Washington, D.C. (June 18, 2018)—The next issue of The Atlantic magazine features The Health Report, with investigations that probe three of the most complex subjects facing Americans today. All three reports are published now at TheAtlantic.com; The Atlantic’s July/August 2018 issue will appear on newsstands and online in full next week.
The cover story, “When Children Say They’re Trans,” by writer Jesse Singal, is a deeply reported, nuanced, and humane exploration of the process of transition for children experiencing gender dysphoria, and the challenges parents face as they try to guide and support their children through that process. Singal spent months interviewing transgender adults and teens (and their families), many of whom found in physical transition profound relief from the suffering caused by gender dysphoria. He also talked with teens who experienced gender dysphoria at some point in their adolescence but ultimately came to believe physical transition was not the right answer for them; for some kids, gender dysphoria can dissipate without medical intervention. And he spent time with the leading clinicians working in this small and still-new field, who hold a wide range of views about the best way to determine whether and when an adolescent is ready for physical transitions that can have permanent effects on their bodies.
The Atlantic’s editor in chief, Jeffrey Goldberg, said of the cover: “This is the story of children and their families in fraught and uncertain situations. With care, thought, and, above all, deep reporting, Jesse asks a challenging and urgent question: What should children experiencing gender dysphoria and their parents ask of medical providers before pursuing a path that may not be reversible? And what are the possible consequences of deciding to delay transition? Like the best Atlantic cover stories, Singal’s investigation asks brave questions for which there are no easy answers.”
Also featured in the Health Report: an in-depth examination by staff writer Olga Khazan of the gaping and persistent racial health divides in America. Khazan’s reporting focuses on the city of Baltimore, where black people face a greater risk of death at practically every stage of life than white people do. And staff writer Ed Yong investigates whether America, under the Trump administration, is ready for the next pandemic at a time when humanity is undergoing unprecedented changes, geographic barriers are disappearing, and threats that once would have been local go global.
Summaries and links to all three pieces are below. Please be in touch with any inquiries or to interview the authors and editors about this reporting.
The Atlantic’s July/August 2018 Issue: The Health Report
“After a dark history in which transgender kids were mostly ignored, ‘repaired,’ or persecuted, a new protocol of social and physical transition has emerged. For teens who experience persistent gender dysphoria, this protocol can provide profound relief from suffering. For some kids, however, gender dysphoria is temporary. And the effects of transitioning can be permanent.”
In this cover story, writer Jesse Singal explores the question of when to consider physical interventions for children experiencing gender dysphoria, and looks closely at how parents can get their kids the support they need while keeping in mind that adolescence is, by definition, a time of identity exploration. As Singal writes, “Where is the line between not ‘feeling like’ a girl because society makes it difficult to be a girl and needing hormones to alleviate dysphoria that otherwise won’t go away? How can parents tell?” The leading medical and mental-health organizations recommend deliberation before teens undergo hormone therapy or surgery, but some clinicians are moving toward a faster process, and view thorough assessments of young people seeking physical transition as unnecessary, or harmful, gate-keeping. After decades of trans people being denied the medical services they desperately needed, such suspicion is understandable.
We are still in the earliest stages of understanding how physical transition affects dysphoric young people, however. As a result, Singal reports, many of the top clinicians in the field—clinicians who helped make it possible for the first teens to transition—are sounding alarms about teens now being waved through the process too quickly: starting hormone therapy, or having surgery, without undergoing a full examination of their mental health or the social and family influences that could be contributing to their gender dysphoria. These clinicians are advocating prudence: for young people who suffer gender dysphoria to be first evaluated comprehensively and compassionately, and then the best course of action determined.
Singal writes: “How best to support TGNC kids is a whiplash-inducing subject. To understand even just the small set of stories I encountered in my reporting … requires keeping several seemingly conflicting claims in mind. Some teenagers, in the years ahead, are going to rush into physically transitioning and may regret it. Other teens will be prevented from accessing hormones and will suffer great anguish as a result. Along the way, a heartbreaking number of trans and gender-nonconforming teens will be bullied and ostracized and will even end their own lives … The best way to build a system that fails fewer people is to acknowledge the staggering complexity of gender dysphoria—and to acknowledge just how early we are in the process of understanding it.”
Despite advances in antibiotics and vaccines, humans are still locked in the same epic battle with viruses and other pathogens that we’ve been fighting since the beginning of our history. Diseases have always excelled at exploiting flux, and as global populations flock to tightly packed cities, humanity is now in the midst of its fastest-ever period of change. Is America—more specifically, America under the Trump administration—prepared for the next pandemic?
The Atlantic’s Ed Yong embarked on an exploration of America’s readiness for the next outbreak, traveling to the Congo, where memories of Ebola persis;, visiting one of the few U.S. hospitals that has a biocontainment unit; and meeting with public-health officials the world over. With advancements in medicine and technology, the United States is as ready to face down new diseases as any country in the world, writes Yong. Yet the country is still disturbingly vulnerable—and in some respects, becoming quickly more so. “Though the U.S. is vastly wealthier than the Congo,” Yong write, “the laments I heard in both countries about how things could go wrong were uncannily similar.”
The U.S. “depends on a just-in-time medical economy, in which stockpiles are limited and even key items are made to order … Perhaps most important, the U.S. is prone to the same forgetfulness and short-sightedness that befall all nations, rich and poor—and the myopia has worsened considerably in recent years. Public-health programs are low on money; hospitals are stretched perilously thin; crucial funding is being slashed. And while we tend to think of science when we think of pandemic response, the worse the situation, the more the defense depends on political leadership.”
African Americans today face a greater risk of death at practically every stage of life than white Americans do. In Baltimore, a 20-year gap in life expectancy exists between the city’s poor, largely African American neighborhoods and its wealthier, whiter areas; and similar disparities exist in other segregated U.S. cities. The major underlying causes, many scientists now believe, are not genetic differences, but social and environmental forces that affect African Americans more than most other groups. To better understand how these forces work, Olga Khazan spent nearly a year reporting in Baltimore—where the legacy of housing discrimination and other environmental factors have caused neighborhoods themselves to become harmful to resident’s health—and following 27-year-old Kiarra Boulware as she fights the odds to get her addiction- and obesity-related health issues on track.
While discriminatory housing policies shaped the physical spaces of black communities, Khazan reports that certain stressful experiences—like living in such disordered or impoverished neighborhoods—cause health-ravaging, sleep-reducing daily stress. Even well-off black people face daily racial discrimination, which can have many of the same biological effects as unsafe streets. One expert on health disparities estimates black woman to be biologically about seven and a half years older than white women the same age. Khazan also reports that studies show that experiencing racism might be part of the reason black women are about 50 percent more likely than white women to have premature babies.
“What I found in Kiarra’s struggle was the story of how one person’s efforts to get better—imperfect as they may have been—were made vastly more difficult by a daunting series of obstacles. But it is also a bigger story, of how African Americans became stuck in profoundly unhealthy neighborhoods, and of how the legacy of racism can literally take years off their lives. Far from being a relic of the past, America’s racist and segregationist history continues to harm black people in the most intimate of ways—seeping into their lungs, their blood, even their DNA.”
The full July/August 2018 issue of The Atlantic will be published next week. Find more stories from the issue now at theatlantic.com/magazine.