brough died. Her mother died in 2023 at the age of 95. Wells is now a widow and a motherless child, grieving her mother and her husband in the same apartment in Prince George’s County, Maryland, where she and Brough raised their children. “I miss them both,” she says. “I talk to them constantly, just like they are still here. But I am relieved, relaxed, and peaceful. It’s like they both had to die for me to finally get some rest, to get some time for myself.”

Wells is a good wife, a good daughter, and a “strong Black woman,” convinced that she had no time for tears, that vulnerability was a weakness, and that her needs and well-being were trumped by the needs of her family. To accept too much help would have undermined her sense of being capable. “Today I would tell anyone going through what I went through to ask for help, accept it when it is given, and take care of yourself,” she says.

Kimberly Fleming, a licensed clinical social worker, social psychologist, and certified telemental health provider, is doing everything she can to preserve her mental and physical health as she cares for Ben, her husband of 27 years, who was initially diagnosed with mixed dementia (Alzheimer’s and vascular dementia) in 2018, and was rediagnosed with Alzheimer’s Lewy body dementia (LBD) in 2022. He’s now in stage 6, so he can’t move his legs, and he’s developed Parkinson’s-like symptoms. While Ben needs 24-hour nursing assistance, the couple can’t afford it; instead, a certified nursing assistant is with Ben eight hours on Monday, Tuesday, and Thursday, and four hours each day of the rest of the week. “After they leave it’s all on me,” Fleming says. “The feeding, dressing him, getting him to the bathroom. I have shoulder and hip problems from lifting him. I don’t sleep much at night fearing he will wake up and try to go to the bathroom and fall.”

After Ben’s diagnosis, Fleming moved them from a four-story house in Edison, New Jersey, to a smaller house in Charleston, South Carolina, to be closer to Ben’s daughter, who was stationed at a nearby army base. However, when Ben’s daughter was reassigned to Japan six months later, it left Fleming with few options. “[Ben’s daughter being reassigned] left me stranded in a sense,” she says. “Navigating a health care system in a new state, dealing with Ben’s nearby relatives who, when they visited us, despite Ben’s clear decline, patted my hand and told me, ‘He’ll get better.’ I wanted to scream, ‘No, he won’t!’ but I understood their inability to accept what I struggled to accept every day.”

For many Black Americans, caring for an aging family member is because it allows the family to keep their aging loved ones close. As , Black Americans tend to have more “burdensome” caregiving arrangements since Black caregivers tend to be younger and unmarried and have to balance caring for their loved one with a full-time job. And yet, than their white counterparts, and for their aging relatives.

, a geriatrician and physician at Johns Hopkins School of Medicine, who cares for the elderly at Johns Hopkins Hospital in Baltimore, knows this firsthand. “I wouldn’t be a physician if not for what I learned and experienced helping my family care for my bedridden grandmother and my grandfather who had dementia, from the time I was 7 to 17,” he says. “There is joy and peace that comes with caregiving. The peace of mind and joy of caring for someone who once cared for you, of giving of yourself to others, easing their pain. And in my community, we aspire to be there for family members. They want to care for their family as an act of love and devotion.”

Fleming knows that the end is near for her husband. There’s only one stage of LBD left, and he’s currently in hospice care. “I’m watching my husband die a bit more each day,” she says. “We had a great life together; we traveled, he supported me, we had fun, we had love, and I find myself living in those memories to keep me going. It’s so hard to grieve [for] someone you are looking at every day.” While she says this has been one of the hardest experiences of her life, she’s also refused to lose herself. She has created a space in their home where she meditates, practices yoga, puts together puzzles for stress reduction, and uses Zoom not only for her continued part-time practice but for regular wellness check-ins with a group of other therapists who provide advice and comfort. 

From her perspective, caring for herself is one of the best ways she can provide for her husband. “Sometimes when the nurse is here, I will go for a walk around a nearby lake, drive to a park, and just sit in my car for a while,” she says. “I’m still working with some clients in my practice who are going through what I am going through, and I tell them what I tell myself and what I try to live: Caring for yourself is caring for your partner. Allow yourself to cry.” 

When I interviewed Fleming via video, I noticed that she was dressed up and wearing makeup. “I’m going out tonight,” she says. “We’ve lived in this community for over a year, and tonight there is a community social event. I’m going. A family member will watch Ben. This will be the first time since we moved here that I have gone out to anything like this. Ben’s care has been all-consuming.”

A weeklong vacation in Scotland was the perfect mix of rest, relaxation, stimulation, and excitement for , who had never traveled to Europe before. The long-overdue vacation was especially meaningful after several years of supporting her elderly parents.

As vice president and chief diversity officer at Johns Hopkins Medicine, as well as a professor of medicine, Golden and her staff oversee the biomedical workforce diversity initiatives and health equity for the Johns Hopkins Medical system, which includes five hospitals in Maryland and one in Miami. At 55, she is at the top of her game, a Black woman in a key position to impact medical policy. She loves her job, but the responsibility of supporting her father in his role as the primary caregiver for her mother, who has Parkinson’s, has required major shifts in her life.

For years, Golden has served as a guide, adviser, consultant, and watchdog as her parents age and as her mother’s Parkinson’s symptoms progress. She’s the one who urged her parents to move from their two-story home in Bowie, Maryland, after her mother fell down the stairs. There had been a time when she and her mom could go to lunch and go shopping together, but that fall changed everything. Though it took months of planning—and then COVID-19 stalled the move for a year—Golden was eventually able to help her parents move into an independent living community about 20 minutes from her home. 

While Golden’s parents have access to medical care, social workers, and even a gym, caregiving still took a toll on her father. Shortly after her return from Scotland, her father passed out and was hospitalized for what his doctors believe was dehydration. It wasn’t until his hospitalization that her mother confessed that her father was falling asleep whenever he sat down. Golden’s father, a proud man devoted to caring for his wife, kept all his fatigue and stress a secret from his daughter. 

When her father was hospitalized, Golden took a week off work to care for her mom. Though her son and a friend helped her, caregiving was still overwhelming. “I was wiped out by the end of that week,” she says. “When [my] dad was released, we knew he had to get more help at home. He needed a break.”

Since that time, Golden has begun seeing a therapist and has become a member of , a support group for Black women caregiving for their parents. Those two decisions have given her the tools she needs to be a more effective caregiver, daughter, wife, and mother. “I had to learn how to set boundaries and how to say no to requests from my family that were unreasonable,” she says. “I had to learn that I could no longer depend on my parents for the kind of deep emotional support they offered me in the past because of all they were going through. … And I realized that I needed someone other than my husband and my son and friends to vent to, to share my frustration and grief, someone outside the family.”

Overwhelmed caregivers need the kind of guidance and support Golden is now receiving. For more than a decade, Paula Rice was a New York–based . “People often don’t know how to ask for help or where to get it,” she says. She encourages caregivers to contact the national foundations for the illness or disease of the person they are caring for. Those foundations can provide information about support groups, the illness itself, and even legal advice. Rice says reaching out to the foundations is a task family and friends can perform for the primary caregiver as a means of support.

Shadowing all conversations about caring for the elderly is dying and death, uncomfortable but essential topics that seem to be unspeakable until the end of life is near or has come. In order to relieve stress, geriatric care manager Craynon recommends that aging people, especially those with children, have these difficult conversations with their potential caregivers. “A gift we give our children is telling them what we want long-term caregiving and our dying to look like,” she says. “It is important to talk about this. Don’t be afraid to talk about the end.”

Craynon suggests filling out all important forms ahead of time, including power of attorney, wills, and advance directives. For caregivers with parents who are hesitant to discuss these matters, Craynon suggests this language: “As your child, I am concerned about knowing what you want. That is an important thing that I can do for you—honor your wishes—but you have to tell me what they are.”

Rosemary Allender, who provided geriatric care services to families before retiring, agrees. She encourages families to design a plan of care that minimizes caregiver stress, expands support systems, and maximizes independence and quality of life for those who require care. “The most important thing is to have open communication and conversations long before the family faces the crisis of how to care for Mom or Dad,” she says. “Call a family meeting and bring family members together to create an action plan to implement if faced with a long-term caregiving crisis. Everyone can’t do everything, but everyone can do something. These conversations, if held in advance, make responding to the needs of elderly family members much easier.”

In 2011, offered one of the most apt and moving descriptions in a written testimony for a Senate Special Committee on Aging: “There are only four kinds of people in the world: Those who have been caregivers. Those who are currently caregivers. Those who will be caregivers. And those who will need caregivers,” she said. As I prepare emotionally to continue to age, I prepare for the possibility of being a caregiver by remembering that because my life is blessed, every day of my life I am caring in some way for someone, and someone is caring in some way for me. 

I’m 63, and I love sex.

I’ve never wanted to be married or have children. I adore being single, I cannot wait to die alone, and I date younger men.

I’m outspoken about all this because we don’t have enough role models who demonstrate how to live fulfilling lives outside dominant social expectations. I’m one of the happiest people I know.

I began dating younger men 20 years ago, accidentally. My ad agency was asked to pitch for an online dating brand. To experience the client’s product—and the competitive landscape—I had to date online. I was honest in my profile about everything, including my age. To my surprise, I was inundated with messages from much younger men. I hadn’t previously considered this as a dating strategy, but thought, Hey, works for me! I’ve been happily dating younger men ever since.

Dating younger men changed my life. Sex with younger men delivered what I like—lots of stamina and short recovery periods. But their behavior in bed also brought home something else: When we don’t talk about sex in the real world, porn becomes sex education by default—and not in a good way. 

in 2009 as an educational website contrasting “porn world” with “real world.” In response, thousands of people from around the world poured their hearts out to me over email, sharing things about their sex lives and porn-watching habits they’d never told anyone. I realized I’d uncovered a huge global social issue. So I turned MakeLoveNotPorn into the world’s first user-generated, human-curated, social sex-video-sharing platform. Our slogan is “Pro-sex. Pro-porn. Pro-knowing the difference.” 

If porn is the Hollywood blockbuster movie, MakeLoveNotPorn is the documentary—an honest, unique window into the funny, messy, loving, wonderful sex we all have in the real world. The platform normalizes and destigmatizes sex: It provides sex education through real-world demonstration.

I designed this online space to celebrate the full, glorious spectrum of human sexuality. Our members and our MakeLoveNotPornstars (as we call our contributors) are all ages. Our many older members tell us how much they appreciate that we showcase the natural human desire to have really great sex for as long as we possibly can. 

In service of even more older people having even more hot sex, I asked our older MakeLoveNotPornstars to share their advice for ensuring great sex in your later years: 

Communication is key

Great sex comes out of great communication. My confidence in being explicit about what I enjoy (and don’t) has increased with age, and I see the same in our older MakeLoveNotPornstars. Our #senior videos are often tagged #chatty, proving that talking is one of the hottest things you can do in bed.

Embrace sexual values

MakeLoveNotPorn exists to demonstrate that values like empathy, sensitivity, generosity, kindness, honesty, trust, and respect are as important in bed as they are in every other area of life. Couples who have been married for 20 years, are still having great sex, and are sharing it on MakeLoveNotPorn model trust, openness, and honesty that benefits our entire community.

What makes you hot is you

Popular culture sends us daily messages claiming we are not desirable unless we are conventionally attractive, skinny, and above all, young. But what attracts someone to you is you—your unique being. And that makes your body hot as hell to them, because it’s yours. The sexiness of older bodies—and the love and appreciation expressed by and for these bodies—positively radiates through the screen in our videos, as it should for real-world bodies at every age.

Pleasure is adaptable 

There is no “one size fits all” approach for having great sex or for navigating how it changes as we age. Our older MakeLoveNotPornstars candidly share how they manage their sex lives through menopause, chronic pain, reduced flexibility, and increased sensitivity. The wonderful truth is that these changes drive exploration and experimentation. A happily married couple in their 50s wrote to us, describing how the husband had survived prostate cancer but was left with permanent erectile dysfunction. Their therapist recommended MakeLoveNotPorn. The couple told us their sex life was now the best it had ever been in their 27 years together—because we had helped them explore all the wonderful ways for partners to enjoy themselves and each other without penetration.

At MakeLoveNotPorn, we’re changing the culture around sex. We’re showing the world that the older you get, the better life gets, and the better sex gets. As one member wrote to us: “I’m 73 years old and have been made to feel like a dirty old man for the sexual desires I still have. But isn’t sexual fulfillment, when shared in consensual relationships, one of the real joys of human life? Thank you for providing a community that helps me feel I’m still a vital, sexual human being.” 

As are we all. 

“Today, I got stopped by three young women who were here for Fashion Week,” says Rapoport from her home in New York City. “One was from Honduras, one was from Peru, and one was from Mexico. We had the best time talking. We became instant friends. We took a video on the street. It’s fun. That’s how you make new friends, right? It’s all about that.”

Her life has been equally impacted by her friendship with , the creator, author, and photographer of Advanced Style, the celebratory platform for ageless beauty and eclectic fashions. Rapoport was one of the first subjects Cohen photographed for his blog; she’s also featured in every Advanced Style book and co-stars in the 2014 documentary.

Cohen first saw Rapoport on a rainy afternoon when she stepped into Manhattan’s New Museum. You could say it was her shock of pink hair and eccentric wardrobe that made him run over and enthusiastically ask to take her picture. But looking back at how his subjects have captivated him over the last 15 years, the author says he’s ultimately drawn to a person’s spirit. “My project was never about fashion,” he says. “It’s about how these women express themselves through what they have on, and that attracts people to them and keeps them visible. For me, it’s symbolic of one’s energy, because [being] 80 and 90, still putting that thing together shows your vitality.”

In a way, Cohen �徱���’t tap into his creative spirit until he followed his late grandmother Bluma Levine’s advice and moved to New York City in 2008. “She was my best friend and the inspiration for the Advanced Style project,” he remembers. “Being so enmeshed in her world helped me discover the power of style. I always loved vintage clothing because it sort of made me feel like I was living at a time when she was young. When she passed away, that’s when I moved and everything sort of began. It was 2008, and I started taking photos on the streets and meeting ladies to fill that void a bit.” Their relationship, and the new friendships he found, nurtured the type of celebrated artist he’d become: a chronicler of older women with a flair for fashion. His blog-turned-empire has produced four books: Advanced Style (2012), Advanced Style: The Coloring Book (2013), Advanced Style: Older & Wiser (2016), and Advanced Love (2018). His next book, Advanced Pets, will be published in 2024.

Cohen’s keen eye helps him find stylish women to photograph, and he receives recommendations from his featured subjects. , 80, was introduced to the author’s work through her online friendship with Rapoport. “I so enjoyed Debra, and we communicated by email,” says Boyd, who lives in Denver. “I told her that I was coming for a visit and we set up lunch. When I got to the restaurant, she had brought Ari with her. We all spent the afternoon taking the bus, going to a museum. Then Ari found some other women to photograph. It was just a delight.”

Known for her collection of vintage hats and frocks, Boyd is now a regular model on Advanced Style and posts on her own site, Style Crone. “I worked in mental health centers and we wore street clothes. I became interested in vintage and I would wear the ’40s [style]. The patients loved it [because they saw it] as a form of self-expression,” says Boyd, a retired psychiatric nurse. “My husband was my first photographer. He had been diagnosed with cancer in 2005, and I blogged during the last nine months of his life. This is how we diverted from tragedy and devastation.”

has been pursuing her singular sense of style since she turned her mother’s curtains into a skirt at age 12. “They were black and white checkered, and I love that print, with red roosters on the bottom,” says the self-proclaimed Jersey girl. “I took a pair of her stockings, pulling them through the place where the rod was, [tying it] around my waist. And that was my first skirt.” Now 65, McIntosh is still creating skirts—the more volume, the better. “I’ve always liked skirts with far too much fabric. I would wear a wedding dress every day just to wear the skirt part,” says McIntosh, who showcases her original fashions at the Sofistafunk website.

“When I first saw Ari’s page, I was in love,” says McIntosh. “I never knew that there were other women that just did what they want.” However, McIntosh noticed there was a lack of diverse faces like hers on his blog. “After we became friends, I told him, ‘I need to see some more Brown people on your page,’” says the designer and stylist, who directed Cohen’s camera toward uptown NYC. “I told him he can start in Harlem, but don’t do it on a Sunday. Mothers will get you about coming up to them at church.” (Amen.)

That’s the unifying thread between the women Cohen magnifies through his lens. They are as unapologetic about aging as they are about their wardrobe. “Everything is a story that we’re telling our mirror. I say it’s an unspoken conversation with the onlooker. I don’t do anything for the onlooker. I do everything for me,” says McIntosh. Rapoport shares a similar mantra. “In my morning meditation, I say, OK, who am I today? My Self, capital S. Then I know intuitively, and I just go in the closet, grab stuff, put it together,” she says. “It quiets me, it focuses me, and it just brings out my spirit.” For Boyd, it’s the simple act of being. “I celebrate my age. It’s a privilege to be 80.”

Cohen is thankful that Advanced Style serves as a motivator for elders who might be hesitant to embrace this glorious time of their lives. “There’s people who, through looking at Advanced Style, started to dress up because they were limited by their careers or by, unfortunately, children and grandchildren who would say things to their older parents or grandparents such as ‘You can’t stand out. It’s not your time.’ I hear that all the time. Like there’s a shame about it,” he says. “Now they are finally like, ‘Whatever. It’s my time again!’ There has always been this desire to express themselves, and maybe that’s just a desire to feel seen, [or] to feel love. And [expressing their] style kind of makes these women get a lot of love.”

For these ladies, getting dressed up is no longer reserved for special occasions because living should be celebrated in grand style, every day.

We are physicians, and in countless private conversations with other physicians, nurses, and medical workers around the U.S., we hear whispers about people being afraid to lose their jobs if they show support for Palestinians. They have been instructed by their leadership not to say the words “Gaza” or “genocide” in their professional roles, while they watch Israeli forces bomb hospitals, murder health care providers, and assault ICU patients. Many health care workers are discovering—much to their surprise—how many people in leadership roles in their institutions support , even when health care workers and hospitals are targets.

We wrote the following essay in response to JAMA’s promotion of ethical ambiguity around bombing hospitals. It was rejected for publication—yet another act of institutional silencing. As Israeli media now tours the Gaza hospitals that Israel destroyed, alleging these were military targets, we see . But we do see thousands of dead patients—many of them children—and hundreds of as a result of .

As physicians, we understand that our work is sacred, and the places of our care are also sacred. There is never an ethical case to bomb hospitals. There is never an ethical case for genocide. We share our response with the larger public to break the silence, to reaffirm our professional ethics, and to encourage all health care workers to speak out and rise in solidarity with our Palestinian colleagues and the communities they care for. 

NOTE: What follows is a lightly edited version of the original essay rejected for publication by JAMA.

There Is No Ethical Ambiguity About Bombing Hospitals

As physicians and health equity experts, we were disturbed to see the publication of “,” by Matthew Wynia, in JAMA. Far from speaking hard truths in the face of dehumanization, violation of medical ethics, and war crimes, �²�Ծ���’s framing is a stunning example of “,” a foundational strategy to justify war and obstruct peacemaking. To engage popular support for war, nations, their militaries, and their institutions to coerce acceptance for atrocities. Ignoring history, power, and context, �²�Ծ���’s arguments introduce ethical ambiguity where there should be none: To be clear, there is no context where bombing hospitals full of sick and injured patients and the medical staff caring for them is acceptable.

�²�Ծ���’s article was published as the world is witnessing , under Israel’s justification of unverified claims that these Days before the JAMA publication, Israeli physicians provided cover, calling for the in Gaza. The combined effect of of Gaza with airstrikes, ground warfare, and complete siege blocking food, medicine, water, and fuel since Oct. 9 has caused the collapse of Gaza’s health care system. As we write, newborns in a neonatal ward are , as power is lost for incubators due to the bombing.

These attacks on health care in Gaza are not a first for Israel. In 2021, and nine primary care centers, and destroyed a desalination plant that supplies clean water to a quarter of a million people. This past week alone, the several hospitals, killing or injuring health care workers, patients, and thousands of displaced people who had been sheltering in hospital corridors and courtyards. These targeted assaults on health care facilities, health care workers, and patients have led to the and the incapacitation of 113 health care facilities (including 20 out of 36 hospitals in Gaza that are now out of operation), and have contributed heavily to the growing casualties in Palestine, which now top 11,000 people.

for international intervention to save them and the overflow of patients they refuse to abandon. Still, Israel continues its devastating assault unimpeded by the institutions that were built to prevent such atrocities. The American Medical Association’s meeting of the House of Delegates on Nov. 11 was emblematic of medicine’s institutional response to this direct assault on our profession. The who brought the discussion of a cease-fire up for consideration. Silencing is the ultimate form of narrative control.

In this historic context, Wynia asserts that health professionals must oppose racism. In the first part of his article, he focuses our attention on antisemitism by reminding us of the Holocaust and medical professionals’ role in speaking out against war crimes, with which we agree. 

The article then pivots to reinforce the dominant narrative that Israelis are the victims, despite decades of that was in the same service of racial capitalism as apartheid in South Africa. Wynia appeals to our humanity by highlighting Hamas’ violence against Israelis while ignoring the evidence flooding the internet of mostly brown Palestinian bodies buried under rubble created through the actions of the Israeli government. 

Wynia demands that we speak out against war crimes and is quick to denounce Hamas for launching attacks from inside or near medical facilities. But then, instead of denouncing Israel for doing the same or worse, he invokes legal justifications supporting Israel’s targeting of hospitals in Gaza. Specifically, Wynia says, “Israel says it is abiding by these rules, but some international law experts believe Israel is not doing all it should to avoid harming civilians,” and adds, almost as an afterthought, that “some believe Israel’s siege of Gaza amounts to ‘collective punishment,’ which is a war crime too.”

Wynia then asks a series of ethical questions probing the moral grounds to bomb hospitals where enemy combatants may be hiding among injured children. The ambiguity of his response is chilling: “Health professionals of goodwill and equally strong commitments to human rights have differing opinions on these questions, which reflects the nature of the questions.” This statement corrodes the ethical foundations of the medical profession. It also belies our profession’s historical allegiance to power.

From a medical ethics perspective, there is no circumstance in which hospitals where injured, ill people are being treated should be bombed. There is no ethical space where “reasonable people disagree” about the question of killing injured children who are seeking medical care. There is no moral ambiguity to preventing . Unfortunately, . The , a subject in which most physicians have neither critical analysis nor literacy. No better case study can be found than the issue of Palestine, where institutional medicine has a demonstrated record of narrative control: .

There should be no ambiguity. From a legal perspective, and are clearly war crimes. Israel is leaning on the Rome Statute of the International Criminal Court’s legal loophole for bombing hospitals, schools, and other places where the sick and wounded are gathered by stating that these locations are protected, “.” Fascist armies have used this logic before, which led to the Geneva Convention’s articles protecting health care in times of war in the first place. In 1935, , claiming they were housing militants. In Mussolini’s world, anything that was not in the interests of Italy’s fascist regime was considered a .

This line of reasoning creates a narrative space where the most sacred aspects of our work as physicians—caring for the sick and vulnerable, regardless of identity—is left open to the kinds of attacks we are witnessing in Gaza and the simultaneous attacks on medical ethics exemplified in . Opening the door to bombing hospitals, killing injured and hospitalized children, and framing it as morally and ethically ambiguous is a dangerous position for JAMA, putting the journal dangerously out of step with the world and the moral code at the heart of our profession.

When I got the email from adrienne maree brown inviting me to be part of the chorus sharing this column on accountability, I welcomed the chance to consider a question that had dogged me when I was a lawyer challenging conditions of confinement in prisons and jails: How do you use the justice system to hold accountable a justice system that understands only punishment? 

The question, I realized, is a ���DzԲ�’a�� (in Zen, a koan): in Chan Buddhism, a paradoxical riddle that first disorients you and then, if you are diligent in practice, leads you into enlightenment. “What is the sound of one hand clapping?” is a ���DzԲ�’a��, as is the question, “When you do nothing, what can you do?” 

I started lawyering deep in the “tough on crime” era that started in the early ’70s with President Nixon’s war on drugs. A cascade of punitive laws had produced the world’s highest incarceration rate, militarized police forces, and a massive archipelago of prisons, jails, and detention centers.

At the Southern Center for Human Rights, our lawsuits were based on the United States Constitution’s Eighth Amendment, which prohibits “cruel and unusual punishment.” In one case, filed in 2003 on behalf of Alabama’s women prisoners, the largest dorm (the prison’s former factory) was squeezed so tight with bunk beds that the women could pass a deck of cards from one end of the room to the other without having to reach, elbows bent the whole way across. When combined with 90-degree temperatures, the conditions were undeniably cruel and unusual.

The nightmarish conditions inside the prisons were created entirely by the state of Alabama, but there was a frank refusal to admit, much less take responsibility for, wrongdoing. There was no sense of accountability. The only language the Department of Corrections could understand was their own—the language of punishment. Where accountability acknowledges and takes responsibility for wrongdoing, the logic of punishment is to inflict suffering commensurate with the suffering caused.

Prison officials understood even the most meager relief —in that dorm, a pair of swamp coolers pushed the hot air around—as a penalty, a chastisement that had to be submitted to, but with maximum reluctance. Practiced in punishment, this was all they understood.

Then in 2013, Black Lives Matter took off. After decades of police killing Black people with impunity, the killings of Eric Garner in Staten Island, New York; Michael Brown in Ferguson, Missouri; Akai Gurley in Brooklyn, New York; Tamir Rice in Cleveland; Walter Scott in North Charleston, South Carolina; Freddie Grey in Baltimore; Philando Castile in St. Paul, Minnesota; and Breonna Taylor in Louisville, Kentucky, sparked large-scale protests: The DOJ opened investigations into multiple police departments. With breathtaking speed, the need to end mass incarceration went from being a far-left fantasy to a centrist talking point.

A regressive era was ending, it seemed, and a progressive one beginning. But very quickly, it became obvious something was amiss. The reforms that were actually implemented—body cameras, surveillance cameras, and more training—did nothing more than enlarge the budgets of police departments. Even as fewer people were locked behind bars, the conditions in prisons and jails got worse. And the judiciary—state and federal alike—shifted right, ever-more reluctant to protect any rights other than the right to carry guns.

Dr. Martin Luther King Jr.’s oft-repeated phrase—that the arc of the moral universe is long, but bends toward justice—seemed… wrong. 

Perhaps there is no moral universe. 

Perhaps there is a moral universe, but the arc is so long that we, like Achilles in , will never arrive at our destination, justice.

Perhaps there is a moral universe, and it is indeed arcing toward justice, but we have fallen off the arc. 

I puzzled over every possibility, until finally I arrived at the last word in the phrase: “justice.”

In creating this nation, the fugitive slave clause in the U.S. Constitution was a concession to enslavers who insisted runaways be “delivered up like criminals,” as fugitives from justice. This is the only substantive meaning of “justice” written into the U.S. Constitution. The practical meaning of “justice” was in enforcement, where local justices of the peace were installed to pass quick judgment on disturbances of the —that is, to put down rebellions and resistance by those enslaved.

With my faith in justice wavering, I left the practice of law. It was as if the north star had blinked out and disappeared from the night sky. During this disorienting time, I found another ���DzԲ�’a�� to be helpful. This was Detroit organizer Grace Lee Boggs’ opening question at every meeting: “What time is it on the clock of the world?” 

Time, in Buddhist and many Indigenous cosmologies, is spiralic. In this spiral, the long arc of the moral universe is but one small segment of a much larger, much longer spiral. The arc of the moral universe is a part of the larger spiral of the moral universe. Can you see it? We are at the turning of the spiral, at a time of revolution. 

As we make this turn on the spiral, the constituent arc now runs in a different direction. Where the present arc bends toward justice, toward what does the emerging arc of the moral universe bend?

We can remember that revolution has two meanings. The contemporary meaning of revolution is of a sudden and great change. But revolution also retains its earlier, astronomical meaning, of a celestial body’s movement in a circle or ellipse. That is, as a return. In this moment, we mean revolution in both these meanings.

The path forward, it seems, is a return to what was—and what remains, as an undercurrent—once abundantly present on this land: reciprocity, democracy, and collectivism. Abolitionists see the revolutionary possibilities of this moment. It is now possible and necessary, per Ruthie Wilson Gilmore, to . Abolition’s goal is not a better justice system, but a world free of prisons, police, and justices of the King’s peace altogether. The work is not to reform, but to dismantle. 

The bend toward such a radically different world is not assured. It will, in fact, be vigorously and violently resisted by the existing system, which will use the criminal justice system, its most powerful weapon, to try and crush attempts to replace it. Case in point: the RICO indictment of #StopCopCity activists cites as evidence of criminal conspiracy.

In this revolutionary moment, then, what to do? Dismantle the existing criminal justice system, certainly, so that the new world being built is not arrested and imprisoned. And then, hands on the plow, we do the work necessary to build… what? With reciprocity, democracy, and collectivism as our new (and old) north star, what are the systems and institutions we want to revive and create?

Here, again, we can turn once more to a ���DzԲ�’a�� to guide us.

We can ask: How can every individual be free to choose how to offer their gifts for the benefit of the group and the earth? 

In the spirit of ���DzԲ�’a��, we know that we don’t know. This paradoxical riddle will first disorient us. And from this disoriented place, our commitment is to be diligent in practice—to be creative, and brave, and try wildly different things, and learn from the many inevitable failures, and try something else, and yet again something else. These are the million experiments Mariame Kaba encourages us to try—experiments we can and must undertake with . In this way, we just might fumble our way into building not only a true system of accountability, but a whole new world.

But a critical program that medically fragile children depend on to get at-home care is broken, leaving families desperate. This is a medical and developmental emergency for children with disabilities, and California needs to act quickly to fix it.

California has some of the most robust programs to support kids with disabilities who are living at home. Kids who are eligible for Medi-Cal, California’s health insurance program for low-income families and people with disabilities, can access private-duty nursing care, medical day care programs, paid family care through In-Home Supportive Services, and specialty care through California Children’s Services. Private health insurance—the kind that people have through employment—doesn’t pay for long-term care. Medi-Cal is the only program that pays for the kind of ongoing care that medically fragile children need to live at home. California has a waiver program that allows these children to access Medi-Cal. The problem is, it’s full. That means children who need access to this program are languishing on a waitlist instead of getting the care they need.

This is rationing and discriminatory—the state has made a budget decision to ration the care that disabled people need to live at home. There is no moral defense for this kind of rationing. We can’t call ourselves a progressive state if medically fragile children and adults can’t get the care they need to stay out of institutions.

Waivers are a way for states to provide extra services to people who have special care needs, or to provide Medi-Cal eligibility to people who wouldn’t otherwise qualify. For disabled, medically fragile children, the Home and Community-Based Alternatives (HCBA) Waiver allows middle-class children to access Medi-Cal programs, like home nursing care.

On July 12, the state announced that the HCBA waiver was at capacity, and that any new applications would be put on a waitlist. The program has a capacity limit of 8,974 people—that means that in a state of 40 million people, a tiny fraction (.02%) of people can access it. As of September, there were 3,233 people on the waitlist. What does it mean to be on the waitlist? It means that instead of providing access to care, the state puts your name on a list of people who need care. There are rules in place that bump medically fragile children to the top of the waitlist—but that isn’t a real solution. The solution is that there shouldn’t be a waitlist at all.

Michelle Zapata’s 15-month-old son Oliver is one of the medically fragile children who is locked out of getting the care he needs because he’s on the waitlist. Oliver was born with a complex heart defect that couldn’t be surgically corrected until he was 7 months old. Even after the surgery, the defect is not fully resolved. He still needs medications to keep his heart from working too hard. He came home from the NICU at 2 months old, with a feeding tube and a need for round-the-clock feedings and medications to manage his heart condition.

When Oliver came home from the hospital in 2022, the waiver was functional—but he fell through the cracks. No one at the hospital told Michelle that her son qualified for private-duty nursing care or the waiver. This has been a longstanding problem with the program—even during the years the waiver was functional, it was a tiny program that wasn’t well connected with hospital-discharge-planning teams. If the hospital had referred Oliver to the program when he left the NICU in 2022, he would have been enrolled while it was still operational. Michelle learned about the waiver through an acquaintance and applied in August of 2023, after the program stopped taking new enrollments.

Michelle works as a nurse practitioner, and her husband works for the government. They’re a middle-class family with private health insurance—but their health insurance doesn’t pay for private-duty nursing care. That means Michelle is responsible for all of Oliver’s complex medical care.

“I’m a bedside nurse 24/7 with my son, [and] on top of that I have my own job,” she told me.

Without nursing help at home, Michelle has to rely on Oliver’s grandparents for help so that she can work. Oliver’s grandmother accidentally gave him too much medication one day—7 mL instead of 0.7 mL—because the labels, syringes, and instructions all had very small print. Medication errors are easy to make, especially for people with no medical training taking care of a fragile infant. Thankfully, Oliver was OK—but he still doesn’t have access to the professional nursing care he needs to reduce the risk of untrained family members making future errors.

If Oliver could enroll in the waiver program, he would also be able to attend Loretta’s Little Miracles, a pediatric, daytime health program where nurses take care of kids who have complex medical care needs.

The irony of the situation isn’t lost on Michelle. “I work in health care—I work in the system that I can’t even get access to,” she says.

For Oliver to qualify for Medi-Cal without the waiver, Michelle and her husband would have to quit their jobs, which would be economically disastrous for the family.

This dysfunction in the HBCA waiver program comes at an especially dangerous time for medically fragile children. During the COVID-19 public health emergency, children remained eligible for Medi-Cal even if their parents �徱���’t complete renewal paperwork. Then, in April 2023, California restarted Medi-Cal redeterminations, which means that families who are over the income limit to qualify without a waiver will be disenrolled. Some of these families have children who are receiving private-duty nursing care without a waiver because they qualified for Medi-Cal when family income was lower. Normally, when a child has a serious disability, they still qualify for home nursing through the HCBA waiver even if their family’s income increases. But because of the waiting list, they’ll instead lose access to care. This could force parents of medically fragile children to drop out of the workforce to take care of them, or to choose unsafe care arrangements that put the child at risk of injury or death so they can keep working. Parents with no other options may have to make the devastating choice to put medically fragile children into .

This crisis doesn’t just affect medically fragile children. Adults who need nursing care at home are also on the HCBA waitlist. The HCBA waiver is a true lifespan program: It provides care for ventilator-dependent infants, toddlers who use parenteral nutrition, children who are on peritoneal dialysis pending kidney transplants, teenagers with muscular dystrophy, young adults who have been paralyzed, adults with ALS and other neurological syndromes, and elderly people with dementia.

Right now, the HCBA waiver is a zero-sum game—the people on the waitlist are waiting for people currently enrolled in the program to die in order to get care. The state is supposed to have a “triage” process for the waitlist that prioritizes some applications over others, but the rules on how that will work and when enrollments will restart haven’t been released. Disabled people who need care are drowning; we shouldn’t have to agonize over who gets a spot on the lifeboat—we can build a bigger boat.

California doesn’t put a limit on how many sick people can get care in hospitals or nursing homes. California has a similar waiver program for people with developmental disabilities called the Home and Community-Based Services for the Developmentally Disabled (HCBS-DD) Waiver, which doesn’t have a capacity limit. But for complicated budget reasons, California sets a limit on how many children and adults with medically intensive disabilities can get nursing care at home, and it’s a very low limit.

It also makes no economic sense. Warehousing disabled people in hospitals and nursing homes costs the state orders-of-magnitude more than just providing nursing care at home. When vulnerable people can’t access nursing care at home, the state spends millions on unnecessary hospitalizations.

The state has committed to providing enhanced case management and community supports for people who are at risk of institutionalization, or trying to come home from an institution. But with the HCBA waiver at capacity, California’s promise of wraparound services for the most medically complex patients is hollow.

California can fix this by immediately funding 50,000 slots for the HCBA waiver and eliminating ongoing capacity limits. This isn’t a problem that can wait until the next budget cycle for a solution. Californians who need care today can’t get it. Families are having to make gut-wrenching decisions: Do their children stay in the hospital, where they have access to medical care but not family life, or do they bring their children home without adequate support? Waiver capacity is set to increase to 10,081 slots in January of 2025 (or perhaps sooner). That’s not enough capacity to handle the people who are currently on the waitlist, or the people who will apply between now and then.

California has made an indefensible decision to ration the care that its most vulnerable residents need to live at home. The rationing needs to stop now.

This column was produced in collaboration with the .

It was the early 1990s, and there were almost no support services in the Silicon Valley area geared toward Asian American families of children with special needs. The Wangs struggled to deal with their son’s behavior and communication challenges. They worried about his future and whether he’d ever reach his full potential. They felt stressed and alone.

“My husband was a physician, and I was an engineer,” Wang said. “We had overcome many challenges in our lives, but having a child with special needs has got to be one of the biggest challenges we have encountered.”

Caring for children with disabilities—whether they have a developmental disorder like autism, a physical disability, a chronic medical condition or a combination of these—is demanding work. Without adequate support or rest, parents can end up feeling depleted and isolated. Stigma in some communities over having a child with disabilities can deepen this isolation. Some parents develop physical or mental health problems as a result. The solution, according to experts and parents who have faced these challenges themselves, is to reach out for help, prioritize self-care and connect with other families of children with special needs.

That’s what Wang did. In 1996, she was part of a group of 10 Asian American families who founded a support network for people with disabilities and their caregivers. They started by hosting gatherings where families could meet each other and discuss how to access care and resources for their loved ones. The organization eventually became a nonprofit called . Today it serves more than 1,500 Bay Area families, about half of them Chinese American, and offers a variety of programs across three locations, from after-school enrichment activities to adult day care and employment services. Parent support groups remain a flagship program, said Wang, who is now vice president of the nonprofit.

“We wanted to bring happiness to individuals with special needs and peace of mind to the families,” Wang said. “As parents we felt that if we can bond together that would be so much more powerful than trying to do everything by yourself.”

The stress of caring for a child with disabilities goes beyond the caregiving itself. Navigating the complexities of the medical system, disability programs, public benefits and special education can be overwhelming, especially if a caregivers’ first language isn’t English. Many parents wrestle with strong emotions such as grief and may even blame themselves for their child’s diagnosis. Financial pressures mount if one spouse has to quit work to take care of the child or medical bills aren’t covered by insurance. Marriages can become strained. Siblings may act up because the child with disabilities gets so much attention.

Another challenge is stigma. Wang said about half of the families she meets struggle with this. Some keep their child with special needs at home, not even disclosing the disability to their closest family members and friends. This leads to further stress and anguish for the parents and is detrimental to the child because they don’t get the resources that can help them live a fuller life, she said.

Kelly Ko, program director for the organization’s East Bay outreach and enrichment programs said she meets families who don’t know what services are available to them or how to apply for government programs. The nonprofit has parent navigators who can assist families with this. But sometimes, even when families are approved for a service such as respite care through the San Andreas Regional Center, they can’t always access it. That’s because there aren’t enough providers, especially those that share the family’s language and culture, Ko said. Friends of Children with Special Needs, for example, has respite caregivers who speak Mandarin, Vietnamese and several other languages, but demand is so high that there are dozens of families on the waiting list.

Given this reality, support groups and events are a key resource for families, Ko said. Friends of Children with Special Needs runs online support groups in Mandarin and Cantonese twice a week, as well as monthly coffee socials, seminars and family outings.

“The family support (events) is where families feel like, ‘OK, I’m not alone in this journey. I have resources. I have people I can share my experiences with,’” Ko said. “That makes a big difference. If you feel like you’re alone and you’re just going through this journey to nowhere, it’s tough. But if you have other people and families and a support system, I think it takes a lot of that stress and burden off because they feel like they have someone to go to.”

Today, Lawrence Wang is 33 years old. Thanks to the support groups and programs his mother helped create through Friends of Children with Special Needs, he is now a professional musician who plays six instruments and sings. He has performed across the Bay Area and internationally. His success inspires Anna Wang to continue helping other families access resources and programs that can help their loved ones with disabilities thrive.

“There are just so many of these types of stories waiting to be found,” she said. “After I discovered Lawrence’s talent it became my mission to give all special needs individuals … a chance to shine in front of the community.”

Tips for managing stress:

Here are some top recommendations from parents and experts we talked to about how to manage the pressures of caring for a child with special needs:

• Practice self-care. This means taking care of your own wellbeing by doing things that help you feel more rested and energized. This includes eating well, getting enough sleep, and doing restorative activities. This can include taking a few moments to breathe and be still during the day, or moving your body by going for a walk, dancing around your living room or practicing yoga.

• Find support. There are organizations across the state that offer resources and information for families caring for children with disabilities. Some, including Friends of Children with Special Needs, offer one-on-one guidance, often from parents who have raised a child with disabilities themselves. Many also run in-person and online support groups for parents, including groups in Chinese and other languages. See below for organizations in the Bay Area.

• Persevere: Help is out there, even though it can take some work to find it. “Don’t give up,” Kelly Ko tells parents. “There are many resources out there, you just need to find ones that can help. Just reach out to us if there are any questions, we’ll help you through it. Just keep your spirits up and learn as much as you can so that you know how to advocate for your child.”

• Shift your mindset. Susana Ruiz, a parent in San Jose caring for a child with autism, offered this recommendation for parents who feel stuck in negative thoughts about their child’s condition or their ability to care for them. She recommends trying to find positive things to focus on, such as a small improvement in your child or accomplishments, and to think about the gifts that your child brings to your family and community. For example, Ruiz said her son’s condition has made her family and others around him more accepting of differences, and that his outgoing demeanor brightens up people’s day.

Resources

You can find parent resource organizations using these directories:

1. Parent Centers. These centers offer support, services and information for families of infants, toddlers, children and youth with disabilities, from birth to age 26. There are nearly 100 Parent Training and Information Centers and Community Parent Resource Centers in the U.S. and territories. Find yours here:
2.  has a network of organizations across most of the country that can match you with a trained Support Parent who has faced similar challenges raising a child with disabilities or special health care needs. Visit to find out more.
3. The Autistic Self Advocacy Network has information and resources for parents of children with autism, including a guide to autism and therapies. Visit . Other helpful autism-related resources can be found at the () and the at .

This story was produced in collaboration with the .

We are designed to know grief. We are designed to hold a relationship with grief. This relationship is not meant to stop us, but rather to propel us to know who we are and what makes us tick. Being in a relationship with something new—even when the newness is painful—can help us appreciate the anatomical presence of breath, and lean into the joy simple, methodical action can bring. This tethered relationship with grief comes in the moment we need it, as an acknowledgement of our divine humanity; as the ability to feel the sensation of tears born of salt water streaming from our eyes and caressing our cheeks. Yet how do we navigate the emptiness? The space that comes as an endless void attempting to rip us from our sense of self, playing as a consistent loop distracting us from the present moment, and locking us into viewing the now through the lens of our past comfort: How do we crack through it?

Our relationship with grief can become a dance with relief, with generational release. Through this dark but necessary, profoundly human thing—our pain, our tears, our persistent breath—we can transform in the wake of the darkness. We can allow the breaking to be a metamorphosis, always. Breaking into new boundaries, we have the opportunity to shape and reshape the energy of grief into something kinetic, which builds toward our desired destination, turning every piece of who we are into who we are meant to become, and leaving behind a somatic signature that marks this moment of sacrifice. Yet as my spiritual twin, Sade Lythcott, reminds me, “I am the altar,” placing my body, my life, in divine alignment with growth, change, and evolution. This process is needed to draw us closer to our divine light, all that exists within our individual and collective possibility. We must search deep within, and have the obedience to stay committed to the work of conjuring our internal salve, rather than falling prey to the vices of external patchwork and fleeting, temporary comfort.

At its core, grief is an acknowledgment of love. Grief reminds us we are vessels able to love, even as the person, place, or thing—the object we cling to in order to experience this love—is no longer accessible to us. Yet have we ever thought that this experience is also an acknowledgment that we have evolved? Perhaps grief is our spirit’s way of telling us we need new spaces to explore, connect to, and transform—to ignite the evolution we have run away from.

If grief is the acknowledgment of losing something we once loved, the echo of a broken pattern, and a place where darkness lives, then I invite it! I welcome it because the best parts of me were created in darkness within the womb. I invite it because I need to be reminded I have the capacity to love. I invite it because the patterns that hold me now are the rhythms of subjugation, not liberation. I want to be liberated. 

If this piece is to lead us anywhere, I want us to accept the broken state we find ourselves in as an abundant opportunity to take up more space as the shards of our constructed self break and scatter to the four winds. I wonder what would happen if we gave in to the breaking, and let ourselves shatter? Could we shatter as elegantly and devastatingly as a star does? Let us shatter to the point we become a black hole—so dense and unknown that no one can understand us but the source that created us. 

Grief is a transformative force I have been intimately working with ever since the transition of my dear friend, chosen family member, and sister, Christine Jean Chambers, on the eve of the pandemic in December 2019. Her passing opened a portal into the intimacy of my humanity in ways I’d never felt before. The global shutdown that happened in the wake of her passing and homegoing service prepared me for the disabling amount of loss and grief, surrounded by the earth’s still-fertile abundance. I needed the gift of her release as the opportunity to gain so much; her transition gave me a chance to be in a relationship with an energetic force that has rocked my world ever since. It has also prepared me to know that as long as I love, as long as I open up to any thing and any person, I must also be receptive to meeting grief. 

And so in this ongoing dance with grief, I also welcome the opportunity to love again, to live again, and to shed old skin to become the butterfly that I need for the world to change. I want to continuously find the courage to flap my delicate wings and watch the world shift because I choose to claim my existence. We all experience love and grief differently, yet I know my own truth about these powerful emotions. My hope in sharing this truth is that these words spark your own courageous, curious, and soulful journey. On this journey, I invite you to hold space for the universal truth your life was meant to articulate; may you sit in the confidence of knowing that when you embrace your unique, personal truth, the world changes for the better.

Disclaimer: The following themes might be difficult to read, especially for those who have been harmed by purity culture. Take good care of yourself while reading.

Vaginismus is a condition we don’t talk about enough. Although common, it is often underdiagnosed, . Since 2021, Bailey Krawczyk has publicly spoken about her experience with vaginismus. As a teenager, she wasn’t able to use tampons without feeling intense pain. Because of that, she worried whether penetrative sex would be more painful than pleasurable for her. In interviews, she shares that her condition originated from having a conservative Christian background. that “as a child, [Krawczyk] associated sex with sin and subconsciously feared penetration.”

There’ve been cases and that connect religious trauma with the shame or discomfort of receiving any sort of pleasure, which can lead to sexual pain like vaginismus. Conservative Christians equate and lustful behavior, and therefore condemn such pursuits. 

Madison Natarajan and Kerrie G. Wilkins-Yel as “a phenomenon promulgated by evangelical Christianity that teaches strict adherence to sexual abstinence prior to heterosexual marriage.” Christians typically justify the purity culture movement by retracing its origins back to the ’90s, when to the AIDS endemic and a spike in teenage pregnancy by doubling down on abstinence as the sensible and, more importantly, biblical solution. What’s left unsaid is Christianity’s participation in and perpetuation of patriarchy, racist sexism, misogyny, and queer- and transphobia. The volume of stories demonstrating the trauma and negative effects of evangelical purity culture is overwhelming. 

In Islam, the prudishness around sex and sexuality was said to be a manifestation of a “colonial hangover,” . Abbas looked back at the Islamic perspective on sex and sexuality in the 1400s and found a regional receptivity on the matter. Although the Quran shares a number of prohibitions with Christianity, such as that against premarital sex, Abbas notes that “dozens of hadith offer definitive, often honest and comprehensive, prophetic traditions on sex and sexuality.” 

For some Muslims, this openness to the subject of sex got distorted, says Abbas, when Western Christendom inflicted the notion of purity and the phenomenon of shame onto a number of Muslim communities when it came to sex and sexual equality, resulting in the aforementioned prudishness and the treating of sex as taboo. As a result, “several attempts to write about sex and intimacy from the Islamic point of view have failed in the face of censorship and criticism,” according to Abbas. We see an example of this in against a medical doctor’s attempt to teach sex education in Pakistan.

Countless members and ex-members of faith communities automatically associate desire and pleasure with shame, guilt, and harmful punishment because of purity culture, and have found it difficult, if not nearly impossible, to receive pleasure freely. How then can we heal and transform our relationship with pleasure from this religious trauma?

The Intersection of Spiritual Healing and Sexual Healing

I was a Protestant church kid when I was young. Back then, I always thought that God had his eye on me whenever I wondered about sex, felt “sexual urges,” or got curious about my body parts. In those moments, I felt like I was under surveillance by not just the church, but by a higher power who, I was told, loved me so much that he sacrificed everything—including his one and only son—just to be with someone as sinful and insignificant as me. Whew. I chuckle sarcastically looking back at it now, and, at the same time, I feel compassion for younger Gabes, who was constantly under pressure to appease this God whom she knew would save her from eternal damnation. The pressure turned into self-punishment over time, because I thought I kept failing God for being curious about my body and desiring to feel good in it. 

What’s crucial about the pressure and the eventual trauma from purity culture is that it rests on the intersection of spirituality and sexuality. It has to do with both the rules and restrictions enforcing purity and chastity and the idea of a divine being who sets these rules and restrictions. When we fail to adhere to such rules, we are not only rejected by our church community (which, for some, is the only community they have), but also by God. Because the trauma is rooted in this intersection of spirituality and sexuality, we must consider healing our sexual and spiritual wounds in tandem.

One approach is finding a type of spirituality or spiritual community that celebrates embodiment and pleasure as expressions of love and collective flourishing. Some of us need transcendence to make meaning in our lives, which might be found in astrology, the mystic arts, the spiritualities practiced in one’s ancestral lineage (if accessible), or even a reverence toward the . 

This can help change our internal stories about pleasure through community and embodiment, welcoming new experiences and conversations on pleasure and intimacy outside of contempt, shame, divine punishment, and ideas of immorality and even evil. 

Christian churches can also be a part of this healing journey, because not all of them uphold puritanical rules and attitudes toward sex and sexuality. about how the Black church has been a “bedrock” for many Black gay and bisexual men. In navigating self-love, , Morrison shares that “there are a lot of different ways to Christ … and to Church.” Morrison believes that God created him the way he is as a Black gay man. He is who he is because God designed him that way, and to resist this design is to question God.

Lyvonne Briggs hosts a podcast and teaches that centers healing and pleasure from a faith perspective; she also wrote a book called that touches further on healing the body. Matthias Roberts is a therapist and theologian who writes on healing from sexual shame in his book . Even with its horrific history of hegemony and dogmatic violence, Christianity still inspires hope via a number of life-affirming and sex-positive . 

Inch by Inch

Everyone will have a different journey of healing from purity culture. It’s important to go at your own pace and to be mindful of internalized expectations of what sex needs to be.

Coming from purity culture myself, I developed . Similar to Krawczyk, vaginal dilators and psychotherapy have helped me in my healing journey, as well as the privilege of having an empowering gynecologist who normalizes the condition for me. She once told me that there are many people who have vaginismus, some of whom have intercourse with their partner only when they decide to have children.

That I have this condition might come as a shock for some people who know me. Many perceive me to be a very sensual person—and yes, this is absolutely true. I can still be sensual, even without penis-centered sex. I have a lot of sex, but not a lot of penetrative sex. 

In my personal life, I am fortunate to have a partner with whom I not only feel emotionally and physically feel safe, but who also shares an understanding that sex doesn’t have to be penetrative all the time. Sex can be satisfying without complying with society’s expectations of it—expectations that resemble that of the church’s: Male pleasure is the only priority; orgasms are viewed as the goal of any sexual encounter; procreation is the main purpose of sex.

Inch by inch, we unlearn these expectations, and then relearn that pleasure is also not always found in sex, but in various expressions of love and intimacy. As said in my previous essay, we can feel alive and erotic even outside of sexual intercourse.

Get to Know Your Politicized Body

It is one thing to get to know our bodies in the context of faith and sex, but it is another thing to understand them from a sociopolitical lens.

The post-purity culture movement and the promotion of sexual agency and gender rights , leaving Black women and women of color by the wayside. Natarajan, Wilkins-Yel, and other researchers have done qualitative studies on purity culture in the context of race and gender. They found that five out of the nine Black women and women of color they interviewed “visualized white women when asked to form a mental image of the ideal pure woman.”

For these interviewees, shame wasn’t just rooted in the ideals of purity (i.e., saving themselves for marriage) but more specifically, the ideals of white purity, where purity is conflated with Eurocentric beauty standards of being white and thin. The study then highlighted the specific struggles of Black women and women of color in the purity culture movement, which involved racialized sexual double standards: to be morally clean from sexual sin in order to be accepted by God, and to appear white in shape and complexion in order to be desirable. In , we endure the oppressive standard of docile submission, perceived as sex objects under the white male gaze and our fetishization by media and society. 

While I believe every purity culture survivor’s trauma is worth processing, we can still welcome nuance in our collective healing and recovery. Not everyone will have the same nature and degree of wounds from purity culture, and it’s vital to heal with the knowledge that white supremacy and sociopolitical powers have been core to our sexual and spiritual injuries. With this knowledge, we need to address that racialized and other marginalized bodies (trans, disabled, fat, and aging bodies) have suffered greater or more complex harm and violence from purity culture.

Hope for Sexual and Spiritual Healing in Our Time

In with Keke Palmer, Janelle Monáe looks back at her baptist roots and shares how her church’s judgment still haunts her experience with pleasure and play. Even with this struggle, Monáe points out that her goal is to fight for body autonomy: “We will not play into [the conservative church’s] social norms [and] assimilate.”

Seeing artists like Monáe combine body agency and creativity gives me hope. In the interview, she �徱���’t sugarcoat the journey nor deny the fact that the judgmental voices of her past still influence her, because, as for many of us, they do. And yet she actively chooses to say no to these voices. Instead, she makes music videos like “” and “,” and became the narrator for the —media serving as beacons for body autonomy and sex education in the entertainment industry.

We live in a time when an album like Monáe’s exists. We live in a time when we can experiment with our bodies and our pleasure more extensively, with the emergence of and that focus on the pleasure and sexuality of women and femmes. We live in a time when we have more resources and social contexts that provide sexual health awareness and advocate for sexual safety in the context of body agency and liberation. If that is not spiritually freeing, then I don’t know what is.

On one hand, girls of the 2020s are depicted as miserably depressed, imperiled, and suicidal. But they are also seen as dynamic achievers, increasingly in education, jobs, and activist leadership, all to the consternation of traditionalists. Which is it?

Bad news first—and it is bad.

American girls are being abused and murdered at appalling rates. From 2010 through the most recent 2023 , 6,600 American girls under age 18 were murdered. The murder rate of American girls averages 10 times higher than in the .

Yet facing the truth about who is violently victimizing girls has long proven inconvenient for American leaders, institutions, professionals, and media. Instead, for more than a century, all have maligned each new generation of girls as the most mentally disturbed ever.

Recently, a new fear has emerged. Modern girls’ arrival in and increasing dominance of many traditionally male domains is frightfully damaging to female mental health and physical safety, declares a barrage of popular commentators led by , , , , , , , , , and , joining what used to be a crusade by . These authors depict teen peers as dangerous, and most argue for restricting girls, or even (like Pipher and Flanagan) for returning “fragile” girls to supervised and “protected” home life.

�մǻ岹��’s , from the to psychologists, lawmakers, and media commentators, stampede to blame violence against girls on , mainly school shooters and “” exacerbated by “kids” finding and “.” The consensus dominating discussion is not just wrong; it’s absurd.

Who’s Murdering and Abusing Girls?

The gyrations the establishment herd indulges in to avoid the real answer is bitterly ironic, given the dangers their own demands to redomesticate girls present. Homes, and the grownups in them, not the outside/online worlds and peers, are what most endanger girls, authorities’ own statistics and surveys show.

show just 7% of murdered girls under age 18 were killed by youthful peers. In contrast, nearly 60%—eight times more—were murdered by grownups ages 25 and older, including 56% of the 2,500 girls murdered by guns. Eight times more children and youth are murdered by guns , overwhelmingly by , than —the single biggest reason guns are the leading instrument of death for young Americans. Three in four murderers of girls are adult men.

The reports that in 2021 alone, 600 girls were murdered and tens of thousands were victimized in substantiated violent, sexual, and psychological abuses at home, overwhelmingly by grownups. The CDC’s 2021 , a massive, 116-question survey of 8,000 teenagers—the most comprehensive, authoritative documentation of teen issues available—details how damaging these abuses are.

One in seven 12- to 18-year-old girls reports violent abuse (beatings, kickings, and other injurious assaults) and 62% report emotional abuse (being sworn at, name-called, etc.) inflicted by parents or other household grownups, compared to one in 11 and 48%, respectively, for boys. Those findings represent 400% to 600% increases, from , of abuses that go far beyond normal family disagreements. Girls are three times more likely to be violently abused by household adults than at school or by dating partners, and four times more likely to be psychologically bullied by grownups at home than .

Standard regression analysis assessing key factors that potentially affect mental health (which authorities either �徱���’t do or won’t publicize) shows that in every case, �貹����Գٲ�’ increasing stand out as more damaging than every other factor—including social media—by wide margins. Compared to the fraction of girls who report no abuses by household grownups, the most frequently abused girls were 2.5 times more likely to report getting five or fewer hours of sleep per night (a strong correlate of depression), 2.5 times more likely to report sadness, 3.1 times more likely to report frequent mental health problems, 6.6 times more likely to binge drink, and 17 times more likely to report suicide attempts.

Girls who are frequently abused by household adults are also four times more likely to suffer bullying at school and five times more likely to suffer bullying online, compared to girls who are not abused at home. That may be why the survey shows abused girls are 30% likely to spend more than five hours a day online, including seeking mental health and medical help. The weak correlation between and depression is a reverse one: Depression drives more online time, not the other way around.

These realities should be igniting loud alarms among mental health and institutional authorities who are well aware of decades of compelling research exhaustively tying to adolescents’ and tragic . The pivotal CDC survey, when fully analyzed, shows the dangers of authorities’ refusal to confront household abuses, while rushing to ban or restrict teenagers from pathways by which teens make connections and find help. Schools, in particular, should drop their grandstanding and, instead, switch to later hours to allow teenagers more time to sleep.

What Does “Depression” Mean?

But there’s a silver lining to all this. Girls are responding normally to the crises of addiction, depression, abuse, violent mortality, and official indifference afflicting America’s increasingly troubled grownups, who lack the will to respond with normal urgency to clear threats. What authorities term a “mental health crisis” is not whiny, self-absorbed adolescents moping over some TikTok or Smartphone snark.

Instead, supposedly depressed, suicidal Generation Z girls and women are sharply reducing their dropout and early parenthood rates, and attending college, earning degrees, dominating career fields, and becoming global leaders for activist causes in increasing numbers. Achievement and are not behaviors traditionally associated with depression. And scientists only recently have begun to explore this apparent contradiction.

find “depression” has risen the most among liberal and politically aware teens, especially girls. However, that clinical term appears to confuse feeling overwhelmed by one’s own problems with feeling challenged by the problems of the world. �մǻ岹��’s youth are “more attuned to political events than prior generations,” developing “political beliefs” that “encapsulate many aspects of lived experiences and social identity” that, in turn, affect “mental health trends.” A 2022 Pew Research Center study found four times more liberal than conservative youth use social media for activist causes, part of complex networks of youths’ online connections.

Meanwhile, American grownups are suffering severe difficulties adapting to jolting modern changes, racial and cultural diversity, and new technologies. tripled amid rising opiate addiction and the stresses of the COVID-19 pandemic. Suicides, homicides, and accidental drug and gun fatalities have skyrocketed over the last two decades among teenagers’ �貹����Գٲ�’ generation.

Grownups who lost jobs are twice as likely to abuse teens, the CDC survey shows. These vital adult contexts for teens’ behaviors are yet another reality authorities ignore. Instead, American leaders and institutions have veered into destructive teen-bashing and culture-war crusading at a time when intergenerational alliance and greater social connections are crucial to confronting unprecedented challenges. 

This is true at the local level and worldwide. Many teenagers are right to feel depressed about conditions in their homes and communities and are right to be disgruntled with the inexcusable failures of authorities to address looming global crises. Supportive adults should not see these youthful attitudes as pathologies to be deplored and treated. They are grounds for hope.

Amid a pandemic that had forced the world into isolation, I found myself drawn to the story of , a 14th-century anchorite who willingly embraced solitude as a path to spiritual enlightenment. Julian’s journey into a life of seclusion, her encounters with divine revelations, and her unwavering connection with her community offer profound insights into the concept of loneliness as a form of fermentation—a transformative process, much like the slow and deliberate changes that turn raw ingredients into something entirely new, like the way cabbage becomes sauerkraut or grapes become wine over time.

Julian of Norwich, born in 1342 in Norwich, England, embarked on a unique Christian religious vocation as an anchorite. This path, primarily pursued by women, required them to take a meaningful step in their spiritual journey. Anchorites, like Julian, lived in isolation, physically walled into a room with their cells cemented shut, rendering them unable to leave. In these confines, they devoted their lives to the study of the Bible, considering it an essential act of offering to God.

As we examine Julian’s life and the isolation she willingly embraced, we can draw striking parallels with the transformative process of food fermentation. Just as foods undergo significant changes, evolving into something more intricate and nuanced, we, too, experience compelling transformations in our lives. Sometimes, we may remain oblivious to these changes until they conclude. Our former selves linger underneath, but the transformation brings forth something new.

Years before the pandemic, I grappled with loneliness due to my depression, spending countless hours in isolation, often pondering the darkest thoughts. The pandemic, however, forced a different kind of solitude upon me. I contracted COVID-19 and developed health issues, compounding my existing disabilities and resulting in a deeper and more distressing isolation than I had previously experienced. It was a time marked by grief, fear, and uncertainty, where the need for community and connection became more vital than ever.

In this newfound isolation, I discovered portals that allowed for connection in online spaces. Communities like provided comfort and a place to be my authentic self. Dating apps allowed me to simulate the touch and intimacy I longed for; I even went on virtual dates, and connected with others in unconventional ways.

Within the disabled community, we have consistently crafted magical gateways into places that allow us to foster a sense of belonging, especially among ourselves. These connections became lifelines during the pandemic, offering support and assistance when physical interactions were limited. They served as a testament to our resilience and the strength of our bonds. Our practices have sustained our existence and extended critical support to others. These efforts endure, rooted in our longing for connection and our right to thrive. 

To seek even a semblance of safety, we create practices that foster safer spaces, acknowledging that perfection is elusive. In these spaces we can connect with like-minded people who can provide access to critical information, from mask recommendations to how to build DIY air filters. Our community possesses essential wisdom that the wider world, facing a pandemic that will disable many more, desperately needs.

Julian lived her entire life during the Black Plague outbreak, and in her book Revelations of Divine Love, she expounded on her principled beliefs regarding care, tenderness, and love. As an anchorite, she had her portal—a small window through which she could guide people in the community, consistently upholding her deep convictions even amid the despair and sadness of her time. Her decision to live in solitude �徱���’t entail a life devoid of community.

I recognize an important lesson here: that even in our solitude, whether forced upon us or chosen, we must strive to stay connected with people.

In fermentation, or prolonged isolation, the significance lies in finding these gateways of connection, whether they resemble Julian’s window or the virtual gatherings I experienced. Even during solitude, it’s crucial to seek relationships and connection. Without it, there is a risk of stagnation, a slow decline into decay rather than a transformative journey toward a beautiful new form. Just as an anchorite relied on community support for food and shelter, these connections are essential, highlighting our need for interdependence.

Amid the backdrop of connection and mutual support in the early days of the pandemic, there were instances where nondisabled individuals failed to recognize the invaluable gifts we were offering, or seized upon them, used them, and abandoned us. This highlights the delicate balance between genuine connection and exploitation, a challenge we must address as we navigate the evolving landscape of isolation and connection.

As the pandemic unfolded and people began shedding masks and precautions, my sense of connection grew more complex. I felt a disconnect in many long-term relationships.

I began to observe a shift in the behavior of my friends and family—masks, once a common sight, began disappearing from their faces. While I couldn’t discern everyone’s safety measures, the sight of people neglecting masks in shared public spaces weighed heavily on me.

Wearing a mask is a small yet potent gesture in the battle against COVID, signifying solidarity with those who remain cautious and vulnerable. It began to feel like I was an outsider, the sole person in my vicinity still wearing a mask. I continued my regular testing regimen and bolstered my protection with nasal sprays, but asking, “Where is your mask?” often drew sighs.

Coming from an organizing background that inherently distrusts our capitalist government’s ability to safeguard our well-being, I found myself both perplexed and infuriated that people chose to relax on this particular issue, as if we could now trust the powers that be to keep us safe. 

We have to keep us safe. 

In response, I first turned inward, seeking solace in my fermentation space. Simultaneously, I sought solidarity among my incredible disabled comrades and friends, who shared similar concerns, politics, and feelings.

I have a lingering fear that these little portal spaces might not be enough to sustain us, and that the fermentation process could go awry, resulting in mold and the need to start over from scratch. Meeting the needs of all individuals demands significant time, energy, and planning—a labor often unacknowledged and unpaid. Many undertake this work quietly and eventually burn out. Nondisabled people often overlook the incredible spaces, work, and contributions that disabled people are crafting for the benefit of all.

Still, within those worries, I must hold on to a belief in a new world where I can exist without shame, embracing my identities as a disabled, fat, queer, nonbinary and trans, mixed-race Black person—and more. I must hold to these convictions like Julian of Norwich held to hers. To achieve this, we must keep creating and experimenting—no matter how small the steps may seem.

In exploring the parallels between Julian of Norwich’s transformative solitude, the magic of fermentation, and the resilience of connection, I’ve come to understand that our experiences of isolation, like the slow fermentation of food, hold the potential to evolve into something deeper and more enriching. Let us not decay, and let us not allow others to waste away either. We must not leave people behind.

So, as I lie in bed, dealing with the pain that overcomes me, I can close my eyes, snuggle up with my blanket, and embark on some thought experiments that can help bring new portals and points of connection into our world. I hope you will do the same.

between the breath’s 

peak and trough

an infinitesimal point

of stillness

(less than a jiffy’s 60^th of a second)

between a pendulum’s swings

at the edges of its repeating arc

gravity grapples with inertia

and wins eventually

always

given air friction

drag force

(unless: think metronome
standing longcase clock
motion maintained mechanically)

at the top of each swing

before the pendulum turns

to return

a pause

in that stillness
we can slide

out

away from the war

declare a ceasefire

a truce in this tug of war��

between the inescapable pull��

downward��

the constant push to move

this face-off

between what we can’t outrun

and all that keeps us running

the weighty dilemmas of history
at war with life’s

bottomless desire for more��

life

trapped in clock

and calendar forced march

we lose circular time

the seasons’ reminders in feeling

that the planet

rotates on its own axis

revolves, inexorable,

closer to and further from its star

we lose the joy of that wheeling

the peace of fulcrums 

of light and darkness balanced

while we��

wild freedom

slip

out

One day, I turned to my phone to relieve some stress. There I saw Instagram stories of friends and acquaintances going out of town to take the weekend off. Others were showcasing their newfound love. A handful of folks shared their visit to a fancy restaurant as a treat for themselves after a long week. Watching my peers feast and relish in their respective enjoyments stirred some contempt in me. I internally criticized them for having a good time without knowing and addressing the present tragedies in the Global South. This was the case even when some of the Instagram stories were shared by fellow organizers or those whose politics I resonate with. 

I mindlessly imagined them giving away their time and money to things less important than donating to necessities in my impoverished whereabouts. It took a couple days of private judgy commentary before I realized: I was harsh about their access to pleasure because I was depriving myself of my own. And whenever I deprive myself of pleasure, it usually means I am disconnected from my body, my emotions, and, ultimately, from my authentic sense of self.

Eros and the Revolution

“The Erotic as power,” are Audre Lorde’s timeless words from her , “Uses of the Erotic.” It is not uncommon for people to view the erotic as solely about sex and sensuality. While those are foundational concepts, Lorde views eroticism more expansively:

“The very word erotic comes from the Greek word eros, the personification of love in all its aspects—born of Chaos, and personifying creative power and harmony. When I speak of the erotic, then, I speak of it as an assertion of the lifeforce of women; of that creative energy empowered, the knowledge and use of which we are now reclaiming in our language, our history, our dancing, our loving, our work, our lives.”

Lorde’s view of the erotic meant an aliveness found in multiple places and experiences beyond sex, such as doing creative work, moving through the spectrum of emotions, and participating in solidarity work. She addresses the need to use the erotic specifically to women because of how we’ve been socialized to suppress and be suspect of our desires.

Lorde’s essay harmonizes with Esther Perel’s views on eroticism. , Perel elaborates on a similar idea: “I really think it’s so important to understand that eroticism, narrowed down to the pure sexual meaning, is a real reduction of what the word stands for. It’s a transgressive force. It is about breaking the rules. That is erotic, because it takes you outside of the borders of reality and the limitations of life.” Because of its “transgressive” energy, eroticism is inherently disruptive to policies and norms enforced by the systems that aim to stifle the creative, empowering “lifeforce” Lorde talks about—so to then identify and step into one’s desires can be a form of dissent to societal expectations and patriarchal demands.

“Guilty Pleasures”

I’ve never met anyone who feels more guilty about pleasure than activists. I see this both in shared discourse with them and within myself as a community organizer. 

Working in social-change movements involves working with oppressed people and within areas devastated by colonization and climate catastrophe. Exposure to poverty and suffering is often high, and it’s easy for activists and organizers to compare their comfort with those whose access is either limited or has been taken away, thus causing guilt in their own pursuit of pleasure.

This guilt can also be tied to capitalism and excess. Living in a culture of “more” conditions us to consume beyond “enough.” As a result, many of us automatically equate pleasure with excess, leaving those of us who are capitalism-critical apologetic and even punitive about feeling good, even though it is a very natural human experience.

“Pleasure is not one of the spoils of capitalism,” adrienne maree brown writes in Pleasure Activism. “It is what our bodies, our human systems, are structured for; it is the aliveness and awakening, the gratitude and humility, the joy and celebration of being miraculous.” We can redefine our relationship to pleasure by separating it from overindulgence—the consumption and escapism that take us away from being present with ourselves, our relationships, and our realities. The erotic invites us to be more present in the moments and areas we feel most alive in and energized for—even when grief and suffering are present.

I had a conversation with Mitzi Jonelle Tan, climate activist and co-founder of Youth Advocates for Climate Action Philippines, about her relationship with pleasure, which shifted from being guilt-ridden to now being “enriched by different kinds of joy.” She brings a balanced perspective and understands that activists and organizers “will go through different seasons in their relationship with pleasure.” Some will consciously decide to momentarily or permanently give up on particular pleasures, while others will finally take a break and step back from the exhaustion and challenges of activism. Tan says that wherever the activist is in their relationship with pleasure and guilt, everyone goes through different stages, it won’t always be perfect, and it is okay.

Tan lights up whenever she is near water, has nonpolitical conversations with friends, and goes to music shows. She shares that “what we are fighting for is a world where everyone is able to access these pleasures,” and organizers and activists are a part of that collective hope. Tan doesn’t lose sight of the fact that “there is joy [even] in frontline work,” showing how a life dedicated to justice is not all sacrifice, and punishing ourselves through the deprivation of rest and pleasure won’t get us free, either.

Stepping Into Our True Selves: One’s Desires and Feelings

Ji-Youn Kim, therapist and co-creator of , considers “Uses of the Erotic” as their “Bible,” guiding and fortifying them in their liberatory practices. In a conversation I had with Kim, they share how they dream of “a delicious, pleasurable, luscious world, where it feels good and orgasmic to be in.” This world, Kim believes, practices deep emotional awareness and expression.

Kim shares that there are three ranges in emotional regulation: 1) the range of emotions that exist; 2) the range of intensities of emotions felt; and 3) the range of emotional expression. With this framework, Kim intends “to live a full-range emotional life,” which does not exclude rage and grief. Kim adds, “Joy felt accessible to me after I became more familiar with my relationships with anger and grief… My capacity for rage and grief shapes my capacity for joy,” alluding to Lorde’s belief that “the erotic is a measure between the beginnings of our sense of self and the chaos of our strongest feelings.”

Kim emphasizes the need to access the full spectrum of emotions, especially as Asian femmes and eldest daughters in immigrant families who’ve been deprived of expressing their feelings, and inevitably their desires. “We are not asked ‘what do you want?’” says Kim, “Instead, we were often told what to do.” Kim then shares an exercise with their clients in which they create a “desire list” for the day, so their clients may practice and even normalize regularly asking themselves what they want.��

It is a capitalist tenet to deny emotion and succumb to a robotic numbness, which makes us even more desensitized to our rights and desires. The desensitization is deliberate. Oppressive systems are threatened by our capacity to feel and voice our rights and demands to stay alive, which means that to feel deeply is to be inherently anti-capitalist. When we allow ourselves to feel emotions, we channel the sensitizing energy of eros to stay in the fight and refuse to be numb to the normalization of systemic harm.

The Erotic Fortifies Our Commitment in the Revolution

The more in touch we are with our desires, the more nourished and rested we are to be kind and creative. The opposite can be true (as illustrated in the beginning of this essay)—that when a person is out of touch with themselves (and therefore out of touch with their desires and aliveness), contempt, cruel projections, and even a sense of punishment ooze out. W.H. Auden wasn’t wrong when he said, “As a rule, it was the pleasure-haters who became unjust.”

But when we live into Lorde’s belief of eros, we become more present with ourselves and our bodies, and therefore build a capacity to be more present with our work. We develop better tactics and strategies. We enhance our visions, dreaming and scheming of possibilities beyond the status quo.

With eros, we also increase our ability to improvise and to move through the unknown, which are necessary skills in resistance work. Maria Popova in her exploration of Lorde:

“To be a complete human being, to fully inhabit your own vitality, is to live undivided within your own nature. No part of us is more habitually exiled, caged, and crushed under the weight of millennia of cultural baggage than Eros—the part that includes sexuality but transcends it to also include our capacity for spontaneity and playfulness, our tolerance for uncertainty, our unselfconscious creative energy.”

To study Lorde’s relationship with eros is to understand that stepping into our desires is a necessity rather than a luxury. The lovers of justice are no different from lovers of aliveness.

Note: There are ways to access pleasure while being mindful of disabled and neurodivergent kin, especially during public events and in private spaces. Ji-Youn Kim guides us through their essay series, “Practicing a Love Ethic in the Ongoing Pandemic ” and “.”

In 2017, Surgeon General Dr. Vivek Murthy penned an , where he named loneliness a growing health epidemic. This loneliness was so dire, Dr. Murthy argued, it could shorten a lifespan by . This wasn’t the first time loneliness had been framed as a public health issue. The New Republic, for instance, published “” back in 2013, and the article began adding new colors to the canvas of men: loneliness, isolation, and disconnection.

Only six months later, Billy Baker’s , titled, “The Biggest Threat Facing Middle-Age Men Isn’t Smoking or Obesity. It’s Loneliness.” Since then, the men’s loneliness epidemic has become a touchstone for understanding how, and to what extent, men are struggling. 

On all levels of the loneliness epidemic, women are right there, charting the course.

But lately, much of the conversation around men’s loneliness has been spearheaded by women. Last February, in , Magdalene J. Taylor explored loneliness vis-à-vis in men under 30. The article encouraged men to screw their way out of isolation (a prospect I imagine is exhausting for the many women pursued as a result). Then in July, by Christine Emba bravely charted generations of lost men and offered a map out of the wilderness that anyone from incel, to manfluencer, to quietly isolated, to well-intentioned young man could resonate with. On all levels of the loneliness epidemic—from , , and life-kits teaching men —women are right there, charting the course.

Certainly, there are public appeals made by men. The Boston Globe columnist Billy Baker went on to about men’s loneliness and friendships, President Biden of this year, and Dr. Murthy has continued his work on the subject, this May (though both President Biden and Dr. Murthy tend to address loneliness in general rather than gendered terms).��

But no matter who wrote what, the implicit takeaway is clear: Everyone should care! Women should care! No man left behind! But caring is a tricky word for many women, as it brims with gendered expectations of labor, open availability, and mental load. For many women—especially those who are sexually and romantically involved with men—the burden of investing in men and their problems often .

And while men’s loneliness certainly requires intervention, the real question is who, exactly, is expected to carry the load of care?

Care doesn’t mean fixing.

“Women have enough problems of their own to deal with. They don’t also have to be responsible for men’s problems,” says Richard V. Reeves, author of the recent book Of Boys and Men: Why the Modern Male Is Struggling, Why It Matters, and What to Do About It. 

Reeves is more or less the authority on the state of boys and men in the United States, and , which he hopes will be the first research-based, nonideological organization vested in improving the lives of men. But when addressing my suspicions—that women are too often tasked with the emotional rescue of men, rather than invited into mutual solidarity—Reeves thinks it isn’t so simple. On the one hand, he agrees that men are often emotionally dependent on women, a dynamic that arose in part from the “patriarchal economic structures [that] held women down economically, but propped men up emotionally.” And now, , “a lot of men are falling emotionally,” says Reeves. But it gets more complicated when considering how institutions neglect men and create a vacuum women are left to fill. 

Take the —a small but indicative example of a larger whole. The office was established in 1991 within the U.S. Department of Health and Human Services. And as there is , resources that should be aimed at men end up re-oriented toward women (like tasking women with talking about men’s mental health). The result? The lack of institutional resources for men, by convenience, is outsourced to women.

Even aside from the institutional shortcomings, there’s a cultural hesitancy to publicly address men’s needs. “A lot of men, particularly men who might be in a position to lead in organizations on this, are very reluctant to publicly voice concerns for men. And the reason for that is because they’re afraid,” says Reeves. “A guy talking about the problems with guys is going to be looked at with suspicion. Especially by women, right?” Here, I recognize myself, and remember the when he launched My Brother’s Keeper, an initiative for at-risk boys.

Part of the issue, certainly, is that there’s a conflation between the data-driven reality of the lives of many men—who account for —and a culture that often writes off men’s gendered issues as just another tantrum of toxic masculinity. Even in queer communities, it’s hard to avoid obtuse, . This environment makes it challenging to persuade men to take up the mantle of men’s issues, says Reeves, because many men feel the association is dangerous. Ironically, this creates another vacuum for women to fill because, as Reeves says, it generally feels more permissible for women to talk about men and gender on the public stage. 

However, when it comes to women in positions of authority, the responsibility may feel a bit more earned. Reeves clarifies that institutions like the White House Gender Policy Council should take up the cause of men—and as for women’s groups and advocacy networks? “I am asking them not to oppose the cause of men, not to criticize those who are in good faith trying to address it, not to make it so risky for them that people won’t,” says Reeves. “I do think there’s a role for a kind of studied neutrality on the part of women.”

Of course, men are not a monolith—some really are well-intentioned, . Still, I believe people should have a stake in the well-being, dignity, and happiness of others. But care doesn’t mean fixing, and women (even journalists) don’t have an inherent responsibility to raise the alarm or save the day.

The recommendation came from Amelia’s immunology team at UCSF Benioff Children’s Hospital. But there were seven other doctors who regularly worked with Amelia that needed to know about this change too. So did Amelia’s private therapist, her family therapist, and the school psychologist. Getting the new treatment also required filling out medical paperwork, obtaining coverage authorization from Amelia’s health insurance program, and sharing information with other officials at Amelia’s school.

This entire job fell to Netherland, a single mother who also has another child with complex medical needs. Altogether, Netherland estimates she spends up to 15 hours a week just coordinating her children’s care.

“There’s no one else to do it, so it’s me,” said Netherland, who also works from home as a health policy consultant. “I end up working late at night because I have to do all [the care coordination] between work hours. I would so love to have that time back to be a mom.”

A new benefit called Enhanced Care Management (ECM) offered under California’s Medi-Cal program could help Netherland and other parents who are caring for children with complex physical, behavioral, and social needs. These include kids with serious medical and mental health conditions, and young people who are homeless, pregnant, in foster care, or leaving the juvenile justice system. Children and teens who qualify for the benefit are assigned a lead care manager to take charge of coordinating all of their health care and related services such as dental care, obtaining medical equipment, and access to developmental programs. The manager’s role is to keep track of the various providers, agencies, and programs a child is involved with and that often don’t communicate with each other, and to connect families to other services they may need.

However, the program—which launched July 1—has been slow to help most families who qualify, including the Netherlands, who are still waiting to enroll.

“It kind of feels like no one was quite ready for it to launch, but it launched anyway,” said Mike Odeh, senior director of health at the children’s advocacy organization Children Now. “I want to be really optimistic about it, but it does make me wonder, if it can’t be done well, should we be doing it right now?’”

Advocates for children with disabilities are asking California to provide more information about the new benefit and how the rollout is progressing. For the program to succeed they say the state must ensure there are enough lead care managers with sufficient training to do the complicated work of managing care for high-needs children. And they urge greater transparency and speed in data collection.

Removing Structural Barriers

As of mid-August, the California Department of Health Care Services, which oversees the new benefit, had not widely publicized its availability, and only about 3,000 of the estimated 175,000 to 292,000 California children expected to qualify for the program were enrolled. When questioned, the agency said there is no specific enrollment target right now because the agency is waiting to gauge demand for the program. Agencies participating in the benefit’s rollout, including some county health departments and Medi-Cal managed care plans, said the program is still in the early stages of development.

The program will be a part of Medi-Cal, the state’s health program for those who qualify based on income or certain health conditions, which more than a third of Californians are enrolled in. Medi-Cal managed care plans can contract with county agencies, health care providers, and community-based organizations to provide the coordination.

In an email, Health Care Services spokesman Anthony Cava said it will take time to successfully implement Enhanced Care Management and other changes to the Medi-Cal program that are part of a transformative effort known as . The department is using feedback and data to tweak these changes as they roll out, he said, noting that the process would be a “multiyear journey.”

“We know that as the benefit rolls out, additional refinements must occur,” Cava said.

Meanwhile, parents like Netherland wait.

She’s received no information from her children’s health insurance plans about the new benefit, and her children’s health providers don’t seem to be aware of it. Netherland only knows about the program because, in addition to being a mom and caregiver, she’s an advocate for children with health care needs and has served as a parent representative on state panels on the topic.

Coordinating doctor appointments and medication details is just one aspect of Netherland’s responsibilities when it comes to caring for Amelia and her older sibling, Sarah. She also spends hours driving them to specialists, including behavioral health clinicians, occupational therapists, and physical therapists. She also takes Amelia to infusion therapy at the hospital. She chases down prescriptions, meets with school staff to discuss individualized education plans, oversees tutoring, helps with homework, takes Amelia to equine therapy, and drives Sarah to a job training program.

“At the end of the day these young people who live with illnesses … they’re just kids,” Netherland said. “I feel like one of the things ECM might do is it might help remove some of the structural barriers that get in the way of young people [getting the support they need] so their families can just enjoy more time being resourced.”

Cava said the state health care agency doesn’t have up-to-date information on how many children have enrolled so far. The department estimates that between 3% and 5% of the 5.8 million youth under age 21 enrolled in Medi-Cal will be eligible. Approximately 3,270 children and teens received Enhanced Care Management services in 2022 as part of an targeting adults, typically because those children were enrolled along with an older family member or were grandfathered in through a previous program, Cava said. The department reviewed all the Medi-Cal managed care plans in the state prior to the July 1 launch of the benefit for children and youth to make sure they had the right procedures in place and enough providers to offer ECM. The department concluded they were ready for the launch, he wrote.

Managed care plans are responsible for identifying eligible children and referring them to providers for service. Cava said the department has also instructed managed care plans to work on increasing awareness of the Enhanced Care Management benefit among their plan members and entities that serve those who may be eligible such as schools, medical offices, and community-based organizations.

Meanwhile, Nicole Kasabian Evans, a spokesperson for Local Health Plans of California, a statewide association representing California’s Medi-Cal managed care plans, said no one was available to speak with a reporter before the deadline. Austin Wingate, public information manager for the Alameda County Public Health Department, said officials there had not yet fully implemented the program and could not provide specific information for several more weeks. Inez Leonard, administrator of the Sacramento County California Children’s Services program, which serves children with disabilities, said her agency planned to participate in offering the benefit, but was still in the planning stages.

Fewer Children in Foster Care?

Some organizations have begun offering the benefit on a limited scale or plan to begin offering it soon. Children’s Hospital Los Angeles began enrolling children in Enhanced Care Management July 1, said spokesperson Lauren Song in an email. Craig A. Vincent-Jones, deputy director of Children’s Medical Services at the Los Angeles County Department of Public Health, said his division had applied for funding through the California Department of Health Care Services, which, if approved, would allow them to begin offering Enhanced Care Management for children and youth in early-to-mid-2024. He anticipated enrolling 1,000 children in the first year.

Vincent-Jones said the program could potentially lead to fewer children entering the foster care system by improving support for struggling families. “A health condition can unravel a family and sometimes that’s what leads to them being in the child welfare system, so if we can find ways of preventing that, hopefully we can reduce the number of kids and families” in the child welfare system.

The California Alliance of Child and Family Services is further along in the implementation process. The statewide organization represents 160 agencies that primarily serve low-income and challenged youth and their families. The Alliance launched an Enhanced Care Management provider network last October that includes almost 50 of its members. Called the Full Circle Health Network, it has already contracted with two Medi-Cal managed care plans to deliver the benefit, and as of July 24, families had been referred for care, said Camille Schraeder, the network’s executive director.

The network has developed an electronic records system that providers can use to manage patient information and referrals, and will collect standardized data on behalf of the health plans to assess program reach and quality.

“It’s a wonderful opportunity to see if we can actually effect change,” Schraeder said.

Odeh with Children Now was less convinced about Enhanced Care Management’s chances of success. He said too many questions remain about who will provide the lead care coordination and whether they’ll have the expertise and relationships needed to successfully do the job. In May, Children Now commissioned a series of focus groups with parents of children with chronic medical conditions. The organization found that few parents knew about the new benefit, and while some hoped it could help, others worried it might add yet another layer of complication to their child’s already complex care needs.

That’s how Netherland feels about it. Although she calls herself a “diehard fan” of the Enhanced Care Management concept, she said she’s worried she’ll end up having to teach the lead care manager herself how to coordinate Amelia and Sarah’s care. So far, that’s been her experience with other case managers and similar workers assigned to help her family.

“I just have questions about how effective it’s going to be,” she said. “And I don’t mean to be a rain-on-the-parade person, because I really hope it works.”

Both Odeh and Netherland said they’d like the Department of Health Care Services to collect and make public data that shows in real time how the benefit is working. The Department is currently planning to collect data on the program quarterly. The first reports are due in November, Cava said.

And children’s advocates said the state should get input from families, including people who often face barriers to accessing health care benefits, such as people of color, those with limited English proficiency, and families impacted by the child welfare system. Odeh said he’d also like the agency to do more to build up the needed network of skilled lead care managers.

Netherland dreams of the Enhanced Care Management program being fully operational, and what that would mean for her and her children. She envisions a care manager who can schedule her children’s appointments at convenient times instead of the haphazard appointment slots they currently get; haggle with insurance when coverage for life-enhancing procedures gets denied; and convene meetings with her children’s providers so everyone is on the same page about their needs and treatment. Perhaps, if someone did this for her, Netherland could even find time to take care of herself for a change. She’d like to go back to training for marathons, which she did before she had children.

“I would love to see what it’s like to be a caregiver and not a care-wrangler,” she said.

This story was produced in collaboration with the .

Many of us are becoming aware that we are living in an apocalyptic, revelatory moment. We are experiencing extreme contradictions as systems based on the white supremacist imaginary (domination, extraction, and violence) are failing.

If we are able to look at world events through the lens of history stretching over hundreds or thousands of years, we will recognize that we are in a time of great transition—a time when the world as we know it is ending and a new world is fighting to be born. For some, the falling away of the only systems they’ve known causes such great uncertainty and instability that they would do anything to protect the dying system. The end of the world as we know it causes grave distress and hopelessness. 

But, as these systems crumble, in the cracks, there is an opportunity for us to insert another imaginary. There is an opportunity to create new worlds from the Black Imagination, freed from the capitalistic notion that our creativity can and should be exploited.

In 2019, my studio embarked on a deep-dive study of the Black Imagination, inspired by Robin D.G. Kelley’s . We curated a list of readings looking to explore whether there were shared principles and methods by which Black- and Afro-descendant people have engaged in bold imagining and freedom dreaming, especially through art, literature, culture, and prefigurative experiments, as part of broader racial justice movements. We found that Black Imagination is an ancestral, Afro-Indigenous way of being based on various cosmologies. Black Imagination centers worldviews that are nonbinary and borderless. It affirms the interconnectedness between our material world, universal consciousness, the past, and our ancestors, the future, and those yet to be born. It is embodied and rhythmic and integrated. It presents many possibilities; it is non-monolithic, affirming multiple ways of being and knowing. It is interdependent and regenerative. It invites us to straddle worlds like or , Orisha of the crossroads; and to be like water, adaptable and abundant.

We access Black Imagination through our ancestral connection and guidance, and we experience it via our dreams, our collective visioning, our intuitions, and our stories. It invites us into the prophetic tradition of envisioning futures in which our descendants are thriving and free. The Black Imagination has been a source of hope and healing at key moments of transition in the history of the Western world, offering a vision of liberation that is expansive and inclusive; an alternative to the destruction brought about by white supremacy.

As an artist, I am especially deeply inspired by the idea of poetic futures outlined in Freedom Dreams. I understand it to refer to the aesthetics of articulating visions of liberatory futures. I am drawn to it because it helped to clarify and affirm for me the role of artists, writers, creatives, and cultural producers in advancing the bold and irresistible freedom dreams held by our movements for liberation at a time when I was embracing art as my purpose after more than 20 years as an organizer. It also contextualizes artists and creatives as integral participants in social movements, right alongside and in relationship to organizers and policymakers and academics. Under the stewardship of artists, radical ideas captivate the hearts and minds of even those who consider themselves nonpoliticized—making other possible worlds irresistible and perhaps inevitable. 

These invitations are evident in the and his articulations of a possible life for Black people on other planets. Or Du Bois’ The Comet, written in 1920, and the way in which it works out the “what if?” of racial equality in the context of a science-fiction novel. Or the Black Panther comic books and subsequent movies. This is the work of radical and visionary world-building, and it is what I am turning to in order to unleash my imagination and that of others. 

World-building is a literary tool primarily used to shape science fiction, fantasy, and other speculative fictions. It can be a way to support Black folks to articulate their boldest political imaginations by reimagining and reconnecting to an ancestral sense of Spirit and Story: who we are and what we mean to the world. Building these worlds allows us to reimagine and reaffirm our shared values and ways of being together, in ways that center Black love, Black joy, Black rest, Black time. We can reimagine and redesign our neighborhoods and cities as liberated zones and decolonized spaces, and reimagine and transform our systems and structures—from governance, to economics, to education—to reflect our values.

For the past three years my studio, , has been experimenting with using world-building as an art and design framework that invites Black communities to imagine futures based on . We see imagining the future as our sacred responsibility as future ancestors. We invite people to craft story worlds for their future descendants 150 years from now, and then imagine the future history—how we journey from the world we know, the now, to the worlds of the future. In so doing, we use world-building to support the development of long-arc strategy, as well as to create works of art and experiences that can inspire. We learn to anticipate ebbs and flows, ups and downs, and pushback, and we prepare to meet those challenges with our hearts planted firmly on a collective North Star. We draw on our desires to cultivate hope, and conjure artifacts and practices from the future that we can begin practicing now in order to make those possible futures real right now. By world-building, we are conjuring hope. Together we are painting vivid pictures of the world and inspiring each other to take bold and transformative action with whatever gifts we have to bring that world into being. As a collage artist, these worlds make their ways subconsciously into my artwork too.

In the three years that we’ve been cultivating this collective practice, we’ve learned a few precious lessons:

1. Imagining the future is mostly about remembering and drawing lessons from the past. It’s also about giving ourselves space to change the present (or the near future). It allows us to temporarily let go of the feeling of the impossible that can exist in the present, and feel the power of creating conditions that allow more possibilities to unfold in the future. Once we can see these possibilities, regardless of when they exist in our imaginations, we can make them real in the now.

2. We mostly know what new ideas we might try. Most of the ideas and solutions already exist from a technological perspective. In our world-building spaces, people echo some fundamental solutions. We mainly need permission to believe these ideas are possible at the level of our collective will. Expressing our desires together, in an affirming and hope-oriented community, gives us the confidence to mention these ideas in other places, and to experiment with them in our work in all aspects of society.
   
3. We have a chance at saving our species from impending disaster if we can get diverse groups of people involved in imagining shared futures, mitigating the kind of uncertainty that breeds fear and violence. We need to collectively craft different stories and scenarios of the future, and commit to working toward some of those scenarios, instead of accepting the stories of scarcity and competition fed to us by people who do not wish for all of us to thrive.
   
4. Collective imagination is essential. And we must build the power to co-create elements of the futures we have imagined. We have to allow our dreams to infect our realities, and allow them to shape the way we think about what we are building. Sometimes that is going to look like simple day-to-day practices and ways of being that embody our future visions in extremely practical ways. And sometimes it looks like changing the way we approach organizing and movement-building, including who we think our movements include.

As we face the uncertainty of transition, Black Imagination is an abolitionist tradition that offers us an invitation to act with hope. It invites us to remember that the key to our thriving exists in our collective dreaming and in our willingness to imagine the impossible. We remember then, that in times like these we have always advanced bold and inspiring visions by demanding transformative policies, creating innovative and prefigurative structures, and by creating visionary and speculative art and ways of being together. How might you create the space and time necessary to unleash Black Imagination, today?

Then, 15 years after giving birth to her son, she found herself pregnant again. She faced insults and name-calling daily because of her age and the long gap since her first baby. Both are considered shameful by those who carry conservative beliefs in India. 

Kumbhar, 34, tried ignoring the criticism, but even her brother abused her verbally. “Is this even an age to get pregnant?” he asked her. Meanwhile, a few neighbors offered empty congratulations, saying they hoped she’d give birth to a boy, highlighting the social disdain toward female children.

“For me, pregnancy was a big thing,” Kumbhar says, recalling the difficulty of her first. “It made me happy for a while, but I had mixed feelings later. I was confused between childbirth and getting an abortion.” 

Many people in her position in India have very few options. Abortion is legal, per India’s Medical Termination of Pregnancy Act of 1971, but that doesn’t mean it’s accessible. Government records show that for the more than of childbearing age in the country, India just has public health facilities that provide abortion up to 12 weeks, and merely 4,213 public health facilities that can abort up to 20 weeks. 

As a result, unsafe abortion remains India’s third leading cause of maternal mortality, with women dying every day. unsafe abortions are carried out in India annually, and most of these are provided to people from marginalized communities. 

Stressed and unsure where to turn, Kumbhar contacted community health care worker Maya Patil, a resident of Kutwad village in Western India’s Maharashtra state. Patil took Kumbhar to a doctor who explained that there could be a potential risk to both the mother and her unborn child. During pregnancy, fetal blood cells can cross into the mother’s blood system. If the mother and fetus have different Rhesus (Rh) factors, for example the mother has Rh-negative blood and the fetus has Rh-positive blood, then the mother’s immune system sees the fetus’s cells as enemy cells, and responds by producing antibodies. This was the case in Kumbhar’s first pregnancy. There is an intervention called the Rhesus injection, which, if given after a childbirth, can slow or prevent that immune response in a subsequent birth. But since she �徱���’t receive the injection after her first childbirth, there was a good chance she could experience an even faster immune response to the fetal cells this time around. When these antibodies cross the placenta and enter the blood of the developing fetus, they can lead to permanent nerve damage or even death. Hypothyroidism further complicated the health risks of pregnancy for Kumbhar, who was already experiencing anemia, muscle pain, hypertension, and weakness due to the condition.

But there is a widespread societal belief in India that an abortion is sinful and equivalent to killing someone. Kumbhar’s husband and neighbors—the same neighbors who were criticizing her for being pregnant—now pressured her not to abort. It took Patil multiple visits to explain to Kumbhar and her husband about the risks involved and why abortion was the only safe option. She spent several hours counseling the couple, ensuring them that she had their best interests in mind and that her recommendations were based on medical science, not societal pressures.

Finally, Kumbhar made a firm decision to end the pregnancy. The local community doctor referred her to the district hospital 50 kilometers away, which she visited multiple times in search of treatment. Each time she went, the doctors would shun her when she tried to talk to them, and ask her to visit some other day. “None was serious,” she says. After four such visits, collectively traveling more than 400 kilometers via a series of public buses despite her severe physical weakness, Kumbhar lost her calm. She asked Patil if she should reconsider her decision.

Working hard to get Kumbhar the treatment she needed, Patil dialed a few doctors and the administrative staff and found that the district hospital was oversaturated and understaffed. A 2020-21 government report that India has only 25% of the obstetricians and gynecologists they need to keep up with the existing patient load. Patil pleaded with the doctors and was able to get Kumbhar a timely abortion. 

But the public health care facility’s limited resources and old equipment led to yet another brush with death. “The medical devices malfunctioned,” Kumbhar remembers, teary-eyed, “and I was in the hospital for nine days.” Kumbhar recovered but calls it one of the worst phases of her life. Had it not been for Patil’s consistent support, Kumbhar says she wouldn’t have survived. “The trauma was just unbearable.”

Accessiblity of Care

To make abortion accessible, health care workers like Patil spend countless hours working well beyond their duties. Patil is an Accredited Social Health Activist (ASHA), and is responsible for bringing health care to rural areas. There are approximately 1 million accredited social health activists in India—one assigned for every 1,000 people in India’s villages. They perform more than 70 different healthcare-related tasks, including distributing medicines for common ailments, handling pre- and postnatal care, ensuring universal immunization, and much more. 

Many ASHAs across India are risking their lives to make abortion accessible. 

As with Kumbhar, ASHAs like Patil talk to the doctors on behalf of patients, explaining their situations and advocating for their care. Several times, Patil has faced abuse for this, from both doctors and community members. And in some cases she’s had to reach out to ASHAs from different states in India for support. But she keeps going until the needed care is provided. She has helped many people, including minors and single women—several of whom were victims of sexual abuse and incest—access abortion safely. 

Patil recalls a case five years ago where an unmarried woman got pregnant. When the woman sought an abortion, multiple public doctors asked intrusive questions and denied her abortion without giving a reason. After three months of failed attempts, Patil got involved. She talked to the doctors on the patient’s behalf and explained the urgency of the situation. When Patil refused to answer the doctors’ inappropriate questions about the patient’s personal life, she was yelled at and verbally abused. In this case, she had to call a senior public health care official in order to get the patient the care she needed. 

The task doesn’t end there, though. Often ASHAs spend months counseling people who face scathing remarks from their families before or after an abortion. ASHAs even take patients to psychologists for therapy. This is significant, especially because for the population of 833 million people currently living in India’s villages, there are just 764 district hospitals and 1,224 subdistrict hospitals with clinical psychologists and psychiatrists.

A 2017 World Health Organization found that India has less than 7 psychiatrists for every 10 million people. 

Accredited social health activist Netradipa Patil, from Maharashtra’s Shirol region, says, “In cases of rape, the district hospitals first ask us to get a police case registered and bring several documents before aborting—despite an emergency. It’s not easy to get a case registered, and the district hospital staff first asks several uncomfortable questions intruding on privacy and then ask the victims to revisit later.” In such cases, she has observed that the victims are forced to reach out to quacks and faith healers, often risking their lives, to end their pregnancies in a timely manner. In other cases, Netradipa Patil says the paperwork and red tape require so much time that the pregnant people end up giving birth. 

“Yes, we are given reproductive rights, but it’s not easy to avail of them,” she says. “Abortion is legal in India, but the process is the punishment.”

How Abuse and Stigmatization Are Leading to Unsafe Abortions

“Many public doctors abuse and insult abortion-seeking women to such an extent that they are forced to use unsafe abortion methods,” says Maya Patil. She recalls an incident two years ago where a doctor berated a pregnant woman, saying, “How many children do you want? Are you going to give birth to a dozen more?”

In the face of such ill-treatment, many pregnant people tell ASHA workers that they are ready to suffer in silence rather than visit the government doctors, Patil says.

One among them is Archana Kamble (name changed for safety reasons), 30, who refused to visit a doctor to get an abortion. “I just took a few emergency contraceptive pills,” she says. But afterward, the bleeding and heavy cramps �徱���’t stop, even after 17 days. Kamble then reached out to her safest point of contact, Maya Patil, who encouraged her to consult a doctor.

However, fearing the insults, Kamble refused to go to the doctor and continued working, lifting heavy farm loads for another 13 days. “It was almost a month, and my bleeding wouldn’t stop,” Kamble says.

Eventually, dizziness and fainting forced her to reach out for medical help; Patil accompanied her. However, just as Kamble feared, the doctor she visited yelled at her for attempting to terminate the pregnancy on her own. “Instead of helping the patient, the doctor kept shouting at us,” Patil says. “He just wouldn’t stop, and kept asking several questions, making her extremely uncomfortable.”

Patil pushed back until the doctor agreed to do a sonogram. “It was an incomplete abortion with the fetus and pregnancy tissue still present,” the doctor said, and referred Kamble to the district hospital.

But Kamble already felt traumatized by the doctor’s comments, so she was reluctant to go. Patil counseled her and explained how urgent it was for her to get surgery to remove the fetal tissue. She agreed, and the surgery was ultimately successful. 

With Patil’s help, Kamble then also got the tubectomy she wanted. “Even this was extremely challenging as the community women kept asking me to try for another child, meaning a boy,” Kamble says.

She isn’t an exception. As per India’s , more than 25% of abortions were performed by women themselves at home. Just of abortions took place in public health care facilities, while 53% took place in private hospitals, which are mostly located in urban areas.

Solving Problems Before They Happen

In 2008, accredited social health activist Suraiyya Terdale from Maharashtra’s Ganeshwadi village got pregnant. “I �徱���’t want another child, but my brother told me he would adopt,” she says. However, in the third month, he denied having made such an agreement. After that, her sister-in-law said the same thing, and rejected the idea of an adoption. “By now, I was into depression,” Terdale says.

In her sixth month of pregnancy, Terdale accidentally fell from a height while cleaning the house, causing severe injuries to the fetus and ongoing bleeding. She went to a doctor who warned of the risks of continuing the pregnancy, which they said could even take her life.

Terdale had no idea about India’s abortion laws or if any doctor provided such services nearby. So she reached out to a local doctor who, with the help of another doctor, performed a surgical abortion without proper medical equipment or care in place. “I still remember how unsafe it was. I can never forget that moment,” she shares.

From that instant, Terdale, who wasn’t able to complete her education beyond grade 10 due to financial constraints and patriarchal attitudes, decided to save lives by making abortion accessible. She studied to become an accredited social health activist in 2010 and went on to complete a nursing and midwifery course.

Since then, she has worked to make her community aware of pregnancy and abortion laws. However, sometimes she runs into challenges that arise from the policy itself. For instance, pregnant women with multiple daughters often have a hard time getting an abortion. “In several cases, an investigation is done whether she has undergone a sex determination test,” Terdale says.

The preference for male children was leading to a decline in India’s sex ratio. In 1981, for every 1,000 boys, only 934 girls were born. By 1991 that ratio was 1,000 to 927. To stop this, the Pre-Conception and Pre-Natal Diagnostic Techniques Act of 1994 was enacted, which made prenatal sex-detection tests a criminal offense. 

“But, this also made it extremely difficult for women to access safe abortion,” Terdale says. For instance, women like Kamble, who have two daughters, are often on the radar of public health care authorities when they seek an abortion. “Many doctors fear they will later be arrested for aborting a female child, and so they deny an abortion,” Terdale says.

During such times, ASHAs talk to the health care authorities and ensure a safe abortion. Terdale’s work brings hope, especially in these times when .

“I always ensure that an abortion is done in less than six weeks. The sex of the baby can be determined after 12 weeks of pregnancy, and since they get an abortion before that, there’s no reason they are denied an abortion,” she says.

However, Terdale’s work isn’t easy. She has been the subject of scorn from several medical officers and community members for helping marginalized women. During such challenging times, she thinks back to what made her do this work in the first place: She never wants anyone to go through what she had to go through. With her tremendous work traveling to villages on foot, Terdale has helped more than a hundred women access safe abortion. ���� my work saves even one woman, I will happily believe that I have done something in life,” she says.

Despite their life-saving work, accredited social health activists, first instituted in 2006, aren’t considered full-time workers and therefore remain overworked and underpaid. They are compensated with an honorarium and , meaning they are paid a small fee for each task completed. In Maharashtra, they average $45 to $60 a month—far less than —and payments are often delayed. 

Many of these health activists have aimed to address these strenuous working conditions by unionizing. There are now a number of ASHA unions across the country. Others like Terdale are silently making abortions accessible.

“While abortion is legal in India, there’s still a long way to make it accessible,” says Netradipa Patil, who has been fighting the system to bring change. She has written letters to the health ministry and meets with senior health care authorities to raise the issue of access to legal abortion. 

Maya Patil, too, talks about why she keeps going despite the risks: “Today, whenever we meet the women and girls we helped, they smile. That smile inspires us to bring more smiles.”

Though air quality laws strengthened over the decades, pollution in Pittsburgh and surrounding Allegheny County has remained high, ranking among the 25 worst metro areas in the United States for fine, easy-to-inhale particles known as PM2.5. Carbon pollution can often feel so big—borne on the air, causing ice caps to go black and melt. But it also causes problems much closer to home. Allegheny County’s inhabitants are in the nation for cancer risk, and the area is for its high rates of asthma and heart issues, both of which, like the biggest emitters, are concentrated in low-income neighborhoods and communities of color. These kinds of health problems can often seem both mysterious in origin and inescapable for the people who live with them. However, the January 2016 closure of the Shenango Coke Works coal-processing plant provided an astonishing example of how quickly those same communities can recover from the most dire impacts of pollution.

Shenango was a coke oven—a facility that heats coal to around 2,000 degrees Fahrenheit to produce coke, which is in turn used to make steel. Such operations are famously nasty particle polluters, emitting not only carbon dioxide but also contaminants like benzene, arsenic, lead, and mercury. 

The , led by the New York University Langone School of Medicine, used medical records from area hospitals to determine emergency room visits and hospitalizations for heart ailments in the three years preceding and following the closure of the plant. They found an astonishing 42% drop in weekly emergency cardiovascular admissions after 2016. That immediate drop was followed by a downward trend that continued for three years. The study also found corresponding steep drops in sulfur dioxide—as high as 90% near the facility and 50% at a monitoring station six miles away. Arsenic levels plummeted by two-thirds.

Study co-author George Thurston compares the sudden improvement to the benefits of quitting smoking. “Over time the body recovers,” he says. “Instead of at an individual level, you’re really looking at a community healing after the removal of that exposure.”

To Thurston, and study lead author Wuyue Yu, this research shows that cutting carbon emissions offers more than an abstract, long-term, far-ranging result. It can actually save lives, almost immediately.

The study was prompted by years of local agitation about the plant. Shenango closed under intense community scrutiny and had paid the county millions of dollars in fines for multiple air quality violations. 

For years, an organization called Allegheny County Clean Air Now, or ACCAN, fought to rein in ongoing emissions at the plant, bringing in the Environmental Protection Agency, the Allegheny County health department, and Carnegie Mellon University to monitor the plant’s pattern of violations and the health consequences for its neighbors. ACCAN members served as community scientists, collecting data and taking the results to local officials, company shareholder meetings, and U.S. Steel. Even steelworkers from the plant occasionally attended meetings, expressing concern about the situation. Now, says ACCAN member Thaddeus Popovich (who was told that there’s a 40% to 50% likelihood that his own triple-bypass heart surgery was prompted by living half a mile from Shenango), he and his peers feel “vindicated.”

After the plant’s closure, members of ACCAN gathered and set to paper their memories of life before Shenango shut down. In the resulting collection, called , people describe living with fiery and sulfurous smells and mysterious ailments. Angelo Taranto, an active ACCAN member, lost his wife to a host of respiratory problems he’s sure were caused by Shenango’s billowing smoke. “These personal situations really energize people to want to do something,” he says. 

After the closure, Taranto says, ACCAN encouraged the Allegheny County health department to pull together some retrospective health studies. In 2018, Dr. Deborah Gentile documented a 41.6% drop in uncontrolled pediatric asthma two years following Shenango’s shuttering.

“What we were hearing from county officials was that they �徱���’t think the closure would be a boon to county health,” Taranto says. “We heard similar things from the company itself and we knew that wasn’t true, and we knew that we couldn’t let those types of statements remain unchallenged.”

There’s still a long way to go for the greater Pittsburgh area, though. Matt Mehalik, the director of the Breathe Project—which used its resources to support ACCAN and connect them to researchers—points to similar facilities, such as the Clairton coke oven and the Mon Valley steel works, as contributors to major public health problems. Clairton, 10 times as large as Shenango ever was, sits near a low-income, majority-Black neighborhood, and community organizations have worked for years to hold the facility accountable to the harm it has caused. Environmental advocates are currently urging the EPA to Clairton’s permit. The EPA has also proposed a for toxic coke-oven emissions, which could increase pressure on plants like Clairton.

Mehalik is excited about a potential transition to forms of steelmaking as a long-term solution for Allegheny County. “We know that an investment in the right type of green steelmaking is needed if there is a future of steelmaking in the Mon Valley,” he says. “Perpetuation of a polluting facility that comes at the expense of our county is highly problematic.”

This in Grist. Grist is a nonprofit, independent media organization dedicated to telling stories of climate solutions and a just future. .

“I was like, ‘Oh my gosh, why do I need therapy? Do they think I’m crazy?’” recalls Lisbet, who asked that her last name not be used in order to protect her children’s safety. “I couldn’t understand at that moment how important it is to seek therapy after overcoming a traumatic situation.”

While it came as a surprise to Lisbet, domestic violence survivors often need mental health care. Like veterans of wars or victims of human trafficking, these survivors have often been subjected to prolonged periods of extreme stress and fear for their safety, which is harmful to the health of both body and brain. The need is widespread: An estimated  in the United States experience severe physical violence at the hand of an intimate partner in their lifetime.

Californians in general , but the access difficulties are magnified for survivors. These access challenges are often compounded by practical, cultural, and linguistic barriers, including—as in Lisbet’s case—the overwhelming nature of domestic violence, health insurance limitations, stigma, and fear of turning to authorities for help. 

Experts who spoke with the California Health Report say the state should do more to help domestic violence survivors and their children access mental health support by providing additional funding to domestic violence agencies to expand mental health services, requiring insurers to better cover mental health care and reimburse providers fairly, and incentivizing more people to enter behavioral health professions. Some advocates and survivors also call for reimagining criminal justice and child welfare responses to domestic violence to reduce the risk of penalizing or alienating victims.

“No Space for Caring for Yourself”

In the seven years prior to leaving her husband, Lisbet’s focus had been on surviving. She walked on eggshells, trying not to do or say anything that might throw him into a rage, trying to keep herself and her three kids safe. She ignored her health: the nagging muscle aches, her inability to sleep, the overwhelming stress that—after one particularly bad argument—sent her body into temporary paralysis. 

An undocumented immigrant, Lisbet lived in fear that she’d get deported or lose her children if she told an authority—even a medical professional—about the abuse. She had no health insurance to see a doctor anyway. And mental health care? Talking about mental health was considered shameful in her family. 

“When you’re in [a domestic violence] situation, there’s no space for caring for yourself,” Lisbet says. “For me it was like, ‘Oh, I’m tired, I’m under a lot of stress, it’s normal.’” 

People in abusive relationships are often under incredible stress, and their partners may control their access to health care, making it difficult for them to seek help. One study of California residents found that adult survivors of intimate partner violence were  than nonsurvivors to report serious psychological distress. Survivors’ children are also at heightened risk for mental health challenges, including post-traumatic stress disorder and difficulty regulating emotions, even if they witness the abuse but don’t experience the violence directly, studies show.

������Ƶ than a third of Californians are insured under the state’s Medicaid program, known as Medi-Cal, and they often struggle to find therapists willing to take that insurance due to low reimbursement rates compared to private insurance or out-of-pocket pay. About 3 million Californians, many of them undocumented immigrants, have no health insurance, and most of them cannot afford to pay for mental health care in cash. For survivors who speak languages other than English, finding therapists who speak their language and understand their cultural background can be especially hard.

Seeking mental health care can also come with risks. Disclosing domestic violence to a medical professional (who under California law must report potential child mistreatment) can end up triggering the involvement of child protective services (CPS) and the removal of children, . The exposure of children to violence in the home, even if they don’t witness it directly, is , which mental health practitioners are required to report to CPS. This is particularly concerning for many survivors of color, whose children are overrepresented in California’s foster care system.

“Afraid to Call the Police”

Communities of color often experience negative consequences from police or social service involvement, such as family separation and incarceration. Black and Indigenous children, for example, end up disproportionately in California’s foster care system, and Black and Latinx Californians also face  due to a legacy of racism in the criminal justice system and society at large. Given these realities, Charmine Davis, director of family wellness at the Jenesse Center, a domestic violence intervention and prevention program in Los Angeles, says many survivors of color are understandably afraid to seek help. 

“You have these survivors or victims who are afraid of the system, they’re afraid to call the police, they’re afraid to go to the doctor, they’re afraid social services is going to be called,” Davis says. “I’ve seen grave consequences … By the time they get to us they can be so depressed they’re ready to commit suicide. They are so depressed they’ve lost touch with reality.”

To encourage more survivors of color to seek help sooner, California needs to work on building access to culturally competent and sensitive mental health services, staffed by professionals who understand and look like the people they are serving, Davis says. California has a shortage of mental health professionals in general, but that shortage is particularly acute when it comes to professionals of color. Latinos constitute 38% of California’s population, yet only 4% of psychiatrists, 8% of psychologists, and 23% of counselors, according to  by University of California, San Francisco. Likewise, African Americans make up 6% of California’s population, but just 2% of psychiatrists (although they are more evenly represented among the ranks of counselors and social workers, the study found).

Davis says she believes the mandatory reporting law for medical professionals should be changed so that patients feel more comfortable disclosing information about domestic violence. She also points to what she sees as unreasonable requirements for many survivors whose children are removed—including being forced to travel long distances to see their kids while also complying with random drug tests, all of which adds stress to an already difficult situation and makes it harder for survivors to recover. These compliance requirements to regain custody of children need to be overhauled, Davis says. 

“In the Black community, a lot of women aren’t treated fairly,” she says. “This community is hurting.”

A Lifeline for Mental Health Support

Organizations like the Jenesse Center that specialize in providing shelter, legal, and other support to domestic violence survivors have become a vital entry point for mental health services. These agencies specialize in working with survivors and their children and are experienced at building trust with wary clients, advocating for them and recognizing signs of trauma. 

Over the past five years, with California’s mental health system  and demand for mental health care growing, more and more domestic violence agencies have set up their own mental health teams, says Jasmeen Kairam, a project manager at the California Partnership to End Domestic Violence, which provides technical support to agencies across the state. These teams are often staffed at least partially by therapy and social work interns completing licensing requirements, which helps keep the cost of providing care lower than hiring fully licensed clinicians. 

At WEAVE, a crisis intervention agency for domestic violence and sexual assault survivors in Sacramento, survivors and their family members can get approximately eight individual therapy sessions and 15 weeks of group therapy for free. The agency, supported by government and private grants along with revenue from three retail stores, also offers some longer-term therapy on a sliding scale for as low as $35 an hour, although even this amount can be challenging for people with very low incomes. Advocates can also help survivors apply for additional mental health coverage through the , a state agency that reimburses crime-related expenses for survivors of violence, including domestic violence. The challenge is that many survivors are intimidated by the paperwork required to obtain this compensation and decide not to apply, says Jaime Gerigk, WEAVE’s head of counseling and outreach. Some providers have also  for being mired in red tape, making it difficult for the agency to serve survivors.

Meanwhile, some smaller domestic violence organizations that don’t have the means to hire clinicians themselves have found ways to partner with other nonprofit, health, or social service agencies to obtain mental health support for their clients. The Family Assistance Program based in Victorville, for example, partners with the San Bernardino Department of County Health to ensure clients that enter the organization’s domestic violence shelter receive mental health support within 48 hours, says program manager Jobi Wood. The program also hires a health advocate whose job is to develop relationships with mental health providers in the community, understand how to navigate insurance, and advocate for clients so they can get the care they need. 

Yet while domestic violence organizations play an important role in helping survivors and their children obtain needed mental health care, there are limits to what they can provide. Demand for therapy often outstrips supply. Funding constraints limit support to short-term intervention rather than the long-term care some survivors need for recovery. At WEAVE, for example, survivors might have to wait a month or two to see a therapist, increasing the risk that their symptoms could worsen, or that they might give up on seeking help and return to an abusive partner, Gerigk says. 

“When someone reaches out for counseling, they’re wanting it right then, it takes a lot of courage to reach out and say, ‘I want to talk to a therapist or a counselor,’” she says. “For me to have to say, ‘Well, it’s going to be about eight, 10, 12 weeks,’ you know, I wish I �徱���’t have to do that.” 

Forced to Limit Patients to Pay Bills

Close to  of adult Californians with a mental illness don’t get treatment. Common reasons cited are cost and . Provider shortages likely add to the problem given that California’s mental health care workforce meets only about a quarter of actual need, according to data compiled by the . The deficit is expected to intensify over the next decade as large numbers of behavioral health professionals . 

Without workers, no amount of funding or tweaking mental health policies will be enough, says Vickie Mays, a psychology professor and director of the  (Bridging Research Innovation, Training and Education) at UCLA. She says the state and federal government need to increase mental health training programs and encourage more students to enter the field. 

“The need has outstepped the capacity to provide that care,” adds Mays. “We just don’t have the workforce currently that we need, and we’ve got to start thinking about alternative ways to meet these needs.”

Another barrier to care is the low rate of insurance acceptance among mental health providers. Many mental health care providers in private practice have stopped taking insurance, or reduced the number of insured clients they’ll see, citing low reimbursement rates and frustrating bureaucratic procedures. A  by the American Psychological Association found that 81% of psychologists nationwide accepted self-paying clients, but just 66% accepted private insurance and only 31% accepted clients with Medicaid. 

Cathia Walters, a licensed clinical psychologist in private practice who works with survivors of intimate partner violence, particularly survivors of color, says she has to limit the number of Medi-Cal recipients she accepts in order to survive financially, even though she would like to accept more. Even commercial insurance plans pay far less than the $200 or more she can charge per hour privately, Walters says, but she mostly accepts clients with insurance because she wants to serve the people who most need her help. 

“I �徱���’t go into [this work] for the money, but I have bills to pay,” she says. “Trying to get these insurances to raise the rates is a battle. Honestly I’ve dropped some insurance because I still have to live.”

Patients who can afford to pay for mental health care out of pocket are . The result is a tiered system for mental health care. Californians who can afford to pay out of pocket have an easier time finding a provider, while those with private insurance or Medi-Cal compete for the remaining pool of providers willing or available to accept their insurance. 

For patients insured under Medi-Cal or without insurance it is often possible to find care at federally qualified health centers, community mental health centers, or through a community-based organization such as a domestic violence agency. But these options can come with long wait times, fewer or less frequent appointments than a patient would like, and providers who are sometimes less experienced than those in private practice.

Some survivors struggle to get any help at all. Anneliese Waters, 44, of Los Angeles, says she left multiple voicemail messages with domestic violence agencies in her area after escaping an abusive marriage in another state, but never got a call back. Both she and her oldest daughter needed counseling, she says. Desperate, she scrounged together enough money to pay out of pocket for her daughter to see a therapist but was never able to afford one for herself. She ultimately started her own support group and is now studying for a doctorate in social work and hopes to open a nonprofit to help other survivors.

“To not get a response was very crushing, it made me very sad and angry,” she says. “It just fired me up to want to be able to do something in the long run.”

Mental Health Care Seen as Secondary 

Psychologist Amber Deneén Gray, founder of Gray’s Trauma-Informed Care Services Corp., which trains a wide range of professionals on how to work with and advocate for domestic violence survivors, says a big obstacle is that mental health care is often regarded as secondary to other needs such as care for physical injuries, legal help, and shelter. Government and private funding for domestic violence services usually prioritizes the latter, she says. Insurance companies cover medical care for someone who’s been beaten or shot by an intimate partner, but often quibble at authorizing more than a few therapy sessions, she adds. 

In recent years, both California and the federal government have pushed insurers to cover medical and mental health care equally—a concept known as “mental health parity.” Gov. Gavin Newsom and state legislators have also enacted or proposed various boosts and changes to mental health funding, and new rules aimed at streamlining and facilitating care.

The Newsom administration has allocated $4.7 billion to a 5-year  that seeks to vastly increase access to mental health and substance use treatment for children and young people. Strategies include increasing the number of school counselors, training thousands more mental health workers, and making family therapy more accessible through Medi-Cal. Family therapy can be particularly important for addressing the mental health effects of intimate partner violence on children.

But the reality is that for many Californians, obtaining mental health treatment remains more difficult than getting care for physical ailments. Evidence of this was on full display last August when 2,000 Kaiser Permanente mental health care clinicians  for weeks, alleging staff shortages, unsafe therapist-to-client ratios, and patients waiting as long as three months to get an appointment with a therapist. This despite a  that requires health insurers to limit wait times for mental health care to no more than 10 business days. California health plans also  medically necessary mental health treatment, and advocates contend that plans are  to provide mental health coverage on the same terms as they do for physical health conditions.

“In the nearly 30 years I’ve worked in this field, [survivors] get mental health services, but not the ideal,” says Gray, who believes most survivors should get at least a year of therapy. “There is money for it, but it’s not prioritized.”

For Lisbet, access to mental health treatment and other help opened up after she worked up the courage to report the abuse to police. Instead of getting deported or losing her children, as she had feared, they directed her to the San Diego Family Justice Center, now called Your Safe Place – A Family Justice Center, a multi-agency service center for victims of domestic violence and other forms of abuse, overseen by San Diego County’s District Attorney’s Office. 

At first, Lisbet agreed only to attend group support sessions, and accepted individual counseling for her son who was showing signs of trauma. As she became more comfortable with the idea, she began individual counseling for herself, and later saw a psychiatrist who prescribed medications to help her with depression. Today, rather than seeing mental health treatment as a weakness, Lisbet regards it as critical to her recovery and an important tool for self-care. She continues to receive counseling, is an advocate for domestic violence survivors, and facilitates a support group for Spanish speakers. 

“I want to use my experience to raise more awareness about mental health for individuals who go through intimate partner violence,” especially in the immigrant community, she says. “We need to do a better job of … educating our community about the impact, the trauma that comes along with being in those abusive situations, and that it’s normal, it’s OK to ask for help.”

Domestic Violence support:

If you or someone you know is experiencing domestic violence, contact the  at 1-800-799-7233 for support and referrals, or text “START” to 88788. You can also find contact information for your local domestic violence program .

For Native Americans and Alaska Natives, the StrongHearts Native Helpline at 1-844-7NATIVE (762-8483) also provides 24/7 confidential and culturally appropriate support and advocacy for survivors of domestic and sexual violence. A chat option is available through their website. 

For information about financial assistance for victims of crime, including for survivors of domestic violence, visit the California Victim Compensation Board at 

Mental Health support:

If you or someone you know are experiencing a mental health crisis, call or text 988 to reach . 

The California Health Report is part of the , a group of newsrooms that are covering stories on mental health care access and inequities in the U.S. The partners on this project include the Carter Center’s Rosalynn Carter Fellowships for Mental Health Journalism, the , and newsrooms in select states across the country.

As an educator on healthy relationships, consent is at the heart of what she teaches. Kaviani is a professor in the Women’s, Gender and Queer Studies Department at Cal Poly, San Luis Obispo who also works with a nonprofit to guide local parents in teaching their children about consent and healthy relationships. The goal is to create stronger families and prevent relationship violence. “I’m just encountering so many parents that have no idea about how to have these conversations, and they need guidance,” Kaviani says.

Kaviani helped the Lumina Alliance, a San Luis Obispo intimate partner violence advocacy, education, and prevention organization, create the ReDefine Parenting Program in 2020. Workshops provide parents and caregivers with the tools to teach their kids about healthy and respectful relationships during their adolescence, to help prevent intimate partner violence before it begins. The workshops are provided primarily to parents of children in elementary school, with the goal of setting a foundation for healthy relationships before they enter adolescence.

Approximately 1 in 11 female students and 1 in 15 male high school students experienced physical dating violence in the last year, according to the federal . Additionally, about 1 in 9 female and 1 in 36 male high school students experienced sexual dating violence. However, through , intimate partner violence can be prevented.

Disrupting Power Imbalances

The ReDefine Parenting Program is designed to encourage discussion and help parents, caregivers, and children to avoid being bystanders when they hear or see abusive behavior. The goal is to provide them with the tools to feel empowered to speak up. Often, sexual violence and intimate partner violence exist because of an imbalance of power, whether that imbalance is between individual partners or .

According to the , in many societies prevailing attitudes and traditional beliefs that women are subordinate to men serve to justify, tolerate, or condone violence against women, and then blame women for the violence they experience. Additionally, according to a published by ScienceDirect, children who have experienced abuse or neglect have a higher risk of becoming the victim or perpetrator of intimate partner violence. By beginning education at the parental level, the ReDefine Parenting Program works to break down the structures of power and abuse that often exist due to societal gender norms and generational trauma—and ultimately break cycles of abuse.

The Lumina Alliance’s community-based prevention programs manager Callie Tennock says that their goal with the ReDefine Parenting Program is to help parents expose their children to these systems of power and talk about why they’re harmful. “We’re trying to make sure that information is out there so that people understand what healthy decisions are and how to make them,” Tennock says. “We can help disrupt the social systems of power imbalances and we can see a disruption of violence altogether on the individual and relationship level, and also, on a social and cultural level.”

According to , promoting healthy and nonviolent relationships can help reduce the occurrence of intimate partner violence. Additionally, they say that early education can help prevent the harmful and long-lasting effects of violence on individuals, families, and communities.

Teaching Consent and Boundaries

This year, the Lumina Alliance received a $600,000 grant from the CDC to expand the ReDefine Parenting program over the next five years. The program consists of workshops that are facilitated by the Lumina Alliance but are held and run by parents. The workshops are created by Kaviani and Jane Pomeroy, chief communications officer at the Lumina Alliance.

���� you’re talking about working with children in particular, what we know is that a one-time ‘sex talk’ doesn’t work,” Pomeroy says. “I think a lot of parents are afraid that if you talk to kids about sex, you’re encouraging them to have sex. The reality is, the more information that we can give them in a way that’s digestible and age appropriate, the sooner the better.”

Parent champions are trained on the curriculum before they go into school spaces, where they host the workshops for other parents to join. The workshops are about consent, bodily autonomy, healthy masculinity, and boundaries. Additionally, they provide tips on how to have conversations with children about these sometimes stigmatized topics. So far, the workshops have been held at three schools in San Luis Obispo, and approximately 15 to 20 parents have attended each meeting. Parents can attend as many or as few of the workshops as they would like, and childcare and Spanish translation services are available on-site to help break down any barriers that would prevent people from attending.

Pomeroy says that while the specific data surrounding the effectiveness of the program is not yet available, they have found that by including parents in these discussions they have been able to reach a wider audience and spread more awareness. As the project progresses, the participating parents will act as primary data sources by taking surveys and attending focus groups that will inform evaluation, improvement plans, and barriers to be addressed in future programming.

The ReDefine Parenting Program teaches caregivers how to talk to kids about consent and boundaries to prevent violence. It focuses on how kids can set their own boundaries in relationships and friendships, beginning at the elementary level. In order to help children understand healthy boundaries and feel comfortable talking about these topics, parents and caregivers should initiate age-appropriate discussions during early childhood. Providing parents with the tools to discuss consent at a young age can be as simple as teaching their children how to say “no” when they don’t like the way somebody is touching them and, additionally, respecting when somebody says that they don’t like the way you’re touching them.

The program is designed to help lay the groundwork for children to understand what consent is before it becomes something that is only correlated with sex. “We’re not talking about talking to elementary kids about sex, that’s more for middle and high schoolers,” Pomeroy says. “It sounds complicated and scary, but really, it’s like me talking to my son about how he doesn’t have to finish his dinner if he doesn’t want to. He’s in charge of his body.”

While the ReDefine Parenting Program is a San Luis Obispo–based organization that currently only works with a few schools, because it is a community-based program it can be tailored to fit any community or school. The program is not proprietary and if any other schools or organizations want to replicate what the ReDefine Parenting Program is doing, they are more than willing to share their materials, Pomeroy says. “I think it’s honestly, really, really important for parents to just have less isolation and have places to talk,” Kaviani says. “I think it can be replicated anywhere, and I would want it to be too.”

Tips for Talking to Your Child About Consent:

• Understand boundaries and triggers during the conversation—respect your own boundaries as well. If there is a topic such as sex or bodily autonomy that makes you or your child uncomfortable, voice your concerns and be transparent. Take your time and don’t force the conversation. 
• You can start talking to your child about consent from as early as ages 1 to 5, focusing on the importance of bodily autonomy. 
• To make the conversation age appropriate, for elementary school kids you can teach them to ask for permission before touching or embracing a playmate.
• Ask your child what they already know about consent, sex, and relationships, and ask them if they have any questions.
• Let your child know that their body belongs to them and that they get to decide what happens with their body.
• Emphasize that no one should touch them without permission and that they should not touch someone else without permission. 
• Consent can be practiced by respecting your child when they say, “I don’t want to share that toy right now,” rather than forcing them to share, or asking your child if they would like a hug before initiating physical contact, or asking if it’s okay if you sit beside them.
• With older children, starting in middle school and continuing through high school, you can start talking about how their bodies and minds are changing and start incorporating consistent information about consent. At this age, sex, kissing, and hand-holding are topics that should be talked about. Discuss drinking and managing actions while under the influence, and to ensure secure nonviolent masculinity, call out “locker room talk” and sexist language.
• For all age levels, explain that it is not impolite or rude to set boundaries if they do not like the way someone is touching or treating them. Teach them that respecting boundaries is a way to show others that they care.

Set against the backdrop of the erstwhile, reclusive lifeworlds of the of Arunachal Pradesh, the story plot revolves around a bamboo-masting event that results in a proliferation of rats that gorge on bamboo fruit, . The rats cause a famine and spark a plague.

Matung, the elderly protagonist of Thongchi’s story, allegedly catches the endur bemar (“rat disease”). He then burns himself alive so that the infection does not spread to his granddaughter and her husband and the rest of the community. As Matung prepares for his voluntary euthanasia, he also reveals that he had to burn his own parents and family during a previous bamboo-masting event to protect the community, as the incineration of infected people and their belongings was believed to arrest the spread of the plague.

“My story tried to capture how the isolated communities in Northeast India tried to cope with extraordinary situations such as an epidemic in the absence of modern healthcare and state,” says Thongchi, 71, who belongs to the Sherdukpen Indigenous community of Arunachal Pradesh and writes in Assamese. “Voluntary and assisted euthanasia was an accepted social practice in many a remote community here—especially when the survival of the entire community was at stake.” 

The most well-documented of the voluntary euthanasia practices once prevalent in remote Northeast India is practiced among the Idu-Mishmi, an Indigenous community scattered through the Dibang Valley. Known as misi-muh in the Idu-Mishmi language, the traditional right to end one’s life in certain appropriate circumstances once enjoyed overwhelming social sanction.

As modern societies, particularly in the West, are increasingly obsessed with and consequently grappling with the , the Idu-Mishmi custom of misi-muh, which was a documented practice as recently as the late 1990s, offers a different perspective on life—and death.

Misi-muh, a Dying Custom

Today, a growing number of Western nations are in cases where terminally ill patients experience pain. In contrast to the ferocious debate over the issue and the confusing medical and legal lingo surrounding Western euthanasia, misi-muh enjoyed unanimous social sanction amongst the Idu-Mishmis on entirely practical considerations. Idu-Mishmi historian Rajiv Miso says that misi-muh was socially sanctioned in two situations: “First, when the patient was terminally ill and going through unbearable pain. Second, when one caught an epidemic disease with risks of infecting others and threatening the entire community.”

Grounded in an animistic worldview, Idu-Mishmis in the past believed that diseases, like everything else, were caused by spirits—specifically, evil spirits known as khinu hembe. This was true “especially [for] epidemic diseases that killed scores of people in a short span of time and lacked cure in the absence of modern medicine,” says Miso, who has obtained a Ph.D. on the cultural history of the Idu-Mishmi community from Rajiv Gandhi University, Arunachal Pradesh. He adds, “It was in cases of such disease that people volunteered to die in order to protect the rest of the community.” 

The first written account of a case of misi-muh appeared in anthropologist Tapan Kumar M. Baruah’s (1960). In 1948, a sexagenarian Idu-Mishmi man named Pwiti Mepo volunteered to be put to death. Sick of his various ailments, including leprosy, which was abhorred at that time, Mepo requested that his son and other family members arrange for misi-muh. Accordingly, a small stone structure (ju) was constructed with no ventilation. Once the funerary rituals were performed, Mepo walked into the structure and eventually died of suffocation. Baruah further notes that Mepo had summoned all his close relatives for a feast as per the custom in order to see them all one last time before walking into the ju. 

In 2016, Tarun Mene, an Idu-Mishmi anthropologist, and his colleague Sarit K. Chaudhuri from Rajiv Gandhi University in Arunachal Pradesh, an additional 35 cases of misi-muh among the Idu-Mishmis between the 1940s and 1990s. 

The most recent case documented by Mene and Chaudhuri is that of Sumi Menjo, an Idu-Mishmi woman in her 60s, who died by misi-muh in 1997 after prolonged suffering from leprosy. Their research also suggests that whereas voluntary euthanasia had high social acceptance in Idu-Mishmi society, the practice of (sometimes seen as two distinct practices by ethics experts)—where the patient was not in a position to give informed consent or their wishes were unknown—�徱���’t enjoy social sanction and was often hushed up. 

“The consent of the person was paramount for a misi-muh to be socially approved,” says Sipa Mena Miuli, a 53-year-old Idu-Mishmi woman from lower Dibang Valley whose late father was a traditional healer and shaman (igu) who had knowledge of the misi-muh custom and who sometimes performed the death rituals prior to the patient entering their enclosure. “My father often used to say that when someone himself or herself asked to be allowed to die with dignity owing to unbearable anguish without any cure in sight, how could the community deny?”

While the custom once enjoyed unanimous sanction among the Idu-Mishmi, today the known incidents of misi-muh have all been reported from remote villages that lack the presence of state authorities. Because euthanasia isn’t recognized in India except in certain exceptional , cases of misi-muh could be legally interpreted as acts of suicide, a punishable offense.

Therefore, Miso says, any incidents of misi-muh are taking place under the rug. “It is in fact a dying custom with the last known case recorded from about two-decades-and-a-half ago.”

A Misunderstood Practice 

As soon as the phenomenon of misi-muh garnered media attention with the publication of anthropologists Mene and Chaudhuri’s study in 2016 in the Journal of the Indian Anthropological Society, multiple reports misrepresented the Idu-Mishmi customary practice as suicide. For instance, was headlined “Are suicides in this tribe a form of euthanasia?” seemingly equating misi-muh to suicide when it is .

An earlier , a well-known Indian newspaper, called the Idu-Mishmi a “highly suicide-prone” tribe. The claim was premised on the fact that between 1971 and 2019, there were 218 cases of people taking their lives in the Idu-Mishmi community, which has a population of around 10,000, with .

While this is indeed an alarmingly high rate, it is quite in line with global disparities in suicide: Worldwide, Indigenous peoples are more vulnerable to suicide. and . A range of issues to higher suicide rates among Indigenous peoples: colonization, intergenerational trauma, loss of culture and land, and ongoing racism.

In the past few decades, the Idu-Mishmis have faced similar structural issues such as , and, of late, . Yet attribute to “primitive” and “impulsive and aggressive behaviour” of the Idu-Mishmi, bordering on racialization of the tribe. These studies also fail to differentiate between misi-muh and events of suicide.

In contrast, covering the 1950s—when the Idu-Mishmis hadn’t yet come into close contact with the Indian state and lived independently of the state’s interventions—anthropologist Tapan Kumar M. Baruah noted in of the Idu-Mishmi that “among the Idus [Idu-Mishmis], suicide seems to be very rare. It is said that, during the last thirty year[s] in [the] history of the Dibang Valley, there have been only four cases.”

An Indigenous Ecology of Common Care

Thongchi, the Indigenous author, believes that the practice of voluntary euthanasia—misi-muh and similar customs in other Indigenous communities of Arunachal Pradesh—was deeply embedded in “an Indigenous ecology of common care.” He explains, “While one may be critical of these customs, it needs to be acknowledged that these practices were fundamentally driven by a care for the greater common good. That’s what I tried show in my story.” Thongchi’s protagonist, Matung, “chose voluntary euthanasia to protect the community from infection because he believed that’s the only way to arrest the spread of the epidemic.”

And Miso, the Idu-Mishmi historian, says that the same logic of care applies to cases of misi-muh where someone decides to end their life due to unbearable pain with absolutely no hope of recovery. “In such a situation, a person pleads for misi-muh not only to end their own pain but also to relieve their caregivers. And the community concedes to their plea to relieve them of endless suffering,” he says. 

“Idu-Mishmi elders say it was essentially about mutual care,” adds Miso. 

Each boarding pass contains more than abbreviated airports A to B
������Ƶ stories formed and remembered
In the in-between
The in-between, that is home
Will every destination be a pitstop in this lifetime?
And how is that wrong?

Ah, springtime. A time of possibility and newness. 

Even though we face great odds in our world today, many of us persevere in finding a strong sense of community and connection amid global anxiety. I believe the search for connection is always a journey worthwhile, but it’s hard not to think about the ways in which capitalism and imperialism have commodified love and even the idea of romance. Oppression did not leave love (or the ideas around it) untouched. With that, how do I remain soft and strong and not let cynicism dissolve my hope of having loving relationships?

As a single person for quite some time, I have befriended the patience and also the agony which grew from the tumultuous milieu of dating. In it, I have been on both sides of love letters unsent, affections unreturned, and emotional needs unmet. Dating as an adult is complex, but dating as a child of the diaspora adds a different dimension.

Diasporic communities are considered to be “.” This population includes immigrant and refugee communities, and those who are descendants of them. These stories and journeys of migration have been coasting from a wide array of circumstances—some voluntary, and others systemically enforced. Whatever the geopolitical condition or motivation, there exists an experience of severance—a separation from one’s roots and motherland.

As a migrant, I was sensitive to this hierarchy of relationships, because I had to be.

As a child of the diaspora, I never lived in one city for more than four years. I spent the majority of my life in constant geographical movement due to immigration policies, survival for myself and my family, and, most prominently, the constant search for what home means to me. 

So it’s fitting that my desire for intimacy is always tied to a sense of home. Literally. While dating, I’ve found that people’s needs for stability and consistency are needs I cannot always accommodate. But can anyone? My conditions make this reality about human relationships more visible—a reality that challenges the norms around love, maintained by Disney and rom-coms: No one can promise a life of guarantees, and neither can one person fulfill all emotional desires and needs.

Many of us have bought into the patriarchal and capitalist ideas of intimacy as a hierarchy, where marital and dating relationships—even nuclear family—are at the top of this societally imposed pyramid, while friendships, extended family, neighbors, and acquaintances reside at the bottom. To echo an earlier prompt: Patriarchy and capitalism did not leave love (or the ideas around it) untouched by way of fabricating top-down taxonomies.

As a migrant, I was sensitive to this hierarchy of relationships, because I had to be. I had to understand it enough to work around it, because I was on the move all the time. It was not easy for someone like me to maintain connections. With that, I had to be sharp and strategic, with active brain muscles, frequently calculating time zone differences, working around language and cultural barriers, and anxiously ruminating: Will this relationship last? Will they stay? Will I stay? Will I ever find a sense of belonging and home? How do I keep my hope from dissolving?

Some say the sense of home does not always depend on a physical location. I like this sentiment—but I’d add that a sense of home is felt and found beyond a singular entity or experience.

In her on narratives of migrancy, Sara Ahmed wrote, “Home is here, not a particular place that one simply inhabits, but more than one place: there are too many homes to allow a place to secure the roots or routes of one’s destination.”

Grief is praise, because it is the natural way love honors what it misses.

—Martín Prechtel

I often wonder if diasporic peoples resonate with this high capacity of finding love in a multitude of people, places, and experiences. I do not solely mean nonmonogamous relationships—although that can most certainly be a part of it—but finding intimacy in many places outside the phenomena of sex and romance.

For instance, I often refer to my closest friends as my “platonic lovers.” I have considered my most favorite books my literary companions, through which I share an indirect kinship with the authors. I have relished in an adventurous aspect of intimacy found in cities and larger communities that have contributed to my formation as a person.

Could it be that we, as diasporic communities, have an expanded ability to find romance out of the mundane or the day to day? Could it be that our ability to find home in many places comes from a loss of it? That we miss it so much, we would have to find it in everyone and everything around us? As Martín Prechtel writes, “Grief expressed out loud for someone we have lost, or a country or home we have lost, is, in itself, the greatest praise we could ever give them. … Grief is praise, because it is the natural way love honors what it misses.”

The flyer showed the woman smiling, with her husband and children. The husband had created the flyer and was calling for help finding his wife. But he gave no context about why his wife had disappeared, only that she was missing.

Danielle, a life coach for survivors of domestic violence, remembered the times she, too, had gone “missing” from her now-ex-husband. She’d been trying to escape his abuse. Once she’d packed her young son and daughter into her car and driven nearly 400 miles from Alameda County, California, to Los Angeles without telling him. He’d threatened to kill himself or her with a gun if she left, but she had to try to get to safety. Could the woman in the flyer be trying to escape a similar danger?

“It was a gut feeling,” Danielle said. “I guess as a survivor you just know the warning signs.”

Partially due to the culture of guns in the United States, and their widespread availability, domestic violence is often linked to firearm use or the threat of it. Survivors speak about partners who have guns and threaten to use them. In fact, about 4.5 million U.S. women have been threatened with a gun by an intimate partner, and nearly 1 million have been shot or shot at during a domestic violence incident. When a person acting abusively has access to a firearm, they are five times more likely to kill their partner, researchers have found.

California has some of the strictest laws in the country aimed at protecting survivors from this danger. Yet enforcement of these laws has . A new law that took effect last year aims to make it harder for people who cause harm to skirt gun restrictions imposed under domestic violence restraining orders, and strengthens enforcement procedures required of family-court judges and the police.

The threat affects women of all backgrounds but is particularly acute for survivors of color, according to data from . (������Ƶ than 40% of women and a quarter of men experience domestic violence during their lifetime, .) In particular, by an intimate partner compared to white women. These disparities reflect broader trends in intimate partner abuse and gun violence in communities of color, fueled by systemic inequities.

“It’s the most comprehensive firearms-relinquishment-implementation law in the country,” said Julia Weber, director of the National Center on Gun Violence in Relationships at the St. Paul, Minnesota-based , a national legal resource for gender-based violence. Weber previously worked at the Giffords Law Center, where she helped draft the law, originally called .

Even so, advocates for domestic violence survivors say additional work is needed to protect survivors, particularly in a nation , where loopholes for obtaining guns abound, and at a time when access to unlicensed “ghost” guns is becoming more prevalent. In this environment, family-court judges need to be knowledgeable about the dynamics of domestic violence and carefully weigh the safety of survivors when establishing restraining-order provisions that could still result in contact with the person who caused them harm—such as through child-custody arrangements—advocates say. Additionally, advocates call for better coordination between family courts and law enforcement to implement civil restraining orders. And there should be easier mechanisms to get civil restraining orders served by police (who are authorized to remove guns). In general, advocates call for a more effective and standardized response from law enforcement when responding to restraining-order violations, particularly if the violations involve guns.

Domestic violence restraining orders are a strong tool to help protect survivors from the threat of guns and other types of intimate-partner abuse, those who work in the field say. Yet given the gaps in gun regulations and enforcement, they cannot be regarded as the sole solution. Survivors still need to create safety plans for themselves and any other family members impacted by the abuse, and seek support from local domestic violence organizations.

An Unexpected Phone Call

Danielle’s hunch about the missing woman was right. Several months after she saw the flyer, Danielle got a call from a mutual friend who knew the woman. She’d been located in another state after running away from her husband, who allegedly threatened to kill her with a gun. Could Danielle provide the woman with life coaching? her friend asked.

For the next six months, Danielle talked with the woman regularly over the phone and via video chat. She used her own experiences with domestic violence, along with training and research, to help her new client understand the trauma she had suffered, rebuild her self-esteem, and weather ongoing threats of violence and manipulation from her ex. She also connected the woman to resources in her community to support her, including legal assistance to obtain a domestic violence restraining order, or DVRO.

“I had already walked that road before her,” says Danielle. “I felt like I was the one called to help her.”

A DVRO is a civil court order designed to protect survivors of abuse, and, in some cases, their children and others from the person who is causing harm. The order can include a variety of elements, such as stipulations that the subject move out of the survivor’s home, child-custody or visitation arrangements, and prohibitions on going near the survivor’s workplace or school, or their child’s daycare. DVROs also ban the subject of the order from buying or possessing firearms or ammunition. This makes them a primary tool for diffusing the threat of guns in domestic violence situations.

DVRO gun prohibitions are powerful on paper. But the orders rely on the accused person to fully declare and relinquish all firearms in their possession to law enforcement or a licensed gun dealer, then submit proof to the court. Follow-up from court officials and law enforcement has long been spotty, . Competing priorities, stretched resources, disjointed enforcement systems, and, in some cases, lack of awareness among judicial or police officials about domestic violence dynamics and the serious threat guns pose to survivors, can undermine these orders’ effectiveness, advocates say.

“Our system on paper is great. In practice it has some gaps,” says Allison Kephart, chief legal and compliance officer at WEAVE (When Everyone Acts Violence Ends), a Sacramento-based support center for domestic violence survivors. “We have pretty good policy on restricting access to firearms, but we rely on disjointed and siloed systems to actually ensure that firearms get relinquished when somebody is prohibited, and that their ability to access firearms in the future while they remain prohibited is limited.”

Advocates like Kephart hope that Senate Bill 320, which took effect in January 2022, will fix some of these problems. The law requires that, when law enforcement officials serve DVRO orders, they ask for and remove firearms from the restrained person. It also requires family courts to provide clear information to the restrained person on how to comply with the law, and to review DVRO case files or hold a follow-up hearing to ensure the person promptly submits proof that they’ve relinquished their firearms and ammunition. If the person hasn’t complied, the courts must notify law enforcement immediately, which must in turn “take all actions necessary” to obtain guns in that person’s possession.

Weber says she was particularly heartened that the California legislature and Gov. Gavin Newsom allocated $40 million in the state budget last year to help courts and law enforcement improve their handling of firearms relinquishment in civil cases, including domestic violence orders. Weber has also trained over 2,000 judges, lawyers, court staff, community members, and advocates on Senate Bill 320 since it took effect.

Because the law is relatively new, there isn’t data yet to show what its effects are, and it will likely take some time for the judicial system to fully implement the changes, Weber says. However, she and other advocates say they have heard directly from people in the judicial and domestic violence advocacy system that the law is already making a difference.

“It’s making a real impact,” said Krista Colón, senior director of public policy strategies at the California Partnership to End Domestic Violence. “It provides much more clarity for the courts and really strengthens the expectations for response and follow-up.”

Remaining Challenges

The threat of guns in domestic violence situations is common. About 75% of survivors that seek help from WEAVE’s legal team believe that the person causing them harm has or could get access to a firearm, Kephart says. Most apply for a DVRO. These orders do often work to diffuse the threat of violence and help keep the survivor safe, but there are challenges with the system that need to be addressed, she adds.

One is that survivors must themselves ask law enforcement to serve the order to the person causing harm. That can be tricky, because sometimes only the sheriff’s department will take on this task, which could require the survivor to travel or wrestle with a clunky online system, and officials may not issue the order in a timely matter, Kephart says. Alternatively, survivors can ask someone they know or hire a professional to serve the order, but these individuals cannot ask the restrained person to hand over their weapons.

Another challenge is that judges have a lot of discretion over how they craft DVROs. This can be a good thing if the judge uses the flexibility to write comprehensive protections. But some judges don’t fully consider how a person causing harm could find ways to continue harassing the victim, especially through joint-child-custody or visitation arrangements, Kephart says. Another bill pending in the legislature, , would require courts to consider requiring virtual visitation if they determine that in-person visitation could pose a threat to the survivor’s safety. Weber says this should reduce the risk of a crime such as last year’s shooting in Sacramento of a chaperone and three children by the children’s father, who had been subject to a domestic violence restraining order.

Danielle pursued a DVRO several times during her struggle to leave her husband. But she had difficulty collecting documentation, filling out the paperwork, and waiting for a court hearing, all while under the threat of harassment and violence.

“It was exhausting,” she says. “This was years of trying to leave this person, years of documentation, taking notes, years of advocating for myself. A lot of victims, quite frankly, don’t have the resources or the energy.”

Now Danielle helps her clients—like the one who ran away from her husband—prepare for and weather the challenges of pursuing legal remedies. Although it can be a struggle to obtain one, restraining orders can bring great relief, she says. In her case, the biggest help was that she obtained full custody of her young son, with no visitation rights. Her older daughter was named as protected in addition to herself, and her ex-husband was ordered to stay away from the family. Although it �徱���’t end her worrying completely, the order did give her space to breathe and begin the healing process, she says.

“It gave me a chance to exhale and look into what my next steps were without having that constant harassment and emotional strain,” she says.

Even so, Danielle agrees that there needs to be better enforcement of DVROs. But, ultimately, a DVRO or any legal order cannot be relied on as the sole strategy for protecting a survivor of domestic violence from guns or other threats from the person causing harm, Kephart says. Advocates at WEAVE also help survivors develop , which can include installing cameras outside their homes and changing the locks, changing and unlisting their phone numbers, and making sure their children’s school or daycare provider knows who is allowed to pick up their children.

DVROs are “not a magic wand, they can’t fix everything,” Kephart says. “At the end of the day they’re just a piece of paper.”

Today, Danielle is proud to be moving on with her life and to be helping other survivors move on with theirs. In addition to her life-coaching business, she has written a book about her experiences and started a nonprofit organization that offers workshops on topics related to domestic violence. She also collaborated with the California Partnership to End Domestic Violence on a newly released toolkit for survivors and advocates that explains the civil legal options available to victims of abuse, including DVROs.

As for the woman Danielle supported, who also escaped a violent relationship, she is now “a completely different person,” Danielle says. She divorced her ex-husband, purchased her own home, obtained a new job, and reunited with one of her children.

To other survivors of domestic violence, Danielle says it’s important to seek help and to know you are not alone: You do not have to stay in a situation that is not healthy for you and your children.

Although leaving an abusive relationship can be challenging, Danielle is encouraging: “Choose to focus on the light, and stay present with what we can control—then each day you will become stronger and more empowered,” she says. “One day, you will look back and say, ‘I made it.’”

The California Partnership to End Domestic Violence recently launched this online toolkit to help survivors and advocates make decisions about how best to proceed in domestic violence situations, especially when guns are an issue: .

If you or someone you know is experiencing domestic violence, contact the  at 1-800-799-7233 for support and referrals, or text “START” to 88788. You can also find contact information for your local domestic violence program .

For Native Americans and Alaska Natives, the Stronghearts Native Helpline at 1-844-7NATIVE (762-8483) also provides 24/7 confidential and culturally appropriate support and advocacy for survivors of domestic and sexual violence. A chat option is available through their website.

This story was produced by the .

I finally chose a night to host a kamayan event in my home with a few good friends, and as that fateful day approached, I saw how the preparation process was just as communal as the feast itself. Aldwyn brought steamed banana leaves from his backyard. Carl and Toni brought the libations. After putting every tasty thing together, we gazed at the generous meal before us—which was roughly no more than $50—and we took in the delicious moment with deep belly breaths. As we commenced, I said a prayer to thank the Universe for the opportunity to preserve our ancestors’ traditions through our bare hands. We then savored and were nourished—in every sense possible. 

Our kamayan night instantly became a core memory of my year, and from there I wondered, how have I forgotten the reinvigorating power and intimacy of sharing a meal? For years, I necessarily paid attention to the alarming sociopolitical issues surrounding food, like the global threats to food security, eating disorders, fatphobia and body shame, the intersection of racism and diet culture, and unethical food production and distribution. These structural and social realities have distorted our relationships with food and severed us from the medicinal properties of food and its sacred presence in our lives and relationships. How, then, do we remind ourselves of food’s healing elements, especially in our social connections?

As early as ancient times, there is a continuous existence of food superstitions. This ranges from throwing grains of uncooked rice at weddings for fortune, hanging garlic at home to keep vampires or the aswang away, or cracking a wishbone. Somehow, across history and cultures, humans have an intuitive sense of the power of food. One of the friends I invited for kamayan night, Carl Cervantes, a professor and the creator of the Filipino psychospiritual project , reminded me of an ancient Filipino belief called paglilihi (conception). It is believed that when a pregnant person has specific food cravings during the first trimester, the characteristics of the food they craved will on their unborn child’s future personality. For instance, Toni (another friend at my kamayan feast) shared that her mom craved fruit salad while pregnant with her. Because of that, Toni became the “jack-of-all-trades” at school because the fruit salad contained a variety of ingredients, thus making Toni versatile with various skills. While the research is inconclusive, this superstition unveils our ancestors’ understanding of our interconnectedness. Even as early as the womb, we are irreversibly connected through food.

Today, these spiritual ideas likely raise numerous eyebrows in disbelief. Food industries have become so severed from ancient wonder and the magical practice of food sharing. This is apparent in the industry’s abusive work environments and its vast spectrum of inaccessibility, ranging from lack of food access to the often pretentious language and culture of food elitism and critics. Stories like show how the industry curates world-renowned eating experiences exclusive to less than 1% of the world. Food reflects who and where we are in our society and, perhaps more importantly, the stark divisions within it. 

When capitalism and colonization sever us from our connectedness, we can aim to reconnect by returning. In the essay “Food as a Portal—to Myself,” Ayu Sutriasa compellingly writes about the desire to heal one’s relationship with food in the midst of food colonization. She then beautifully narrates a pivotal stage of reconnecting with her roots through cooking. Ayu cooked Indonesian meals as loving, meditative acts of embodiment and remembrance—revering her roots and the power of the senses in the process. She writes, “Eating is a sensory experience that stimulates our touch and spirit and connection to each other as much as it satisfies our smell and taste.” This is what it means to return: to re-root and re-member, after being violently dismembered by capitalism and colonization.

Similarly, mainstream storytelling demonstrates this same invitation as the antidote to the loss of vitality in toxic food industry environments: to return to why the chef protagonist started cooking in the first place. The story almost always ends with cooking simple, childhood meals, like ratatouille in , sandwiches in , and, spoiler alert, a cheeseburger in The Menu. The medicine was to return.

It is no wonder the kamayan meal I shared with Aldwyn, Carl, and Toni was so healing to me. Together, we returned to a Filipino tradition while having conversations about spirituality and superstitions that deepened our conversations and our connections to each other and to our ancestors. There was even active embodiment: With our hands, we took in every spicy and savory flavor. We relished in a deeper, tastier kind of intimacy. We were mesmerized and messy, laughing from our very full and delighted bellies.

The COVID-19 pandemic is a likely contributor to these startling figures, but rates of teen mental illness have been .

One crucial factor that has received little attention in supporting teen mental health is the role parents can play.

This is surprising, since research has clearly established that  in their child’s mental health treatment is directly related to a successful outcome. A key reason for this is that parents generally interact with their teen on a daily basis and can model and cultivate coping skills.

Yet, for mental health professionals, it can be challenging to integrate parents into teens’ treatment when there are discrepancies between the perspectives, goals, and expectations of teens and parents. In addition,  laws sometimes limit providers’ abilities to disclose key details about a teen’s mental health to parents.

As researchers  and , we see parents and caregivers as a critical link in addressing the urgent mental health crisis among teens.

The Teenage Years Can Be Brutal

Parents often , anticipating mood swings, risk-taking behaviors, and endless arguments. Some of this is developmentally normal: Teens are developing their identities, testing limits, and . These combined factors can lead to hostility and a  parent-teen relationship.

Physically, , in part due to   and hormonal changes associated with puberty. As a result, teens can be irritable and sensitive to stressors. They also haven’t developed the .

And it’s important to note that half of all mental illness emerges , making adolescence a  and treatment of mental health problems.

Signs and Symptoms of a Mental Health Concern

Mental health problems in teens can sometimes take unexpected forms. Depression and anxiety can manifest as irritability and noncompliance, which parents may reasonably view as disrespect and laziness. Understanding what is beneath those behaviors is challenging. Teens are quite secretive, so they may not disclose the extent of their struggles.

Traumatic experiences, like , , and , are unfortunately too common in adolescence and can cause drastic changes in behavior and affect.

Although anxiety is a normal emotional response at any age, about a third of adolescents , and about 10% experience severe impairment as a result. Teens struggling with chronic anxiety may experience agitation or irritability, issues with sleep, or perfectionist tendencies, or may try to avoid stressful things altogether.

Among teens, . Depression generally involves a loss of interest or pleasure in daily activities, but it is more than feeling blue. For teens, symptoms of depression may look like withdrawing from family or social activities, shutting down during conversations or conflict, lethargy, difficulty concentrating, hopelessness about the future, or negative feelings of self-worth.

Depression can also be associated with  and suicide.

In determining whether a teen is experiencing a mental illness, parents should consider how behaviors are affecting their teens’ everyday lives and plans for the future. Those who are falling behind in school, damaging important relationships, or engaging in high-risk behaviors may be most likely to be experiencing a mental health issue—as opposed to typical teenage challenges.

A Shortage of Mental Health Care

Despite the growing need for mental health care, the U.S. has a  to meet the demand. Insurance companies create barriers to accessing mental health care by restricting the numbers of  and approved sessions. As a result, many providers prioritize patients who will .

Parents and teens may wait months for an appointment, and the quality and effectiveness of the services they receive are highly variable. All the while, symptoms may worsen, straining the family and compromising teens’ social and academic opportunities.

The Powerful Role Parents Can Play

This is where parents come in, since they can  for teens’ coping and emotional development.

While good sleep, consistent exercise, and quality meals can often be the first line of defense in preventing and managing symptoms of mental health problems, there are several behavioral strategies for parenting struggling teens. Indeed, foster parents care for children with complex histories of trauma, and many of the  taught to foster parents may be useful for traditional family settings as well.

When teens are unkind or disrespectful, parents may take it personally. But parents who are aware of and able to manage their own triggers can react calmly to challenging behavior, creating opportunities for effective communication with their teen.

Building and maintaining the parent-teen connection, such as by watching a TV show together or doing other low-pressure activities together, is key. These experiences  to communicate about difficult emotions or situations. Parents who assist teens in recognizing, talking about, and dealing with difficult thoughts and feelings help them understand how their thoughts and feelings can affect their behavior.

Parents can also help their teens manage negative emotions by  and strengths and encouraging self-efficacy. Parents who offer praise to their teens who are working hard to overcome challenges—as opposed to focusing solely on the outcome—can help teens see their worth beyond their accomplishments.

At the same time, teens require boundaries that allow them to build self-reliance, exercise independence, and practice compromise in certain situations. Behavior contracts—in which teens and their parents agree to certain conditions in writing—can provide a structured way to establish shared expectations.

When consequences are necessary, natural consequences allow teens . For example, if a teen stays up late the night before a big softball game, their coach may bench them for playing poorly. Parents can help teens connect the frustration and disappointment they experience to their choices regarding sleep, which can be more helpful for their future decision-making than getting into an argument with a parent about their decision or receiving a parent-imposed consequence, such as removing phone privileges.

When natural consequences are not an option, discipline should be specific, time-limited, and focused on a specific outcome, such as not allowing preferred activities until homework and chores are complete.

It is also important that parents  with their teens by modeling respectful communication without trying to manage the teen’s reaction or perspective. Teens are unlikely to admit to being wrong—particularly in a heated moment—and if the point is made, there is rarely a benefit to insisting upon a particular reaction, such as a forced apology.

Parents can best support their teens by maintaining connection alongside enforcing structure and discipline. While challenging behaviors can be the status quo of adolescence, parents should be on the lookout for signs that might reflect a pervasive mental health issue, since early detection and treatment is crucial.

This article was originally published by . It has been published here with permission.

This particular day in Kent—where many immigrants and refugees in the greater Seattle area live—the topic is nutrition, and Osman and her team have brought in a local Somali nutritionist to speak with the women and lead a food demonstration. Quinoa is available for the women to try, which the nutritionist explains is a healthy alternative to rice and pasta—foods many Somalis eat frequently.  There is also Somali tea and chickpea soup—a traditional Somali dish—prepared by Osman from her mother’s recipe. 

The group is led in a short prayer before the session begins. The class is mostly in Somali, but English phrases are used. Many participants trickle in late, and soon volunteers have to bring out more chairs as the room fills with about 30 women eager to learn about nutrition. The nutritionist begins talking about food groups and portion sizes. She explains that iceberg lettuce doesn’t have much nutritional value, but that many Somalis buy it because it can be cheaper. She describes further what quinoa is, because many Somalis have never heard of it.  

“The most important thing is to have knowledge so that people can make their own choices,” she says. “Try to make your plate beautiful so that it feeds your eyes first.” She adds that a plate should be half greens, and that the darker greens are healthier. 

The goal isn’t weight loss, she emphasizes: “We have to love our body and soul. God gave you this body, you have to love it, not think about getting thin.”

The discussion soon moves past food and into cultural norms—an underlying theme of these classes. While Osman and her team of doulas, volunteers, and educators regularly instruct the women on health-related matters, they also address negative experiences and frustrations they have with the U.S. health care system.

Researchers found in a 2010 study originally published in Social Science & Medicine Journal that  “related closely to situational factors and contrasted sharply with the biological model that drives Western medicine.” To alleviate their vexation, health care practitioners in largest Somali communities around the country—Minneapolis, Seattle, and Columbus, Ohio—provide services that meet their medical and cultural needs. Osman and her team work with the Mama Ammaan Project: African Mother to Mother Antenatal Assistance Network in the Seattle area to provide the women with access to better and more culturally responsive health care. Mama Ammaan, which means “safe mother” trains doulas and offers free health and well-being education to the women.

In 2017, University of Washington anthropology professor Rachel Chapman was looking for someone to partner with on a health care-related project after she and a colleague secured a . Chapman sat down with Osman and made a plan. Along with the nonprofit Somali Health Board, a grassroots organization of  and volunteers, they hosted focus groups and learned that health care education was a pressing need within the Somali community. The two formulated an initial series of classes, hiring doulas for pregnant women and new mothers, and providing stipends for the women who participated.  

The funding is coming to an end, but Osman plans to continue the classes on a volunteer basis because the community loves them so much and still needs them. 

According to Osman, many of the Somali women don’t understand what doctors tell them, and therefore aren’t able to comply with doctors’ suggestions. The women are thus read as “noncompliant” by their doctors or that they don’t care about their health. She says a lack of proper translators is one of the biggest issues Somali women face, and many of the women are immigrants who have experienced very different health systems in their home countries, and have to navigate the U.S. system without a strong grasp of English.

When translators and translated texts are available, many times translators do not fully translate what doctors say, and often, some of the women can’t read the documents given to them because limited reading skills, Osman says. 

This is why Osman and her team use mostly images to convey information in the classes. It’s just one way Osman is making health care education more accessible to the people in her community.  

Hana Mohamed, co-programs director with the Somali Health Board, says the organization wants to be sure they base its programming on the community’s needs. “The Somali community is based on oral communication and relationship building,” Mohamed explains. “By hosting various community events, the community’s needs can be heard.”

The purpose of the health care classes, which discuss everything from pregnancy to birth, and the changes women’s bodies go through between—and after, is to increase awareness and understanding around different topics related to health.  

One of the participants, Ibado Farah, has lived in Kent for 10 years. The 55-year-old came to the United States from Somalia when she was 30. Farah is a mother of seven children, the youngest age 16, and the oldest age 34. She says she felt welcomed by Osman and the other women, and her positive experiences in the classes have kept her coming back. Farah now brings friends from the Somali community with her and gives rides to many women who don’t have access to cars. She says her favorite part of the day’s class was about nutrition because she was able to learn how to prepare healthy meals as a way to take care of her body.  

Osman and her team also are addressing mental health with the women. The topic is stigmatized in Somali communities, Osman says, and so she is careful in leading the discussion in her classes. Osman says that many women choose “to suffer in silence” because of this taboo, adding that it’s important “to approach [the issue] and not be obvious” to start a conversation on how to take care of one’s own mental health. 

The doulas who work with women through pregnancy often continue to provide care to the mothers after childbirth to watch out for signs of postpartum depression. If they see signs, they will connect the women to other resources or service providers for extra support. The doulas approach the conversation with culturally appropriate way of speaking about it with them, such as incorporating the women’s faith in their work, encouraging the women to take care of themselves because God wants them to. 

Osman and the others also encourage the women to exercise, to get out of the house more, listen to music, and do other things to help them take care of their mental health. 

At the end of her class, Osman plays Somali music and leads the group in dancing. At first, some of the women are shy and reserved, while others wait impatiently for the music to start and dance excitedly when it does. Osman dances freely, with joy, and she beckons the others to join her. Eventually, even the shyest women join in for at least one song. They clap in rhythm and some sing along to the lyrics. It is one small way they take care of their bodies and share laughter within their community. 

Birth narratives might also contain clues about how the adjustment to parenthood will go.

 to understand difficult experiences. Stories may be particularly valuable as a source of “meaning-making,” the process of finding order in chaos by making sense of unexpected events, identifying silver linings, and discovering the patterns and connections that thread seemingly random events together into a coherent narrative.

In a new study led by , a former graduate student in , we found that the levels of meaning-making in the stories new parents told about their baby’s birth  in the child’s first months.

Constructing Meaning in Your Own Life

Finding meaningful themes and patterns in life’s seeming randomness is a fundamentally human activity. As writer Joan Didion put it, “.”

Meaning-making can buffer despair in the wake of tragedy. Holocaust survivor Viktor Frankl’s memoir, , argues that meaning and purpose can prevent the bitterness and disillusionment that can otherwise fester after great loss. Research on what psychologists call “” has found that the level of meaning-making in people’s narratives about a difficult event predicts their mental health over time.

For example, studies have found  in cancer patients, bereaved parents, and caregivers. Cancer survivors might discover that their chemo ordeal brought them closer to friends and family, or helped them step back from the hustle of everyday life and embrace a slower pace.

Although childbirth is typically experienced as a joyful rather than a tragic event, it can still be unpredictable, frightening, and even life-threatening. Indeed, psychologists have begun to recognize that particularly difficult labors , not just in mothers but in their partners as well. Even normal, nontraumatic births require parents to cope with hours, sometimes days, of pain and discomfort. Therefore, we hypothesized that meaning-making might be an important part of couples’ birth narratives, potentially promoting resilience in new parents.

To test these hypotheses, we collected birth stories from 77 couples who were participating in our lab’s . We visited couples at the hospital within a day or two of their infant’s birth, and audio-recorded them sharing their stories together. We told couples, “We’d like to hear you tell the story of your birth experience. Start from the beginning and tell us as much as you remember.”

Listening for Meaning-Making in Birth Stories

A team of coders listened to each story and recorded examples of meaning-making, using three categories established in the research literature:

• Sense-making: Identifying reasons that an event might have unfolded the way it did or making connections that show why an event was meaningful. For example, one mother in our sample found meaning in her long labor, describing her baby as “very brave and tough” because she survived hours of pushing.
• Benefit-finding: Pointing out silver linings or unexpected positive effects of a difficult experience. For example, after a difficult birth, one parent in our sample stated, “It was scary, but the nurses and the doctors were so nice to us.”
• Change in identity: Describing how an event has transformed one’s sense of self. As a parent in our sample said, “I feel like my life has changed completely with the baby now here.”

Although couples told their story together, we tracked meaning-making separately for each partner. We also rated how much each partner participated in telling their story so we could adjust for their levels of engagement in sharing their birth narrative.

The : Almost all the participants made at least some meaning-making statements in their birth stories. Of the three categories of meaning-making, change-in-identity language surfaced least often, appearing in about 37% of the birth stories. Mothers tended to use more sense-making and benefit-finding language than fathers. And both members of a couple tended to use similar amounts of meaning-making language.

Becoming Mom or Dad

After we had coded all of the narratives, we next looked to see whether meaning-making predicted relationship satisfaction and parenting stress in our couples. The transition to parenthood can be a  and is often linked with .

But when mothers used more sense-making and benefit-finding language, they showed a smaller drop in their relationship satisfaction than moms who used less. Fathers who used more sense-making and benefit-finding language reported lower parenting stress at six months postpartum than dads who used less.

And partners of fathers who used more change-in-identity language also reported lower parenting stress later on, suggesting that dads who experience the transition to parenthood as transformative may be able to help mothers cope better with new parenthood. On the flip side, though, when mothers showed more meaning-making, their partners actually reported more parenting stress at six months postpartum. It may be that when mothers find the birth experience to be more personally meaningful, partners feel left out or pressured to step up their own parenting.

Overall, these results supported our initial hunch that meaning-making might be detectable in birth narratives and forecast �貹����Գٲ�’ psychological adjustment after birth. Greater meaning-making language seemed to benefit the couple relationship and largely buffer parenting stress.

This study was limited by a fairly small sample of cohabiting heterosexual parents. Nevertheless, it highlights the value of stories in shaping family transitions. For therapists working with new parents in the wake of a difficult birth, encouraging couples to seek meaning in their birth story may help ease their transition to parenthood. Journaling and storytelling exercises may help couples process their feelings about their childbirth experiences. After all, the birth of a baby is also the birth of a story—and that story is well worth telling.

This story was originally published by . It has been published here under a Creative Commons license.

I’ve always wondered where the myth of the “nature-starved city kid” originated. Who first penned the story about urbanites who are chronically disconnected from their natural environments, and how has this parable persisted into the present day? 

Understanding the assumption is easy. Combine a bustling metropolis, a sea of “,” a disproportionate car-to-tree ratio, streets smothered in cold, gray concrete, and millions of people moving at a superhuman speed that allows no time to stop and smell the roses, and you have a recipe for a life allegedly detached from the natural world. I see that all. But I see other scenes, too. The other side of that nature-starved narrative is a beautiful and powerful story about locating our unique earth connections within ourselves, from wherever we are born and wherever we may be. 

I was born and raised between two major New York City parks: the 40-acre woodland landscape of Central Park’s North Woods, and the sprawling waterfront oasis of Riverside Park. These parks were my playgrounds, my classrooms, and sites of infinite wonderment where my curiosity for our precious planet was seeded. In retrospect, whatever universal fate deigned to set my roots between these two urban parks ultimately led to my identity as The Earth Warrior, and later, as Moon Mother—two aliases that make clear my connection to our home planet. By tuning in to the soundtrack of the natural world—a practice I call “intentional earth listening”—my relationship with these two parks taught me that I was not only a witness to the wonder of Earth, but just like the trees, flowers, and waterways I studied and adored, I, too, was an earth being. 

In the back seat of my mother’s navy blue Oldsmobile, I memorized the West Side Highway and FDR Drive, two New York City freeways that hug the riverbanks of the Hudson and East rivers, respectively. As we rode up and down the island of Manhattan, I’d watch the morning sunlight spill over onto the surface of the water like a blanket of silver glitter. At night, I’d follow the full moon as it played peek-a-boo across the skyline, letting her escort me home, all from my backseat window. I cherish these nature-filled childhood memories: from packing coolers with spaghetti lunches for a family beach day at Coney Island or Brighton Beach, to waking up early to get a good picnic table at Bear Mountain. I feel fortunate that these experiences, inspired by our ancestral connection to the natural world, rooted me to my native land and inspired my fierce connection to New York City and its vast and unique ecological cosmology. On a 13.4-mile-long island, I learned my position in the universe. I accepted my place in the divine flow between humans and Mother Nature, and leapt joyfully into a life that honors our sacred, innate union with the natural world. I was a city kid and an island kid, and I �徱���’t have to relinquish my urban identity to feel my connection to the living world. Both were possible, and both were essential elements of my reality.

Still, despite the more than 200 bird species that visit New York City annually via the , some people assume there’s no nature in cities. They assume that our cities lack meaningful ways to connect with the air, soil, grass, wildlife, and waterways more commonly associated with the suburbs and rural areas. New York City nature is beautifully real, and I hope someday to document the experiences of New Yorkers whose lives stand in as counter-narratives to this myth—those who are connected to their earth birthright through community gardens, rooftop farms, balconies, and even fireplaces. Until then, I find immense joy and pride in making these New York nature connections through my own stories. 

Every afternoon, I empty my daughter’s school backpack and pockets knowing that what awaits me is a treasure trove of rocks, sticks, weeds, and wilting flower petals—living remnants of her long day of play in the Ramble of Central Park. Each artifact is special in its own way, she insists. The rocks are transformed into crystals, sometimes diamonds, through her mind’s eye, and the most special ones often make their way to her altar: holy earth. This is Luna’s love language with the earth. In this ritual of collecting, she brings the preciousness of her planet closer to her person, seeing in nature such a captivating beauty that she welcomes it into her world.

I used to wonder whether Luna’s connection to nature was instinctual, or whether we’ve nurtured an earth-love in her through our family values, stories, and overall ways of being in the world. I am confident now that both are at play. In 1984, American biologist and naturalist “biophilia,” referring to “the innate tendency to focus on life and lifelike processes.” His book by the same name discusses the inherent tendency and desire for humans to seek connections with nature and natural systems. Wilson suggests that as humans, we have an evolutionary bond with the natural world. Furthermore, our well-being is closely intertwined with the health of our ecosystems. This is devastatingly clear when we consider our present-day health and climate change crises alongside one another. We are not only intimately connected, we are interdependent. And while Wilson offers us some language for this knowing, our natural harmony with the earth and our predisposition toward nature run deep in our bones, predicated on our ancestors’ understanding of our role in the interdependence of all living earth beings.

While walking Luna to school recently on a gorgeous spring morning in Brooklyn, I was reminded again of the intuitive relationship we have to our natural surroundings. We’d recently shifted our school commute and started riding a new subway line, a decision sparked by the deteriorating conditions along our original route. Things had gotten unruly and unpredictable after the height of the pandemic, so we decided to switch to a new line. But another major factor behind the shift was the advantage of riding aboveground, outside of the dark, claustrophobic MTA (Metropolitan Transportation Authority) subway tunnels, for 3 minutes between Brooklyn and Manhattan. Our 60-minute trip on the original train was fully underground, but on our new commute, Luna has an opportunity to view the East River from 90 feet above the water. Riding aboveground is a unique New York delight that many of us eagerly anticipated as children on our journeys to Van Cortlandt Park or Yankee Stadium. 

This in our morning routine proved to be a complete game changer, offering Luna and me a moment of serenity amid the chaos and an opportunity to emerge from the darkness of the tunnel. I watch Luna now, her nose pressed against the train car window, as she counts the boats traveling up and down the river, marveling at this seemingly mundane miracle of flying above hundreds of buildings and cars, her wonder unmatched, never diminished by the everydayness of it all. I think about this slight adjustment in our otherwise very usual New York morning school commute as one that prioritizes the sensory experience of witnessing nature above all else. I revel in the choices we’re able to make to be closer to the beauty of the world.

One morning, while traveling on our new school route, Luna turned her small, radiant face to me and asked, “Mommy, do you hear the birds chirping?” I replied, “I do, my love.” And she added, “It’s going to be a beautiful day, right, Mommy?” I beamed. What a proud moment, to know that this native Brooklyn child can distinguish birdsong from the cacophonous sounds of her home city; that she can, and makes an effort to hear the beautiful earth music that surrounds her over everything else competing for the attention of her ears. Most importantly, she equates the morning birdsong with knowing that it’s going to be a beautiful day. Nature is beauty—and we can return to experiencing that earth beauty anytime we tune in, even in our urban environments. What’s more, we are attracted to the sensory experiences that nature gifts us every day: the smell of lavender flowers, the flute-like sound of the robin’s morning song, the feeling of wet grass or warm sand beneath our feet, and the overall calm these earthly sensations provide.

We can activate (and reactivate) our connections to the earth from any place, and most importantly from within ourselves with intention, focus, and confidence. The orange-breasted robins in New York City have always been here, and they still sing their morning song, adding to the city symphony of taxis honking, babies crying, planes roaring, ambulances wailing, and the buzz of nearly 9 million people living their lives side by side. These same robins make their nests in the small, secret openings of our lampposts and streetlights, but they’re here among and together with us—adding their earth magic to the fullness of urban life.

I know, because my son was institutionalized in a pediatric subacute facility for most of the first year of his life. When he was only a few weeks old, he had surgery to place a tracheostomy tube for breathing and a gastrostomy tube for feeding due to a complex craniofacial syndrome. Care of a child with a tracheostomy, especially a tiny infant, requires constant supervision and intervention to keep the breathing tube open and in place. I remember being told that the mortality rate for children with tracheostomy tubes in the first year of life was so high that the hospital had to send them to a facility for transitional care. It was presented as a place where both his medical needs and his developmental needs would be met, because it was supposed to be more homelike than the hospital.

At the time this was happening, I �徱���’t know what care at home could look like for a child with complex medical care needs. I �徱���’t even know it was an option. My husband and I were making decisions based on the information that was presented to us. I wasn’t an advocate. I �徱���’t know the history of disability rights and the fight for disabled people to receive care in their own homes, not nursing homes. I was just a mom, convincing myself that I had made the right choice of how to take care of my son in a situation where I �徱���’t actually have any good options. On the one hand, the facility felt less alien than the NICU. On the other hand, it �徱���’t feel like home either — it felt like a clean and well-run orphanage.

Institutionalization refers to care that is provided in a location other than home. The location can be the rehabilitation wing of an acute care hospital, a pediatric subacute facility, like where my son lived, or a specialized home for children with developmental disabilities or medical needs. In some situations, children with medically complex disabilities spend months in the Intensive Care Unit, the most expensive and least developmentally appropriate place for kids. Institutionalization is orders of magnitude more expensive than home care and developmentally harmful for children. It also disrupts the lives of parents and siblings.

When my son was born, we lived in a small rural town in Fresno County. The closest facility that met my son’s medical needs was 170 miles away in the Bay Area. California only has 10 pediatric subacute facilities, two in the Bay Area and eight in Southern California. During this time, as a mother, my heart was broken no matter where I was, because whether I was at home or at the hospital, something was always missing. Our family eventually settled into a routine. I would drive up and stay in the Bay Area Tuesday through Thursday in order to be at the facility with my son, and my husband would take our daughter to daycare. Friday through Sunday we would bring our daughter to the facility. As a toddler, she quickly learned that she was allowed to mute her brother’s pulse oximeter but not any of the other children’s machines.

When I couldn’t be at the facility, my son spent most of the day alone in his crib. If he had been at home, I could have picked him up when he cried. Picking up a crying infant is a basic human instinct because being held is a basic human need. In the facility, if I wasn’t there, he would cry alone in his crib. He would cry until he spit up whatever formula was in his stomach, then stomach acid, then intestinal bile. This eventually spiraled into total oral aversion — he vomited so much and so often that he rejected oral feeding and a pacifier, anything that touched his mouth or lips would trigger a gag reflex. This also worsened the problem of not being picked up — when the staff did have time to pick up one of the babies, they tended to avoid the one who was constantly vomiting and leaking stomach acid.

The root cause of the problem was that his basic human and developmental needs �ɱ�����’t being met. That problem couldn’t be solved as long as he lived in the facility. Instead, doctors changed the way he was fed, using a system that drained his stomach to keep it empty and delivered formula directly to his small intestines at all times. With that system, he could cry and gag constantly but still gain weight because there wasn’t anything in his stomach to throw up. That was the kind of solution that institutional care could provide.

In order to bring our son home from the subacute, my husband and I had to demonstrate competence in the medical parts of his care. That part was difficult by any objective measure, but was easy compared to the second requirement. The facility also required us to find home nursing coverage — their initial requirement was that we have 16 hours a day of coverage, including overnight coverage, seven days a week. That requirement was insurmountable, but I spun my wheels for months trying to meet their demand. To bring him home it was my job to find home nurses, a supplier for his breathing machines, a pharmacy that could fill compounded and specialty prescriptions, and figure out all of his insurance and Medi-Cal paperwork. Institutional care provided all those things automatically, home care required me to be the ringmaster of the whole circus.

The facility eventually agreed to release him to home care on the condition that we find a day-shift nurse and agree to sleep in shifts for the rest of our lives. One of the most common and tragic ways that children with tracheostomies die is that an emergency happens overnight, and the exhausted parent sleeps through the alarms and doesn’t wake up in time to resolve the problem. I can still hear the doctor’s stern intonation when she told us, “You can never fall asleep.” She was solving the problem that she perceived — kids die when their parents fall asleep. But the solution she was providing put the blame and responsibility on the people with the least amount of power in the situation. The assumption was that the system of home care wasn’t going to be functional, and the solution was for parents to simply never sleep.

When children are dependent on medical technology — like ventilators, IV nutrition, feeding pumps and home dialysis — and require round-the-clock nursing interventions, our system struggles to provide that care outside the four walls of an institution. In institutional care, the system seamlessly provides equipment, supplies, medications and care for kids with complex medical needs. By contrast, bringing medically fragile children home is a do-it-yourself project for families. Our system can do more to make the transition to home care smoother, and to make sure children have real access to care at home with their families.

Spending time in acute care hospitals may be unavoidable for these children when they receive treatments that can’t happen anywhere else. But in many situations, we could do more to allow these children to stay at home, instead of being forced to live in institutions that provide medical care. Our children and families deserve better.

This story was produced by the .

Though , astrology has significantly since tumultuous 2020. Maybe people need something to make sense out of the chaos, or maybe they just need a new hobby. Either way, people are turning to the heavens in search of clarity and solace.

Hummingbird, the creator of , says that “astrology provides a unique angle for viewing our moment in history, a framework we can lean into in times when so much else is uncertain”—this unique angle being the observation of the movements and positions of the planets. According to astrology, the planets’ activity and their relationship to the sun and moon influence the personalities and moods of people, as well as the events occurring at both an individual and global level.

Research shows that the earliest evidence of the use of astrology was . Others argue that this tool originated during , during a time when the boundary between astrology and astronomy �徱���’t exist. In —the integration of astrology and drama therapy—astrologer and embodiment teacher says that historically, astrology has been used in the fields of meteorology, alchemy, psychoanalysis, and medicine. She refers to Ptolemy’s Tetrabiblos, where “astrological associations in anatomy … eventually became a prerequisite for medical treatments at medieval universities.”

In many cultures, astrology is sacred and has existed for thousands of years.”

In everyday life, people have long referred to the moon’s waxing and waning to observe and to explore how these phases , which is why the term “lunacy” is derived from “lunar cycles.” And if you’ve ever wondered why the abbreviation for “pound,” the unit of measurement, is “lb.,” it’s because it originates from the constellation Libra, an astrological sign symbolized by scales.

The planetary movements and lunar cycles may affect us, but they do not dictate our choices. There are astrologers who highlight people’s power and personal agency during astrological events, including Chani Nicholas, author and founder of the . , Chani explains that “it’s not that the planets make us do something or the planets do something for us. … I think of it as the sky is a mirror, and it’s kind of giving us a weather report.” And whenever there are weather conditions we need to prepare for, we access the tools, clothing, and even the mental awareness to get us through the particularly severe ones. 

Astrology can help us understand ourselves and the times we’re living in. Because of this, it is a powerful tool, which has been used for the common good and also by oppressive forces. , also known as Ace, wrote the book , where they survey the role of Western astrology in maintaining political power. They write: “A lot of people are surprised when I tell them astrology has lived longer as a right-wing practice than anything left-leaning. I don’t understand why. Adolf Hitler, J.P. Morgan, and Ronald Reagan all used astrology.”

According to Ace, the West expresses itself through “the manufactured memory of Roman idealism,” and the zodiac amplifies this through its Roman imagery. Ace challenges Western astrologers who impose Greco-Roman ideas as universally applicable to all identities and experiences. This imposition involves gendered and hierarchical archetypes, such as the Sun and Jupiter exerting higher dominance than the rest of the celestial bodies, or Cancer serving as the feminine mother sign of the zodiac, and Capricorn as the masculine father. A number of Western astrologers have used this mystical system to assert superiority and control, and in doing so, have commodified the stars to satisfy capitalistic greed.

Astrology’s recent increase in popularity has resulted in . Social media trends, zodiac-related products, and even impersonating prominent astrologers on social media are suddenly rampant. This kind of pop astrology removes the study from its context and waters it down through memes and satire that oversimplify the signs, which capitalism tends to do. But using astrology as a marketing opportunity is ironic, considering its history.

In many cultures, astrology is sacred and has existed for thousands of years. In India, the early use of Hindu or Vedic astrology determined calendar dates for rituals and holidays, as well as specific days for making significant life choices. Newborns are also named according to their natal charts. Today, schools in India offer Vedic astrology courses, as it is now considered in their education system. 

As human beings, we are enchantingly robust meaning-making creatures.”

Native American astrology is based on the medicine wheel and each calendar division is assigned an animal totem that embodies specific personality traits. For instance, if a person is born during what Western astrology considers the Leo season, they are associated with the salmon. The salmon is creative, passionate, and takes risks to get where they need to be. The purpose of Native American astrology is to be in harmony with the natural world. Brady Wakayama that “the core philosophy of Native American birth totems is connectivity. People are connected to the universe, the stars, and nature as a whole.” The stars are sacred to these Indigenous communities, because they serve as a compass to their ancestry and our sense of interdependence.

There is also the potential for this ancient system to be a liberatory force and a tool for self-compassion. Astrology offers language to people who have a difficult time expressing themselves, especially when it comes to complex feelings and inner tensions. Gamboa finds that by combining drama therapy with birth-chart information, “the client is allowed to express what may have been inarticulate.” In her research, astrology not only brings self-understanding, but also brings folks together in community—sharing similar interests and questions about life, marveling at the sky for insight.

Consulting the stars can also be a form of subversion to colonial systems of power, such as Christian hegemony. People who’ve been traumatized by the church and by Christian dogma can continue their search for transcendence in astrology, as a way to heal beyond spiritual trauma.

Astrology has been a guide for folks who do social-change work, giving them a feel for the potential mood of the people and systems around them. For example, Chani Nicolas did a on Saturn arriving in Pisces, lasting through May 2025. Because Saturn, the planet of governance and rules, is currently in Pisces, a water sign known for benevolence and mutability, we can collectively anticipate rigidities to soften and restrictions to lift. This can be beneficial in contexts known to be systemically punitive. With this information, organizers and unions who lobby legislators and negotiate with executives can utilize this cosmically opportune period to make or demand the changes they want in the workplace and in communities.

In my personal work with mentees, we analyze birth charts to find their individual strengths and optimize them in organizing spaces. For example, we examine Mercury, the planet of communication and reason, in their charts and identify the most effective ways of communicating or distributing information so that they can apply these skills in unions and protests. Astrology can be the map to our personhood, illuminating skills that can be fostered for the greater good. “Others see astrology as having the power not just to explain the political situation but also to change it,” .

Ace calls in through a collectivist and queer lens: “Queer people are reinterpreting astrology in our own way too, because some of it’s really gendered, and it can be a little bit rigid. But then we just play with those meanings.” Togetherness and (re)imagining possibilities seem to be foundational in studying the cosmos. Astrology is a map that directs us to deep connections and meaning-making.

Wherever you are with astrology, we can rest in the thought that, as human beings, we are enchantingly robust, meaning-making creatures. Many moons ago, humans from all over the world were able to make images out of bright and scattered celestial bodies in the sky. They traced the lines between the stars and drew the ox, the fish, the scales, the archer, and so forth. They assigned stories that widely resonate and endure centuries later, preserved and revered by their descendants. There is a deep comfort in knowing that we are wired for wonder, and in that wonder, we create tools for self-realization, compassion, connection, and justice.

Gratitude to and for guiding me through this essay. We need community in conversations on sacred matters.

We live in a world where we are constantly bombarded with narratives of forever friendships and lifelong partnerships. But for many of us, the traditional road map to building relationships has never been navigable. Our society insists that “forever” equals best—that it is the prime destination for meaningful human relationships. But there is a beauty and power in valuing short-term connections and fluid relationships. 

As a queer Black millennial, “long-term” has never been accessible to me. I was kicked out at 15, quit school at 16, and have navigated layoffs, breakups, and rent-hike-induced displacements. It’s been hard to maintain relationships. People I’ve held dear have vanished. Our capacity to show up as besties, chosen family, or even as comrades has been stretched thin by grief and bills and geographical distance. We’ve been reduced to digital heart reactions, occasional text messages, and TikTok shares. And I don’t think I’m alone in this experience—many of us feel untethered, displaced. Black and queer, just out here…

So this is a loving invitation for Black queer folks who struggle with belonging, who feel unmoored, who long for someone to tell their life story to—or better still, someone who already knows our story by heart.

What would happen if we just embraced impermanence? Could we release our attachment to the idea of “forever people”? Maybe let the god we know as “change” lead. Maybe, just maybe, through this lens we can reassess the way we value momentary connections. 

It’s Pride Month, a time to celebrate resistance, persistence, and existence—shout out to our TRANScestors who have paved the way with bricks and bottles. If you know anything ’bout the Black girlies, gays, and theys, you know queer life is the mother of invention. I often marvel at the strategies we’ve devised for our collective survival. If anyone “be like water,” it’s Black queer folk. We reinvent home, family, community; we decolonize relationships. Our hearts crack open and something beautiful grows out of the fault lines. We adapt and adopt one another. It’s an appropriate adaptation, one passed down to us generationally. 

This idea of appropriate adaptation comes from Dr. Joy DeGruy, author of . 

“What originally began as an appropriate adaptation to an oppressive and danger-filled environment has been subsequently transmitted down through generations,” DeGruy writes. DeGruy also notes that by embracing this appropriate adaptation, enslaved people—and their descendants—“were able to pass on their phenomenal powers.”

I can’t stop thinking of all the ways that has manifested in how we Black and queer folk communicate, the way we bond with one another. Even a meeting of side-eyes across a crowded room can capture an entire conversation. Conjure, but make it communication. Telepathy.

“You can’t have a short memory and be Black,” says Koko Zauditu-Selassie in the 2021 film . “You’ll open yourself up for attack. You’ve got to have a long memory cause you’re singing a long song.”

And we are not the only ones singing a long song. Elephants—despite experiencing displacement and trauma—adapt, gather knowledge, and create fluid societies, seeking out what nurtures and supports them. These elephant kindred model another way of being, anchored in fidelity, flexibility, fission, and fusion. 

I’ve recently been captivated by this book, , which chronicles a multi-decade study of Amboseli elephant groups, also known as elephant parades. 

As a card-carrying member of the LGBTQIA alphabet gang, I can’t resist a good parade. 

Through climate change, displacement, and witnessing the state-sanctioned murder of loved ones, the Amboseli elephants know impermanence. Yet still they have gathered an immense database of ecological knowledge and create fluid societies that survive and even thrive. So what lessons can we take from the elephant parades during Pride? 

Queer Elders Be Knowin’

Younger elephants find fidelity in Amboseli elephant matriarchs. These matriarchs can distinguish between hundreds of other elephant voices; determine if they are friend, foe, or unknown; and react appropriately. They’re discerning and they stick around when times are tough. Our queer elders of the Global Majority can spot “stranger danger” too. They know where the spiritual and the physical medicine is; they know how to fight—and love—in the midst of a storm. They know when to let that love go. While their physical presence is impermanent on this side of the veil, these elders hold the stories and experiences that make up our long song. It’s our job to sit at their feet and learn to sing it for the next generation. Speaking of which…

Support Your Local Gaybies

Amboseli elephants are often orphaned by poachers. But those who are able to join a bonded group or clan survive. Same goes for humans. that young people with at least one supportive adult in their life can make a way out of no way. Want some honest people to hold you accountable? Want to practice curiosity, question everything in order to decolonize? Then support young people. It’s such a precious gift to provide a supportive environment for gaybies to glow up in. Working with youth can be transient—they grow up and move on to the next stage of life. But the impact we have on one another is permanent. It’s worth it, plus new gays just keep getting born.

Political Airbnbs

You will eventually experience “movement heartbreak” in any social justice movement space. Conflict is inevitable. Letdowns happen. 

I think of movement spaces like elephant “clans”: a combination of families and bonded groups. They unite to navigate scarcity and threats together, finding strength in numbers. Within the clan, individuals will sometimes leave their bonded group or even their family and link up with a more compatible one. But they don’t leave the clan. Clan equals safety. 

This is a lesson in fluidity. Our strength lies in our ability to stick together without stagnation. Burnout is so common in our movements. Many name guilt, and fear of “the work” suffering if they leave, as a primary reason they remain in positions that no longer feed their souls. But do you know what makes “the work” suffer, for real? Burnout. So find the work that feeds your soul. Fluidity in our affiliations does not diminish our power or numbers—in fact it grows both. It empowers us to find spaces that align with our evolving principles and aspirations. A political home may be goals, but political Airbnbs can help you figure out where that home is.

Alphabet Gang, Good in Every Hood

At least a few times a year, the Amboseli visit the Kitumbeini elephants, and the Kilimanjaro elephants visit the Amboseli. There are entire populations, hundreds of elephants, mingling together in parades. And then they go home. 

This lesson is especially for the folks who lack local queer spaces, and introverts like me. I put the “bi” in “by myself.” But the rest of the alphabet gang is outside. Adventuring beyond your immediate circles can be hella difficult, even terrifying. But it also might just lead to some of the most transformative relationships you’ll have. Try to visit clans outside your own—at least a few times a year. Ableism and capitalism keep us isolated, so if you are free to travel, visit someone who can’t—free them from isolation. Sometimes connections only last a weekend. But the support, love, and power we receive in that moment should not be devalued. 

Shit Happens

“Bond groups” of Amboseli elephants don’t have a strong direct lineage, but they form a village to raise their young. That, too, can change. Maybe resources are too scarce to support everyone, so they fissure. Maybe violence has orphaned a calf, so they fuse. They allow an ebb and flow of relationships that is both appropriately adaptive and kind. 

What if we embrace the non-foreverness of our bonds as an appropriate adaptation to an unstable society? What if we hold more grace for those leaving our lives, and make more space for those entering our lives? What if we charge it to the system, not the heart? My whole body relaxes at the thought of it. 

There Is Beauty in Impermanence

������Ƶ and more these days, I pay attention to the way my body reacts to these separations and abandonments, this grasping for others. I find myself curious about what feels good, what feels safe. What do we do when everyone’s capacity is limited and the world is a never-ending earthquake? I am often afraid to think of what I need beyond survival. But as my appreciation for impermanence grows, my fear shrinks. 

Embracing the fluidity of relationships and understanding that they don’t have to be permanent is liberating. Celebrate those connections that last only a decade, a year, a weekend. Oscillate from family to clan to bonded group and back again. In an unstable society, embracing the non-foreverness of relationships, fissuring, fusing, forming, and reforming feels like a beautiful and appropriate adaptation. There is significance in the moment, the touching and being touched by others, even if only for a brief time. 

I believe belonging is not defined by traditional notions of permanence, but by the fluidity and adaptability of our connections. If we are adaptation experts—and we, as Black queer people, are—belonging is inherent to our existence. Change is encoded in our DNA, woven into our culture. Our relationships may not conform to societal expectations… but when have we ever conformed? Happy Pride!

Be thirsty for yourself, 
Your wet-feelings-soaked self 
you been thirsty for so many others
seen oasis in them
ventured (escaped)
from the shores of your own wetness, 
your own waterfalls, 
tidal waves, and delicate delicious depths

Mmmm… just be honeyed 
waywardly spiral 
within your own insides and
chaotic cliffs and backwoods
that whisper all of the shadows 
and all of the dreams 

Dreams are falsetto in the forest and 
gospel at the shore.
it makes sense, when you show up unexpectedly, 
over-dressed and dressed to kill. 
You wanted a long catwalk from bush
to oceanic orgasm splash. 

You take off the coat and fling it aside,
a silk and layered rhumba of ruffles
a long train of drama to be rid of, 
in a decided drop off your shoulders 
and that was only the beginning. 
(Excuse the ominous tone, but heed it.)

The coat: sauna heat, a balloon of warmth and
handmade by your grandmas on both sides,
when they first arrived in this country. 
15 years apart and 2,000 miles away, via St. Croix, via Trinidad. 
Maybe they felt feelings? 
Emo, melancholy island girls feels 
Maybe their feelings were erotic and plump and secret?
Or a blaring collective knowing? 

We retrograde to shores 
they were told to leave, 
because someone said 
dreams are better 
away from the wetness,
in the chronically distant, dehydrated oasis. 

This catwalk sashay literally took 400 years, 
We arrive and sit 
neon-lit in the moonlight, 
nude, goose skinned 
and there is 
a big jar of water with mango slices in it, 
goldenrod 
sticky yellow sweet  
in the mouth, between the lips. 

You know how long we gon’ drink that water? 
Pour it over the head.
And suck more down our throat.
How thirsty is we?
How many eons?
Splash and pour the water down the chest 
and tummy and down the pussy and ass crack 
and it tickles as it cleanses. 

Walk waist-deep into the water 
and start wining and let the saltwater 
succumb the accumulation of things that don’t belong to you,
a panic attack inside of
the jazz hall of a heart chamber

But make it xylophone and steelpan��
re-home the graveyard and keep the music,
a sweet, soca, a quadrille, a humming.

Finally
wandering
floating
in your waters.

Disclaimer: This essay mostly addresses issues among cisheterosexual partnerships.

Ah, dating in the 21st century—a time when many of us entrust the fate of our love stories to algorithms and the swipe of our thumbs.

In my own dating life, I reflect on the many risks it’s taken to find intimacy. I remember the times I braced myself to see if the person I was about to meet from a dating app resembled the photos on their profile. I also remember notably good first date experiences, and how they �ɱ�����’t quite good enough to warrant a second date. Those were the days when I anxiously awaited their invitation, slightly startled whenever my phone vibrated, wondering if the problem was me or Mercury retrograde.

The struggle to find love also exists outside the digital world. I went out with a lot of people in college and graduate school when dating apps were still in their earliest stages. Even then, I endured the volatility of modern romance, with questions and tensions orbiting around my relationships: Is timing going to be an issue? Is this political belief they just shared a sign of incompatibility? Are we “trauma bonding”? Are the dynamics with their family going to be a problem over time? Are we even ready?

Why is modern-day dating challenging for many single people?

As a single adult, I am no stranger to firsthand and secondhand dating stories, ranging from horror to blissful success. The latter seems miraculous at times. Simply put: Dating is hard. It is hard even after our access to meeting potential partners increased with the diverse modern dating tools and platforms we have today. After World War II, the majority of heterosexual American couples met because they were set up by mutual friends or had similar social settings, like school, the workplace, church, etc. This changed in 2012 with the development of online dating apps, which have turned into the primary modes of finding love (The Daily Sundial provides of the evolution of online dating). It’s easy to assume that having more options would help make dating easier and faster, but, ironically, it might’ve complicated things. Overall, the question remains: Why is modern-day dating challenging for many single people?

“The past had things easier.” I hear this a lot. This sentiment is backed up by reports like that of VICE Australia, which from people from around the world, reminiscing about the quality of love and connection just before the digital era. Eileen Pai, based in Taiwan, shared: “I miss true connections. Dating apps are like a convenience store. You don’t end up taking things seriously. You end up moving on and on to the next person who can compensate for the boredom of the last date. In Taiwan, back in the day, going for karaoke together was a big thing. Just singing together with your date was special. We would also be very adventurous and move beyond just restaurant dates. I remember going on dates to the high mountains on scooters, and taking in the whole view together.”

There is much to say about the beautiful intentionality in relationships when we had less technology and screen time. But over-romanticizing the past might make us overlook some of its own problems and challenges.

The , with nearly 23 divorces per 1,000 marriages each year until reaching a decline in 2019. This shows that even though some relationships began quickly and smoothly, that doesn’t mean they were happy, safe, exempt from loneliness, or worth keeping. We must also consider the dominant ideals that infiltrate relationships among mostly monogamous and cisheterosexual couples.

Love is messy—and messy isn’t marketable.

Patriarchal standards of relationships were heavily and explicitly imposed on the basis of gender: Men are expected to lead and take a more active role in pursuing and preserving the relationship, while women took a more subservient one. With these hierarchical dynamics (based on unprocessed traumas and internalized sexism), cisgender men commonly assume they should be the main recipient of a relationship’s benefits and privileges, causing a strong sense of entitlement and a lack of accountability. (I wrote a short message for accountability to cis men .)

Speaking of patriarchy, let’s look at 19th century Britain, when . During this time, the Queen coordinated the London Seasons to stage marriageable young women so they could meet eligible bachelors who align with their interests and class backgrounds (yes, like Bridgerton). It was a way to protect the aristocracy and, ultimately, to appease the throne. 

These oppressive ideologies still exist and fester in our relationships today, but unlike before, the discourse around gender rights and equality in relationships is gradually becoming more accessible in North America. 

While some may argue that people in the past had it “easier,” it doesn’t mean these relationships �徱���’t have issues similar to what we have today, which are still related to social and political power and material value. Amy March, a character from Little Women, had a point when she said, “Marriage is an economic proposition.” We can see that in every era, love—in all its symbols and institutions (i.e., marriage, dating apps)—is a marketable product. Even though most of us are sincere in our pursuits of true love, how much do we actually perceive love as a product, and how does this influence our relationships?

I believe Pai was onto something when she mentioned dating apps are like convenience stores, because for certain people, when the connection no longer feels gratifying, easy, useful, or excitingly new, the tendency is to dispose of it (i.e., ghosting). Ironically, our relationships become impoverished when we seek them out of the sole purpose of gaining or consuming—whether or not we are aware of it. Are we capable of pursuing relationships without this capitalist impulse? As long as we are human beings in a capitalist society, I don’t think we can fully escape it. But it helps to be aware of the impulse to consume and then take responsibility for it as it shows up within our partnerships. 

For instance, I am aware that I want to date for closeness, pleasure, and joy. However, am I willing to also admit and take responsibility for when I also want to date so my partner can mend my relational wounds and fill the emotional gaps my parents left me with? It might feel uncomfortable to notice the transactional element of our motivations in finding love, but it illuminates our legitimate needs for connection and how they �ɱ�����’t always fulfilled growing up. With this awareness, I can be mindful of the times I project onto my partner, putting unfair expectations on them based on my own trauma. 

Ultimately, love is multifaceted. Love is messy—and messy isn’t marketable. It takes courage to confront that each of us loves in complex and untidy ways—and that means we won’t always get things right. The good news is that being a lover doesn’t mean being perfect. It’s about showing up. And I love that no matter how hard love gets, we still intrinsically look for it, work for it, write about it, calculate and take risks for it, and embrace it in all its mess, which feels like a nice “fuck you” to capitalism.

A recipe for racialized, anti-youth panic? Apparently not. The sushi, vegetarian, Mongolian, and smoothie shops nearest the school calmly offer the long lines of chattering students specials tailored to teenage budgets.

The “teenager” was invented as a corporate marketing target by 1940s . However, from the 1970s forward, the label was repurposed by political “” to describe a fearsome —reckless, hormonal, impulsive, crime-prone risk-takers fueling numerous social panics.

That “teenager” of legend no longer exists, if it ever did. Defying alarmist headlines, younger Millennial and Generation Z teenagers rarely commit crimes, have babies, engage in violence, drop out of school, or flounder in college. America’s calcified grown-up institutions—the media, interest groups, political leaders, etc.—remain distinctly uncomfortable with the “new teen” and unable to adapt to dynamic new realities. Placer’s youth revolution remains a secret, just as in communities across the country.

The Youth Revolution Is Everywhere

Placer County, a breathtakingly beautiful county of rising just over 100 miles in elevation from Sacramento’s sprawling eastern suburbs across the High Sierra to the Nevada state line, is one of California’s few remaining Republican-voting bastions, with thundering trucks sporting gun racks and conspiracy stickers.

Placer might seem an unlikely place for a youth revolution—especially one accompanying a massive increase in its youthful population of color and remarkable changes among its young women. Life is dramatically different for local teens today compared to just a generation ago. Go back two generations? Their grandparents grew up on a different planet.

Placer’s adolescent population age 10 to 17 has exploded from 16,200 in 1970, to 43,700 in 2023. Its teenage population of color (Hispanic, Black, Asian, Native, or other nonwhite) has skyrocketed tenfold to more than 12,000 today.

National predictions in the mid-90s filled California headlines with dire warnings that the growing teenage population, particularly Black and Brown teens, threatened a “” led by “” and massive social disruption. What actually happened? Virtually every cherished, disparaging myth adults hold about adolescents is being demolished.

The rate of criminal arrests of Placer youth has fallen by a mind-boggling 95% since 1995, and by 97% since 1975. In 1975, arrests handcuffed nearly one in 10 Placer youth; today, the figure is one in 300. In 1995, in a much smaller teen population, more than 200 Placer youth were incarcerated in state and local detention facilities. In 2022, there were just 13.

Placer County’s crime plunge has been so precipitous that teenage youths are no longer a crime problem, with arrest rates falling below those of residents in their 50s. The reduction in crime rates, which mainly affects boys, isn’t the only change. The revolution among teenage girls is even more startling.

In 1960, the grandparent generation, girls between the ages of 15 and 19 gave birth to 260 babies in Placer. In 2021, there were just 62 babies among a female teen population six times larger. That’s a birth-rate drop of 96% over two generations, and nearly 90% in just one generation.

Since they’re not raising babies, committing crimes, and getting locked up, what are Placer’s teenagers doing with their time? Going to school, for one thing. Since 1990, the high school dropout rate among Placer youth ages 18 to 24 has fallen by 60% while college enrollment has risen by 28%.

In 1960, six in 10 Placer women had babies in the five years from ages 15 to 19, while just one in seven women aged 18 to 24 were in college or had college degrees. In 2021, the change is staggering: just two in 100 teens became mothers from ages 15 to 19, while nearly six in 10 women age 18 to 24 were in college, and 2,100 held degrees.

Today, persons under age 20 account for just 7% of Placer’s violent crime arrests, 5% of its drug (including fentanyl) overdose and binge-drinking , 4% of its total criminal , 2% of its deaths by suicide, and 1% of its gun deaths.

Placer County’s youth revolution is happening everywhere. Whether urban or rural, blue or red in politics, regardless of region, similar evolutions are occurring in communities nationwide as young people become more racially diverse and technologically connected.

Antiquated psychological-development and brain-pseudoscience doctrines flatly assert that what today’s adolescents are doing cannot be happening. (“Brain immaturity fuels delinquency. Scientists have confirmed that the brain does not fully mature until age 25, and this lack of brain maturity makes lawbreaking and other risky behaviors more common during adolescence.”) sounds downright silly amid 2022’s realities. The popular stereotypes of teenagers, founded in faulty brain-scanning technology , were but recrudescence of century-old bigotries.

Why Did This Happen?

Placer’s youth improvements did not occur because of youth-targeted crackdowns or remediations, most of which have been found ineffective, or worse, harmful. California’s decriminalization of marijuana in 2011 and temporary COVID-19 restrictions in 2020 might explain around one-tenth of the drop in youth arrests.

The explosion in online cultures since the early 1990s may have had beneficial effects. Amid the panic over social media, the Pew Research Center’s found large majorities of teens saying that “social media gives them some level of connection, … reassures them that they have people to support them during tough times, and … makes them feel more accepted.” That might reduce troubles.

“The virtual universe has offered wonderful opportunities for young people to broaden their horizons and grow in many ways,” Minister Alex da Silva Souto observes. “My main concern is that the significant reduction of in-person human interaction might negatively impact the positive trends.”

The most plausible correlates of reduced teenage problems are the dramatic, largely undiscussed 80% to 95% reductions in and attendant hazards like over the last 30 years. Poverty rates are strongly correlated with arrest, gun violence, and birth rates, while lead toxicity is connected to poorer educational outcomes and higher levels of antisocial behaviors. In 1993, 27.9% of children and youth lived in poverty, according to ChildTrends researchers, using the comprehensive . In 2021, that number was reduced to just 5.2%. Blood lead levels, lagged 15 years to allow for growth from childhood testing to adolescence, show a similar plunge, economist Rick Nevin of the Centers for Disease Control and Prevention .

Are America’s biggest crime fighters and social reformers the Environmental Protection Agency and the Earned Income Tax Credit, the government transfer most responsible for reducing poverty? �մǻ岹��’s teenagers make a strong case, if we can drop old prejudices and see it.

Placer County’s youth revolution, and that nationally, is a stunning affirmation of progressive faith that racial and lifestyle diversity can accompany—and perhaps is even essential to—a safer, healthier, better-educated society. “Biodiverse environments are stronger than homogeneous ones,” da Silva Souto says, “so I believe that increasing racial, ethnic, gender, and lifestyle diversity have improved the conditions for teenagers to access the information, opportunities, and connections that they would not otherwise.” The most likely drivers of improved youthful behavior, greater public aid for poorer populations, stronger environmental protection regulations, and more interconnected youth, also stunningly affirm progressive ideals in the face of right-wing demands for more policing, guns, sexuality controls, environmental deregulation, and social safety-net cuts. Why, then, are authorities and media so afraid of the disappearance of the reckless “problem teenager” that they refuse even to talk about it?

Fantasy fiction book sales increased dramatically in the past three years just as teen depression, anxiety, and mental illness skyrocketed—parallel trends that may be both a symptom of the pandemic and a possible remedy, literary and mental health experts say. 

In 2021, fantasy sales went up 45% compared to 2020, the largest increase among all genres except for graphic novels, according to , an international industry-research organization. That same year, fantasy audiobooks racked up revenue of $1.6 billion, number eight among most competitive genres on Amazon, WordsRated reports. 

Barnes & Noble CEO James Daunt attributes some of this to improved marketing strategies. But mental health care professionals believe that there is a better explanation. 

“Our worlds became very small [during the pandemic] and … fantasy fiction provided this vast opportunity to delve into worlds unknown and worlds unseen and worlds unexperienced,” says Melissa Sporn, a clinical psychologist who treats adolescents and children as well as adults. 

Fantasy is a type of speculative fiction that features fantastical or supernatural elements that do not exist in the real world. In fantasy novels, you’re likely to learn about different systems of magic, encounter mythical creatures such as dragons or unicorns, and follow characters both tragic and heroic as they navigate enchanting worlds that have nothing in common except this—they look utterly unlike our own. 

The genre is extensive and covers a wide range of scenes, topics, and plots. Some famous examples of fantasy novels and novel series include The Lord of the Rings by J.R.R. Tolkien, the “Harry Potter” series by J.K. Rowling, “The Stormlight Archive” by Brandon Sanderson, and “Percy Jackson and the Olympians” by Rick Riordan.

Other prominent fantasy fiction includes “His Dark Materials” by Philip Pullman, “The Earthsea Cycle” by Ursula K. LeGuin, “The Kingkiller Chronicle” by Patrick Rothfuss, “A Song of Ice and Fire” by George R.R. Martin, “The Chronicles of Narnia” by C.S. Lewis, and “The Wheel of Time” by Robert Jordan.

Experts believe that there are concrete reasons why fantasy fiction experienced a surge in popularity. First among them may be the simple relief that such stories offer from a daily reality that may still seem dark, dangerous, and uncertain. 

Esther Jones is an English professor at Clark University in Worcester, Massachusetts, and author of Medicine and Ethics in Black Women’s Fiction. She discussed this phenomena in a . 

“Readers are suffering from reality overload,” writes Jones. “Young people today have unprecedented access to information about which they may have little power to influence or change. … The fact that the setting or characters are extraordinary may be precisely why they are powerful and where their value lies.” 

Experts note that even before the pandemic, other factors carried serious health consequences for youth today. In this era of social media, young people are constantly bombarded by swaths of information regarding tragedies the world over.

As the COVID-19 pandemic took hold in early 2020, society already was experiencing historic social and emotional upheaval occasioned by racial injustices and the struggles of an LGBTQ+ community seeking to gain and retain hard-fought rights. By 2022, members of Generation Z were twice as likely as the average American to struggle with feelings of depression and hopelessness.

That dynamic continues. On March 2, Tennessee Gov. Bill Lee signed a law that will ban trans youth from starting “gender-affirming” medical care such as puberty blockers in the state starting July 1. Youth who’d begun such care prior to that date will be required to discontinue treatment nine months later. 

“I think there is a parallel between our society really coming to grips with diversity in terms of gender identity and sexual identity—and fantasy fiction,” says Sporn.

“[In fantasy fiction] you’re presented with people and protagonists who are diverse … and you have to accept them for who they are, and you learn to empathize with them and care about them,” Sporn explains. 

“You recognize where they’re coming from—it’s a way to bridge that gap and understand something you otherwise couldn’t understand.”

Members of Generation Z, compared to other generations, are more likely to worry about rising suicide rates, deportation and immigration, mass shootings, climate change, and violence against women.

However, that may explain why young people are turning to fantasy fiction not just for a release, but for a feeling of security. 

In fantasy novels, “youths see examples of young people grappling with serious social, economic, and political issues that are timely and relevant, but in settings or times that offer critical distance,” says Jones. 

“This distance gives readers an avenue to grapple with complexity and use their imagination to consider different ways of managing social challenges,” she adds. “What better way to deal with the uncertainty of this time than with forms of fiction that make us comfortable with being uncomfortable, that explore uncertainty and ambiguity, and depict young people as active agents, survivors, and shapers of their own destinies?” 

Experts note that reading generally improves teens’ self-regard and general feelings of accomplishment. Reading fantasy fiction, they say, not only confers those benefits but improves teen mental health while they are doing it. Reading fiction has been found to improve social cognition and increase levels of empathy, Richard Sima of the International Arts + Mind Lab reported in Psychology Today last year. Sima adds that research shows reading programs and social groups centered around reading can support youth mental health through conversation and connection. 

Reading fantasy novels provides respite, according to Sporn: “It really provides pause and relief for kids who are in [difficult] circumstances and situations.” 

Adults are reading these, too, Sporn adds: From 2016 to now, there has been a “nice incline, because we all needed to escape.” 

Even Sporn acknowledges feeling such a desire. 

“I needed that escape,” she says. “I couldn’t read anything deep or tragic or painful. Life was painful enough.” 

In adults, reading has been proven to reduce cognitive decline, reduce stress, and improve quality of sleep. Reading also may be connected to living a longer life, .

Parents might be concerned about their teens escaping into other realities. The misperception that reading fantasy is an unworthy or even unhealthy practice is just that: a misperception, according to Jones. Instead, reading science fiction and fantasy can also help young people learn how to cope with stress and anxiety.

Bibliotherapy, a relatively new take on therapy, mixes books and other forms of literature with traditional therapy models. The catharsis involved in the process has been shown to help increase a patient’s empathy and creativity, and to help patients cope with conditions such as generalized anxiety disorder and post-traumatic stress disorder. 

If parents are still concerned that reading fantasy fiction might skew their kids’ reading habits, they can rest easy. As Jones noted in her article, a 2015 survey showed that readers of fantasy and science fiction also consume a wide range of other types of literature and media. 

But in the end, Jones has a simple three-word dictum that she says should guide parents, teachers, and teens themselves: “Let them read.” 

“In this time of COVID-19 and physical distancing, we may be reluctant for kids to embrace creative forms that seem to separate them psychologically from reality,” writes Jones. 

“Let them read. … In [fiction], young people can see themselves—coping, surviving, and learning lessons that may enable them to create their own strategies for resilience.” 

��This story is part of a series on fantasy fiction’s impact on young people’s mental health. Read the full series at MindSite.

Tattooing is a reclamation of my body, 
where I consensually welcome a wound 
as opposed to the ones that violently invaded my being, 
physical and otherwise. 

Tattooing is a sacred “fuck you” to colonizers and their attempted erasure of us,
while labeling the ink on our skin as dirty and demonic

Tattooing is a holy permanence on my brown skin,
a deliberate reverence to Indigenous ancestors, whose tattoos 
symbolized honor, achievement, and beauty.

Tattooing is a reiteration of “by [my] wounds, [I] am healed.”

—personal notes from the evening I got my first tattoo in 2022

Our bodies carry stories and there are many ways to tell them, with various types of ink and alternatives to paper.

For centuries, tattooing has represented much more than mere aesthetic or a tough facade. The majority of Western cultures and religious traditions have associated tattoos with criminality, primitivity, and other forms of unsophistication. For most Christians, tattoos are biblically forbidden, with verses like Leviticus 19:28 instructing to “not cut your bodies for the dead or put tattoo marks on yourselves.” The case is vastly different for communities outside the West—especially to Indigenous peoples. Tattooing is medicinal and sacred, symbolizing a person’s great milestones, beauty, and bravery. Tattooing is more than decorative: It is a form of devotion to one’s true self and community.

Artistically and resolutely, many of the colonized today counteract the violence of cultural and religious erasure by getting inked. For others, tattooing is a form of body liberation and healing: Choosing to mark one’s body and determining which designs to be permanently marked with is a reclamation. 

One Saturday morning, I had breakfast with tattoo artists and at , a tattoo and piercing studio in Manila, Philippines. We gathered to have conversations on tattooing, which began with the topic of body autonomy. Lacsamana, who is also an illustrator and author, shared that growing up in a Catholic and conservative academic family, she got her tattoos in secret. This shifted over time when Lacsamana started choosing body placements that appeared more visible to others. But early in her tattoo journey, she recognized the courage that younger Wiji already had before getting inked, even while hiding. Every tattoo was a declaration of self: “This is my body.” Similarly, Lacsamana believes that whenever a person gets a tattoo, “You are becoming more ‘I am’—more yourself.”

Indigenous communities across the globe also consider tattooing as a preservation and amplification of cultural integrity and belonging.

This coincides with co-founder of ’s words on the connection between tattooing and body reclamation. In an interview with Welcome to Chinatown, :

“Tattooing is a tradition that has been alive and breathed in new life in our generation. As a queer Asian American, I found a community in tattooing that is all about reclaiming our bodies and our identity. The generational trauma of feeling like our bodies belong to our parents, or belong to the male gaze all fall apart when we are in a space that accepts our nuance in a collective embrace. Being able to hold a physical space for that feels sacred.”

The connection between body agency and tattooing isn’t just about separating from oppressive social conditions but also includes the choice to (re)connect to one’s community or lineage.

In the powerful documentary , Sāmoan tattooist Rosanna Raymond shares her experience with the art of the tatau, and specifically, the malu for women. She shares that the cultural symbols tattooed by and for women are not to be easily “put away in the cupboard.” Once tattooed, “you are present with your ancestors every day,” because of how these symbols are infused with history and heritage.

Dulcie Stewart of when she had her tattoos done with Julia Mage’au Gray at —veiqia, or weniqia, is a tattooing practice in Fiji where young, pubescent women receive veiqia by the daubati, elder women tattooists, as an initiation to womanhood. Stewart shares her experience:

“At my first session with her, Julia marked me by reconstructing weniqia (tattoo patterns and designs) based on 1870s sketches of Fijian women that we both had seen online. Over the years the process changed, the marks became personal and were based on familial designs. Being marked by Julia is an emotional and personal process, with each marking telling a story relating to different parts of your life; each tap revealing a memory and healing the soul.”

Indigenous communities across the globe also consider tattooing as a preservation and amplification of cultural integrity and belonging. Recently, , the venerable Apo Whang-Od. The article not only decentralized beauty standards (“unmarked women were considered imperfect, undesirable”) that are widely imposed and commodified, but also recognized the tradition of , marking the skin through hand-tapping, as a sacred heritage of the Kalinga tribe. remarked in one of the episodes of the series that the sound of hand-tapping is like a “rhythm that wakes the ancestors.” The Onaman Collective, on the other hand, revitalizes the tradition of tattooing as a way to subvert the shame imposed by the church and government by marking the skin with sacred symbols to commemorate their achievements, healing, and visions. A member of the collective, Alethea Arnaquq-Baril, calls on non-Indigenous folks not to use the same spiritual symbols of their tradition. She says, “There are many other ways to honor our culture without appropriating it.”

For those of us who are non-Indigenous, we can still get tattoos as a way to honor ourselves and our lineages without culturally appropriating Indigenous traditions. For example, I was at a coffee shop one day and noticed a beautifully detailed illustration of a piece of , the cheese-filled pretzel snack, on the barista’s arm. At first, I thought it was such a unique and quirky image to have on his skin. I inquired more and learned that Combos were the snack he and his grandmother shared during his childhood. Now that she has passed, my new barista friend honors her memory with this permanent mark that represents their bond. This encounter shows how we can still honor our heritage without appropriating that of another, especially when the sacred symbols are only tattooed when earned and/or inherited within a specific tribe.

There is something medicinal in choosing the kinds of scars that mark us.

Alaga, a tattoo apprentice and artist, considers tattooing a form of ceremony and celebration. As someone who was raised surrounded by strict conditions of what it means to be accepted, Alaga’s first experience with tattooing was an introduction to empathy: the kind of empathy that softens the internalized rules and the need to defend themself and their identity. Serendipitously, their first tattoo was placed on the throat, which, based on Chinese medicine, indicates that the tattoo will activate healing for the closest meridian. Similar to acupuncture, tattooing uses needles, thus stimulating this channel of energy via penetration of the skin. Alaga’s tattoo then stimulated and released the blockage residing in their throat, enabling them to speak their truth and take back their power from a life that formerly hid their identity and denied their reality. They say that tattooing offers “the beautiful potential [for the] physical wound to open up a portal,” enabling the spiritual and physical wound to heal in tandem. Other that tattooing has the potential to build immunity because of the body’s strengthened agility and immunological defenses. (However, this is not always the case for all bodies, especially for the immunocompromised and those with certain autoimmune conditions.)��

Toward the end of our time together, I asked Alaga and Lacsamana about their hopes in the world of tattooing. Alaga reflected on a future where tattooing “was more accessible to everyone. Art doesn’t choose, especially among class. It’s the studio’s responsibility to have a sliding scale.” In addition to this, I also wonder what it’s like for tattoo artists to use their work as a platform for solidarity in social movements. For instance, is a Filipino organizer who was incarcerated for defending land and human rights. Tattoo artists in Manila have joined the by offering , with a portion of their proceeds redistributed to free Echanis, whose three-year-old child joins her in prison. The tattooing campaign will continue on until Echanis is freed.

Alaga and Lacsamana share a similar hope to have more women and queer folks in the tattooing world, as studios have been predominantly masculine in the Philippines. Because tattooing is a vulnerable endeavor for the client, a warmer and perhaps more nurturing energy can provide safer spaces that honor the client’s trust and boundaries. Lacsamana also desires to reframe ideas surrounding femininity and tattoo designs. Floral and soft designs are often mocked and belittled, to which she responds, “Why is girliness a bad thing? I love stepping into my femininity.” She hopes that the tattoo world may welcome the interplay of softness and fierceness, power and gentleness, when it comes to tattoo design selection.

Lacsamana imagines tattooing as a way to give talismans to her clients. She shares that the process turns the client’s vision into something tangible, and, by embedding it onto the skin, “alchemizing tattoos into a talisman.” As a tattoo artist, she understands the mutual healing of this process, being a witness and creator who illustrates chapters of other people’s lives on their bodies. 

There is something medicinal in choosing the kinds of scars that mark us. In these practices, we get to decide on these wounds and welcome them, as opposed to the ones that invade us without our consent. Through catharsis and colors, we are free. By our own wounds, we heal.

 is a health policy researcher at the University of California, Los Angeles, who studies HIV treatment and prevention. She explains the history of the ban and the reasoning behind its long-awaited reversal.

1. When and why did the ban begin?

When the FDA  in 1983 for men who have sex with men, there were good reasons for broad regulations to ensure the safety of the blood supply. At the start of the AIDS epidemic, public health officials were dealing with an unknown virus that was spread through unknown means. Researchers  a year later, in 1984, and it took another year to approve the first test to screen blood donations for HIV in 1985.

Despite the ban on blood donations from men who have sex with men, there was some small risk that failures in  and  could lead to transmission of HIV or other diseases from blood transfusion. But over the years, scientific advancements and strict protocols have helped to nearly  through blood. In fact, the last documented transmission of HIV through the a U.S. donor’s blood product .

Starting in 2013, the U.S. government began implementing a  the safety of the U.S. blood supply for a variety of different pathogens, including HIV.

2. Why lift the ban now?

While the blood donation ban—as well as many other —was reasonable at the time, the science has changed. Researchers and public health officials have gained a better understanding of how HIV is transmitted and the risks associated with different activities. Given today’s knowledge, many  that the benefits of the ban no longer outweigh the hit to the blood supply or the harm caused by what is a discriminatory rule.

The FDA has been slowly working toward this change. In December 2015, the organization took a big step by allowing men who have sex with men to donate blood if they haven’t had . That period was  in April 2020, during the height of the COVID-19 pandemic, to help fight a .

While a step in the right direction, these updates �徱���’t change the blunt assessment by the FDA that men who have sex with men are performing high-risk sexual behaviors and are themselves high-risk donors. Researchers and gay-rights advocates have long argued that  and fail to realistically consider the differences in risk associated with the type of sex, type of relationship, number of partners and frequency of sexual encounters.

The FDA’s latest  go a long way toward improving clarity about what makes a person a high-risk donor and remove the blanket categorization of prospective donors based on their gender and sexual orientation alone.

Under the new guidelines, there is a way to differentiate between individuals who are monogamous and those who are not, as well as between those who have not engaged in anal sex in the prior three months and those who have. The recommendation now suggests that blood donor history questionnaires be used to evaluate an individual’s risk, rather than a reliance on broad categorizations. If the assessment finds an individual to be high-risk, then the guidelines recommend that person be prevented from donating blood for three months.

3. What effect could this have on the blood supply?

The FDA’s latest move represents a seismic shift for men who have sex with men as well as for the .

According to recent research, a conservative estimate suggests that the lifting of the ban will lead to a . With the ongoing blood shortage, that increase could help save more than a million lives. In addition, removing gender and sexual orientation from the risk assessment for blood donation will take the U.S. one step further in addressing stigma and discrimination against men who have sex with men.

This article was originally published by . It has been published here under a Creative Commons license.

Most recently, she launched a collection of empathic greeting cards for people living with illness. She designed them to be more honest and appropriate for people living with cancer than typical “Get well soon” cards.

“A card resonates in a way that email and text can’t,” explained McDowell . “It’s a personal, simple, tangible way to be present for someone struggling with illness.”

She designed the card collection to help friends and family find the right words to send to sick loved ones. And, as a cancer survivor herself, McDowell hopes the frankness of the empathy cards will offer people struggling with illness some much-needed understanding, honestly, and even humor.

It’s time once again for our favorite year-end ritual here at UC Berkeley’s Greater Good Science Center: Our annual list of the top scientific insights produced by the study of happiness, altruism, mindfulness, gratitude—what we call “the science of a meaningful life.”

We found that this year, the science of a meaningful life yielded many new insights about the relationship between our inner and outer lives. Cultivating mindfulness can make us more aware of knee-jerk prejudice against people who are different from us; believing that empathy is a skill helps overcome barriers to taking another person’s perspective; concern for others, even for animals, can move people to action for the greater good more quickly than focusing on ourselves.

But this year we also learned more about how to cultivate pro-social skills like gratitude—and we discovered how those skills can yield far-reaching benefits to our mental and physical well-being, and even to our pocketbooks.

With input from our staff, faculty, and some of the leading outside experts in our field, here are the 10 findings from 2014 that we anticipate will have an impact on both scientific research and on public debate for years to come.

1. Mindfulness can reduce racial prejudice—and possibly its effects on victims.

Racial bias in policing is at the forefront of our national news. So it was heartening this year to see a that found bias could be reduced through training in mindfulness—the nonjudgmental moment-to-moment awareness of one’s thoughts, emotions, and surroundings.

Mindfulness has the power to interrupt the link between past experience and impulsive responding.

Adam Lueke and Brian Gibson of Central Michigan University looked at how instructing white college students in mindfulness would affect their “implicit bias”—or unconscious negative reactions—to black faces and faces of older people. After listening to a 10-minute mindfulness audiotape, students were significantly less likely to automatically pair negative descriptive words with black and elderly faces than were those in a control group—a finding that could be important for policing, which often involves split-second assessments of people.

Why the connection between mindfulness and bias? Mindfulness has the power to interrupt the link between past experience and impulsive responding, the authors speculate. This ability to be more discerning may explain why this year found that people who were high in mindfulness were less likely to sink into depression following experiences of discrimination.

As we back in 2009, numerous programs have successfully helped officers become aware of their own unconscious biases. But by specifically looking at the effects of mindfulness training—even just 10 minutes’ worth—these new studies point to innovative techniques that might help prevent fatal mistakes from being made in the future.

2. Gratitude makes us smarter in how we spend money.

For years, Greater Good has been reporting on the social, psychological, and physical benefits of . This year, research suggested that there might be profound economic benefits to a grateful mindset as well—which might pay emotional dividends down the line.

The results suggest that gratitude … strengthens self-control and the ability to delay gratification.

In one study, in Psychological Science, researchers asked participants how much money they’d be willing to forgo in the present in order to receive a greater sum in the future—a measure of their self-control and financial patience. People prompted to feel grateful were willing to pass up significantly more cash than were people not feeling grateful, even if those less-grateful people were feeling other positive emotions. For instance, happy people were willing to sacrifice $100 in the future (one year later) in order to receive $18 in the present, but grateful people preferred to receive the larger, future payment; they only gave up that $100 when the amount offered to them right away reached $30.

The results suggest that gratitude reduces “excessive economic impatience” and strengthens self-control and the ability to delay gratification, according to the authors. This finding challenges the long-held notion that we must rein in our emotions in order to make smarter spending decisions; instead, it seems that consciously counting our blessings can serve our long-term economic interests.

published this year, in Personality and Individual Differences, suggests that gratitude can guide us toward better decisions about what we actually choose to spend our money on. Participants who were more materialistic—meaning that they place a lot of importance on acquiring material possessions—reported lower feelings of gratitude and lower satisfaction with life. In fact, the researchers determined that materialists feel less satisfied with their lives mainly because they experience less gratitude. Their findings help to explain why, according to much previous research, materialistic people are less happy.

Prior research has also found that less happy people make more materialistic purchases, creating a vicious cycle. But the authors of this new study argue that gratitude can help break this cycle. Based on their results, they suggest that boosting one’s level of gratitude might reduce materialism and its negative effects on happiness.

So gratitude might not only encourage financial decisions that are better for our long-term economic health but better for our long-term emotional health as well.

3. It’s possible to teach gratitude to young children, with lasting effects.

One of �貹����Գٲ�’ biggest fears is that their child will become an entitled brat; one of their biggest questions is what they can do to prevent that.

The curriculum encourages kids to think about … kindness as a “gift.”

Instead of just lecturing about the importance of gratitude, the curriculum encourages kids to think about something nice that another person did for them, and to see that kindness as a “gift.” Through the curriculum, the students reflect on the value of the gift, the cost incurred by the person who gave it, and the kind intentions that motivated the gift.

The curriculum was taught to 8-11-year-olds for half an hour every day for a week—and the kids started to show increases in gratitude just two days after the curriculum ended. When Froh and Bono offered the curriculum once a week or five weeks, they found that it increased gratitude and other positive emotions for at least five months.

Dozens of previous studies—many of which on Greater Good—have suggested that gratitude can combat feelings of entitlement and foster happiness. But only a small handful of these studies have examined the effects of gratitude on children, and the kids in Froh and Bono’s study were the youngest ever involved in a study of a gratitude program.

Their results offer hope that it’s actually possible to nurture lasting gratitude—and happiness—in children from the time they’re young. And their provides parents and teachers with concrete guidelines for achieving that goal.

4. Having more variety in our emotions—positive or negative—can make us happier and healthier.

Is the route to simply to feel more positive emotion and less negative emotion? Our cast some doubt on that view, and an even stronger rebuttal emerged this year in published in the Journal of Experimental Psychology: General.

People high in emodiversity were less likely to be depressed than people high in positive emotion alone.

Researchers from four different countries and six different institutions—including Yale University and Harvard Business School—measured participants’ positive emotions (like amusement, awe, and gratitude) and negative ones (like anger, anxiety, and sadness). They not only looked at the level of these emotions but also their variety and abundance—what the researchers call “emodiversity.”

Their first study surveyed over 35,000 French speakers and found that emodiversity is related to less depression. This was the case for all types of emodiversity: positive (experiencing many different positive emotions), negative (many different negative emotions), and general (a mix of both positive and negative emotions). In fact, people high in emodiversity were less likely to be depressed than people high in positive emotion alone.

With almost 1,300 Belgian participants, the second study linked emodiversity to less medication use, lower government health care costs, and fewer doctor visits and days spent in the hospital. It was also related to better diet, exercise, and smoking habits. Surprisingly, the effect of emodiversity on physical health was about as strong as the effects of positive or negative emotion alone.

? Emotional monotony is a drag, so we may be better off mentally and physically if we seek out and embrace a variety of emotional experiences—even the negative ones.

5. Natural selection favors happy people, which is why there are so many of them.

If you subscribe to the philosopher Thomas Hobbes’ view of life as “nasty, brutish, and short”—as many people do—you’d naturally expect humans to live a pretty miserable existence. But many studies from around the world have suggested that, on average, humans’ default emotional state is to be pretty happy, regardless of their life circumstances—a phenomenon researchers call “positive mood offset.”

Many of the chief benefits of happiness … increase a person’s chances of passing his or her genes to the next generation.

This year, a massive review of the research on happiness set out to explore ; the study, published in Personality and Social Psychology Review, was led by Ed Diener, a pioneer in the science of happiness.

Given the benefits they find to be strongly associated with happiness, the researchers conclude that the ubiquity of happiness is a product of human evolution. Why? Because many of the chief benefits of happiness—including better health, longer lives, greater fertility, higher income, and more sociability—increase a person’s chances of passing his or her genes to the next generation.

“People are happy most of the time because they are descended from ancestors who were happier and engaged in fitness-maximizing behavior more frequently than their neighbors who were less happy,” they write.

In other words, natural selection favors happy people, leaving us with more of them today.

Of course, though based on an especially comprehensive review of happiness research, Diener and his colleagues stress that this is just a hypothesis—albeit one worth subjecting to future study. “Although our opposable thumbs, big brains, and upright posture have all received in-depth attention and study as reasons for human [evolutionary] success,” they write, “it is time to consider how positive mood offset might have also contributed.”

6. Activities from positive psychology don’t just make happy people happier—they can also help alleviate suffering.

This idea that happiness might arise from natural selection suggests that, perhaps, you’re either born happy or you’re not. But research on positive psychology activities—like keeping a gratitude journal or regular meditation—has offered compelling evidence that it’s possible to cultivate happiness over time. What’s more, during the past year, we saw many different papers suggest that positive activities aren’t just for positive people, and that negative conditions aren’t just alleviated by targeting negative influences. Instead, nurturing positive skills can help pull people out of depression, anxiety, and even suicidal thoughts.

Participants’ ability to forgive themselves and others seemed closely associated with the will to keep on living.

The key, it seems, lies in the way these skills enhance relationships. found that 11 people who had gone through an eight-week Mindfulness-Based Cognitive Therapy course became less stressed about relationships with friends, family, and coworkers—which, in turn, helped prevent future episodes of depression.

in the July issue of the Journal of Affective Disorders looked at the impact of another positive behavior, , on reducing suicidal thoughts in impoverished, rural people. The researchers found that participants’ ability to forgive themselves and others seemed closely associated with the will to keep on living. They also found that forgiveness seemed to reduce participants’ feelings of being a burden to others, and people who were able to forgive themselves for being a burden to others were much less suicidal. found that keeping a journal about gratitude or kindness helped people who were on waiting lists to receive psychological counseling.

The upshot of this research is that there are likely far-reaching applications of the skills targeted by positive psychology. As researchers move forward in understanding how we can foster human strengths and use them to save lives, clinicians and teachers can put these insights to use in real-world settings.

7. People with a “growth mindset” are more likely to overcome barriers to empathy.

Just as many people believe that you’re either happy or you’re not, so many believe that you’re either empathic or you’re not. The trouble with this “fixed mindset” about empathy is that the ability to sense the feelings or take the perspective of others is , such as when we are stressed or overwhelmed by other people’s needs. Some research is even showing that stressed-out, hyper-connected Americans are becoming less and less empathic.

According to a published in the Journal of Social Psychology, our beliefs about are critical to fostering it. Stanford University researchers recruited 75 participants, asking them to pick one of these two statements as being true: “In general, people cannot change how empathic a person they are” or “In general, people can change how empathic a person they are.” Across five studies, they tested their hypothesis in situations where empathy is both challenging and “crucial to positive social outcomes,” such as pitting the participant against someone with different political views.

Anyone can cultivate empathic skills—even psychopaths.

In the final study, researchers told half of the participants that they had failed a diagnostic test of emotional understanding and that the other half succeeded. Then they gave participants a chance to go through exercises that might improve their empathy—theorizing that “participants induced to have a malleable, as opposed to fixed, theory of empathy would be more likely to capitalize on this opportunity to develop their empathic abilities.”

This turned out to be true. People primed to see empathy as a skill—in other words, people given a “growth mindset” about empathy, seeing it as something one can build through practice—were more likely to “stretch themselves to overcome their limitations.” Across all of their studies, they found that people who believe empathy can be developed expended greater effort in challenging contexts than did people who believe empathy cannot be developed, suggesting that our beliefs about ourselves are key to expanding empathy on both individual and societal levels.

This insight echoes a trend we highlighted in of top scientific insights: Anyone can cultivate empathic skills—even psychopaths. And in fact, this year from the United Kingdom extended those findings to narcissists, finding that even they could be coached into taking another person’s perspective.

8. To get people to take action against climate change, talk to them about birds.

Imagine what might happen in the future if climate change goes unchecked. Are you more likely to take action to prevent that outcome if you feel like it is a threat to humans? Or are you more likely to reduce your carbon footprint if you fear for the safety of other animals, like birds? Well, according to a group of scientists at Cornell University, .

The researchers 3,546 people (largely bird-watchers) to evaluate how their willingness to engage in climate-friendly actions might be affected by how the problem of climate change is described to them. Specifically, respondents were presented with these four statements and, after each, asked about their willingness to lessen their carbon footprint:

1. Climate change is a danger to people.
2. Climate change is a danger to birds.
3. If a large number of Americans do something small to reduce their use of fossil fuels, it would have a large impact on our national carbon footprint.
4. If a large number of Americans do something small to reduce their use of fossil fuels, it would have a large impact on our national carbon footprint—and be of benefit to future generations.

Invoking a threat to birds led to the most significant change of all.

As expected, the findings revealed that the positive framing of the climate problem (numbers 3 and 4) increased people’s willingness to take action. Numerous earlier studies have shown that positive messages—such as those that emphasize the collective impact of carbon-cutting measures—are generally more effective than fear-based messages. But responses to the two fear-based messages (numbers 1 and 2) revealed a surprise: Invoking a threat to humans led to no significant impact on the respondents’ willingness to reduce their carbon footprint—while invoking a threat to birds led to the most significant change of all.

Why would a threat to birds provoke more willingness to act than a threat to humans? One theory suggests that threats to humans cause us to think about death, which activates defenses against the anxiety caused by confronting our own mortality. Researcher Janis Dickson says the findings do point to a potentially important lesson for educators and communicators: Combining a sense of empowerment (by reminding people of our collective impact) with (for non-human others) can help cultivate the psychological resilience needed to overcome denial and inaction.

9. Feelings of well-being might spur extraordinary acts of altruism.

What would motivate someone to donate a kidney to someone they have never met?

A published in the journal Psychological Science looked at this act of extreme in all 50 states, cross-referencing donations with data on each state’s levels of “well-being,” which refers to people’s levels of life satisfaction, emotional health, physical health, healthy behavior (e.g., exercise, good diet), job satisfaction, and ability to meet their basic needs like food and safety. By analyzing statewide data, the Georgetown University researchers hoped to find large-scale trends that might not be apparent from looking at individual cases.

“Policies that promote well-being may help to generate a virtuous circle…”

Their efforts paid off. showed that states with high levels of well-being tended to have higher rates of “altruistic” kidney donation—kidney donation to a stranger. Indeed, the researchers found that even when controlling for key factors such as education, race, age, income, and religiosity, a state’s level of well-being still significantly predicted donation rates. Furthermore, analyses combining states into larger geographical regions confirmed that as well-being increases, so do rates of kidney donation to strangers. And because altruistic kidney donation happens relatively rarely, the researchers were able to rule out the possibility that these altruistic acts caused widespread increases in happiness rather than the other way around.

So while prior research has suggested that performing altruistic acts fosters feelings of happiness, this important study adds a new twist: Feelings of happiness might actually spur extraordinary acts of altruism. This insight has real-world implications. , “Policies that promote well-being may help to generate a virtuous circle, whereby increases in well-being promote altruism that, in turn, increases well-being. Such a cycle holds the promise of creating a ‘sustainable happiness’ with broad benefits for altruists, their beneficiaries, and society at large.”

10. Extreme altruism is motivated by intuition—our compassionate instincts.

While the previous insight relied upon big-picture aggregate data to understand how social context influences altruistic acts, this year the same Georgetown University team that conducted that study went deeper into the individual human mind to understand the psychology of altruism. has identified patterns of brain activity related to extreme anti-social behavior, but this tried to locate the neural mechanisms that might support extreme pro-social tendencies.

The gut-level decision overrode any deliberative process.

Researchers Kristin M. Brethel-Haurwitz and Abigail A. Marsh used brain imaging technology to map the brains of kidney donors, who make an extraordinary sacrifice for total strangers; they then compared these brain images with those of psychopaths and people who did not show extremes on either side of the pro-social divide. They found that the brains of extraordinary altruists had slightly larger right amygdalae—a brain area associated with a fearful response—and they reacted very strongly to fearful facial expressions—the exact opposite of psychopaths.

How might these different brain structures show up in behavior? Another research team, this one at Yale University, examined the testimony of Carnegie Hero Medal Recipients, who all risked their lives to save others. that recipients’ decisions to help were “overwhelmingly dominated by intuition” and “significantly more intuitive than a set of control statements describing deliberative decision-making.” This remained true even when researchers took into account that the medal winners had enough time to think before they acted, suggesting that the gut-level decision overrode any deliberative process.

Taken together, these findings from Yale and Georgetown reveal how extreme, heroic acts of altruism might be motivated by deeply-rooted, even instinctive, psychological processes.

To what degree are these different brain structures—and the instincts that spring from them—shaped by nature or nurture? That’s a question that research will need to tackle in 2015.

Along the way, we pick up other ideas about what’s important—status, possessions, money, a bucket list of experiences and accomplishments. But those who reflect back, as they near the end of life, often rediscover love as the source of real happiness.

It is a form of happiness that endures because it starts with the fundamentals and aspirations of being human.

Philosophers and religious leaders have long warned against getting distracted by petty ambitions. “It is preoccupation with possessions, more than anything else, that prevents men from living freely and nobly,” said British philosopher Bertrand Russell.

Still, many of us do get distracted and confused. After all, we need material security to live, and support our families, and our increasingly unequal society makes that more and more difficult. Meanwhile, advertisers spend billions to convince us that buying more stuff will make us happy; the elusive goal of material well-being stays just out of reach.

It is true that all of us need a basic level of material security. But after that, more stuff does not bring more happiness. The research shows that sustainable happiness comes from other sources, like having meaningful work to do (paid or unpaid) and having authentic relationships. It is a form of happiness that endures, through good and bad times, because it starts with the fundamental requirements and aspirations of being human.

In the nearly 20 years we’ve been covering sustainable happiness, we’ve found a remarkable consistency to what spiritual leaders, philosophers, and researchers say about it.

A starting point is to realize that we have choices.

Viktor E. Frankl, concentration camp survivor and author of Man’s Search for Meaning, wrote, “Forces beyond your control can take away everything you possess except one thing: your freedom to choose how you will respond to the situation.”

Here are some of the things we’ve learned that you can do right now:

1. Show up for your life mindfully

Mindfulness—and its sibling, compassion—can lighten the burdens of your past and lessen your worries about the future. Matthieu Ricard, a Buddhist monk and translator for the Dalai Lama, says that by fully inhabiting the present moment, we become conscious of the interplay of our emotions and desires and less at the mercy of events around us.

2. Kick your addictions

If you rely on drugs or alcohol to get through the day, then kicking that addiction and dealing with the underlying causes is your first step. But many forms of addiction are more subtle. Maybe you spend so much time on Facebook or checking email that you miss out on connecting with the people around you. Some cafés now have laptop-free days to encourage customers to show up ready to interact with each other. Or maybe you’ve gotten addicted to shopping and having the best or the latest. Make conscious choices about where you direct your attention, and consider what brings deep happiness.

Getting clear on the work that ignites your interest and passion adds greatly to your happiness.

3. Find work you love

In a time of chronic unemployment, this may seem like a luxury. But getting clear on the work that ignites your interest, if not your passion, adds greatly to your happiness. When Shannon Hayes finished her dissertation, she realized what she really wanted was to work on her family farm. And she risked everything she had worked for to make it happen. There are times when we have few choices—when we have to take whatever job is available. But there are also moments when we do have choices, and doing work that taps our deepest gifts and desires is among the most satisfying experiences we can have.

4. Live simply and liberate your time

With less clutter, you can spend time on the things that offer you the most meaning and enjoyment. If you don’t need as much stuff, to choose how much time you spend working for pay. If you make or grow more of what you need and trade with others, you can be less dependent on the cash economy and paid employment.

5. Find and celebrate gifts—yours and those of others

Too often, we lose track of our uniqueness because our gifts don’t fit the expectations of schools or work places. Puanani Burgess, a native Hawaiian poet and community builder, learned this lesson when she met a so-called at-risk student who was struggling with school, but he came to value his gifts as a fisherman and the resources they provided for his family.

6. Give the gift of your time

Share meals with your family and friends, like author and mother Cathy Garcia-Prats, who spent years of dinner time feeding her children’s minds and souls, not just their bodies. This holiday, instead of shopping to exhaustion, give repurposed gifts or gifts of service. Instead of multitasking, give your coworkers or acquaintances your full attention.

7. Choose gratitude

We can rehash over and over every slight or perceived insult, allowing the sense of being wronged to dominate our experience. Or we can choose to turn our attention instead to what we appreciate. Some people keep a gratitude journal, noting things each day that bring beauty or pleasure. Research shows that these journals increase happiness. Take Pavithra Mehta, who with her friends started a restaurant where meals are free—paid for by the voluntary donation of other customers. Once you’ve eaten, you can choose whether to make a contribution to cover someone else’s meal.

Sustainable happiness is enhanced when everyone is doing well.

The good news for our world is that sustainable happiness doesn’t mean we have to use up and wear out the planet in a mad rush to produce more stuff. We don’t need people working in sweatshop conditions to produce cheap products that feed an endless appetite for possessions.

Instead, sustainable happiness is enhanced when everyone is doing well. It comes about in thriving communities free of the poverty and powerlessness associated with highly unequal societies. And it flourishes when we live in a healthy, natural world, where other animals, birds, and fish also thrive.

The work of rebuilding thriving communities can be difficult and contentious. But this is the way to authentic and sustainable happiness. When our families, our neighbors, those we meet on the street, and the creatures of the natural world are doing well, their happiness contributes to our own. Trust and well-being become a generative cycle. Sustainable happiness in one realm fosters well-being in all the other realms of life. Interconnectedness—love, even—is unleashed.

Interested in tiny house living? Before you ditch your possessions and make the move, you can give the lifestyle a spin by renting a tiny house on . Here are 20 of our favorites.

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Located on the Santarella Estate in the Tyringham Valley, this former sculpting studio is surrounded by gardens, a pond, brooks and streams, a walking path and “storybook architecture.” Want to do more exploring? Check out the nearby Appalachian Trail.

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Go really old school with this lovely garden house on a renovated medieval farm in upper Normandy.

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Handbuilt by the host Brittany, this tiny home is nestled away in a lovely rural setting overlooking the Puget Sound, but is still just minutes away from downtown Olympia so you can take in some local culture as well.

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This peaceful treehouse has cozy accommodations, stunning views, and the aroma of surrounding herb and flower gardens to boot. Described as a “suspended nest” it’s a wine lover’s paradise, surrounded by top-quality wine producers and imbued with enological history.

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Built for a Romany by a Romany and taken to the Appleby Horse Fair, this little wagon is the real deal. I’m thinking that sleeping in this beauty would lend itself to some pretty amazing dreams and the sense that you’ve just time-traveled to another dimension.

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Calling all wordsmiths: How does hiding away in a writer’s cabin in Stockholm sound? Pretty nice, eh?

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This warm, simply-beautiful wooden cabin is just a short walk from town and a perfect way to get off of the tourist path.

8.��

Located on Maui’s north shore, this little cabin comes complete with everything you’ll need for an island vacation, including surfboards, boogie boards, beach chairs, ocean views and fruit trees.

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In addition to being gorgeous and hip and fun, this tiny apartment is located inside a former city gate, one of the most important monuments in Porta Romana, with origins that trace back to the Roman walls of the city.

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Feeling rustic? Don’t mind roughing it a bit? Check out this hand-built, A-frame cabin in the heart of Six Rivers National Forest. Oh yeah, and there’s an outdoor kitchen, organic garden, wood-fired sauna and custom bodywork sessions available.

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Why not take in the Big Easy tiny house style? This little cottage, which has been described as a dollhouse, is close to cultural hotspot Magazine Street and has convenient access to public transportation so you can move about the city with ease.

12.��

The reviews do all the talking for this tiny house which features gardens, a meditation room and more: ���� you want to refill yourself, this is a perfect place for you!”, “…a true piece of heaven on earth!” and so on. And all for $21 per night.

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It’s rustic, it’s modern, it has stairs and a sleeping loft, it was built by its hosts, and it was featured on the TV show Tiny House Nation. According to previous guests, it’s a great way to have a rustic little getaway, in the middle of a hip, happening city.

14.��

A barn that’s been lightly converted into sleeping quarters, this one is not ideal for the winter months, but it’s beautiful, peaceful, and comes with wi-fi.

15.��

Who doesn’t want to stay in a Roma-style, handcrafted wagon? It is absolutely adorable, full of made-with-love details, and a provides great story material to take back home.

16.��

Part of a yoga and meditation homestay facility, this treehouse is a way to really get away from it all. As one guest writes, it offers “falling asleep to the raucous sounds of crickets, tree frogs, and waking up to birdsong and the smell of trees.” And, it’s only a 10 minute drive from the town center.

17.��

Home of the Grand Ol’ Opry, the famous Bluebird Cafe, the Country Music Hall of Fame and lots more, Nashville, known as Music City, USA, simply oozes music. This tiny house bills itself as the city’s tiniest, fully-equipped guest house, with a full kitchen, a full bathroom, running water, heat, air conditioning and wi-fi.

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A treehouse, on a volcano, on Hawaii’s Big Island? Now that sounds like a great getaway. Expect: lava tubes, rainforests, a steep climb to your accommodations, a gorgeous treehouse designed by TV’s Treehouse Masters, lots of hiking, exploring, lots of flowers and birds.

19.��

A stunning structure made from teak wood, this little boat comes complete with views of the harbor, two cats and breakfast! So if being lulled to sleep by the sway of a boat sounds good, and Hong Kong is in your travel plans, this might be just the thing.

20.��

In Granada, Spain, people have been inhabiting caves since ancient times. Now you can see what it feels like to stay in a place where you can feel “the embrace of the earth.” Yes, they’re fully equipped, yes, they are pedestrian-friendly and close to public transit, and yes, the caves even have wi-fi!

But one type of baby carrier has existed well before all others. It’s safe, economical, and beautiful. It comes in all types of designs and many, many sizes. Some are adorned in furs and leathers, others in colorful beads and shells. Some have intricate wood carvings and floral designs, while others are made of simple, natural fabrics such as muslin or cotton. Babies love this baby carrier, and so do moms. It’s practically perfect, but there’s a catch:��It’s extremely difficult to find at any store or even any online shop.

Most cradleboards are made by people within the baby’s family or close circle of friends.

It’s called the cradleboard, and it has been used by indigenous families from hundreds of nations across North America for thousands of years.

Once ubiquitous, they’re still used today, although they are now more of a rarity. The impacts of colonialism and cultural assimilation have taken away the tradition from many families whose grandparents or ancestors wore them. The decline of the cradleboard has mirrored the decline of other Native American customs and, depending on the tribe, region, or family, the tradition has remained about as intact as other traditional practices.

In your city, you might be more likely to see one in a museum than at a park (plenty of museums carry astounding collections of them), but there’s a chance that that will change in the near future. Cradleboards are being created, worn, and passed down once again. Both artistic and utilitarian, they’re nurturing indigenous babies today in increasing numbers. Although no data is available to measure how many cradleboards are in use today, anecdotally, several thousand are in circulation on reservations and in urban areas with high Native American populations.

But even though the practice is being revitalized within Native communities, it doesn’t appear as though cradleboards will be readily available for non-Native people anytime soon. It is impossible to put a price on cradleboards, and because their design elements are so culturally significant and specific to families, an authentic cradleboard is not something that can be mass-produced.

Most cradleboards are made by people within the baby’s family or close circle of friends, and the price is always negotiable and based on what parents and artists can afford; it is not uncommon to hear of a cradleboard-maker donating to a young family who cannot afford one.

Wakeah Jhane, 22, from the Comanche Nation in Oklahoma, is an artist, aspiring midwife, and, quite possibly, one of the youngest cradleboard makers out there. She has been passionate about both art and babies ever since she was a small child.

Jhane was not carried in a cradleboard when she was a baby, but her little sister was. As a child, she observed and admired her family’s heirloom, which had been passed down to her mother from previous generations of women.

“When I was growing up, seeing my little sister in a cradleboard was pure magic to me,” she said, “I would watch over her while she slept in it, analyze its magnificence, and admire how it soothed her while my mother carried her in it.”

Jhane remained fascinated by cradleboards throughout her childhood and teens. She collected books carrying their pictures and researched different styles. They soon began to influence her ledger art paintings.

However, for some reason, it hadn’t occurred to Jhane that she could actually create cradleboards herself. But one day, when she was a teenager, her mom connected Jhane with mentors. She immediately began a five-year process of learning the art. This year, she completed her very first.

“I just don’t think I could ever raise a baby without one, and my daughter felt the same way.”

Like many indigenous women who are committed to revitalizing traditions that have temporarily faded, she dreams of creating one for her own child one day. She is also happy to see that dream come to fruition for her contemporaries, as her tribe just began offering classes for cradleboard-making—and moccasin-making—for others who hope to learn.

“I just want our babies to have access to what our people had back then,” Jhane said.

Ava Marie Paul, a cradleboard maker who now resides in Salt River, Arizona, confirmed that there has been a resurgence in the craft in Native communities all across the country.

“I see a lot more babies now being wrapped up in cradleboards,” Paul said, “I see them at powwows and at gatherings, but I’d like to see hundreds more.”

Paul, 64, began making the boards in 1974, during a decade when the roots of Native cultural revitalization began to take hold and ultimately reshape Indian Country. Paul, like Jhane, was not cradled in a cradleboard. But an elder friend, Cindy Moody, from the Warm Springs Confederated Tribes in Oregon, taught and mentored her. Since then, cradleboards have been a huge part of her family’s lives and have helped her to nurture her four children and 12 grandchildren. She has also made a number of cradleboards for people outside of her family, including several for families who have not been able to afford to pay her.

It isn’t just the beauty of the boards that is bringing women like Paul back to the art—it’s also the practicality and health benefits.

“I just don’t think I could ever raise a baby without one, and my daughter felt the same way,” Paul said. “The cradleboard helps them have a straight back; there’s a donut-shaped pillow inside so the baby has a nice round head; and they just feel so protected and safe snuggled in there—it replaces being in the mother’s womb. That’s why babies love them so much.”

Indeed, while research has yet to be done on cradleboards specifically, have found that babies who are carried more often cry less. Because the tight swaddle of the cradleboard mimics the mother’s carrying (and the mother is often carrying the cradleboard on her lap or back), the benefits of the indigenous cradleboard align with what science is now suggesting: Babies are happier when they’re carried more.

The purpose of the cradleboard has remained the same even as lifestyles have changed.

“Women in the past would hang them on a tree branch or lean against the tree to keep baby safe while mom worked,” Jhane said, “we would also often carry them on our backs, or hang them on our saddles. Often, the babies were eye level, to show that we nurtured and respected them.”

“Today, we carry them in our laps or lean them against our couch. They also keep baby protected and safe for co-sleeping,” Paul said.

While styles vary from tribe to tribe, the general concept is consistent: a decorative cloth or moss bag of rawhide, wool, or other fabrics is attached to a wooden board or woven basket. The materials used depend upon the resources of the region or tribe of the baby.

According to the page, Native children often spent most of their first two years securely wrapped in the board. The board kept babies safe while the mothers worked, and were easily transported so that mothers could keep an eye on their babies, accessing them for feeding or changing. The babies in boards would often be placed next to one another so that they could socialize. The art on the boards often represented kinship and identity, as it still does today, which makes them such a special item for Native families everywhere.

I found this out recently after experiencing a family crisis that sent me into the night, trekking from Indiana to Colorado, my scared children in the back of my car along with only the belongings we could carry. I was somewhere in Iowa when I got the text that changed everything—again. My destination in Colorado—with a relative, another single mom with two girls—was no longer available. My relative was afraid of bringing the drama to her own family. I had to find somewhere else to go.

When driving through the Midwest in the middle of the night, things start looking like a video game. And not the sunny games with smiling mushrooms, princesses, and happy Italian plumbers. No, this is a serious, somber game where you must make it to the end with only one life, with no guides and no power-ups; the resources that do exist are well hidden. There are no game reviews or chat forums to scour for cheat codes or clues on how to reach the end alive. Instead, our hero must blindly stumble through, hoping to slap the right box or utter the right word to unleash a secret-but-essential guide who can point the way toward the final credits. 

Pulled over on the side of some highway in Iowa, I needed information—and fast. I took to the internet, messaged, and called people I thought would be friends in the know. “Try the shelters.” “Have you called your dad?” Most people asked, “Have you tried Googling?” 

I had—and I’d found out that the charities I so often saw promoting their donation campaigns to “round up your total” or “add $1” were just that: donation engines. Those charities send the money raised to other organizations, which have their own processes for distributing the funds. However, a single mother who’s scared, stressed, and homeless isn’t in a position to comb a site to look for application links. I eventually learned that those links do exist, just not where they can be easily found. 

I posted a message on Instagram describing my plight, along with links to my digital-payment profiles. I got help that night from my internet friends, and a best friend from childhood whom I hadn’t seen in forever. I’ll call her Mo. Within minutes, I had a direct message from Mo: “How much do you need to get someplace safe for the night?” That was all she asked. I told her. She asked for my payment information, and, minutes later, I was able to book the kids and myself into a safe space for the night. That was the first hidden bonus level I was able to access for direct support: social media. Next I posted a video describing our struggle to all my social media platforms and YouTube, along with my payment-app information.

That’s how I got the money to not only fund a place for that first night on the road, but also to cover our first month living in a hotel when we got to Colorado. Crowdfunding, including a , was the unexpected bonus I unlocked, and it helped tremendously.

I turned to these resources, desperate for a glimmer of hope, after I realized my family was not willing to support the safety of my kids and me. Months later, the only explanation anyone in my family has provided came via a social media DM: My family thinks I am wrong for leaving a marriage of 24 years. Because no one else will talk to me, I must assume this is true. 

After getting temporary shelter in Colorado, the next major hurdle was getting the kids into school. This endeavor requires certain documents—including the children’s birth certificates. I �徱���’t have them, nor could I order them, due to a federal rule about permanent addresses. I �徱���’t have one of those.

So I met with a resource counselor at my kids’ school. During the meeting, I started to explain where I lived, only to have one of the kids blurt out, “At the hotel!” Apparently, the word “hotel” unlocked another bonus level. The counselor told me about the federal , which guarantees access to education for children whose families are unhoused, migrant workers, or whose shelter is temporary. 

Thanks to the law, my kids were enrolled in class within a week of that meeting with the counselor. If one of my kids hadn’t said the code word “hotel,” we would have been waiting weeks for help in enrolling, and we would have missed the treasure trove the counselor was about to share with us. The same counselor sent me a list of agencies and organizations that became my “cheat codes” for navigating this game. Using the words “McKinney-Vento” unlocked a magic door to what felt like an easier level of playthrough.

The counselor’s resources also included , which I now know is available in all 50 states. Although it may not be advertised, the 211 system is like the 911 system in that all calls and texts are routed to the closest call center. The number in Colorado goes to the United Way in various counties, and, during business hours, it will connect callers with someone who can answer questions and offer contact information for support organizations. Operators are trained to address housing emergencies, suicide prevention, mental health crises, and domestic violence safety, among other topics. 

In my case, 211 helped connect me to , a state-run site where I could sign up for a range of services with one application: housing, medical insurance, child care assistance, public-transportation aid, food, jobs, and more. The Peak caseworker I spoke with also told me about programs that helped with the deposit and first month’s rent payments for families in transition, in addition to cash aid for families without work. It was like she had opened a “loot chest” and was handing me weapons to use in my quest.

It does take time for those programs to kick in—about a month from the time I filed the applications. As such, there was a moment when I did not have the money to pay for our hotel room for another week. I’d been paying weekly to save $110 versus the daily rate, and I needed the money in a few days. Our crowdfunding had dried up. A friend suggested the Black Fairy Godmother. She sounded like an oracle in a game, sent to give advice and set the players back on the right track.

She did just that. I found the —she is also known as Simone Gordon, a philanthropist who dedicates her social media accounts to helping families in need. I found Gordon’s email address, and she guided me to the application on her website. Less than 24 hours later, she had raised $600 by telling my story on social media and gathering donations from her followers. I’ve learned that there are a few other organizations that do similar work, including the , , and . 

At the time of this writing, my kids and I are on the waiting list for several housing spaces, and I have landed a job to help cover the costs of the hotel until permanent housing comes through. The divorce is pending, but the kids and I are safe, fed, and here.

My experience has made me look closely at the many spaces where donations to help the needy have become practically routine. I now want to know where that money goes and how someone can access it when needed. There are too many families in dire need who don’t have a month, a week, or even a day to wait. They are face-to-face with a treacherous foe, and they need those code words, those secret passageways, and access to Black Fairy Godmothers now. I hope this beacon finds them and helps light the way. 

I often reflect on how small things, like my children playing loudly in our backyard, would be impossible in a different time or place. My heart aches knowing I experience a level of freedom and agency the mothers in my lineage couldn’t visualize, let alone exercise. Still, the artifacts of injustice don’t feel distant. I see the afterimage of “whites only” signs every time I blink. I lose my breath calculating how I’d explain such an explicit color line to my children, though today’s covert line is equally overwhelming. And while so many things are better, so much feels the same. 

I found the thread that helped me make sense of this feeling during graduate school. The exact moment I learned of , an English legal doctrine passed in 1662 that loosely translates to “the status of the child follows the mother,” escapes me now. But I remember feeling something shift. I felt like I had learned the answer to a question I hadn’t known to ask. I recognized this revelation as a through line, equally past and present, and sensed I’d encountered the most crucial mothering lesson of my life.

Enslavers created the principle to enshrine the relationship between race and slavery. It solidified enslaved women as capable of giving birth but never truly mothers and created a binary between white and Black wombs: The former held an unborn human; the latter was a queue for chattel. 

I wanted to parent in resistance. But I found mothering in anticipation of harm made me tired.

Partus sequitur ventrem explained why the Black mothering experience felt inseparable from narratives of hypervigilance and trauma. The doctrine captivated and taunted me with reminders of why I wasn’t carefree like the white moms I found community with. But it also offered direction in my mothering: I could fight wholeheartedly to free my children. But if I was unfree, my efforts would be futile. Partus sequitur ventrem revealed that my foremothers and I share the goal of raising free Black children despite contextual differences. 

, a licensed clinical social worker certified in perinatal mental health, says that historical circumstances limited Black mothers’ agency in parenting in every area—from conception to caring for our children. Often, that involved hard choices. Williams says this history can leave Black mothers with a feeling of powerlessness and the pressure of knowing: I have to keep my children safe, especially when I know the systems are not keeping my children safe. 

“And still, today, we have so many different reminders and events that the system is not supporting our care and well-being,” says Williams. “That pressure on us as Black mothers to wonder: If I don’t choose my kids, am I also dismissing them like the system is?”

Black infants and birthing people today face death-rate disparities comparable to . Black families are trying to make ends meet as layoffs disproportionately impact Black employees. We are grateful they’re not the identical stressors our ancestors experienced. But painful headlines like those describing the Texas Child Protective Services removing newborn from her �貹����Գٲ�’ care and 16-year-old being shot after going to the wrong house reveal that family separation and the dehumanization of Black youth hasn’t ended. “A lot of us are carrying things that our ancestors and grandmothers �徱���’t get to resolve,” says Williams.

It hurts to read the heritability of nonfreedom. Enslavement has ended, but this doesn’t feel like freedom. Generations of Black women have tried to pass an inheritance we never held. I wanted to parent in resistance. But I found mothering in anticipation of harm made me tired. It impacted my relationship with myself and my children; I was anxious, irritable, and often depressed. 

, a licensed clinical psychologist, says putting your mothering identity first is natural. But the pressure to be a “good mother” can lead to negative emotions, including exhaustion and social isolation. Similarly, parents can experience guilt and shame when they don’t meet their own parenting goals and expectations: “This can lead to depression, anxiety, or even obsessive-compulsive tendencies, because even though we know perfection does not exist, we continue to hold ourselves to impossibly high standards and judge ourselves harshly when we are unable to meet them.”

I know I’m the best mother when I start from the inside out.��

I found this especially true for marginalized parents. I felt guilty that I wasn’t more grateful to mother with new stressors instead of those my grandmother had. Shame told me it was my job to give my children the world because I had unprecedented access. I went through the motions of gentle parenting—and the guilt, rage, and shame when I “failed.” I grew resentful that I wasn’t giving my children the soft landing they deserved. But with reflection, I realized that gentle parenting wasn’t the problem: I had to start with myself. I needed something that met me where I was. So I built it.

I created a framework called #FreeBlackMotherhood to actively challenge the lineage of partus sequitur ventrem. But I realized perspectives on motherhood disparage all caretakers, albeit to varying degrees. “” is the expectation that mothers sacrifice themselves at the altar of motherhood and be judged by their capacity to mother based on race, class, and other parts of identity. This version of mothering weaponizes old harm in new ways. Like the dehumanizing English law of partus sequitur ventrem, intensive mothering reinforces a binary of valid and invalid mothers based on standardized expectations, when, in reality, mothering is subjective.

Williams notes a myriad of personal and familial factors—including whether a parenting journey was planned—impact how we show up as caretakers. She says we need “individualized mothering plans” in the same way we have individualized education plans for our children. Intensive mothering affirms motherhood, especially Black motherhood, as a site of suffering. It creates a racist, heteronormative, class-based definition of mothering where mothers carry a disproportionate share of the burden. The model also upholds individualized solutions to systemic issues and emphasizes responsibility over joy.  

Black motherhood is often seen as a , leaving little room for freedom, authenticity, and joy. Once I abandoned binaries, I realized my views �徱���’t conflict with gentle parenting: They conflict with standardized mothering that is rooted in white supremacy and patriarchy. But I know I’m the best mother when I start from the inside out. 

Montfort affirms that child-centric models, like gentle parenting, are a wonderful way to build secure attachments with our children. But they can’t be done at the cost of supporting the self. Placing my needs at the center reminded me it’s OK to pause and have days I don’t feel like mothering. Montfort says scheduling time alone, communicating with your child-rearing support team, and having a therapist can help during rough times.

Like Williams, Montfort supports abandoning a standardized image of mothering. She encourages caretakers to define—or redefine—their values for themselves instead of basing them on prescribed models. This starts by asking who you want to be and what qualities you want to embody as a parent and taking small steps to get there. 

My journey is still unfolding. But I’m grateful I’ve created a personal mothering practice that resonates with caretakers of diverse identities. 

My framework helps me break the binary that racism and intensive mothering created and helps me hold my love for myself and my children simultaneously. It encourages me to abandon the weight of mothering perfectly to reduce systemic harm. But it also reminds all of us that we deserve motherhood rooted in shared responsibility and joy.

The best way to transmit freedom to my children is to hold it myself.  

let the city be a place
we care for as we traverse it
let the country remember wildness
remember how to breathe amongst
the living

let the concept of billion die
bury it in gold and linen
next to scarcity, under greed
only a shared world can rest

love, melt on our tongues
memory, flood our palms of grief
this year has stripped us bare
how can a year feel so brief

we have done enough
let it be, this is our best
you have done so much 
you need rest, deep rest

As a girl who grew up in Iran during the rise of the Islamist regime, I witnessed firsthand the impact of the morality police on our daily lives. This included censorship of the arts and free speech, restrictions on basic rights for women and minorities, and rules against socializing between men and women, among many other harsh decrees. 

Enforcement of both explicit and implied rules affected everyone I knew, causing us to suffer in numerous ways. Armed guards raided . One family friend was lashed publicly. Another had a miscarriage from the shock of witnessing a public hanging on a street near her house. My teenage friend was executed unceremoniously and without a public trial, and her parents were never told which specific law she broke.

But recently I’ve observed that “morality police” are not limited to Iran’s paramilitary enforcers. They’re a global force, and they’re spreading. In 2019, with their street-level thugs enforcing restrictive laws outnumbered democracies around the world. Even in the United States, in a disturbing trend that reminds me of my childhood in Iran, the morality police are busy at work on both sides of the aisle. 

On the right, in the aftermath of the overturning of Roe v. Wade, have banned abortion, compromising reproductive care for nearly 50% of their residents. Book banning is now practiced in at least 32 states and nearly , affecting marginalized communities. Around the country, nearly have been proposed to target LGBTQ individuals. 

On the left, the echo chamber of moral judgment and results in the loss of livelihood and status, while its insidious effects reach far beyond the harm to an individual. Canceling has the propensity to fuel oppression and vitriol similar to what it’s trying to address, while wreaking havoc on the of the canceler, the canceled, and the onlooker. 

The morality police are loose in the free world, but they’re also lurking in our heads, silencing us from within.

In the U.S., we don’t fear imprisonment, torture, and execution in response to our social missteps online, but because the repercussions of canceling are severe enough, they result in self-censoring, something in which I’m exceedingly well-versed. In the Islamic Republic we learned to be secret-keepers, as it wasn’t unusual that a child would innocently recount the previous night’s dinner conversation at school and her parents would soon end up as political prisoners. 

Here, freedom of expression is our constitutional right, but many U.S. residents are about what they can say and where they can say it, and they have become hesitant to have certain kinds of conversations, fearing the consequences. The morality police are loose in the free world, but they’re also lurking in our heads, silencing us from within.

Marriage and family therapist and trauma expert Mahshid Fashandi Hager, who herself lived in Iran as a child, says whether we’re dealing with the actual morality police or an internalized version, “it instills fear, and we have no choice [but] to respond to that fear by self-protection.” People who’ve experienced or even witnessed aggressive disagreement and the threat of cancellation on social media are less likely to express themselves because of their need for self-preservation. 

“The other piece is that innate need for belonging,” says Hager. “When our belonging to any group gets threatened, we shrink away.” As a result, the nuanced conversations that might make us feel a sense of belonging, and also allow us to be more vulnerable in the larger community, stop happening or get relegated to more private interactions. The loudest, most polarized, and extreme voices end up controlling the public discourse, while the rest of us are self-censoring.

This self-censorship is increasingly showing up in traditional media, where journalists hold back on covering certain issues. Violent crimes against journalists are worldwide, and domestically, journalists fear both their employers and the online mob—a fear that was recently reinforced by the example of Ben Montgomery, a Pulitzer Prize–nominated journalist for Axios, who was recently after not self-censoring, and calling a news release about an event by Florida Gov. Ron DeSantis “propaganda.” A recent Washington State University showed that online mobs deliberately use popular platforms to silence journalists. These online attacks seem to be disproportionately focused on women, people of color, and members of the LGBTQ community, leading them to quit the profession, which in turn further silences their voices.

We can even find instances of morality policing in spiritual communities. For example, pervasive , or the attitude and belief that one should always maintain a positive outlook, uses “good vibes” as a policing strategy. Some groups or individuals enforce strict codes of behavior and the suppression of certain emotions or expressions of vulnerability. It’s as if there are bouncers standing at the door of the psyche who only allow in the most attractive and best-dressed emotions. Rather than being able to share their authentic feelings and receive support, people facing toxic positivity have to either isolate themselves from a harmful situation or engage in self-censorship. When policing is turned inward and the inner critic is weaponized, it leads to the suppression of important emotions such as sadness, anger, and frustration, and this takes a massive toll on the individual’s well-being. 

Self-policing is always a response to a threat. “Whether it’s getting imprisoned and tortured or it’s getting canceled, or [it’s being] in this spiritual bypass all the time, the threat response in our biology is induced,” says Hager. Whether it’s a physical threat or a psychological one, the body doesn’t know the difference.

The antidote to this self-imposed police state and the rise of extremism is for us to feel safe enough in our bodies and in public forums to be able to engage in nuanced and often difficult conversations without the fear of backlash. In other words, Hager says, we need what she calls a “solid container”: a mechanism or program to help develop and maintain healthy connections with one another.

The book highlights the success of Denmark, Norway, and Sweden in transitioning from poor authoritarian societies to rich democracies in just a few generations. Much of this success can be attributed to visionary Nordic politicians and activists who provided a solid container for social development: They enabled a large part of the population to become active co-creators of democracy. They established state-funded yet autonomous retreat centers that allowed young adults to become self-authoring, develop healthy relationships with themselves and others, and resist the siren call of extremism in any form. 

“We’re missing the solid container in terms of our own self-regulation, and we’re missing it in the culture,” Hager says. 

How can we engage in important conversations when we’re afraid of getting canceled or when we’re easily triggered because of personal trauma and the intensity of our culture? And even if collectively we do create such a container, how do we safeguard against bad actors who are determined to spew hate and spread harmful messages?

Addressing this conundrum requires us to confront a glaring fundamental challenge: As a society, we haven’t prioritized cultivating healthy relationships with ourselves, others, and our environment. Math, something many of us don’t use daily, is taught every year in schools, but it’s unusual to find a single course dedicated to relationships in K-12 or beyond, even though research shows that gaining such skills is to a good life. And while the reigns among people of all ages, we have no blueprint or map for how to proceed in developing healthy relationships. We don’t spend enough quality time with our , and we haven’t been taught to practice having . 

Few adults, let alone children, are taught or are aware of the physical manifestations of stress on their bodies, or what to do when they’re and unable to modulate their emotional, behavioral, or physiological responses. And while Iranians are risking their lives to dance in public, for many of us in freer societies, our inner morality police prevent us from exercising this right. This resistance to the remedy seems to be a response to trauma too. 

“It’s hard to say I’m not dancing because I’m traumatized,” says Hager. “It’s easier to say I’m not dancing because it’s just not appropriate right now.” This excuse is a protective measure our inner morality police conjure to keep us disconnected from our bodies. So, we shrink and silence ourselves rather than engage in healthy and safe activities that help us reestablish a relationship with our bodies.

As a species, we’ve prioritized relationships for millennia, but we’ve never had to contend with so many powerful opposing forces. Traditional and social media, and the pharmaceutical, cosmetics, and diet industries, all profit from our disconnection from our bodies, our environment, and each other, while our government rarely puts the well-being of individuals ahead of corporate profits. Plus, the busyness of life in a capitalistic world without a social safety net doesn’t leave much room to cultivate relationships.

In the absence of safe societal and cultural containers, we have no choice but to educate ourselves and our children, and practice establishing a relationship with our . It’s up to us to learn how to have healthy relationships, prioritize nurturing our current healthy connections, become intentional about finding new friends, and restore our relationship with the earth. Some of us will be nourished by meaningful conversations with , supporting the independent press, facilitating book clubs or discussion groups, or participating in local grassroots organizations. We don’t have to do it all. But any daily practice to mend our relationships is a step in the right direction. It’s the only way we can soothe and integrate the inner morality police, and help each other do the same.

As an organizer and mental health practitioner, I naturally wonder about sustainability within our movements, given our human limitations. What are the potential practices, or reminders, that keep good trouble going? I use “good trouble” here as a term conceptualized by John Lewis, who, working alongside Dr. Martin Luther King Jr., established a legacy of public defiance.

How can we cultivate good care for good trouble?

While there are existing prompts and tips on how to practice community care in a myriad of places and platforms, the following will be specific to organizers, unionizers, and the everyday people who resist alongside them. My hope is that these practical invitations for good care will help sustain those of us in the struggle, fighting the good fight.

Bring Good Humor and Play 

We do not talk enough about the power of laughter and mischief in the revolution. To bring jokes and good humor into organizing spaces does not necessarily mean dismissing the seriousness of our work. Instead, we work from the understanding that, as humans, it is natural to feel fear in these spaces. Humor and play have the power to de-escalate that fear, which can embolden us to take higher risks, make more creative decisions, and deepen our trust in our team players and fellow organizers.

Revolution consultant Srđa Popović advocates for the power of jokes in the revolution. In his Ted Talk, “,” he explains the reasons why humor is an important weapon in serious, large-scale resistances (even to the extent of toppling dictators): “Humor melts fear. … Fear is the air dictators breathe. They cannot survive without fear. … Nothing breaks fear faster than a joke.”

When it comes to assessing the injustices perpetuated by political leaders and regimes, there are times when to appropriately expose the absurdity of corrupt governance. A perfect example is , a web series created by anonymous creators in Syria and beyond, practicing “” to address the Syrian government’s inhumane violence against civilians. Not only is the web series an act of creative defiance that undermines state power, but it also has become a beacon that preserves and lifts the Syrian people’s spirit in the face of unimaginable suffering.

On a smaller scale, incorporating play and laughter in our movements might mean scheduling a night or weekend of bowling or video games, or going to a comedy show with fellow organizers. These occasional gatherings of play can strengthen bonds and access the joy and rest we need as human beings.

Revisit Revolution Stories

Strikes, protests, and other forms of resistance take time, determination, and the ongoing fortification of one’s hope. As much as there is an appeal to public demonstrations, especially since the 2020 uprisings, the efforts and responsibilities behind the curtain involve endless spreadsheets and phone calls, late-night strategy meetings, the completion of tedious tasks, and days of discouragement from what feels like a lack of progress. When the going gets tough or when the collective energy dampens, we can increase our vitality by revisiting stories of revolution—from the past, present, or those imagined.

Stories of past revolutions help us learn or rediscover ideas and tactics that once worked—which offer a reliable foundation to build from—and revitalize our motivation or sense of purpose. Remembering these stories is also a way of listening to the elders of our political lineage. Resistances are built on these stories.

One night, I sat down with friends and climate activists and . We talked about the revolution stories that keep us going amid incessant systemic oppression. Mallari, a youth climate and human rights activist with , shared that her favorite revolution story was that of , a grandmother and leader of the Coal-Free Bataan Movement. This fierce elder led this grassroots organization against the expansion of coal plants that caused harm to her people and their environment. She was later killed for pioneering such efforts. Mallari believes that the anger and grief from this atrocious loss and injustice fueled the community’s drive to persist in the struggle for environmental change.

Veloso, a climate justice writer and founder of the youth organization , transcends the stories of our time and place as she seeks utopian hope in the world of fiction. Although the Avatar: The Last Airbender series is categorized as a kids’ show, Maria finds deep truths in it. She recounts that the narrative portrays a multitude of heroes: The protagonists need the help and skills of the people they encounter on their journey to fight the Fire Nation, the metaphorized representation of the oppressor in the series.

We can expand beyond our reality, finding inspiration in the stories of imagined worlds, such as the incomparable Octavia Butler’s , or more modernized stories such as the subliminally anarchist .

We can also seek stories and processes of other justice-oriented communities within and beyond our local vicinity. Creating synergy among these communities can strengthen our movements by increasing our access to allies, resources, and tactical knowledge, or drawing our attention to important details that we might have overlooked.

We are not alone in the struggle. There is something about this awareness that brings comfort to our nervous systems—knowing we have the collective power to reach the change we want, and we can do so in a broader ecosystem of solidarity.

Reclaim the Commons

as “the source of sustenance for most people,” who use their own resources and skills to sustain themselves and their neighbors. An example would be the emergence of mutual-aid networks since the pandemic. ������Ƶ than the organizers and activists, everyday people participated in these networks by collecting food, drinking water, clothing, toiletries, and other basic necessities to provide for families, students, and especially the poor and houseless during the COVID-19 crisis. 

When I was in labor union movements, I learned that workers frequently hesitate to join strikes because participation feels like a threat to their livelihood. Even though they have the right to unionize, they do not want to jeopardize their jobs and inevitably the well-being of their families and loved ones. When this fear gets in the way, reclaiming the commons can build the sense of security needed for our movements.

The concept of time banking can be applied here. Time banking is “a system that lets people swap time and skill instead of money,” according to lawyer and educator Edgar Cahn. In his work, Cahn refers to the rise of unemployment and the need to expand our ideas on how to use our skills and talents. With time banking, we establish a reciprocity of providing to and accessing skills and resources from our neighbors, such as child- and eldercare, community gardening, carpools. This is a system that strengthens our alliances and our reliance on each other to meet basic needs—and lessens our dependence on monetary resources, and, ultimately, the state. Cahn notes:

“Over the years, I’ve watched time banking go through phases—but it has always been about empowerment. The first phase was about neighbor-to-neighbor skill sharing. Too often, we live close together, but as strangers. We don’t know what our neighbors can do; we don’t know whom we can trust. Time banking provides the vehicle to discover the vast wealth of capacity that surrounds us—and it makes trust possible because every action creates a track record known to others.”

������Ƶover, basic needs include emotional and relational needs as well. In , Marina Sitrin tells the story of teachers in Mendoza, Argentina, who organized to provide support and care for their neighbors, above and beyond traditional ideas of basic needs that merely involve food, water, shelter, etc. The teachers organized with artists who provided songs, lullabies, and art to families, which the collective considered “the other fundamental aspect of sustenance.” They knew the necessity of feeding the soul as well as the body.

There is no perfect or standardized way to access care. But we do what we can to access it as sustainably as possible. Just as the honorable says on the power of storytelling, myths, and songs, “It’s not possible to constantly hold onto crisis. You have to have the love, and you have to have the magic. That’s also life.”

It is possible and necessary that care intersects with our organizing efforts and social change movements. How can you be an accomplice of defiant fun? What stories of liberation can you hold onto to fortify your hope in mobilizing and organizing? What passions, talents, skill sets, and knowledge can you offer to reclaim the commons in your community?

Good trouble calls for good, thoughtful care.

The mask was a defense mechanism. What I was defending was myself. My life. 

I survived verbal and physical abuse throughout my childhood and much of my early adulthood. But now, as part of my journey to heal those wounds, I am working to prevent domestic violence and child abuse because I don’t want anyone to have to go through what I did. 

Domestic violence, also known as intimate partner violence, comes in many forms. When you experience this type of trauma, it can create mental health challenges that can define your future if you let it.

It took me more than half my life to figure this out, and I am still learning. I tried to cope by becoming a peacemaker, a people-pleaser who was always trying to avoid conflict. I did not know how to set and enforce boundaries. I kept a smile and masked my pain with sarcasm, deflecting from the truth while minimizing the number of people I associated with who might see my pain. I now realize that this was part of a defense mechanism I used to prevent myself from being hurt again. 

Verbal abuse can create emotional fractures that break one’s spirit and self-esteem, just as physical abuse can. For me, it seemed as though a dark cloud hovered over me, overshadowing my life, refusing to let the sunshine force its way through. I was never taught how to let the sunshine in. I often felt that my life had no value because of the deeply rooted trauma I experienced. 

At the age of 2, family members were told I had six months to live, as I had a childhood cancer called retinoblastoma. Treatment required my right eye to be surgically removed in a procedure called eye enucleation.

To this day, when people feel threatened or lack a sense of security around me, they often attack me and make unpleasant comments about my eyes. I learned early—starting in kindergarten—how to endure such verbal attacks, despite how badly they hurt. Throughout school, students and teachers often made me feel less than because of my disability, including my sixth-grade teacher, who demanded I take out my prosthetic eye in front of the class to show them.

My childhood was lonely, and coming from a��marginalized community outside of Los Angeles that was overpoliced, under-resourced, and subjected to systemic racism, I lacked the tools to understand healthy relationships.��I experienced multiple sexual assaults—the first time when I was only 6. When I was 8, I witnessed my neighbor’s grandfather murder his wife in front of their house after a disagreement.��

As I grew older, I continued to experience domestic violence in relationships. Eventually, I managed to escape��those abusive relationships, and��I believed��I was protecting my children in doing so.��But in 2011, I lost my eldest��son��to domestic violence.��He was 22 and left behind two young children. The tragedy is that because he experienced domestic violence during his childhood, he may not have known how to protect himself from more violence as a young adult.��

I began writing my first book in 2008, feeling like I was ready to share my story. But after the loss of my son, I had a lot more to say. I began to write as part of my therapy and healing process, becoming a . I continue to write today. 

I also��started��a nonprofit organization in honor of my son, , which��raises��awareness of how��boys and men��are also victims of domestic violence.��I work with��survivors��and with those who have caused harm—so that they, too, can unlearn the cycles��of abuse.��Those in abusive relationships often suffer from , but they may not understand why.

As I continue to educate myself and encourage others to develop healthy relationships, I’m incorporating trauma-informed practices into my work. Ultimately, abuse is a mental health issue, because hurt people hurt people. If we can get to the root of the pain and hurt, we can often begin to heal. I am working on letting my healing begin by sharing my story, in the hopes it can help others too.

If you or someone you know is experiencing domestic violence, contact the  at 1-800-799-7233 for support and referrals, or text “START” to 88788.

This column was produced in partnership with the .

Editor’s note: This is the first installment of the next iteration of Murmurations, the monthly column originated by adrienne maree brown for YES! in 2021. As adrienne wrote in their final reflection late last year, they are eager to grow the chorus of voices amplified in this space, and have invited a number of emergent strategists to share in authoring this column. Each month, Murmurations will be authored by a different emergent strategist, hand-picked by brown, and edited by YES! staff. Readers can expect the same depth, nuance, and empathy they’ve come to expect from Murmurations, with an even greater breadth of experience, perspective, and wisdom to share. Fittingly, the first installment of this new iteration comes from Leah Penniman, the farmer, author, and food justice activist whose voice will be familiar to longtime YES! readers. brown describes Penniman as “an inspirational farmer-writer who is always thinking about how to bring us into closer relationship with the land that holds us, and the people we build the future with.” Here, Penniman offers timely lessons gleaned from her latest book, Black Earth Wisdom: Soulful Conversations with Black Environmentalists, that will help us all embrace what she calls “collective thrival”—which is as essential in this moment of climate crisis as it ever has been.

While I was studying traditional farming and ecospirituality in Ghana with the Queen Mothers of Kroboland, they offered a teaching which has been seared into my soul ever since. Manye Nartike asked: “Is it true that in the United States, a farmer will put the seed into the ground and not pour any libations, offer any prayers, sing, or dance, and expect that seed to grow?” Met with my ashamed silence, she continued, “That is why you are all sick! Because you see the earth as a thing and not as KIN!”&�Բ�����;

Indeed, this uniquely Western (and white) non-kin thinking is what leads to both racialized oppression and earth ravaging. It is the severing of family and the relegating of others to “nonperson” status that make possible the enactment of violence and oppression on “the other.” Embedded in the theory of white supremacy is the theory of human supremacy over nature. 

The dangerous philosophies and practices of colonial conquest, subjugation, extraction, and commodification mutually reinforce each other, and simultaneously exploit racialized people and the Earth. Any hope of solving the environmental crisis will require an examination and uprooting of the white supremacist ideologies that underpin the crisis. 

In this moment, we are acutely aware of the fractures in our system of runaway consumption and corporate insatiability. The path forward demands that we take our rightful places as the younger siblings in creation, deferring to the oceans, forests, and mountains as our teachers. The voices and expertise of Black, Brown, and Indigenous environmentalists must be heeded if we are to halt and reverse planetary calamity. 

Ecological humility is part of the cultural heritage of Black people. While our 400-plus-year immersion in racial capitalism has attempted to diminish our connection to the sacred earth, there are those who understand the intrinsic value of nature, and who still know that the land and the waters are family members. Humanity’s collective thrival depends upon remembering the covenants of moderation and cooperation that we have with all beings on this one tiny life raft called Earth. 

Contrary to mainstream mythology, the movement to listen to and defend the earth did not begin with Rachel Carson, Henry David Thoreau, John Muir, or any other thinkers of European heritage. From the who turned the desert green, to the who cured white and Black folks alike, to the , to , ecological thought and practice have run deep and wide in Black communities. The people whose skin is the color of earth have long advocated for the well-being of our beloved Mother.

It is in this tradition—and with respect for this history—that , a project of Soul Fire Farm, weaves together the voices of 40 of today’s most respected Black American environmentalists, who have cultivated the skill of listening to the lessons that Earth whispers to them. Contributors include Alice Walker, Dr. Ayana Elizabeth Johnson, Steve Curwood, Rue Mapp, and Queen Quet, among others. 

As the days in the northern hemisphere get longer, and we find ourselves called outside to once again engage with the earth, I invite you to consider these three central lessons that emerged from conversations with the brilliant Black environmentalists I had the privilege to work alongside in capturing our Black earth wisdom.

Earth as Text

If I were to tell you I had lived in the same neighborhood my whole life and �徱���’t learn the names of the people next door, you might pass some judgments on my character. And yet, here we are in a neighborhood of trees, insects, and amphibians that many of us cannot call by name. 

One of the great challenges of our time is that humanity is increasingly illiterate in the languages of the earth. Audrey Peterman, Jamaican elder and lover of wild spaces, put this well when she explained that there was once a time when most people could read the night sky. We could tell directionality, seasons, weather, story, and calendar by looking to the stars and clouds. The sky was our primary source, our central guide. Society has come to rely on secondary and tertiary sources, farther and farther away from the sky, in order to get our information, playing a dangerous and distorted game of telephone yielding scrambled messages. The languages of the earth are many: The planet speaks through ice cores, the pH of the ocean, birdsong, gravity, tree rings, animal tracks, and silence.

Our directive is to relearn the languages that Earth uses to communicate with us. 

Earth as Teacher

What if we learned to love and emulate our elder siblings—the hawks, black bears, and wolves—in a practice of sacred biomimicry? The earth is cooperative, generous, queer, and accepting—all characteristics worthy of emulation. 

Nature centers cooperation over competition more often than we are taught to believe. For example, mutualistic interactions are vital for terrestrial to function, as over with to provide them with trace elements. Creatures help each other out, too. Ground squirrels, velvet monkeys, and prairie dogs cry out to warn their peers of predators, even though drawing attention to themselves increases their chances of becoming prey. Ants and bees give their lives to protect their colonies. In fact, mutualism is so pervasive that scientists are now suggesting the very concept of the individual organism needs rethinking. Multicellular organisms and their symbiotic microbes may be regarded as cohesive units acted on by natural selection.

Nature does not discriminate. The flowers bloom and the birds sing for all, regardless of race or class. Nature also celebrates queerness. At least 90% of flowering plants have “perfect flowers” that contain both male and female reproductive organs. Same-sex intimacy, including courtship, pair-bonding, affectionate touch, intercourse, and parental activities, have been , including black swans, Amazon river dolphins, American bison, elephants, giraffes, marmots, lions, spotted hyenas, and dragonflies.

Earth as Kin

Western thought teaches us that our human dignity is rooted in our difference from other earthly beings, suggesting that we are better than and distinct from animals and plants. 

Professor Joshua Bennett sees it differently. “The animals are my kin, my truest kin, since we all belong to the earth,” he writes. “The lie of whiteness is that we can separate ourselves from the earth. In considering animals as co-laborers, friends, and partners in the field, Black people resisted a social order predicated on confinement, and opened to a more radical sociality grounded in the desire for a world without cages or chains. It follows that prison and police abolition has environmentalist roots, viewing human life as part of all life on earth.” 

All life on earth shares a narrow band of habitability that extends from the deepest root systems of trees and the dark environment of ocean trenches up to the highest mountaintops. This layer, called the biosphere, is only about 12 miles from top to bottom, comprising only 0.3% of the planet’s radius. We share this tiny life raft with all earthly beings. 

To survive together, we must rehydrate the memory that all beings—the mountains, birds, lakes, and amphibians—are “people” too. The Afro-Indigenous religions Yoruba and Vodun both deify nature and prohibit wasteful extraction. No amount of capitalist logic that attempts to quantify ecosystem services or scheme carbon-credit swaps can substitute for the necessary worldview shift toward kinship. If our species is to survive, we have roughly one generation to collectively remember and honor the familial covenant of moderation and cooperation that we signed with all beings at the dawn of time. 

The good news is that Earth is still welcoming us home. As Alice Walker said, “All people deserve to worship a God who also worships them. A God that made them, and likes them. That is why Nature, Mother Earth, is such a good choice.”

Indeed, that was the point. The University of Virginia Medical Center in nearby Charlottesville had a clinic specifically for women like Rhoda. In fact, doctors there had been prescribing hormones and performing surgeries—what today we would call gender-affirming care—for years.

The founder of that clinic, , had cut his teeth caring for transgender people at Johns Hopkins University in the 1960s. There, he was part of a team that established the nation’s first university-based Gender Identity Clinic in 1966.

When politicians today refer to gender-affirming care as new, “,” or “,” they ignore the long history of transgender medicine in the United States.

It’s been nearly 60 years since the first transgender medical clinic , and 47 years since Rhoda started her hormone therapy. Understanding the history of these treatments in the U.S. can be a helpful guide for citizens and legislators in a year when  in statehouses target the rights of transgender people.

Treating Gender in Every Population

As a trans woman and a , I have spent much of the past decade . I also take several pills each morning to maintain the proper hormonal balance in my body: spironolactone to suppress testosterone and estradiol to increase estrogen.

When I began HRT, or hormone replacement therapy, like many Americans, I wasn’t aware that this treatment had been around for generations. What I was even more surprised to learn was that HRT is often prescribed to cisgender women—women who were assigned female at birth and raised their whole lives as women. In fact, many providers in my region already had a long record of prescribing hormones to cis women, primarily women experiencing menopause.

I also learned that gender-affirming hormone therapies have been prescribed to cisgender youths for generations—despite what contemporary politicians may think. Disability scholar Eli Clare has written of the history and continued practice of  to boys who are too short and girls who are too tall for what is considered a “normal” range for their gender. Because of binary gender norms that celebrate height in men and smallness in women, doctors, parents, and ethicists have approved the use of hormonal therapies to make children conform to these gender stereotypes .

Clare describes a severely disabled young woman whose parents—with the approval of doctors and ethicists from their local children’s hospital—administered puberty blockers so that she would never grow into an adult. They deemed her mentally incapable of becoming a “real” woman.

The history of these treatments demonstrates that hormone therapies and puberty blockers have been used on cisgender children in this country—for better or for worse—with the goal of regulating the passage from girlhood to womanhood and from boyhood to manhood. Gender stereotypes concerning the presence or absence of secondary sex characteristics—too tall, too short, too much body hair—have all led parents and doctors to perform gender-affirming care on cisgender children.

For over half a century, legal and medical authorities in the U.S. have also approved and administered surgeries and hormone therapies to force the bodies of intersex children to conform to binary gender stereotypes. I myself had genital surgery in infancy to bring my anatomy into alignment with expectations for what a “male” body should look like. In most cases, intersex surgeries are  for the  of a child.

Historians such as Jules Gill-Peterson have shown that  in this country are deeply interwoven with the . Doctors at Johns Hopkins and the University of Virginia practiced reconstructing the genitalia of intersex people before applying those same treatments on transgender patients.

Given these intertwined histories, I contend that the current political focus on prohibiting gender-affirming care for transgender people is evidence that opposition to these treatments is not about the safety of any specific medications or procedures, but rather their use specifically by transgender people.

How Transgender People Access Care

Many transgender people in the U.S. have deeply complicated feelings about gender-affirming care. This complexity is a result of over half a century of transgender medicine and patient experiences in the U.S.

In Rhoda’s time, medical gatekeeping meant she had to live “full time” as a woman and prove her suitability for gender-affirming care to a team of primarily white, cis male doctors before they would give her treatment. She had to mimic language about being “”—language invented by cis doctors studying trans people, not by trans people themselves. She  she would be heterosexual and seek marriage and monogamy with a man. She could not be a lesbian or bisexual or promiscuous.

Many trans people still need to jump through similar hoops today to receive gender-affirming care. For example, a diagnosis of “,” a designated mental disorder, is sometimes required before treatment. Many trans people argue that these preconditions for access to care should be removed because being trans is an identity and a lived experience, not a disorder.

Feminist activists in the 1970s also critiqued the role of medical authority in gender-affirming care. Writer Janice Raymond decried “,” her term for the physicians, psychologists, and other professionals who practice transgender medicine. Raymond argued that cis male doctors were making an army of trans women to satisfy the male gaze: promoting iterations of womanhood that reinforced sexist gender stereotypes, ultimately ushering in the displacement and eradication of the world’s “biological” women. The origins of today’s gender-critical, or , movement are visible in Raymond’s words. But as trans scholar Sandy Stone wrote in her , it’s not that trans women are unwilling dupes of cis male medical authority, but rather that we have to strategically perform our womanhood in certain ways to access the care and treatments we need.

The Future of Gender-Affirming Care

In many states, especially in the South, where I live, governors and legislatures are introducing bills to ban gender-affirming care——in ignorance of history. The consequences of hurried legislation extend beyond trans people, because access to hormones and surgeries is a basic medical service many people may need to feel better in their body.

Prohibitions on hormone therapy and gender-related surgeries for minors could mean ending the same treatment options . The  may directly clash with  in several states that aims to codify “male” and “female” as discrete biological sexes with certain anatomical features.

Prohibitions on hormone replacement therapy for adults could affect access to the same treatments for menopausal women or limit access to hormonal birth control. Prohibitions of gender-affirming surgeries could affect anyone’s ability to . So-called cosmetic surgeries, such as breast implants or reductions, and even facial feminization procedures, such as lip fillers or Botox, could also come under question.

These are all different types of gender-affirming procedures. Are most Americans willing to live with this level of government intrusion into their bodily autonomy?

Almost every  in the U.S. has come out against new government restrictions on gender-affirming care because, as doctors and professionals, they know these treatments are . These treatments have histories reaching back over 50 years.

Trans and intersex people are important voices in this debate, because our bodies are the ones politicians who oppose gender-affirming care most frequently . Legislators are developing policies about us despite the fact that most Americans say they .

But trans and intersex people  to have to fight to access the care and treatment we need. And we know the joy of finally feeling comfortable in our own skin and being able to affirm our gender on our own terms.

This article was originally published by . It has been published here under a Creative Commons license.

Wartime

frolic
cavort across 
fields that hold
labor and bones
lovemaking and laughter
and each of you 
black with joy 

jit and jive
the frontmost line
is everywhere now
but we still alive
we carry our dead 
in our eyes
crying out: it’s summer

find the bullet beat
percussive pace
duck and cover
exhausted pulse
flinging forward
only your softest 
parts

relinquish ahistorical safety
hysterical corrections
and hyperbolic declarations
all wars are internal
but remember
summer is a good time
for revolution 

so mirrordance
see the light 
in your own eyes
on the longest day
heal, or go down swinging
swallow your own shadow
and, whole, rejoice

Let us remind the world
How many shades of green there are
How, together, we look like life itself
How tender the dirt gets in spring

Let us burst open, one multitudinous bud
Unfurled by that internal pressure of petal
Ripe, yes, and soft 
You will learn to inhale us

Let us punch up from the earth, a lava
Bright and abundant dreams of tomorrow 
Flowing molten and free
Turning ignorance to ash

Let us act like we got some roots
Know that we are held deeply
Even as we dance towards the golden breast of the sun 
life delectable again

Let us remind ourselves
That life moves ever towards life
This is the season of our nectar
Beloveds this is the season worth the sting

And before any pedestal formed against me can prosper, I want to be clear that I am not above or beyond this behavior. When situations feel violent, when children I love are endangered, when people in my community are causing harm, I still feel that first instinct to control the situation and clarify a right–wrong binary, and sometimes that instinct goes as far as wanting to dispose of those causing harm. I grew up in the United States (nation and occupied territories) during late-stage racial capitalism; I was trained to be exactly this reductionist and punitive.

But then I began the lifelong journey of decolonization, in which I have slowly and steadily been politicized into alignment with a collaborative, adaptive, healing worldview. I have been on a journey of self-exploration and community exploration: How do we get free? Not just individually, but on a collective level, as a species? Is it possible to free ourselves from the patterns that turn us against our complexity and longevity? What does justice look and feel like in practice? Can it be something we enjoy? 

We are dreaming of abolition, but in order to make it real, we have to understand that every relationship with other people, or with the land we are on, is practice ground. And we need each of these places to practice toward a viable, embodied accountability, one we can rely on under pressure. 

Our dreams get fortified each time we move through conflict, misunderstanding, harm, or violence without turning to the carceral state of prisons and policing. Many of us are practicing, learning, and evolving a framework called “transformative justice,” or community accountability. Instead of endangering ourselves by engaging the police, who will show up armed with weapons, biases, and quotas distorting their view of what’s happening and what’s possible, we turn to each other. Instead of responding to the surface-level symptoms of conflict and misalignment, we reach to the roots, looking for the patterns of systemic and structural impact. We acknowledge we cannot go backward, but we seek a way forward that honors peoples’ dignity and capacity to recover, to heal, to reclaim themselves, and possibly to return to each other in new relationships. We release the binary of right and wrong and instead pay attention to the complexity of the situation in front of us: What happened? How can the community support resolution and possibility? 

In the interest of moving toward making our abolitionist dreams into reality, I want to share what I’ve learned about how it looks and feels to be in accountable relationships and structures.

We know punishment doesn’t work.

First, it’s reality-based. While we may have huge long-term visions of utopian communities, right now, particularly in the U.S., we live inside of systems that pit us against each other. So much of the conflict we face is rooted in human-made scarcity and illusions of identity-based supremacy. Rather than hold people to some ideal, we invite people to their own honest assessment of where and how they are, and what is needed to move forward.

Second, it requires a release of punishment. Mariame Kaba has . She reminds us that our current carceral system is a 250-year-old experiment in punishment. This system comes directly from the systems by which slavery was enacted and upheld. (I recommend reading “” and if this piece of history is new for you.) If punishment worked to end harm, we would know that by now, because we have punished more people in more ways than any other Western civilization. And yet within U.S. borders, we have immense injustice, violence, sexual abuse, and unmitigated conflict. Punishment isn’t working. Even if you aren’t quite ready for abolition, it is time to acknowledge that we need to try other strategies.

Third, accountability is generally a private journey. Sometimes, we think accountability happens with a press release or a hashtag. Those tactics can bring attention to the need for accountability, but the actual processes of being accountable involve slow work, growth work, work to undo and learn and become more self-aware, learning how to make an authentic apology and being willing to accept appropriate consequences. This doesn’t move at the speed of social media, it moves at the speed of one human, changing. Think of things in your life you have been wrong about, mistakes you have made, beliefs you once held that now seem ignorant to you. Think about how you realized you were mistaken, or caused harm, or were ignorant. How did you change? 

This is a very exciting time to be an abolitionist.

And even though it can feel satisfying to demand immediate apologies and changes, what we often get from that approach is performance and punishment. We know punishment doesn’t work. And I think most of us would agree that the performative accountability acts—apologies that clearly aren’t rooted in true understanding of harm or contrition, but rather in shame or public pressure—fall flat, and often leave us deeply unsatisfied. We don’t need the performance of accountability, and in our recent cycles of history, what we see is that the absence of authenticity in that performative apology practice actually leads to backlash. People may even go so far as to believe transformative justice and developing a culture of accountability aren’t possible, because they haven’t felt it. Yet.

Fourth, accountability culture, transformative justice, and abolition are all on the horizon, but we are just beginning the slow movement toward realizing these ideas. We aren’t there yet. We aren’t even close. Not only do we not know how to take accountability in meaningful ways, we don’t really know how to feel satisfied by the moves others make to be accountable to us. We often want a fireworks of satisfaction that completely rights the wrongs and erases the wounds. We sometimes show up to these processes thinking we can move backward in time, to the way we were before hurt entered the dynamic. I have mediated so many situations in which one person wanted a total reconciliation, and the other wanted a visceral punishment, and the most satisfying outcome we could land on was clear boundaries and an authentic accounting for harm. 

There are some incredible tools available to us now that were not around five, let alone 10, years ago. The culture of accountability is growing, even if it feels too small or chaotic right now. Here are some of my go-to tools:

• “” by Mia Mingus 
• by Mariame Kaba and Shira Hassan
• by Ejeris Dixon and Leah Lakshmi Piepzna-Samarasinha
• by Mariame Kaba 
• by Patrisse Cullors 
• podcast, hosted by Prentis Hemphill
• And my own works, and

The truth of this moment is that we don’t quite know where we are going or exactly how to get there. But we are practicing, and you are invited to practice accountability in every relationship and structure that matters to you. We are growing a muscle to make our dreams of abolition and ending cycles of harm a reality. We are creating a future in which accountability is the norm in our culture. This is a very exciting time to be an abolitionist. What are you practicing?

In the world that is ending, identity-based superiority reigned, and it shaped everything. White people enslaved Africans, men enslaved women, and anyone who �徱���’t fit into the colonial capitalist heteropatriarchy—because they were disabled, or queer, or trans, or not a citizen, or �徱���’t fit into the “subservient” role they were cast into—were punished, locked away, or killed. 

We are in a long arc of releasing that world in myriad ways: protesting it, opting out, critiquing and ridiculing it, developing analyses to help see how it works, educating each other. In this way, we change culture and assumptions and structures a bit every day. But because the shift is gradual, and occurs while we still exist in a world where regressive values manifest in pervasive and unique ways, it can feel like we are not the spark of change. Even as we divest from power structures that are predicated on the denial of any group’s humanity, the pace of our evolution and the ongoing struggles, the backlash, and the egregious acts of continuing harm can make it feel like nothing is really changing.

One of the ways I recognize how much is changing, and how rapidly, is by thinking back to the culture of my 20s (I am 44 now), and then the culture of my childhood. With this longer lens, I can see how much is changing, how rapidly the changes are coming, and sometimes I can even see where my generation has shaped those changes—about what was legal, spoken, sold, or normalized—which now shape the present culture. When I see both the impact of ancestral and elder organizing, and the impact of our organizing and culture-shifting, it makes me feel even more accountable for what comes next. This era is for visionary death doulas with time-traveling presence, able to stand in this moment full of embodied wisdom from our lived and ancestral experiences, and ripe with possibilities and practices for a future that is nourishing for all of us. 

Being accountable in this moment includes a few key activities and perspectives:

Notice where dying ideas show up in your life.

We have all been inundated with the colonial, capitalist, heteronormative, and patriarchal ideas that this dying world inflicts upon us. Interrogate these ideas as they arise. Ask yourself if any of them actually feel true and compelling to you. One hint that they don’t is when you find yourself in structures of obligation, imbalanced care, constant sacrifice, or perpetual frustration. These dying ideas might also show up in massive meltdowns of spaces that ought to be commons, such as what we’ve all watched with Twitter this month. When those still clinging to antiquated power structures and mythologies (like money signaling brilliance) steal your agency, time, ideas, labor, or straight up displace you from your (physical, cultural, or ideological) home, learn to recognize the desperate grasps of a power structure that is dying. Find the opportunity to grow beyond their reach. 

Notice collective denial.

We are living in a global pandemic with a virus that has long-lasting and debilitating impacts, if it doesn’t kill you. Those who survive are reshaped by the virus, some in overt ways we currently call long COVID, some in ways that don’t show until there’s a sudden death months later. We also don’t know what COVID will do to the generation of children we forced back into schooling conditions where they could not truly protect themselves—let alone the . 

And yet, we now board planes and traverse a world full of unmasked, unprotected people—because our government supports the capitalist-fueled rejection of necessary COVID adaptations. Precautions that save lives, that protect the disabled and immunocompromised among us, aren’t lucrative. Taking even the smallest, simplest step toward community care—like consistently wearing a mask—now feels like swimming upstream, or shouting a political stance, even as people continue dying from a virus that keeps spawning new variations.

Our society has approached climate change the same way: Adaptations only seem to move where they can be monetized. But denying reality doesn’t work as a long-term solution. The ; the hurricanes are knocking out neglected, unprepared ; the droughts and floods are ; and nonhuman species are disappearing in the sixth great extinction of our planet, caused primarily by our human impact on the planetary living conditions. All while COVID-19 is still slipping people out of this life. 

Notice collective experiences.

The pandemic has changed us in other ways too. The amount of grief we carry is a collective weight. The way everyone is having to figure out safety on their own has increased distress and overwhelm. And it has hurt relationships—trying to be close to people who navigate boundaries differently can be tense at best, dangerous at worst. 

We are perhaps more aware now of how much everyone is carrying, if we let that in. COVID and climate catastrophe aren’t the only things we are surviving as the systems we’ve been socialized into become obsolete and explicitly regressive all around us. How can we move through this period of endings, this anthropocene, with grace, rigor, and curiosity?

Slow down and embrace awe.

When I slow down and tune into the world around me, there is so much wonder available to me. If I am terrified, combative, or try to dominate the beyond-human nature around me, I get stung; I feel disconnected and hopeless. But if I slow down and lean into the experience of being of one species among many, I experience so much mutual curiosity, and I feel so much awe at the marvel of our collective existence, even in this moment of upheaval.

A worker bee was curious about me recently, and rather than panic, I got curious. She buzzed powerfully around my crown, and I felt wonder as that small and mighty buzzing moved down my body. She landed in my hair, and as she stepped around, I felt wonder at how small her body was, and whether her legs were narrower than the strands of my hair. I wondered how I smelled to the bee, what she found on my surface. 

A seven-legged spider was curious about me shortly after the bee. I felt something moving on my face and instead of swatting, I got slow. I drifted my finger softly along my cheek toward the temple, and there she was, now moving along my fingertip, leaving web in her wake. I spoke to her, wanting the hum of my voice to show that I intended no harm. She climbed from finger to finger, hand to hand, stopping often to just sit there. I felt wonder, watching her move, watching her choose to stay with me rather than move to the concrete, glass, and canvas surfaces I offered her. 

I worry that the world, which can abundantly care for us and for which we have found no replacement, is going to become uninhabitable to us and so many other species because we choose to live such contentious and distracted lives. We humans have made so many decisions that separate our species from the natural order, and thereby from curiosity and wonder about the world around us. Watching how biodiversity—and our chance of survival—has decreased as our wonder has dwindled and been confined inside fences, buildings, and screens, I can’t fight the urge welling up inside me to rekindle our wonder about all that is still living and changing on Earth, even now. 

It is too late to sidestep the crises that arise from the tech-utopian false-solution futures that capitalism has predicted and promised, but perhaps, and I daresay I hope, that it is not too late to have a future in which our species is here and living in right relationship with the Earth and the other survivors of our palest age. 

In my next and final column for this series, I will explore the practical wisdom of “transforming ourselves to transform the world,” tying together the arc of accountability into a cycle of dialectical humanism that allows us to not just survive, but evolve.

I think this is good news. For most of my life I have been told what my ancestors have done so that I might live, so that I may experience freedom and voting and vacation days and peanut butter and other joys now. I try not to place my ancestors on a universal pedestal, to remember that they, too, were flawed and perfectly imperfect humans. But I do think they have the wisdom of death, which I hope is, at minimum, a liberating lens. 

There are, of course, my familial ancestors, of which the vast majority are unknown to me—not only their personalities, but also their names. They exist in my mind and heart as stories and songs and memories. They offer instructions that I can feel myself wanting and needing. 

And I am fortunate to experience the continued blessings of some of my ancestors who are known to me. My Papa (maternal grandfather) and my (paternal) Grandma Brown feel present with me in a steady and ongoing way, distinct energies of the same generation. They lived their entire lives two hours apart but never met—unable to cross a social distance that was, at that time, galactic. 

And I have always felt my work to be in collaboration with specific ancestors, those whose blood may not course through my veins, but who have helped shape me and the work I am called to do nonetheless. I feel responsible for uplifting and continuing the work of Octavia Butler, Audre Lorde, Lucille Clifton, James Baldwin, Frida Kahlo, and El-Hajj Malik El-Shabazz. 

I had the privilege of sharing space and time with some of the ancestors in the lineage of my work: I met Octavia Butler before I was 20 years old; I saw Nina Simone wield a peacock feather and piano in concert at 21; I was able to sit with both Ursula K. Le Guin and bell hooks in my 30s, reveling in the brief and delightful moments where the ships of our lives crossed paths. And, of course, there is Grace Lee Boggs, whom I got to befriend and neighbor in Detroit during the last eight years of her life. 

As I explore accountability within this column, I find myself wondering how, exactly, can I be accountable to my blood and chosen ancestors? How can we be accountable to those who lived and died before us?

The answer to this question feels most clear in the context of my ongoing relationship with those ancestors I met, saw, touched, and was held by. I know what they approved and disapproved of in me when they lived, so I can extrapolate some sense of their opinions on my life now, although I suspect that in the portal from life to beyond life, the limiting beliefs and phobias that some of us carry can fall away as we return to being part of something whole.

I sometimes feel my Papa’s hands on my shoulders, see my Grandma Brown’s smile on my face, hear the shape of Grace’s excitement about an idea. There are times when I am thinking about a character and I clearly hear a voice of critical development that feels like Octavia. I am grateful for even the slight possibility of specific ancestors who care for me, who watch over me.

Simultaneously, I hope these ancestors, in their current planes of existence, don’t actually spend their cosmic energy intervening in the petty business of humans. But perhaps the guidance I have felt from these ancestors is part of our shared connection to a collective whole, much greater than any individual, time, or place. Perhaps our ancestors are connected to us by the threads, transformed but not broken, in that portal between life and what’s beyond it. For the ancestors I love, this thought is comforting—I want them to feel free and remembered, honored, and needed.

What feels less clear to me is what to do with all the ancestors I never met, whose legacies flow through my life even if their blood doesn’t, to my limited knowledge, flow through my veins. I have such an extravagance of lineages that it sometimes amuses me, just imagining them all in a space with each other that grows more global and rebellious with each addition. 

And thinking about that space shared by all the ancestors I do and do not know, I find myself grappling with a more challenging question: What about being accountable to ancestors who believed in things I don’t believe in? What does it mean to honor all our ancestors, including some who colonized, some who share responsibility for creating the mess we humans find ourselves in today? 

I often feel this unspoken hesitation when I am in rooms of mixed cultural heritage, when we are invited to call our ancestors into the room. A flitter of questions across the brow: Are you sure? Even my ancestors? Even the ones who messed everything up?

My answer to that hesitation is that our ancestors are already in these rooms with us, because we are there. But I suspect that the ancestral accountability we need, in more cases that we want to admit, is to continue to learn the lessons; continue to course-correct their mistakes and limited beliefs, without negating the long arc of our young species. I think about the things I grew up believing that now seem ignorant to me. This thought floods me with humility about how fast we can learn in times of change. 

To be accountable to my ancestors who were racist, homophobic, colonizers, capitalists, to those who killed and raped and stole land and people, to those who lied and robbed and hurt children and manipulated partners and generated systems of punishment, I live my life not in denial of all this complexity, but as an evolution from those harmful, dehumanizing, and traumatizing worldviews. 

There is a saying that has been popular in the past few years: “I am my ancestors’ wildest dream.” I love this idea, and I have put seeds in that soil. I love that it highlights those ancestors that dreamed of their own liberation and of their successors. But there are also, in my lineage, ancestors for whom I am likely their worst nightmare. A Black, queer, pansexual, poly-curious, unmarried, childless, defiant, feminist, post-capitalist, Earth lover, constantly thinking about what might be the most revolutionary next step I could take. Yes, I know there are ancestors who would feel they had failed in their work because I exist.

But what I know, which maybe these ancestors have some sense of now, is that the impulse to dominate, and control, and harm, and deny the truth of divergent human experiences is rooted in self-loathing. There is something in those fear-based, scarce, damaging worldviews that is a fundamental rejection of the miracle of life. So many of the systems my ancestors survived are structural, systematized self-loathing. 

I have to honor that those ancestors lived in a time of less knowing, less connectedness, and less possibility. I have to honor that their lives are crucial to my callings. I pass my current experiences of freedom and delight back to the ancestors who did not have access to rest, or agency over their time. I pass my current experiences of self-love and radical self-acceptance back to my ancestors who thought they could only belong through some version of destruction, of themselves and others.

These rituals, along with those that help me listen to my ancestors through tarot and prayer and writing, are ways I keep growing my accountability to all who came before me. 

Stepping outside is another practice of ancestral accountability for me. I know in a scientific, tangible way that ancestors fill the land, are part of the dirt and the air and the water. Everyone who ever lived and died is buried or burned or otherwise deconstructed back into the matter of this world. These ancestors existed, and in the same way the matter of their bodies is part of the earth, the things they thought—their mistakes, their ignorance, their curiosity, their experimentation, their complicity, and their brilliance—are what fills the world today. 

Many of the conflicts we are currently embroiled in are rooted in ancestral misunderstandings. We are trying to break the future out of cages some of our ancestors constructed, and we are still caught in the power dynamics of ancestral beliefs of worth and destiny. Being accountable to the unknown lives—the foolish, the wrong-headed, the ignorant, the lives that caused harm—helps me have more space for those I see living those ways even now. The human experience is not designed for perfection, or only loving those just like us. I think this is why we experience blood and cultural relations before those we choose—we are connected. We are experimenting across time, to see if humans can find a way to belong to each other and our world. Our ancestors teach us what to do and what not to do, if we are accountable to their teachings.

Later, I thought I heard him again, but he was awake, and it was an owl hooting deep in the Blue Ridge Mountains, the pitch of the hoot moving up, up, up the scale, and into the moonlight. Another time, it was a cat nearby, mewling for attention. I was reading a book about a talking cat, and for a moment, fiction and fantasy merged as I felt certain I knew what the cat meant: Now, now, now! The baby, the owl, the cat—they all sounded the same to me, each crying out for attention, for care, in a language that translates across species.

This pattern of screaming prayer returns me to a familiar question: How do we hear beyond the human cry for help?

The Earth seems to be crying. I hear the concurrent calls of one-third of Pakistan underwater in massive floods; Jackson, Mississippi, without water for drinking or toilet flushing for the foreseeable future; Puerto Rico’s power grid flooded out by Hurricane Fiona. And that suffering barely scratches the surface. There are fires that never rest into ash, there is water that doesn’t recede, waves where we need ice, islands whose highest point is now below water, heat waves that send while on the hoods of cars. The anniversary of Hurricane Katrina passed nearly a month ago, and I noticed how normalized these disasters have become; how comfortable we are becoming with mass displacement and death.

What would it look like to answer the demanding cries of Earth, to be accountable to the needs of the planet? Given that these questions are likely already familiar to the readers of this publication, perhaps we need to ask something different: Can those of us willing to be accountable do enough to counter the choices of those bent on destruction? How?

Over this past year, I have been experimenting with a climate ban on unnecessary travel. I don’t fly for work or speeches. If I am in transit, it is for love only: going to family, blood or chosen; going to home; going to health. If it’s within reach and my body is up for it, I drive my electric vehicle to get there.

I’ve mostly been able to hold this practice, and it has felt like a choice that helps ease my impact on the Earth, while also easing the impact that travel and being away from the sanctuary of home has on my body. I am feeling myself more every day as an earthling, understanding how what is good for my body is good for the Earth, and vice versa.

Another practice I’m interested in is folding the Earth into every other thing I do, every decision I make. When I consider any concern I have for people, place, animal, culture, danger, I root myself back to the relationship to our Earth and the changes currently unfolding for her. What would the Earth have me do, have us do?

These questions bring me to this brief but powerful wisdom from Margaret Killjoy: “You can’t write fiction on a dead planet.” I think the same is true for everything, far beyond fiction. If the planet effectively dies for us, if it becomes uninhabitable for humans, nothing else we are doing here matters. So many of us have cried this out, in so many ways, for so long—I know I am adding my voice to an ancient wailing, for attention. For care.

If every issue was seen through an Earth-related lens, what might we learn? We wouldn’t put down our myriad priorities, but maybe we would reframe and redistribute our time to more accurately account for the care of our only home, currently crumbling and buckling, infested and burning and flooding in every room. Our home, too, is wailing.

But imagine for a moment that everyone was tapped into this pattern of accountability to the planet, of anchoring our actions in consideration of their impact on the Earth. Imagine a common reality of collectively prioritizing our most universal gift: life on Earth. Imagine, for instance, a movement-wide, Earth-forward ban on work travel, and a shared commitment to turn our global attention to the wisdom and need of the Earth beneath our feet and over our heads, flowing all around us.

Imagine what we could do together if our movements were focused on sustainability or, even better, sustenance—that which sustains us, that which answers the cry for care. What if movement’s job were to hone the parental instinct of our species? I am not suggesting here that the Earth needs us to parent it in terms of a power dynamic, but rather that there is something communal and universal in the need and offer for care among the species that share this planet. There is a rhythm to care that flows in every direction. Rather than centering a human purpose of domination and forcing the Earth to serve us, imagine if we centered in a human purpose of care, among and beyond our species? 

As I write this, my friend is off the coast of Bahia, on a boat, leaning out over the front prow and singing at the top of her range. From miles around, whales come to her, spending the afternoon singing to her, with her, circling her boat in chorus and conference. She recently gave me some highlights on , and in addition to the message “We are one,” which she has shared from her whale comrades before, this time, she said it was clear one message was “We will rule.”

Harrison is singing and whispering and translating, and it will take some time to understand the meaning of these messages. But as I reflect on this larger practice of listening to the Earth’s cries for our attention, it occurs to me that this message could be as much a promise or comfort as a warning or threat. And yet, whales ruling wouldn’t have to come from conflict. Just being a water mammal on a drowning world would yield a definitive superiority.

But I also hear something softer, ancient, parental: “We will be here. We will take charge. We can be trusted with this place, even if you can’t.”

This is a time of overwhelming change. We must do more than we have capacity to do, on too many fronts to count. The key is for each of us to do all we can, to add our voices to the planetary scream for responsive attention. For care.

If we can do that, then perhaps all we have left is to trust that our respite, balm, and collective care will scoop us out of this mess. Or the work of crying will teach us to be so tender with our collective self that we are finally able to mother all that mothers us.

I find that this idea brings me as much peace as does the idea of healing as a victory. These ideas might even be the same idea. They are variations on completion, though our society tends to lionize one form (healing) while fearing the other (rupture). I want to offer you the peace that is inside this connection between completion, accountability, and community—but to get there might feel a bit scary, because we have to talk about endings. 

The material world is necessarily temporary, and it is only a matter of how deep we are willing to look, how far into the past and future we are willing to consider, to understand this. If you don’t believe me, look at the ruins of every society that has predated us on this planet. Remember that the matter that makes up our moon and planet is the dust of stars exploding in other galaxies. Remember that we can be partially made of stardust only because stars die.

Death is a non-negotiable aspect of the pattern of life for most creatures we are aware of. (With the exception of , .) For humans and most species we have encountered on Earth—and even for most celestial bodies—there is a life cycle that includes death.

If death is, as many of us believe, the portal to a vibrant spiritual realm, then death itself would seem to be fed by life as much as it feeds the cycle of life. In some variations of this belief, in death we become part of the whole again, relinquishing our individuality. In other variations, we are able to both maintain some specific aspects of ourselves in an ancestral identity, while also being part of a larger spiritual existence that can be felt by (and is somewhat concerned with) those still living.

In a reincarnation worldview, death is the door to a waiting room where our spirits rest before re-entering the life cycle. But there are also those who believe that this life is the total experience, that death is completion, followed only by the decomposition of the material body back into the earth. The souls that follow us, the babies that come through us, are also on a one-way journey through a life that has a material end.

Our spiritual work is, at its heart, finding a sacred peace in the present, which will change, and which will end.

We can have faith in one of these beliefs over the others, but so far, we cannot have a scientific certainty beyond faith. We have stories of people who have had near-death experiences and made their way back; many of them speak of a light they move toward, some see family and loved ones beckoning to them, some speak of feeling an incredible peace and falling into darkness. When I hear these stories, I always wonder how much of the experience itself is shaped by the faith of the person having the experience. If you believe in heaven, does death present as a white light or a cloud full of loved ones? If you believe in nirvana, do you experience peace? If you believe there is nothing after, does death present as slipping into the dark?

And what if you don’t really think about this at all? What if, from the time you are born, you are given a story of your life in which you don’t really need to be accountable? In which you don’t have to decide for yourself what death is, what life is, and what your soul is up to?

I want to explore how our spiritual practices and beliefs around death interact with the work we have to do here on Earth. My intention is not to judge, insult, or dismiss any particular way of believing, navigating faith, or being in the world. But I do think we need to accept death as a part of the life cycle, and deconstruct the concept of heaven, or any form of future utopia, if humanity is going to continue to exist here, now, and into the future. Our spiritual work is, at its heart, finding a sacred peace in the present, which will change, and which will end.

I am ruminating on all of this because, for me, the reality that I will die is a component of how I approach accountability day to day. I accept that my singular life is not everlasting, and that I have a mysterious timeline in which to have this particular human experience. I have thought and felt a lot about my spiritual responsibility in this life, and concluded that I don’t want to spend time on causing or perpetuating harm. I want my lifetime to be part of an evolution toward ending unnecessary harm and suffering for my species and planet.

I was raised with a concept of heaven as something that came after this life, a utopia that I had to be “good” on Earth to deserve.

The oldest story I ever heard was of a vengeful, violent god who would punish and shame and erase his people, who then eventually sent his only son down to suffer for our sins, blanketing us in a conditional forgiveness that, if we followed the rules, would grant us access to eternal heaven. I know a lot of different belief systems likewise envision some sort of punitive divine force and embrace the sacrifice of an innocent in exchange for a blessing. Ursula K. Le Guin has a short story called “The Ones Who Walk Away from Omelas” about this kind of setup: a child who lives in constant suffering as the cost of utopia.

If there’s nothing but this life, how do we generate our accountability to all the life that will follow us?

I was very young when I started to pull at the threads of the story. In the same way I slowly outgrew the delightful carrot-stick mythology of Santa Claus, I have slowly outgrown the idea of a punitive god waiting in a future heaven, and that my access to eternal peace and joy is predicated on my Earthly behavior.

That story felt and feels like a narrative for people who want to judge but not be judged, who want peace without the rigor of practice, who want heaven without having to change how they live in any significant way. That feels like the opposite of accountability, to me.

I know a lot of people for whom this, or some other story of God, or gods and goddesses, makes sense and provides meaning. I feel the holiness in these people, in their rituals and practices. Many of the rituals—lighting candles, letting aspects of nature represent divine material, asking for divine support and shaping of our lives—align with my own witchy practices of the present.

But I always notice the contradictions between what people say they believe, their perceived proximity to heaven, utopia, or peace, and what they do. I particularly notice the growing alignment between wreaking havoc on Earth and using the idea of a delayed, merit-based utopia to claim a moral high ground. Driving to the beach here in North Carolina recently, I was surrounded by flags with AR-15s in the stars and stripes print of the U.S., with the words “Jesus” and “Trump” framing the weapon. Some of these flags were in front of small houses of worship.

My grandfather was a Christian evangelical man. He rode hard for Jesus, and the assignment he received from studying Jesus was humility, attending to those who were suffering, and noticing the humanity in the houseless and the sex worker and the sinner. He lived in one place most of his life, and he stewarded that land and all the creatures on it. And they loved him: He would walk into a field and swiftly be surrounded by horses and dogs, and sometimes I think even the birds would follow him around singing. His holiness was unquestionable to me, and as I get older, I respect more and more the way he understood that his assignment was to love this planet and all that lived on it.

There is necessary adaptation in the sacred stories we tell, in the holy structures we build, and in the values we practice with each other. My grandfather was given fire and brimstone, and then a compassionate and forgiving savior who washed the feet of those others called dirty, evil, disposable. He made choices to live his faith as a continuous act of love.

My sense of a spiritual connective tissue between all that exists is nourished by the deep knowing that my grandfather and I are both people imbued with a holy calling, guided by love and compassion, even if those paths look so different as to appear oppositional. This sense inspires me to cultivate curiosity for what is different from me, mysterious to me. My humility in the face of the biodiversity of our world is woven from the same fabric as my humility in the face of what I call the divine. I sense that there is infinite complexity beyond my comprehension that is unfolding in all of our choices.

This has been heightened by my growing sense of preciousness for the Earth itself. For life itself. For the present moment itself. I no longer assume that human life is the peak of divine creativity or purpose. There is something about the multitude of ways of being that is itself holy and worth our steady embodiment and fierce protection.

I think that we must reawaken our collective wonder for life, and respect for death, if we hope to shift the course of our species on this planet. Especially in those who currently espouse a life led by faith but are engaged in practices of destruction, oppression, patriarchy, rape culture, and other toxic and perpetual harm. But I wonder if we must also be willing to bring heaven, nirvana, peace, rebirth, and even death into the way we think about accountability every day.

If the ultimate accounting for our lives lies solely in the hands of a divine figure who has already handled it all, there is no real incentive to stretch and grow and become a human who can be in relationship with everyone else who is here, now. Likewise, if we are destined to spend eternity on another plane of existence, where do we find the motivation to steward the planet we live on, making sure that humans can be in a positive relationship with our home? If there’s nothing but this life, how do we generate our accountability to all the life that will follow us?

Many of us know it is time to seek the completion—or death—of our collective experiments with racialized capitalism, with ecological hubris, and with human supremacy. What is harder to discuss, but growing more necessary daily, is challenging destructive worldviews where they show up in our spaces of divine collective practice. If our places of spiritual community, our houses of worship, cannot adapt beyond regressive, harmful worldviews, we risk losing the divine gift of human life on Earth.

But if we can look at these gifts of divine story as emergent ways of speaking of the life cycle, and the inevitable change and death that accompanies all existence, there is a peace available right now. These systems of oppression will inevitably fall. The structures that are not compatible with life on Earth will end. Our spiritual work is either shaking the foundations of injustice, or letting go of our reliance on anything that results from oppression. The teacup is already broken.

When the teacup breaks, we see how that particular tea was never for us, leaving us the holy lessons of mindfulness, intention, deeper presence. Our temporary and cyclical work is to notice what is broken, clean up the dangerous fragments of the past, and let them go—or remake them into something beautiful, and then begin again.

My mentor Grace Lee Boggs used to ask this question all the time, to anyone who came to visit and learn with her, in any meeting she attended, or speech she gave. She wanted us—her students, comrades, and community—to keep a wide, long lens about our work. To remember, all of the time, that this moment is not the only moment. Human development moves in these massive cycles and phases, and there are always agents of change who ideate and practice and push and grow those shifts. She reminded us that there are changes available to us that are distinct to this time, and she urged us to be present to the opportunities that are current. She knew that we are not individuals simply living these solitary lives in a vacuum; we are the cells of our time-body, the collective physical body of this moment, interacting with each other and the earth and technology in ways that will create an age.

Grace also said, “We must transform ourselves to transform the world,” which is taking me years to understand and embody. The way I think of it now is in the framework of the imagination battle: there is a war going on for the future—it is cultural, ideological, economic, and spiritual. And as in any war, there is a front line, a place where the action is urgent, where the battle will be won or lost. The world, the values of the world, are shaped by the choices each of us makes. Which means my thinking, my actions, my relationships, and my life create a front line for the possibilities of the entire species. Each one of us is an individual practice ground for what the whole can or cannot do, will or will not do.

Grace visits me with the insistent memory of her words. I see her speaking them with her hands cupping the future in front of her. It’s her birthday month, and here she is, spirit teaching.

So I put these two wisdoms in direct relationship with each other more and more often these days: given the time on the clock of the world, how do we need to transform ourselves to transform the world? How do we need to be? How do we need to grow ourselves in order to both spark and cultivate the kinds of species’ evolutions we want to see? What do we need to practice?

This, to me, is the work of internal accountability. We are cultivating within ourselves a transformative practice that helps us heal from what the world has been, while generating what the world will be.

We must become accountable to our time, our earth, our species, our people, and our loved ones, from the inside out.

One of the first steps we can take towards generating internal accountability is to develop an assessment of why the world is as it is. This requires us to leap from the uninformed faith we have in the societal myths we were given as children, to the informed faith that we need in order to co-create the real world as adults. This informed faith is based not in cultural myths, but instead in lived experience, political education, and analysis. And this informed faith can allow us to embark on the right assessment, which then helps us find the balance between understanding the systems that have most deeply shaped us, and the responsibility we have over our own lives, choices, and impacts.

We live (and die) inside of systems that were imagined centuries ago by those ambitious and narrow minds of colonists and patriarchs. We live inside the lineage of relatively ignorant imaginations, which were obsessed with protection and domination. But we know so much more now. We know each other’s pain and complexity now; we know we are one interconnected ecosystem—so far the only planetary development specifically like us. 

Some of us know there is no supremacy amongst us as a species. Some of us know humans aren’t meant to be the center of creation. In the same way we had to evolve our thinking from the sun orbiting Earth to the more humbling truth that we are one of many planets orbiting the sun, we must remember (or learn) that the Earth is not designed only for us humans to consume and destroy. We must recognize it is meant to serve all the biodiverse species who walk and fly and swim and form mountains here.

Speaking of other species, my friend Michaela Harrison is a whale singer, who goes down to Brazil, into the water. She sings to the whales, and they sing back, and she feels and listens. And they told her, quite clearly, “We are one,” which both deeply resonates with me and challenges me. The idea that I belong to one whole thing sometimes feels too vast.

The fragmentation that has resulted from colonial constructs of race, gender, class, and power has wounded many of us so deeply that we identify more with the wound than with any experience of wholeness or oneness. Because we identify with the wound, we fight against each other over differences that don’t need to be battles. We opt in to these constructs, often without conscious choice.

I feel my mind sometimes splitting and labeling my whole self into smaller and smaller boxes because I have always been labeled out of others’ boxes. I am tired of hurting and splitting and shrinking myself, and tired of requiring that from anyone else, tired of all the violence required in the denial of self and the denial of biodiversity.

The assessment I form from laying all this knowledge down on a page is that I am accountable for shifting massive systems, and one of the most important ways I can be accountable in the grandest sense is by being intentional and radical in how I behave, what I believe, and what I practice.

A second practice towards internal accountability is to recognize that you have healing to do, given the conditions and legacies you were born into. There is healing related to how your people have suffered, and healing related to how your people have created suffering for others. As a multiracial person, I can immediately reach the healing work needed on both sides of that coin in the family trees that I am aware of. But even for the many of us who cannot access our full history—because our lineage has been lost, stolen, or erased—I would say that an honest assessment would reveal that all of us have caused harm, some of which has been systematized and sustained. And all of us need healing in our lives. Recognize that the healing need is a universal one, and tell yourself the truth about your parts of that. 

Next, identify what healing means to you, what it feels like within you. I believe healing is the victory that actually moves us beyond oppression. And that healing isn’t a fixed state, but rather an embodied state that is cultivated with ongoing practice. If you’ve been developed as a traumatized, numb, selfish, or harmful person, healing is evidenced when, under pressure, you are able to stay connected, stay present, stay interdependent, and be accountable for harm. For me, working with an embodiment framework through a somatic lens has most helped me feel healing, rather than just think about healing. I feel the presence of my healing work when what I feel within is totally aligned with what I am expressing and practicing externally, socially. I know I am in healing dynamics with others when I can fully be myself, without feeling pressure to wound myself with contortion, dishonesty, or overextension. How do you know when you feel healing in yourself, and in your relationships?

Ultimately, internal accountability is about moving from fragility to fortitude, from within. You are not a set of constructs easily destroyed, you are a whole being inside of a whole ecosystem, and you are healing. You can be intentional about directing your energy’s flow to the places and memories that will be most healing to the deepest wounds within you. The answer to Grace’s question is that now is time to heal our systemic wounds.

For the next piece of this series, we will look at internal accountability in relationship to others.

I want to begin that exploration with internal accountability. In my own healing journeys around trauma, food, relationships, and giving my body the care and love it deserves and needs, my internal accountability was required for the necessary changes to take place. I had to change how I thought about things, what I believed, and what I was willing to practice. I had to learn to see the difference between what I’d been socialized to believe (my fat body is bad and deserving of ridicule and punishment), and what I’d been politicized and liberated into understanding (my fat body is gorgeous, glorious, normal, desirable, and deserving of my attention, care, and worship). I had to learn to be accountable from the inside out, accountable when no one was watching.

I’m still learning. 

Who or what do you feel accountable to?

Your community? How do you define that, who is included? Family? Immediate or extended or chosen? Or perhaps friends? People with whom you are unified by identity? People who follow you on the internet? People you work with? To the government? To a religious institution, or to a deity? 

And when you feel accountable to them, what does it feel like? How do you know you are being accountable? Has anyone ever said directly to you that you were being accountable, that you seemed like an accountable person?

I ask y’all these questions because I want us to be on close to the same page. I am contemplating the same questions these days, both as a human attempting to live an accountable life, and as someone to whom people often turn when they want to become more accountable. 

It is time to deepen our practices of internal accountability.

As I reflect for myself, one of the biggest patterns I notice is that accountability is often discussed as something that lives outside of us. We have to be accountable for things we do to others, and things we said we would do that we �徱���’t. We are generally held accountable by others: accountable for harm we have caused, or for patterns of trauma, pain, and abuse that we have participated or been complicit in. 

For most of us, it is easier to see accountability as it relates to others, to see their beauty and flaws, to see their victories and missteps, to see ways they seem to be better or worse than us. In this era of internet society, it is especially easy to see what someone else has done wrong, or hear the rumors, and then to tell them about it publicly. And whether you have ever been publicly held accountable or not, these days it feels like constant pressure, the anticipation of external accountability from the world beyond our own knowing and feeling. 

But I think this kind of external living creates in us a collective fragility. If we are constantly tracking each other for things that need accountability, always operating in pursuit of the approval of others, or being held to standards set by others, how can we trust our own choices? If accountability happens outside of us, and is judged and corrected by others, how can we learn to recognize, let alone honor, our own needs and values? 

I suspect that this externalization of accountability, especially the structural outsourcing of accountability from the self or community to the government or religious institutions, is part of what feeds cycles of harm. When we are not able to choose accountable actions on our own, when we are only held accountable once we are caught by another body, many of us can get caught in a state of arrested development, childlike, acting from a place of reckless abandon, instant gratification, and short-term thinking. 

When we are stuck in this collective fragility, outsourcing our accountability, we often expect others to do the labor of not harming us, while also not being harmed by us. We are fragile because we are not living with internal clarity around what feels right to us, so we lack the internal capacity to assess the potential harm of each action. Too many of us are living according to an amorphous, highly adaptive and reductive external standard for accountability. Instead of rooting our choices in what we truly believe and value, we end up making choices that conform to a variety of external values and standards. 

I believe it is time to deepen our practices of internal accountability. How do we answer for our own impacts and choices? How do we discern what deserves our attention, what boundaries we honor, what we communicate and how? 

I want to focus on this because I think too often we claim a victory based on some external public declaration, campaign win, or shift in social standard. The thinking is, now that we have articulated a commitment to this standard, we have some way to hold others accountable to it. 

On one hand, this is true. I am grateful for any external standards against sexual assault and harm, against homophobia, transphobia, racial discrimination, ableism. But these standards alone don’t go far enough to address the issues. If we don’t cultivate internal accountability, nothing really changes. If I act like I care about equal rights for everyone, but internally I believe I hold a superior position to one group of people, that internal superiority will find a way to surface. I see this often with men who rush to use the language of feminism, but still operate in harmfully patriarchal ways behind the scenes—until they get caught. Or White people who have Black Lives Matter signs in their yard but are racist to the Black people in their lives—until they are called out. 

If the only thing keeping us accountable is the external call-out, if the only way we choose to be accountable is when we are caught, then we necessarily have to police each other, constantly watching one another for the latest transgression. This is sometimes presented as solidarity, or allyship, and you can feel when the correction or lesson comes with a sense of humility and compassion. But more and more often, especially in the public sphere, what we are up to is not solidarity, but mass policing. The subject of our policing is determined by whichever issues we are willing to surveil. 

Part of truly learning a lesson is the embodiment of it, knowing it from within, knowing it so deeply that it can guide your next choices and decisions. What we have learned to do really well is to police each other. We are in a constant state of division, conquered by those who benefit from our inability to think collectively and structurally.

So a first step toward ending cycles of harm, toward deep healing of some of the systemic wounds we carry, is honing our internal sense of accountability. Not “Let me be careful not to offend” or “Let me do this messed up thing and hope I don’t get caught,” but “Let me act in alignment with my values.”

In my next column, I will talk about the practices of internal accountability. 

We are in a period of history where it is difficult to speak and sense the truth. In our 24-hour news cycle, the truth is spun and remixed and dramatized and tweeted. It can be confusing to determine what stories are real, what stories actually impact our lives, what is worth our attention, and what, once heard, we are accountable for acting upon. Many of us now find our attention directed by the trends and algorithms of social media. As I write this piece, there is an incredible unfolding, as scientists around the world lock themselves to the doors of their institutions, begging us to attend to the acute climate catastrophe unfolding. But I am watching that storyline be swallowed by celebrity news and other dramas. 

Distraction and redirection have become a field of specialization. There are professionals in every field and political distinction constantly calculating new ways to manipulate us into making decisions that serve their clients, their values, their politics, or their pockets. This focus-grouped messaging doesn’t come with a label, even though it’s the GMO of communications. 

There is also so much complexity of perspective in how human life unfolds—the reality is that there is no single truth. Context is everything. Power dynamics, cultural experiences, class norms, and age can all have a radical impact on what we understand to be the truth.

And then there’s the emotionality of language. I have been guilty of using hyperbolic language when caught up in a moment of anger or despair, language which oversimplifies or outsizes the truth in ways that can either reduce or oversell the narrative of what is actually happening. 

So how, in these times, do we “speak truth to power,” as our civil rights ancestor ? How do we speak honestly about where and how we are right now, and what we actually need to center in our organizing? How do we learn to “be impeccable with our words,” as Toltec wisdom through Don Miguel Ruiz advises in his outstanding text ?

I want to offer some of what I am learning—as a human, as a facilitator and mediator, and as a writer.

Fact-check everything.

Every source of information isn’t equal, especially in the realm of social media. Before passing information along, consider the source. Do they have expertise in a relevant field? Is the information well-researched? Does it include the voices of organizers actively working on the issue? What about communities directly impacted by the issue? Is the source a journalistic outlet committed to fact-checking? 

Speak as precisely as possible.

Especially when sharing information others really need to hear. I remember a poetry teacher telling me to “write it, now cut it in half. Now cut in half again.” As a verbose writer in love with words, I struggle with precision of communication. But in both intimate and collective moments of accountability and negotiation, I find it helps to take a deep breath before I speak, and think about what precisely needs to be communicated. 

Discern.

Is this the right time for this communication? Is it urgent, or is there time to ask questions and fact-check? If it is urgent—why? Who says so? And who benefits from the information being spread? Do you want to benefit them? Could someone be harmed by that information spreading? Do you want to harm or punish them? Are there other perspectives to consider? What are the potential impacts of this communication? Are those impacts you want to be accountable for? 

Speak when we are afraid.

I used to think that if I could not speak without my feelings showing—for instance, speak without a tremor in my voice when I was afraid, or without tears when I felt sad—that I should be quiet, and wait until the emotion passed. But I have been learning that my most powerful words are often accompanied by the release of tears, or the quaking of my gut as fear moves words out of my mouth. When I take the risk of speaking not through or over my emotions, but rather in alignment with, or even from, my emotions, I am speaking my truth. 

Speak truth that allows other truths. Hold strong boundaries against mistruths, lies, assumptions.

Not every perspective is equal, nor does every viewpoint deserve to be equally held or considered. None of us holds a definitive truth, and we need to speak with each other in ways that make room for a multitude of experiences. But we must set a standard of not indulging lies and willful mistruths. For instance, any indulgence of denial of the current climate catastrophe is dangerous for us as a species. We need to be clear and consistent in our standards for truth, and stop uplifting perspectives which cannot survive a fact-check. 

Speak from our own experiences.

We are each responsible for bringing our piece into the great story of our species, which is a long and complex story. Just because something feels true for you doesn’t mean it resonates for everyone. Relinquish control of the collective narrative—we are not meant to dictate and control each other. Live into your truth, and allow others to live into theirs. 

Speak as a body.

One thing that is helping me in my unlearning of dishonesty culture and cultivating the muscles for honest, accountable speech is to really listen to my body as I listen to others, and as I communicate. The body is often aware of the gap in integrity, whether it is in another or in us, the space between what’s being said and the truth. Start to pay more attention to how your body lets you know that what you are hearing or reading might not be true. I feel it in my belly. I have a good friend whose palms get a little sweaty, and another who feels a twinge in her spine. 

Speak what is kind, necessary, and true.

I learned this from Buddhism, and it is one of the simplest and most effective tools for accountable speech that I have ever come across. It only works as a balance. Truth without kindness can veer into cruelty. Truth that is unnecessary can cause harm. Kind speech that is unnecessary or untrue is infantilizing, patronizing, and diminishing the person you speak to. Necessary truth spoken without kindness can land as a blow that produces a defensive response, rather than an opening for connection and action. 

This is just some of what I have learned—and I am still learning. Like many of you, I suspect, I am not just navigating our current culture of communication confusion, but also recovering from cultures of politeness, passive-aggressive speech, repressed truths, and the webs of deceit and distrust that are woven into so many of our cultures. 

Commit to using language in ways that shed light. This is a time when we cannot afford to live in the fog of dishonesty. Our future depends on being able to turn and face what is, and to be honest about what we are going to do to survive.

I have cultivated, for my whole adult life, a place in myself that intentionally seeks to understand each person’s choices as their own life learning. I strive to not take things personally and to invite people to learn and think, with me or not. I have held a wide space for the divergence of beliefs that shapes the future and worked to grow my compassion to be as big as the world and all its inhabitants. And I have been on the socialist–communist end of the economic spectrum, believing there is some cooperative and collective way of approaching our lives and resources. 

Almost two years ago, I set my vast cultivated compassion on the altar of my normal life, which I’d surely be coming back to soon. I found a hole with an ocean view to hide in, and I bought three months of groceries and all the toilet paper I could see. 

I apparently also picked up a narrow compassion, just wide enough for me and mine, my family and friends and people who thought like me. The space I could hold for our human unfolding wasn’t prepared for COVID-19. I couldn’t extend my love, my care, my understanding and respect, or even just basic well wishes to those who crossed my 6-foot boundary, or who were unmasked, then unvaccinated, then gathering in groups, then unboosted. An “other,” an enemy, was unleashed in my consciousness: Those are them. They hate the planet and Black people and freedom and the collective good. They deserve the consequences of their own dumb choices. 

Even when I started noticing that they included people I loved, I �徱���’t really soften. Even when respected comrades reached out like, “Hey, you seem to be out of alignment with your own beliefs of big diversity and being with difference,” I defended myself and called it collectivism. I let my love stay narrow. I couldn’t spare my grace for people who didn’t even believe in science! I couldn’t cast my generous love and compassion on, on … them.

At moments, I felt twinges of doubt, but mostly, they got swallowed up in quick righteousness. I am grieving people taken by COVID, I am fighting to protect my loved ones from those who would risk their lives, I have an autoimmune condition and don’t trust that my body can survive exposure, and so on.

I know denying that which is is a waste of precious and possibly connecting energy. But I was so scared and so angry.

Then Thich Nhat Hanh died. 

And I remembered his teachings. I reimmersed myself in the sound of his voice, surrounded myself with his books, let his vast wisdom nudge my tiny balled-up heart. 

I remembered that he told us that happiness is in the present moment. And compassion is a necessary component of being present; compassion allows you to gently and honestly understand and love the self, and everyone else, in a state of interbeing. We don’t have to try to be connected, we have to become mindful to the truth of our existing and constant oneness.

The night I learned of his ascendance, I wept with gratitude for his big heart and generous offers, and I wept at how narrow my heart has become. I wept at how tightly I was gripping onto life with miserly hands that looked for reasons to draw a boundary.

I am not interested in, nor can I sustain, the binary right–wrong tension of this moment. I don’t want to put my energy into these judgments. I am particularly disinterested in the way my fear shapes my judgment to be sharp and dismissive of anyone who casts doubt on my choices. 

I choose Earth.

I choose the practice of interdependence. 

I choose to figure out living on this Earth with the beings who are here, finding the boundaries that allow my love to flow, in the spirit of Prentis Hemphill’s wisdom that “boundaries are the distance at which I can love you and myself simultaneously.”

I choose to root into compassion.

My choices are all rooted in my values of compassion, liberation, community, and pleasure for all. What I have come to understand as an adult is that the values we hold most dear always carry an economic component. 

Movement Generation the management of home. This planet is our home, and our economy is how we manage the resources and needs of our home, including ourselves both as resources in the stewardship of land, labor, and creativity and as beings with common and distinct needs. 

We are living through an age of immense fear—or, more precisely, we are in a postcolonial age in which fear is the most consistent and lingering quality of colonization. We know that this country exists because one European man got lost and others felt persecuted, and that the founding of the United States was a dance between slaughtering so many of the people indigenous to this land and then working enslaved people to death to pull a fortune from it. We have an economy based in terror. 

And yes, it exists in a true and persistent precarity. At any moment, millions of people on this land could justifiably rise up and declare a war of revenge for oppression. In those moments when we do temporarily rise up against injustice, the economy, in the form of property, is usually the first entity the state moves to protect. Property, in the United States, is more valuable than people, as are corporations, the right to purchase guns that can kill 17 schoolchildren or nine parishioners, and the ability to evade taxes more easily as you accumulate wealth. 

What I know for certain is that humans act from need and belief, most of the time to protect what they love. That knowing always fills me with compassion, even for those I know to be wrong, to be inhumane and planet-harming. They speak from a wound as much as I speak from a terror. We live in an economy of wound and terror, of collateral damage, of greed and stubbornness.

Not to mention that so many of us are still lost, are or feel persecuted, and are still working to encroach on land and labor in ways that are violent and unjust. Since the founding of the United States, fear has shaped the budget and priorities of our nation and shaped our collective response to any new challenge. The bulk of our budget consistently goes to military and police budgets instead of health care and education, or climate-responsive adaptations. 

Fear makes it hard to adapt well, because adaptation requires the release of the familiar in order to change. Fear can be demoralizing and distorting, or it can be wisdom that is trying to keep us safe. We have not been able to appropriately adapt our collective fear to the wise kind, the kind that quickly turns us to face the true threats of our species in both the current moment and the immediate future: climate catastrophe, violence at the border of supremacy and oppression exhaustion, and pandemics that expose how interconnected we are in spite of all that cultivated and resourced hate. 

A compassionate economic approach would care not just for the safety of people on earth right now, but also for the generations we hope to bring into a world we are simultaneously attacking and depleting. 

What fascinates me, even in ideating about a compassionate economy, is how quickly it becomes clear that what would serve the Earth would also serve us. We are one, as .

If we had significantly cut down on air travel a decade or two ago (or at any of the many times the climate-oriented scientific community advised us to do so, because the pollution is so damaging), we would not have been so susceptible to a global airborne pandemic. Conversely, when we stopped traveling and committed (much too briefly) to a local and often quarantined life, the Earth rejoiced in her way, took a deep breath into the spaciousness our absence created.

We don’t want to show the Earth she is better without us. So we must make a shift in our management of home that is both personal and systemic. 

For me to imagine how we pivot from a competitive economy to a compassionate one—from capitalism to something in the realm of socialism, collectives, and cooperative economics—I have to look at how I let capitalist behavior patterns root so deeply into my own heart, into shaping me.

When I feared for my life and that of my loved ones in the bloom of COVID, I became a microcosm of the capitalist system: competing to survive, trying to decide in my mind whose lives were most valuable, hoarding resources for myself and those I think of as my people, shopping at places I am not aligned with for the sake of speed and access. I became ungenerous, tight, scarcity-based, narrow, grasping. I even let myself touch into a superiority complex when I read that COVID deniers and anti-vaxxers comprised most of the dead, self-righteously thinking, “We told you so! What did you expect? That you could believe yourself into surviving a virus that is killing everyone?” 

I am so sorry. I feel so ashamed. Capitalism benefits from this divisiveness; it allows us to perpetuate a system in which we have to sustain an “other” that we hope to dominate, oppress, deny, steal from, displace, or kill. 

We are all at the same edge. We are all on a planet under our attack, stuck in a set of norms that cause harm, trying to survive an overwhelming number of challenges, mostly without the spiritual and interpersonal tools we need. As a species, we have not cultivated enough of a sense of “we,” a “we” that is strong enough for this moment. From business to government to movement, we have not been ready to let go of capitalism and move toward each other. 

That is what is right now.

And I don’t know the way forward from what is. I have ideas, theories, practices. But I don’t know how enough of us become a “we” that can truly be compatible with our planet and each other before we go extinct. 

Neither do you, I suspect.

All of this unknown has me scared. 

And if I remember that you are also scared, and that being scared makes sense right now, it quiets my petty, defensive, and capitalist-trained self. It allows room for something other than My Way to be The Way forward. It allows a collective, interbeing, compassionate self to emerge.

With enough of those, enough of us, a new economy becomes inevitable. An economy that allows us to do as Thây taught us, to move softly, and with love, on this home. What you change in yourself and your own life matters: It ripples out through authentic relationships to form a web that can meet the future. I feel us all in this web, I feel us growing it.

My name is adrienne maree brown. I am the writer in residence at the , which is a collective of facilitators, mediators, artists, healers, and curious human beings interested in how we, as a species, align with each other, this planet, and the future. 

My work and thinking are rooted in , which is the way we get in right relationship with the constant force of change—specifically, how we build patterns and relationships that can hold our complex nature through relatively simple interactions. It is a way to remember we are earthlings, we are of this place, and we can learn to earn our place here from the adaptive practices of everything around us. Emergent strategy includes adaptation with intention, interdependence and decentralization, fractals, nonlinearity and iteration, resilience through transformative justice, and creating more possibilities. How do we change in ways that increase our freedom and our compatibility with Earth?

My work is also informed by and radical imagination. I believe we are living in a world imagined by ancestors who �徱���’t love us, who �徱���’t believe in an abundant earth and our collective power to steward it. It is time for us to imagine beyond the current oppressive construct. My work is powered by pleasure activism, the belief that justice and liberation must become the most pleasurable experiences we can have, and that we must reclaim for everyone the experience of joy and satisfaction. How do we build the future on a deep yes, a deep longing for what we want?

Attention is the difference between a life you observe from a distance (sometimes within your own bodymind) and a life you live.

My writing is informed by over two decades of experience as a facilitator of movements for social and environmental justice and more than four decades of being alive in late-stage racial capitalism and a rapidly expanding climate catastrophe. I have stepped back from facilitation in the past year to rest, train emergent strategy facilitation, make room for other incredible facilitators, write, and make meaning of the patterns I have observed in human behavior. How do we keep returning to a beginner’s mind about our species’ survival? 

This column will be a space to ask these questions and share what I am seeing and feeling as potential answers or directions.

What do we mean when we say abolition, accountability, interdependence, community, liberation, and compelling futures? These are the kinds of topics I want to explore here.

I want to ask aloud a lot of questions that I thought I had answers to. So many of us speak as if we have answers, but we aren’t free yet, so I suspect we would all benefit from a period of listening and shifting in nuanced but distinct ways, together. 

Let’s write and inspire all manner of fan fiction and fan poetics for the future as our collectively channeled answers to questions beyond our comprehension.

Let’s explore how the justice we mete out interpersonally connects to the way we treat our own bodies and the planet. Let’s explore how we consider justice for those who have less power than us, and those who have more. Justice for babies and children, for elders, for species who speak in ways we have not yet learned to understand.

Let’s examine hopelessness as a tool of our oppressors. And cynicism and meanness. And capitalism, which nourishes death in all these ways and so many others. Can we slip the fatal grip of the economic system of our lives? 

How do our relationships reflect and shift our economic conditions? Our survival of gender and race constructs? Can everyone learn to be in healthy relationships? Can we learn these things without captivity—I mean, without the armed guard under which we currently all live, tithing our overseers?

How do we face the children we love? And the children in our imaginations? What do we owe them as stewards of their futures? That was the other possible title for this column, you know: Stewards of the Future. It’s aspirational. I shamelessly want to cultivate that sensibility in everyone who reads this and in everyone they tell about this column. 

There will be prose, with some gifts from poetry. The emphasis here is on experiential learning, observation of patterns, and what to practice. And how to be loyal to the miracle of our lives. The emphasis here is also on being more than doing. I deeply believe you can live a completely worthwhile life in contemplation and reflection, and waste it all while working every second of waking life. 

All of my work is about attention. Attention is the difference between a life you observe from a distance (sometimes within your own bodymind) and a life you live. My work is also always about change. How do we pivot from being victims of change to being shapers of it? I am one of many who picked up this lifelong question from the Buddha and Octavia E. Butler, among others.

On each solstice and equinox I will offer a spell, because it’s a way I know to be in reverence of the cycles of life on this planet: through patterns and spells and evolution.

There is an idea that keeps coming to the surface in me, in a dance with Octavia E. Butler’s Earthseed concept: that we are the seeds, that our lives are the Earth’s seeds. We live these lives, blossoming, growing, learning, seeding—and then, as our DNA gets tucked back into the Earth, as our spirits fly back into the next breath, the wisdom and love and learning of our lives shapes what is possible for the next generation to come forth. As often happens, right as I get excited at the feeling of a new idea, I realize this is just my way of internalizing and making poetry out of something I learned from a friend-ancestor. 

Grace Lee Boggs said, “We must transform ourselves to transform the world.” And as I wrote this column over the past year, it became clear to me this direction is the heart of my work and thinking, the heart of this period of emergent strategy. I mean heart in the literal sense: an idea that all my other ideas pass through repeatedly, a center that gathers and distributes and sets the pace of the rest of my thinking. I don’t believe any future worth living into will come to pass without an equally radical internal transformation in our self-concept of what it means to be human.

I am less and less interested in concepts that center around accountability for the choices of people who have long ago passed—accountability is something for the living, and for those to come. If our ancestors did things to imbalance the scales, our work is to seek the balance available in our lifetimes. For some of us that means reparations, and for others it means reclamation. Because concepts such as race and nation are constructs with ever-changing boundaries and rules and power dynamics, most of us have to find some balance of both reparation and reclamation in how we move into accountability with our lineages, in what we allow to flow through us into the future. 

I also feel clearer than ever that we are not meant to outsource the labor of our lives to a future we cannot see and will not experience. We are not meant to allow others to use our life force like a battery for a machine that doesn’t know our names. It matters that we are creating more possibility and justice and joy for ourselves in the present. Yes, our ancestors perhaps knew more about how to be with the Earth; and yes, the more of us who find a relationship with the Earth, the better the future is. But choosing to love the Earth is not just in right relationship to ancestors and those to come, it’s also one of the most healing ways to exist right here and now. 

What was unveiled for me in writing each column this year seems simple to know and immense to practice: how we do everything, every single thing, matters. Bringing our attention to each decision will unveil what kind of transformation is possible in us, and in our lifetimes. I want to pull the essence of this year of writing into a relatively simple spell:

We are the stewards of the future.
We will care for our shared home.
We believe we can heal and learn. 
We will speak the truth with held hands.
We will uproot oppression from within us. 
We will have fractal humility and epic connectedness.
We will let go of death-worship and learn to grieve.
We will listen to our ancestors, and let our lives grow beyond theirs.
We will make new pathways with our healing.
We will expand our we beyond humanity—to all that lives.
We will accept the gift of our wholeness.
We will call all of this love. 

I think it’s all in there. 

So what comes next? I want to continue these Murmurations, but I have reached a joyful place of being tired of my solitary voice. 

This month, I got to share a work in progress called To Feel A Thing: A Ritual for Emergence at The Shed in New York City. One of the most important aspects of this ritual is getting to move from a culture of isolation and solitary achievement or experience, to one rooted in a felt sense of belonging. We emerge as part of a choir where every voice is different, and the shape of the whole compels us toward a future in which we can be ourselves, in which we can revel in an abundant world. I want to try the same practice here, to take this column from being a single voice to becoming a collective chorus.

I have invited a number of emergent strategists to share this column with me, and they have enthusiastically said yes. In the year ahead, they have so much they are eager to share. They want to explore questions of how we adapt together, their practices for doing so, and their grief and their brilliance and their poetry and their voices. I am so excited for you to hear from these other voices in this murmuration. I may drop in occasionally to make meaning of the thread, but no promises—I mostly want to read and learn alongside you all. 

Thank you for reading so far. Let’s keep learning, and keep moving, together.

Hello beloved readers, and welcome to Murmurations. Every solstice and equinox, I will generate and cast a spell to share here, where I’ll otherwise be writing and reflecting on the patterns of life in our current world. 

The solstice marks time, the longest and shortest days of the year, or, conversely, the shortest and longest nights. Humans have tracked solstices for such a long time, building structures that allow our reverence for the cycle of our planet. Solstices give me a sense of rhythm and pace that I can expand into. The winter solstice is a time for deep rest, for hibernation, for resting inside the abundance we gathered through the year—we can let the harvest be enough to nourish us until spring. Let the darkness invite us into deeper release. 

Next month, I will introduce you more deeply to this Murmurations column that YES! will publish monthly, but we wanted the first touch to be a spell. 

tucked into
stargazing wonder
we arrive so quickly to the
night of the longest moon

we too 
are rock moving water 
even when we feel adrift 
we are in orbit 
there is a force greater
than we can comprehend
we are enraptured
from the root
and never alone
even in shadow you hold us

and we sing a song
only the ocean can hear
sometimes it sounds like 
we are sorry
or 
we are dying
but sometimes 
we sing
we are of you, we are of you 
we are one*

we sing to the thumbprint of moon
ink on ink
shadow slipping through the cloudy cold
of winter
we sing 
of breaking the earth’s heart
and realizing it is our own

we sing forgiveness
we sing of the fire
between skin and dirt
the rivers within us
the storms we conjure
before we sleep

tonight we dream our longest dream 
of the farthest future 
we look in those children’s faces 
without regret 
without shame 
whispering: we will change everything for you

it is because of these dreams 
that we will remember 
to hibernate 
to slow down to the pace of snow
to feed on the memories
of a year we call good
because we survived it

we place our mouths to the sky
and cast this spell

may we all have a warm place
may we all have a soft blanket
may we all hold a steaming cup in our hands
may we all know a sated belly
may we all have a shoulder for our grief
may we all set down what we cannot bear
may we all be unhunted 

may we all remember we are sacred
may we all touch our bodies in worship
may we all have room enough to stumble
as we dance to the moonlight’s subtle music

we dose this enchantment
with our holy intentions

and in this taste of eternal darkness
may we honor all that is black, and shadow
in ourselves, and in the world
may we crawl into the cave
carved especially for this season
and hear nothing but the quiet of stone
may we know, without question
that there is time for our rest
may we remember surrender
touching the dirt that holds our ancestors 
and our futures
with reverence

and in this way
may we all know the love of earth

*This line comes from the whales of Bahia, via Michaela Harrison.

Except the city of Los Angeles would be sending it to her in a debit card every month. A thousand dollars. To spend however Sara Calderon and her family wanted.

For the first time in two years, the 25-year-old mother from South L.A. felt the clouds of hardship start to part. It had been a dark two years. Calderon and her partner had both lost their jobs in early 2020, at the start of the pandemic, kick-starting a cycle of debt as they fell increasingly behind on rent and utility payments and were forced to put basic necessities on credit cards.

And there were health challenges. Calderon, who gave birth to her first child during the stressful height of pandemic lockdown, developed preeclampsia and postpartum depression, complicating her entry into motherhood. When she received the call about being accepted into the guaranteed income program through the Los Angeles Community Investment for Families Department, she was pregnant with her second child. She had been worrying constantly about her family’s financial situation as she juggled parenting, a new job as a teacher’s assistant, and completing an associate degree.

“I was so happy, so happy,” said Calderon, who had applied for the program several months prior, but had forgotten about it because she �徱���’t expect to be selected. “I felt some of the stress leave my body.”

In February, Calderon received her final monthly payment of $1,000, capping her participation in the Basic Income Guaranteed: Los Angeles Economic Assistance Pilot (BIG:LEAP), one of a growing number of guaranteed income pilot programs across California providing regular, no-strings-attached cash payments to low-income people in an attempt to address economic inequalities.

Several of these programs, including the BIG:LEAP, target pregnant people and families with children. That’s because by helping parents and caregivers gain financial stability, guaranteed income has the potential to improve the lives and health of children as well. Poverty and other stressors during pregnancy and childhood, especially early childhood, have been shown to harm the physical, developmental, and mental health of children, problems that can persist into adulthood and perpetuate cycles of poverty.

The goal, said Aaron Strauss, the program’s manager, “is to break the multigenerational cycle of poverty in Los Angeles.”

Other Guaranteed Income Programs

Communities of color often lack generational wealth, which can provide a financial cushion during difficult times. This is largely due to historical and systemic inequalities that have led to fewer economic opportunities and hampered wealth accumulation. It’s also at least partially why these communities were hit hardest both physically and financially by the pandemic.

The BIG:LEAP welcomed people of all races and ethnicities into the program, but targeted those living under the federal poverty line who had experienced economic or medical hardship related to COVID-19. Over 50,000 people applied for the program; 3,200 participants were selected at random, provided they met the criteria. The $38.5-million program, which will soon end, was funded almost entirely by the city of Los Angeles.

“We found that our cohorts really reflect the faces of poverty in the city of Los Angeles,” Strauss said. “Eighty percent are women, over half are Hispanic, the significant majority are people of color in general.”

Payments to the last cohort of participants in the BIG:LEAP will wrap up early this year, and data from the program will be analyzed by the University of Pennsylvania’s Center for Guaranteed Income Research to gauge the pilot’s impact. Findings will be published next year. Strauss said the city doesn’t have the budget to continue the program, but is considering putting together another, smaller guaranteed income pilot, possibly targeting people who are housing insecure.

In addition to the BIG:LEAP, several other guaranteed income programs in California are working or plan to work with pregnant women and families.

These include the in San Francisco, which provides $1,000 per month to nearly 150 Black pregnant and postpartum people and aims to address racial and income disparities that affect birth outcomes; the , a two-year pilot program that will provide a guaranteed minimum income of $500 a month to 305 low-income families and study the impact on reducing poverty; and the program, providing a basic income of between $1,200 and $1,500 a month to 55 families with a child under the age of 6 or pregnant people who are enrolled in other social support or housing programs.

The state is providing $25 million for seven additional pilot programs. In 2022, to fund guaranteed income pilots. The seven programs will serve almost 2,000 pregnant people and former foster youth across California, who will receive monthly payments ranging from $600 to $1,200 per month for a period of 12 to 18 months. For example, the will provide 18 monthly payments of $1,000 each to 150 Humboldt County Medi-Cal recipients in their first or second trimester of pregnancy. Each program will be evaluated by the Urban Institute and the University of California, Berkeley.

The programs aim to help Californians during life transitions, “such as the birth of a child or entry into independence after extended foster care,” California Department of Social Services Director Kim Johnson said in a statement announcing the grant program.

When Financial Stress Gives Way to Health Challenges

Pregnant women and their babies are especially vulnerable to the effects of stress, which is often tied to poverty and exposure to violence.

Research led by Nicki Bush, a professor of psychiatry and pediatrics at the University of California, San Francisco, has found that the children of moms who experienced hardship during pregnancy have a higher risk of mental and physical health problems, including clinical depression. She’s also found an association between a pregnant woman’s exposure to domestic violence and neighborhood crime, and poor behavioral and mental health for their babies at 1 year old. A mother’s exposure to violence during her own childhood can impact the health of her offspring too, a concept sometimes referred to as the intergenerational transmission of trauma.

“It’s really important to understand that these intergenerational health effects are universal, but there are communities that are exposed to much higher rates of adversity and have many fewer buffers that can protect them from these risks,” Bush said. “We find that there are groups of women, based on income or histories related to the color of their skin and discrimination and systemic policies, that have greater exposure to these types of challenges.”

Meanwhile, stress during pregnancy can exacerbate the impact of environmental pollution on the mother and baby’s health—a problem that disproportionately impacts people of color due to structural inequities and racism. A recent study by the University of Southern California found that higher levels of psychological stress among Latina women living in areas of Los Angeles with high air pollution correlated with increased risk of giving birth to an underweight baby. Low-birth-weight babies are more likely to suffer short- and long-term health problems, such as breathing issues, jaundice, developmental delays, and heart disease.

Lead study authors Carrie Breton and Zhongzheng Niu said the link is likely due to stress hormones interfering with the body’s ability to fight inflammation and oxidative stress caused by air pollution. In a pregnant person, this can influence the flow of nutrients and oxygen in the blood to the baby.

���� you’re very stressed out during pregnancy and you also are exposed to higher levels of pollution, those things combine,” Breton said. “It makes things worse.”

But targeted financial support for pregnant women and families with young children, such as that provided by guaranteed income programs, could make a significant difference, Bush said.

One ongoing study called is measuring whether unconditional $333 monthly cash payments to low-income mothers during the first few years of a baby’s life impacts the child’s brain development. An initial found that babies of moms who received the payment showed brain activity associated with higher cognitive, language, and social-emotional skills at age 1 compared with babies in a control group.

, that provides the equivalent of up to $60 a month in unconditional cash to low-income Indigenous women during the two later trimesters of pregnancy was found to reduce the risk of preterm birth and low birth weight, increase breastfeeding and vaccination rates, and lower children’s risk for developmental problems.

Closer to home, the one-year expansion of the child tax credit as part of COVID-19 relief efforts of the adults who received it, which could in turn improve the mental health of their children, Bush said. It also . Experiencing poverty early in life is associated with lower school achievement, reduced earnings, and poorer health, as well as differences in brain development compared with children who grow up in more affluent households.

“The Space to Invest in Themselves”

Research on guaranteed income programs is in its infancy, but so far, the results are promising. A groundbreaking  in Stockton that provided $500 a month to 125 randomly selected residents for two years found that the program dramatically increased participants’ financial stability, reduced depression and anxiety, boosted employment rates, and allowed for greater self-determination. Analysis of participants’ monthly expenditures—which was tracked through the debit cards on which they received their stipends—showed they mostly spent the money on food, utilities, car maintenance, and transportation. Less than 1% of the money went toward tobacco and alcohol.

The BIG:LEAP has observed similar expenditure trends and positive benefits to participants, Strauss said, although a full evaluation of the program by the University of Pennsylvania’s Center for Guaranteed Income Research is pending. Expenditures include catching up with bills, paying for health care or food, buying school supplies for their kids, investing in school tuition, or starting a small business.

“We have heard anecdotes from folks that they’ve used the funds to secure their future—some are able to make investments that allow them to take higher-paying jobs; for example, repairing a car that now lets them get farther to a higher-paying job, or investing in a computer or tuition for school,” Strauss said. “In that sense, we believe guaranteed income is a positive investment in folk’s futures because it gives them the space to invest in themselves.”

The guaranteed payments are not intended to replace a recipient’s existing income. Most participants also have jobs or receive some support through other public assistance programs, such as CalWORKS, CalFresh, and Medi-Cal.

Sara Kimberlin, senior policy fellow at the California Budget Center, said providing unrestricted cash support gives people the flexibility to address their most pressing needs, while respecting their dignity and ability to decide for themselves what they need most. That differs from the standard, more widely available public assistance programs, such as CalWORKS, which imposes work requirements for many participants, and the Supplemental Nutrition Assistance Program or CalFresh, also known as food stamps, which is restricted to grocery purchases. Kimberlin said the results of California’s current expansion of guaranteed income programs could provide information on how to improve the effectiveness of existing public assistance programs, as well as offer a model for additional cash assistance programs that target specific groups, such as pregnant women and young families.

Guaranteed income programs could also be used to assist people who are experiencing or vulnerable to domestic violence, Kimberlin added. Flexible cash support could make it easier for survivors to quickly access the funds they need to obtain housing or other resources they need to seek safety. Cinthia Chicas, a management analyst for the BIG:LEAP, said at least one participant used the funds to help her leave an abusive relationship and buy food and clothes for her children.

“The stress of dealing with a [domestic violence] situation you’re exiting, and the trauma, can be a barrier to navigating processes to access different types of programs and resources,” Kimberlin said. “A core tenet [of guaranteed income] is reducing burdensome requirements and minimizing red tape.”

Calderon, who received her final $1,000 payment in February, used the money to lift her family out of a financial hole and improve her career prospects.

Before entering the program, she was on the verge of quitting community college because she had no computer to do her homework and �徱���’t have a car to get to class. With the additional money, she was able to purchase a computer and a used car and is now on track to complete her associate degree in sociology in December. She then hopes to gain a bachelor’s degree in social work. Her boyfriend, meanwhile, has obtained a tax preparer certificate. They’ve built some savings, and Calderon said her mental health has improved because some of the financial stress is gone.

“It just makes me feel more positive knowing I have a little more advantage than I did last year,” she said. “I’m actually very excited for what the future holds, now that I had a little bit of help.”

Guaranteed income programs are currently not widely available, and most target specific populations. However, the number of programs is growing. Here is a way to find city-led and a list of in California.

If you or someone you know is experiencing domestic violence, contact the  at 1-800-799-7233 for support and referrals, or text “START” to 88788.

This story was originally published in in collaboration with  and  as part of the .

As  who have studied  and , we have found that Indigenous nations have reacted quickly and effectively to the pandemic. 

In our analysis, tribal nations have implemented guidelines and policies that appear to be far more effective than those used by the states they are in. These responses include locking down roads and implementing guidelines earlier and more carefully than others and developing relevant modes of delivery of supplies. Their response shows that Indigenous nations and communities know what they need; they are the directors of their own protective measures. 

Protecting Themselves and Their Land

Even when governors in the states tribes are in disagree with them, nation leaders stood out. Responding to the pandemic also means continuing to exercise sovereignty.

For example, in April, tribes in South Dakota  for cars coming onto their land and asked passers-by not to enter. South Dakota Gov. Kristi Noem characterized the checkpoints as illegal roadblocks and ordered the tribes to cease their activities and called on  to intervene. 

Later, , President Trump referred to the Native Americans protesting his gathering on their land as “angry mobs” and  the well-known Seventh Cavalry regimental song played by Custer in battle. Still, as the coronavirus spikes continue to break records, Native nations have managed to control traffic on and off reservation land. 

The Shinnecock Nation is also successfully organizing strategies to protect its people, land, and ancestors. The Shinnecock Nation is surrounded by Nassau and Suffolk counties on Long Island, home to some of the wealthiest people in the world. Those counties served as an escape for New Yorkers last spring when the pandemic raged. Even with the onslaught of people, many of whom may have been exposed to the virus, the Shinnecock took action and kept the number of cases to a mere  by following guidelines provided by the Centers for Disease Control and Prevention.

This is nothing new for Shinnecock people. Protecting themselves has been a necessity for survival since 1640, when English settlers purchased 8 square miles of Shinnecock land, the origin of what is . European settlers brought smallpox to Long Island, which had devastating impacts on Shinnecock and other Indigenous peoples of Long Island. Centuries later, however, they travel across Long Island and from all over the U.S. to attend one of the largest annual powwows on the East Coast, held on Shinnecock Nation every summer. This year, for the first time since its inception in 1967, the powwow was . 

In fall 2020, at the behest of members of Shinnecock Nation, Southampton adopted the . This move came after years of development and disruption of burial grounds. One such example is the well-known Shinnecock Hills . Now, a coalition of Shinnecock and its allies, Warriors of the Sunrise, has set up camp on the Shinnecock Nation and is asking for statewide passage of the . They also want the state to drop its lawsuit against the Shinnecock Nation over a signboard that has provided COVID-19 related  for heavy commuter traffic.

Navajo Mask Mandate and Organizing from Inside

In the Southwest, multiple tribes have quickly responded to COVID-19. The Navajo Nation has acted more swiftly and strongly to COVID-19 numbers than Arizona Gov. Doug Ducey, who was slow to suggest guidelines at the pandemic’s beginning and quick to let them expire. In contrast, Navajo Nation President Jonathan Nez put out a  on the Navajo reservation in the early days of the pandemic. Still, numbers and impacts of COVID-19 continue. 

Other Native-led efforts to meet community needs have been relevant and strong. This includes the Native-led , a Navajo-Hopi relief fund that raises money for food, water, and “kinship kits” with Navajo and Hopi people in the region.

Grassroots strategies work because they are dynamic and vigilant; tribal members best understand community needs. Ethel Branch, former Navajo Nation attorney general, told our authors that the fact that COVID-19 disproportionately affects these communities indicates a “target on our culture.” Elders, she said, carry language and traditional knowledge. This is why Yee Ha’ólníi Doo distributes two weeks’ worth of food and water to elders through a “family-based relief approach”: Elders, they know, will “share with their family members.” 

Other organizations left the area after the first surge, but this one has continued to provide consistent relief. They know the foods and resources that are most appropriate for people who live there. “We love our people and we care about them,” said Branch. “They are our family members, and so we are really purposeful in how we apply resources. We care about saving every life until this pandemic is gone.” And now, during another spike, this organization and others continue to collect resources for lifesaving actions across tribal lands. Perhaps it is time to consider dispossession as an ongoing health disparity. Stories that focus only on the need and despair of Native people overlook long-held practices of sustainability, kinship and health.

This article was originally published by . It has been published here with permission.

People who use medical devices that depend on electricity need continuous access to electricity. Some of my son’s most critical machines—such as his ventilator—have built-in battery backup. But other machines, like the oxygen concentrator that supplies oxygen to help with breathing and the humidifier that adds moisture to the air from the ventilator, need to be plugged in. Previously when the power went out, I had to scramble to jerry-rig his ventilator circuit to run without many of the accessory machines he usually uses. This required making quick, complicated changes in the dark—putting his health at risk. I then had to quickly figure out a way to get to a place with electricity.

But on this occasion, for the first time, I had access to a portable power station. That meant I was able to simply unplug the machines from the wall and plug them into backup power without the outage affecting my son.

Portable power stations are rechargeable batteries that can provide hours of backup electricity, which is especially important for people who use medical devices or assistive technology. The battery takes up about the same amount of space as a suitcase, and using it is as simple as turning it on and plugging equipment into it. But even though this lifesaving technology exists, most people who need it don’t have access to it because of cost.

The power bank that we used to keep my son’s equipment running overnight was funded by my utility provider, Pacific Gas & Electric’s (PG&E) Disability Disaster Access and Resources Program. This program pays for portable backup batteries, food replacement, transportation, and hotel stays related to power outages. The program works well—but only a limited number of California residents qualify. It’s only open to disabled PG&E customers who live in high-fire-threat areas subject to Public Safety Power Shutoff, a particular type of planned power outage intended to reduce the risk of wildfires. PG&E’s program isn’t available in the cities where most customers live. Other utilities with these programs have similarly narrow restrictions. Those who live in other states, such as the 1-year-old in New York whose mother had to use a bag valve mask to manually give breaths to her child when the ventilator battery ran out, are also in need of backup power.

For people who depend on electricity-powered medical devices to live, any power outage is an emergency. When I’m scrambling to change the arrangement of my son’s ventilator circuit in the dark, I don’t care whether the power is out because of a wildfire threat or because a car knocked over a power pole. From a practical standpoint, it doesn’t make sense for one type of outage to be eligible for utility-funded backup power and the other not to be.

Access to electrical power during outages is an equity issue for low-income California residents. The power bank that we used to keep my son’s equipment running retails for almost $6,000—as much as a decent used car. In California, 26% of people with disabilities live below the poverty level. Families don’t have thousands of dollars to spend on a device that will be used, at most, a few times a year. The sad irony is that because portable power stations are so costly for many families, those who can’t afford them may end up calling 911 during outages and requesting ambulance transportation to a hospital, an even larger expense.

Gasoline-powered generators are cheaper, but not a good option for many disabled people in an emergency. These generators require a well-ventilated outdoor space for safe operation. People who live in apartments typically don’t have access to a place to safely operate gas generators, or a way to store them when not in use. Setting up and operating an outdoor gas-powered generator also requires substantially more strength and agility than using an indoor power station. Using an indoor portable power bank is as easy as bending over to plug equipment into the device.

Access to electrical power during outages is critically important as climate change brings wildfires, hotter summers, and more unpredictable storms. When the power grid fails, it’s an inconvenience for most people, but a matter of life and death for disabled California residents who depend on medical devices that need to be plugged in. The limited program that utility companies have in place proves they can identify customers who have a medical need for backup power and build a distribution network to get them the devices. California’s public utilities should build on this program and expand it across the state to any consumer who needs continuous power for medical devices.

This column was produced in partnership with the .

The Americans with Disabilities Act (ADA) was signed into law in 1990 and forms the foundation of disability integration into employment and public spaces. The ADA prohibits discrimination on the basis of disability and requires that public spaces be made accessible to people with disabilities.

But the mechanism of enforcement relies on people with disabilities filing individual complaints and lawsuits—the system as it exists delegates a collective responsibility for accessibility onto the people who are excluded. The result is that, even though the law requiring accessibility for public spaces is more than 30 years old, many places are still inaccessible for people with disabilities.

During the first few years of my son’s life, he had several medically complex health issues, and life was overwhelming—my focus was on keeping him alive. I �徱���’t have the bandwidth to pick fights over accessibility, so when things �ɱ�����’t accessible, we just �徱���’t do them.

As a child with medical complexities, my son took a few years to learn to walk well enough to get around. The process of him learning involved several different walkers, along with a stroller to carry his medical equipment. The ADA rules that are in place to make public spaces accessible for wheelchairs should have made more spaces workable for strollers and walkers—but they �徱���’t. I threw out my back more times than I can count trying to balance a crying, fragile child in one arm and 40 pounds of equipment in the other.

What did I do to solve problems in those early years? I leaned hard into abled privilege and tried to steamroll my way through them. I figured out a 40-pound backpack system that could carry his oxygen, suction machine, feeding pump, and all his gear with me on the move. As a small child learning to walk in a world that constantly tripped him, he fell constantly. And with 40 pounds on my back, I had a hard time picking him up.

My next solution was Crossfit—if he was going to get heavier and would still need to be carried, I would just have to get stronger to keep being able to lift him. I love being strong—but I was wrong in thinking I could powerlift a solution to his need to interact with the world.

Here in the United States, we tend toward individual solutions, even when structural solutions would do a much better job at fixing things. The ADA has existed for my son’s entire life, but it’s still up to us to figure out whether a location is going to be accessible. The process of figuring out accessibility concerns in advance places a time and planning burden on people with disabilities, and the amount of pre-planning that is required to do basic things that abled people take for granted is immense.

Now that I’ve given up on being a bulldozer mom, I’m learning how to be more assertive about accessibility needs, and at the same time, I’m teaching my son how and when to pick a fight over accessibility. In scenarios where there is likely to be pushback, I take the lead as the adult. In scenarios like the movie theater, where staff is (usually) trained and compliant with ADA requests for closed captioning, I nudge him to make the request.

Our major accessibility concern recently has been less about the built environment and more about the way we all behave in public spaces. The lack of COVID-19 mitigation strategies in most of public life creates a substantial accessibility burden for children and youth with medically complex disabilities. Children like my son are at much higher risk for death and serious illness from COVID than children without underlying medical conditions. To pursue their right to an education, medically complex children have to either accept the substantial risk of COVID transmission in classrooms with unmasked, frequently sick and symptomatic classmates, or opt out of in-person school entirely. It’s in scenarios like these—where the potential for harm is high, but the pushback on accommodations is frequently hostile—that I don’t have any good guidance to give him.

The curb-cut effect, a phrase coined by civil rights advocate Angela Glover Blackwell, refers to the way programs originally intended to benefit people with disabilities actually turn out to benefit society as a whole. Her initial example is how curb cuts—the small ramps built into sidewalks to allow for wheelchairs to roll smoothly down—make life easier for pedestrians, bicyclists, and families with strollers. The kind of reasonable accommodations under the ADA that make life run smoothly for children and youth with special health care needs work in much the same way. If we look at the accommodations that children with disabilities need as being part of inclusive and universal design, rather than looking at them as special requests, we can all end up with better solutions.

This commentary was produced in partnership with the .

Like many policy efforts when it comes to youth, this misses the mark and ignores the real crises afflicting teenagers.

The real crises the most troubled teens face involve their �貹����Գٲ�’ rising addiction, suicidal and addictive behaviors, and violent and emotional abuses. Bans on teens’ online access are dangerous, since indicate the most distressed fraction of youths use social media to connect to others and find “people who can support them during tough times.”

Unfortunately, the Centers for Disease Control and Prevention’s (CDC) just-released “,” generating alarmist headlines like “,” invites exactly the kind of distractions and scapegoating being pushed with ill-advised bans.

The latest report finds a bizarre contradiction. On one hand, teens themselves are generally improving their behaviors with respect to drugs and alcohol, school violence, and sexual responsibility—findings similar to those of the FBI, CDC, and Census Bureau that actual crime, unwanted pregnancies, and school dropouts by youths are plummeting. Only 15% to 16% report bullying (even under a very broad definition) at school or online—the two venues with which commentators and leaders seem obsessed.

Decades of research show that troubled teenagers are the product of abusive, troubled adult families.

On the other hand, the new CDC report finds dangers and violence toward teens inflicted by others is increasing dramatically. For example, 18% of girls report being sexually victimized. But, as in other areas of endangerment, the CDC fails to explore who is perpetrating the violence. If, as the , rape and sexual assault by teens have plunged to all-time lows, who is sexually victimizing young women?

The latest CDC report similarly finds LGBTQ+ youth, and youth who have otherwise had same-sex sexual contact, reporting alarming levels of forced sex and violence. It then fails again to ask about the perpetrators. Are they partners? Peers? Adults? ? Instead, the CDC seems to invite speculation as to who to blame.

The previous survey, released by the CDC in March 2022, , although it did pose more questions than the most recent report. It found 11% of high school respondents reporting violent abuses and a shocking 55% reporting psychological abuses by parents and household adults. A 2013–2014 using slightly different measures and age groups showed sharp increases over teens’ reports of violent and emotional abuses by parents and caregivers.

The CDC’s 2022 report cited violent abuses by parents that included hitting, beating, kicking, and otherwise physically hurting their children, while emotional abuses included insulting, swearing, and name-calling. The CDC did not ask about sexual abuse by parents and grownups—which was in keeping with major commentators, like The Atlantic’s and The New Yorker’s , whose reports have dodged abuse issues altogether to blame teen problems on social media.

The CDC’s 2022 report found 3 to 4 times more teens reporting parental abuses (55%) than its 2023 report found for school (15%) or cyber (16%) bullying, even though the agency’s  is narrower than for . They are 4 times more likely to be violently abused by household adults and 3 to 5 times more likely to have attempted suicide than non-LGBTQ+ youth.

Decades of research show that troubled teenagers are the product of abusive, troubled adult families. and abuses inflicted by household adults are firmly linked to their children’s , closely tracking the increase in teens who  (26% in 2013; 44% in 2021).

Crises among America’s grown-ups are severe. Among parent-aged adults over the past three decades, per-capita rates of suicides and drug and alcohol overdose have more than tripled, reaching record peaks in 2020–2022 during the COVID-19 pandemic. Adult depression recently also tripled, a 2020 study found.

Compared with 15-year-olds, today’s 45-year-olds are 1.5 times more likely to die by gunfire, 1.5 times more likely to be criminally arrested, 3 times more likely to commit suicide, 4.5 times more likely to die from all violent causes, 25 times more likely to fatally overdose on illicit drugs (including 23 times more for fentanyl), and over 100 times more likely to die from binge drinking, the and report. Higher death rates are only the tip of the iceberg pointing to a much larger number of family problems.

This is not a “teenage mental health crisis.” It is a troubled-adult crisis compounded by the obliviousness of derelict leaders and interests who have failed to address America’s burgeoning epidemics. We should be shocked if teens �ɱ�����’t more anxious and depressed.

Abuses cause real-life injuries and deaths. The latest “” report, covering 2020, by the Children’s Bureau of the U.S. Department of Health and Human Services, tabulated about 160,000 child and youth victims of physical and sexual abuses and nearly 40,000 victimized by severe psychological abuses inflicted by parents and other household adults in substantiated cases that represent only a fraction of what actually occurs. project that nearly 500 homicide victims ages 12–17 were killed by people ages 25 and older in 2020—a dozen times more than were killed in school shootings.

Missing (and Misrepresenting) the Point

Nearly all press reports seem to avoid admitting the disturbing realities that teens cannot evade.

A typical example is the scary-sounding but meaningless statistic that “suicide is the third leading cause of death among teens.” That’s not because suicide is particularly rampant among teenagers, but because teens rarely die from natural causes. For example, in 2021 and 2022, the to date records 4,184 suicides and 2,705 deaths from cardiovascular disease and cancer for ages 12–19; and 8,661 suicides and 73,257 deaths from cardiovascular disease and cancer among ages 42–49. Deaths can be lamented without completely misrepresenting teens as uniquely self-imperiled.

Unfortunately, legislators and other leaders have proven unable and unwilling to design effective responses to the United States’ epidemics of drug and alcohol , gun violence, suicide, and related self-destructive behaviors that together in the U.S. in 2020-2021. Yet, many of those same commentators and leaders eagerly blame social media and teens.

Should we also ban youths from associating with their parents, going to , joining organizations like the , , and going to , all of which have histories of large-scale abuses of children and youths and institutional cover-ups?

Studies that examine social media impacts in a nuanced fashion have found the large majority of teens benefit. Only 9% told a 2022 that social media negatively affects them personally. (Interestingly, 32% thought it negatively impacted other teens.) Pew found “80% said social media gives them some level of connection to what is going on in their friends’ lives, 71% said it’s a place where they can show their creativity, 67% said social media reassures them that they have people to support them, and 58% said it makes them feel more accepted.” (One unspoken motivation for Republicans to back restrictions might be that, according to Pew, youth identifying with the Democratic Party or politics are both more numerous and more likely than Republican youth to communicate and organize.)

In contrast, few teens among both those who find social media positive and negative , like pressure to conform, feeling excluded, feeling worse about their lives, or being “overwhelmed by all the drama.” Both teen groups said their online experiences are better than parents think.

Surveys question youths on problems chosen by surveyors. When surveys ask , they cite worries over , not social media.

Leave Those Kids Alone

Congress has a dismal record of imposing effective age limits on what it deems dangerous behavior. Long-term research using improved techniques found that raising the nation’s , initially celebrated for “saving lives” (albeit at the cost of hundreds of thousands of annual teenaged arrests), actually just “” into young adulthood by disrupting the vitally important gaining of “” with alcohol. Likewise, imposing was associated more with than with reducing them among younger teens

Alarmism hurled at every younger generation for has proven useless. Within a couple of years, the alarmists are back to proclaim new youthful crises worse than ever.

of the early 1900s trumpeted the “” in “child suicide” they blamed on popular media (“cheap theaters, pessimistic literature, sensational stories”). The American Youth Commission’s found 75% of young men were suffering debilitating mental troubles. Science News Letter reported in 1937 that kids “as young as six to thirteen” were being treated for suicidal thinking. (Pundits now call those kids the “Greatest Generation”).

Surveys found mental health professionals of the 1980s estimating the average teenager was more mentally disturbed than psychiatric patients. In the 1980s, the psychiatric industry profitably hyped the “” to fill empty beds in overbuilt hospitals. In the 1980s, the Parents Music Resource Center, led by Tipper Gore, blamed rock music for teenagers’ woes. A declared suicide had “soared” among young adolescents. In 1998, blamed television for children being “the most damaged and disturbed generation this country has ever produced.” In the early 2000s, college and university counselors proclaimed a “” and won tuition increases to fund more staff. Apparently, it �徱���’t do any good. Counselors are back again, demanding more money because “.”

What we should be studying is how teenagers, supposedly impulse-driven, , “,” should be so unlikely to act self-destructively compared with supposedly stable, mature grownups. They don’t need authorities stepping in once again with more misdirected alarmism and destructive bans that trivialize the real-life problems they face.

Launched in 2010, The Family Dinner Project was created to help busy households make time and space for regular, stress-free dinners, said Anne Fishel, cofounder of the Cambridge, Massachusetts-based organization and associate clinical professor in psychology at Harvard Medical School.

Fishel said she grew up in a household where family dinners were the most reliable family tradition. That was part of the reason she wanted to help others maintain a similar practice.

“It was a formative time,” she said.

Over the past three decades, by more than 30%. Families with children under age 18 share dinners three to four times per week, while one-third of families with 11- to 18-year-olds share one or two meals per week at most. Only one-fourth eat seven or more family meals per week.

As those numbers decline, more and more research show the benefits of family mealtime: better communication, higher academic performance, and improved eating habits.

On The Family Dinner Project’s website, families can find games to play at the table, conversation starters, and tips to prevent conflict. The site also offers a free toolkit for anyone interested in hosting a family or community dinner. The number of families attending any single community dinner varies, but some components are constant: participants cook, play games, have conversations, and, of course, eat together, Fishel said. Conversations are facilitated through story cards, which can prompt conversations about favorite family recipes, migration history, or how their parents met, to name a few.

“When kids know their family’s stories, it increases their resilience and self-esteem,” she said.

The Family Dinner Project’s goal is to help families that don’t often share dinners jump-start the practice. Fishel said dozens of community meals have been held, and each served as a place to reinvigorate, inspire, and create a sense of relating to others. Community meals have been held at the Boys and Girls Club in Newark, New Jersey; the Boston Children’s Museum; and at Hanscom Air Force Base outside of Boston, to name a few.

Heather Nelson, a mother of four from Virginia, and her family participated in a community dinner in May 2016 at Hanscom Air Force Base. They were in the middle of moving, and were living in a hotel. A free dinner and something different seemed like a good idea, Nelson said.

Although Nelson’s family has dinner together often, she said attending a community dinner helped them improve their shared mealtimes and gave them ideas on how to make them more meaningful.

“We loved the experience” because it led to discussions rather than one-word responses, she said. “I felt like we learned a lot.” Her family has used resources like recipes and conversation starters from the site.

Simply eating together is an important first step, but that alone will not give families the benefits of a shared meal, said Barbara Fiese, a professor and director of the Family Resiliency Center at the University of Illinois. Television, screens, and other distractions during dinnertime take away from the “power” of what could happen during the meal.

“You got to get together first,” she said, adding that when there is a routine in place, families may find it easier to talk about bullying or other difficult topics because they know the dinner table is a safe environment.

Making an effort to have a shared meal is not just for nuclear families, either; the benefits logically extend to any household wanting to reconnect. Additionally, people living in low-income households don’t need to worry about the meal being extravagant or expensive.��The shared meal can be a snack; it does not necessarily need to be “perfect or formal or fancy food,” Fiese said.

“While the food is just what brings the family to the table,” Fishel said, “what keeps them there and what makes the benefits actually happen is there being a warm, inviting, welcoming environment at the table.”

For Beverage, who is a certified personal trainer and owner of Sweet Momentum Fitness in Portland, Ore., that was an introduction to an online community of queer and trans trainers across the United States. “Before I found out about Decolonizing Fitness, I really struggled with feeling very isolated as a trans person in the fitness industry and as someone trying to build a business based around pretty progressive values,” they said.

In 2017, ,��according to the International Health, Racquet and Sportsclub Association. The number includes YMCAs, community centers, and studios, among other places to work on your fitness. And yet, there aren’t a lot of places where queer and trans people to feel safe to work out and train.

Queer and trans people often experience discrimination in fitness spaces.��The very design of gyms, both in the physical buildings and their processes, is often gendered. Intake forms offer “male” and “female” gender options, and restrooms and changing rooms typically don’t make room for people who identify as nonbinary. Additionally, people point to ��them.

That’s where the Decolonizing Fitness database comes in. Ilya Parker, owner of ��to confirm the need to create a free, downloadable list of fitness trainers and movement trainers who provide affirming services for queer and trans clients.

“I hope Decolonizing Fitness can help improve the lives of trans, queer, fat, gender-nonconforming, disabled, and chronically ill people by carving space for us to exist freely just as we are,” Parker wrote by email. “I firmly believe that fitness can be used [as] a healing modality which will offer us room to reconnect with and find peace in our bodies.”

Decolonizing in the fitness world means creating spaces where trainers and clients are intentionally accepting of everyone, no matter their gender, sexual orientation, race, or any other identity. For example, there’s a body-positive gym in Oakland��that was founded with the purpose of meeting the needs of everybody who uses the space.

Since Parker, a licensed physical therapist assistant and medical exercise coach, started the database, it has grown to include about 100 personal trainers, strength coaches, yogis, and other fitness or wellness professionals. They’re based in many U.S. cities and the database even includes a few international listings—in Melbourne, Australia, and Toronto.

Bianca Russo, a personal trainer and founder of Body Positive Boot Camp in Washington, D.C., was one of the first people to respond to Parker’s post about queer- and trans-affirming trainers. She said she felt uncomfortable in previous gyms, and most fitness services aren’t “positive, inclusive, trans-affirming” like the one she owns and others on the database.

“The business model stands for almost the antithesis of what the greater general fitness community is putting in everybody’s faces,” Russo said, noting that Decolonizing Fitness is encouraging all fitness and wellness professionals to make their work more inclusive and accessible.

“The focus is shifting from only centering cisgender, heterosexual, able-bodied people,” Parker wrote. “The database is prompting people to be mindful of those who carry multiple marginalized identities.”

“The database is prompting people to be mindful of those who carry multiple marginalized identities.”

In addition to the database, Decolonizing Fitness has a growing (16.9K followers as of this writing). There, Parker posts messages related to health, racial, and queer justice as well as photos and videos of people who are queer, trans, and/or of color in fitness spaces.

Both Russo and Beverage said Decolonize Fitness has helped them connect to other trainers across the country. Beverage recalled a post where trainers discussed how they make their businesses accessible and others where Parker discussed how trainers can maintain active awareness of their clients’ various identities when working out.

Having this awareness is important because a person might have different needs related to identity. For example, people using chest binders might need to adjust their reps because the garment can affect the ability to flex and cause shortness of breath.

“These are conversations, that for me, I don’t get to have in networking groups or in other places,” Beverage said. “It’s giving a voice to folks … totally overlooked and not taken seriously.”

On another post about social media allowing marginalized people to engage in important conversations, one user commented,��“I found you recently while looking for alternative spaces in health and fitness world outside the heteronormative mainstream, and I’m so glad I found you.”

This is one of those examples of social media providing a constructive learning tool for connection. Decolonizing Fitness helps each body and gender find its role in being an ally to their neighbors who may not identify in the same ways that they do.

This article was funded in part by a grant from the Surdna Foundation.

My mother and father integrated their Episcopalian faith with low-impact living in a 1970s subdivision called Wild Oaks. They cycled with their four children throughout our hometown of Fairhope, Alabama, hiked the Appalachian Trail, and gave up trash for the 40 days of Lent to reduce consumption. With her salt-and-pepper bob and lilting Southern accent, my mom joked to her bridge group that my father always wanted to give away their stuff after their long-distance hikes. At 58, she was hit and killed by a teenage driver while biking to the farm where Dad worked in exchange for produce. After her death, the ladies of the First Baptist Church of Point Clear, Alabama, completed a quilt she’d pieced together, and he slept under its comfort each night. Then two years later, riding on the shoulder of the road with a reflective vest, my 64-year-old dad, a retired IBM salesman, was killed in a mirror-image accident. Three days before his death, I told him on the phone that I was pregnant with my younger daughter, although separated and soon-to-be divorced. I carried my �貹����Գٲ�’ deaths inside me, like the weight of the soil. I wasn’t sure how to be a single mom after the sudden deaths of both of my parents, whose marriage had only gotten stronger with time. Approaching my 40th birthday, I nursed my newborn daughter in their four-poster double bed I inherited, facing the Blue Ridge Mountains, underneath their quilt in the colorful pattern of Grandmother’s Flower Garden. A decade later, the quilt’s white cotton background was yellowed and nearly brown in places. The bunting escaped from the stitches like bunny tails poking out of a rabbit hole. When my children flung themselves on the bed, their growing limbs tore at the seams. I called fabric stores and wrote Facebook messages to quilting bees. One hot summer day, I heard from Sharron, The Quilt Lady, who had seen my online pleas and made repairs at reasonable prices.

She arrived, her car filled with stacks of colorful spools because she taught sewing at the women’s prison, where she precut the squares because her students �ɱ�����’t allowed to have scissors. She described the process of soaking cloth with Lipton tea bags to match the tint of my mother’s material. After one year, she’d repaired 127 colored hexagons and 39 white diamonds, working 80 hours in small blocks because of arthritis. When we placed the patchwork blanket on my sheets, I read aloud to my daughters the embroidered names of those who’d worked on the quilt, including their grandmother, Ann Jones McDuff. When my father died, I inherited a family toboggan, which stood like a sentinel outside my front door in North Carolina, although the old wood had splintered with age. “Let me take a stab at fixing the sled,” said Steve, my college roommate’s husband who lived down the road. Before the first snow, he delivered a restored beauty with bright-red canvas straps on either side. The wood glistened with a waxy sheen, as he’d replaced rotted sections with solid pieces. He’d found the exact replica of the original screws. Strangers asked my daughters for a ride on the faster flyer on the big hill on campus, and we shared the sled and its story. Four adults piled onto the wooden frame, setting a distance record, met by applause that echoed in the valley. That spring after the snows, a colleague visited with her boyfriend, Dave, who tuned my damaged guitar, a gift from my dad. He emailed me a week after leaving on a hiking trip: “This might seem like an odd request,” Dave wrote. “But walking on the Appalachian Trail, I couldn’t stop thinking about your parents.” He wanted to return to Asheville to visit an elderly local man who restored guitars.

When I was in high school, my father gave me the Martin guitar he longed to play, worthy of his bluegrass band’s renditions of “I’ll Fly Away.” But the instrument sat in the corner of my living room, a patched hole in its side hidden like a secret. Although we had just met, Dave drove four hours, placed the guitar in the back seat of his green Subaru, and left on a mission to repair it. When he returned, I learned the costs to repair it would be more than the instrument was worth, but the old-timer provided tips for prolonging the life of the guitar, which my dad would have approved of. In my 20s as a Peace Corps volunteer, I’d once chided my mother for buying china as a wedding gift, claiming that I would never want so much “stuff.” She’d responded, “Someday these things might mean something to you.” And she was right: this year of restoration brought me closer to their lives.

“I found flashes to be desperate, uncomfortable, sometimes even sublime, but never funny,” she writes. The book is getting quite a bit of media attention, and has helped create a space for talking and writing about menopause from a new perspective. “There’s so little that’s good that’s written about it,” Steinke says of the menopause books on offer, which she says almost exclusively consist of advice on how to overcome symptoms with self-care, herbal remedies, or hormone therapy (otherwise known as “HT”). While she found Dr. Christiana Northrop’s bestseller The Wisdom of Menopause marginally helpful, something was still missing. “I wanted a more personal view,” she says. “I wanted to see myself reflected somewhere. And I could never find that.” A great deal of advice from the menopause industry homes in on sex: whether menopausal women can still do it, and whether they’re still desirable enough that anybody would want to do it with them. Taking HT can delay or lessen symptoms like hot flashes, diminished libido, and the thinning of vaginal membrane, but that comes with a small increased risk of cancer.

In��Flash Count Diary, Steinke speculates that there might be something of value on the other side of the hormonal withdrawal that is menopause: “Some scientists say menopause is triggered when the number of viable eggs in the ovaries is too low; others admit they don’t know why egg maturation stops and hormones diminish. Without hormones, my body changes again, just as it did in adolescence when I was flooded with estrogen and began to menstruate. While menstruation still carries stigma in our culture—we are ‘on the rag’ and considered unstable because of fluctuating hormones—the fertile years of a woman’s life are also considered her most essential. Menopause, on the other hand, is disparaged, even considered shameful. No one proposes we eliminate childhood, adolescence, or adulthood from the female life cycle. Only menopause is considered something to be cured and reversed, done away with completely.” The natural world offers unexpected sources of inspiration. After another sleepless night of hot flashes, Steinke reads an article about killer whales, one of the few mammals other than humans that go through menopause. For most female mammals, fertility doesn’t stop completely, just dwindles until they die. But orcas—the cetaceans known as “killer whales”—go through menopause and have a long post-reproductive life, like humans.

Research indicates that menopause had an evolutionary advantage for orcas.

Whale researchers know this thanks to the Southern Resident Orcas, an endangered group now numbering 75 living in the Salish Sea close to dense human populations in Canada and Washington state. Their location is convenient for research but not so good for the Southern Residents, a cluster of related pods, or families, with big, convoluted brains, and what researchers describe as a distinct “dialect” of whale calls and a “culture” of learned behavior. Orcas also have strong social relationships, and their pods are led by post-menopausal females. Research indicates that menopause had an evolutionary advantage for orcas, because having post-reproductive females around to help with care and feeding increased the life chances of the young. In the study of human evolution, this is “the grandmother hypothesis”—the theory that post-menopausal women in hunter-gatherer societies were good for the group as a whole. Freed from the work of bearing their own children, they helped care for and feed their grandchildren, increasing the likelihood of their survival. The next generation carried their genes, and the menopause advantage was passed on. The wise historians of the world’s few remaining hunter-gatherer communities, Steinke says, are very old ladies who know from experience where to find food in times of scarcity, where that well was and where to dig, and what young couples need to do to get along.

In Flash Count Diary, the Southern Resident Orcas become Steinke’s long-distance menopause companions. From her study in Brooklyn, she livestreams an underwater whale research mic in the Salish Sea and listens for their vocalizations. She dreams about them. If comparisons between women and orcas feel like overreach, consider that Steinke is not the first to make them. One of her beloved orcas, a 6-year-old female snatched in the great Puget Sound whale capture of 1970 and flown to Florida, was placed in a pool at Miami’s Seaquarium with a much older male. Her new owners cleverly named her “Lolita,” after the Nabokov novel about a pubescent girl held captive by her predatory stepfather. Steinke’s fascination takes her from a protest at Lolita’s too-small pool in Florida to the Pacific Northwest, home to free female orcas, including the 100-year-old J2, or “Granny,” the Southern Residents’ post-menopausal matriarchal leader of the pod. There, on a kayaking trip, Steinke has the good luck to be approached by J2 and looks into the eye of a whale. It’s the culmination of her menopausal journey, a transcendent experience of wonder and mystery. If that sounds a little woo-woo, be assured that the writer’s craft, buoyed by research, guides readers thoughtfully to her orca encounter.

Steinke is aware that “what orcas and menopausal women have in common” is a tough elevator pitch. “The publishing industry was like: ‘Don’t talk too much about the orcas until way after the book comes out,’” she says with a laugh. Steinke concedes her book is unusual. “This is one of the weirdest books I’ve ever written,” she says. But her choice to let the narrative go where her menopausal quest takes her opens up radical new possibilities for the reader. As it stands, there’s no way to know what menopause might be like when not viewed through our culture’s patriarchal lens. But Steinke would like to see a cultural reframing of menopause. Along with that, she’s considered a new name for the process—a rebranding, as it were. “I have thought about this a lot, in part because I had to say ‘menopause’ so many times in my book,” Steinke says. “I have a list of words I could use medically. I looked up what it was called in other cultures.” But she says she still hasn’t found a term that feels right. The thing about menopause, says Steinke, “is there’s real struggle, but there’s also real gain. It’s a paradox, like all good things in life—like parenting, like sex, like everything. There are bad parts, but there are good parts. The part that’s kind of lost right now is—maybe it means we can be more free.”

• • Connect With Your Family Across the Table—and the Political Divide

At the Karma Kitchen, people enjoy a meal that’s already paid for—and are invited to continue the chain of generosity. In the process, organizers and participants alike learn the transformative power of gratitude.

In This Season of Thanksgiving, an Invitation—and a Challenge

“Some people grumble that roses have thorns; I am grateful that thorns have roses.”
—Alphonse Karr

I used to think being grateful meant appreciating the things that give us cause to be glad—healthy families, meaningful work, fulfilling communities, a thriving world.

But then I read a story about a woman on a quest to radically expand her sense of gratitude for all the ways life shapes us—including through struggles. Her brother-in-law had lost a one-year-old child, and the author wondered how he and his wife could ever come back from such irreversible loss. How could any of them be thankful for anything again? Then her brother-in-law, through his grief, told her: At least we were given a whole precious year of our lives to know him. That was more than nothing.

It’s one thing to give thanks for things that make us glad, but it’s a different challenge to expand our appreciation toward all the ways life makes us who we are. We’re expected to be happy, to succeed, and to flourish financially—and when it doesn’t turn out that way, it’s easy to miss the roses for the thorns.

What if we expanded our sense of thankfulness and appreciation so that it wasn’t only responsive to what makes us feel good, but what makes us grow? What if we cultivated an outlook of gratitude every single day? Would it be easier to try that together, with the encouragement, insights, and inspiration of others?

For the next three weeks, we’re inviting you to join us in a 21-day Gratitude Challenge—a call to fill your heart and expand your awareness by recognizing gratitude at least once every single day. YES! is partnering with and the thousands of people around the world who have already signed up to share their experiences and support as they do this—starting on November 7 and finishing on Thanksgiving. You’ll get daily support emails and be invited to participate in an online space where you can swap stories and share ideas. You’ll see some of the most inspiring ones on our website—maybe even your own.

Developing a grateful approach to life can improve your health, strengthen your relationships, and encourage a sense of purpose in your life. We hope you’ll of finding the good in each moment.
—Christa Hillstrom, web managing editor

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A moving sampling of participants’ reflections from the first two days of the Gratitude Challenge.