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The Uncertain Future of Gender Care for Teens in Europe

The Atlantic

www.theatlantic.com › health › archive › 2023 › 04 › gender-affirming-care-debate-europe-dutch-protocol › 673890

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As Republicans across the U.S. intensify their efforts to legislate against transgender rights, they are finding aid and comfort in an unlikely place: Western Europe, where governments and medical authorities in at least five countries that once led the way on gender-affirming treatments for children and adolescents are now reversing course, arguing that the science undergirding these treatments is unproven, and their benefits unclear.

The about-face by these countries concerns the so-called Dutch protocol, which has for at least a decade been viewed by many clinicians as the gold-standard approach to care for children and teenagers with gender dysphoria. Kids on the protocol are given medical and mental-health assessments; some go on to take medicines that block their natural puberty and, when they’re older, receive cross-sex hormones and eventually surgery. But in Finland, Sweden, France, Norway, and the U.K., scientists and public-health officials are warning that, for some young people, these interventions may do more harm than good.

European health authorities are not reversing themselves on broader issues of trans rights, particularly for adults. But this turn against the Dutch protocol has inflamed activists and politicians in the United States. Republicans who have worked to ban its recommended treatments claim that the shifts in Europe prove they’re right. Their opponents argue that any doubts at all about the protocol, raised in any country whatsoever, are simply out of step with settled science: They point to broad endorsements by the American Medical Association, the American Psychiatric Association, and the American Academy of Pediatrics, among other groups; and they assert that when it comes to the lifesaving nature of gender-affirming care, “doctors agree.”

But doctors do not agree, particularly in Europe, where no treatments have been banned but a genuine debate is unfurling in this field. In Finland, for example, new treatment guidelines put out in 2020 advised against the use of puberty-blocking drugs and other medical interventions as a first line of care for teens with adolescent-onset dysphoria. Sweden’s National Board of Health and Welfare followed suit in 2022, announcing that such treatments should be given only under exceptional circumstances or in a research context. Shortly after that, the National Academy of Medicine in France recommended la plus grande réserve in the use of puberty blockers. Just last month, a national investigatory board in Norway expressed concerns about the treatment. And the U.K.’s only national gender clinic for children, the Tavistock, has been ordered to close its doors after a government-commissioned report found, among other problems, that its Dutch-protocol-based approach to treatment lacked sufficient evidence.

These changes in Europe have so far been fairly localized: Health authorities in many countries on the continent—among them Austria, Denmark, Germany, Italy, and Spain—have neither subjected the Dutch approach to formal scrutiny nor advised against its use. Yet questions about the protocol seem to be spreading. At the end of March, for example, a Belgian TV report described a 42-fold increase in patients at a leading gender clinic in Ghent and raised questions about the right approach to care. Doubts about the protocol have even come to the country that invented it, at the Center of Expertise on Gender Dysphoria in Amsterdam. “Until I began noticing the developments in other EU countries and started reading the scientific literature myself, I too thought that the Dutch gender care was very careful and evidence-based,” Jilles Smids, a postdoctoral researcher in medical ethics at Erasmus University in the Netherlands, told me via email. “But now I don’t think that any more.”

Kirsten Visser, a Netherlands-based advocate and consultant for parents of trans teens, says her own son, Sietse, started receiving “definitely lifesaving” care at the Amsterdam center in 2012, at the age of 11. Around the time that Sietse showed up at the clinic, the Dutch protocol was becoming established internationally, largely through the work of a child and adolescent psychiatrist there named Annelou de Vries.

After completing a Ph.D. on gender dysphoria in Dutch adolescents, de Vries published two seminal papers with the clinical psychologist Peggy Cohen-Kettenis and other colleagues, in 2011 and 2014. The former looked at the psychological effects of puberty suppression on 70 young people over a period of two years, on average; the latter tracked outcomes for 55 of those people who had gone on to receive gender-reassignment surgery, over an average of six years. Taken together, the studies found that the teens showed fewer symptoms of depression after having their puberty suppressed, as well as a decrease in behavioral and emotional problems; and that the ones who went on to take gender-affirming hormones and have surgery grew into “well-functioning young adults.” De Vries’s expertise has since been widely recognized within the field: She served as a co-lead on the revision of the adolescent section of care guidelines recently published by the World Professional Association for Transgender Health, and is now president-elect of the European equivalent, EPATH.

But in the years after her two studies were released, research done in other European countries led to concerns about their relevance. In 2015, for example, Finnish researchers described a phenomenon that “called for clinical attention,” as they put it: More children were reporting gender dysphoria, and a greater proportion of them had been assigned female at birth. The fact that three-quarters of those Finnish teens had been diagnosed with separate and severe psychiatric conditions appeared to be at odds with the data from the Netherlands, the paper argued. The Dutch studies had found that just one-third of adolescents with gender dysphoria experienced other psychiatric issues, suggesting they were in far better mental health.

In Sweden, too, clinicians grew alarmed by the sudden increase in the number of teenagers seeking gender care. Mikael Landén, a professor of psychiatry at the University of Gothenburg, told me that this population has increased 17-fold since 2010. One explanation for that change—that more open-minded attitudes around gender have emboldened kids to seek the help they need—just doesn’t ring true to him. He’d studied those views in his early work, he said, and found that, on the whole, Swedish attitudes toward transgender people have been very positive for a long time.

When the government asked Landén and a group of other scientists to write an evidence-based review of hormone-based treatments for young people, their verdict, after two years of study, was expressed definitively: The original research findings from de Vries were outdated, and do not necessarily apply to the group of teens who have been coming forward in more recent years. The Dutch protocol had been “a valuable contribution,” he told me, and “it was reasonable to start using it” in Sweden. But times had changed, and so had the research literature. In 2021, for instance, a team based at the U.K.’s Tavistock clinic published research showing no detectable improvements in the mental health of youngsters who had been put on puberty blockers and followed for up to three years.

[Read: The war on trans kids is totally unconstitutional]

De Vries acknowledged some concerns about the research when we spoke in February. “Our early outcomes studies were really from another time and comprised small samples,” she told me, and they looked only at trans youth who had experienced gender dysphoria from childhood. She granted that there is some research to suggest that kids who don’t arrive at the clinic until they’re older are worse off, psychologically, than their younger peers; but she also said her team has run studies including 16-year-olds, and that their findings were “not worrisome.” She agrees that other researchers have not replicated the long-term follow-up research on kids who went through the Dutch protocol, but she pointed out that the short-term benefits of such treatment have indeed been seen in other studies. Research conducted in the U.S., and published earlier this year, found that a group of 315 trans and nonbinary youth were on average less depressed and anxious, and better-functioning, after two years of hormonal treatment.

In the meantime, de Vries and her colleagues have urged clinicians in other countries to do more of their own investigation, in part because the youngsters who receive care at gender clinics in the Netherlands seem to be in comparatively good mental health from the get-go. It’s not yet clear, she told me, that studies of this group will be applicable to youth in other countries. “Every doctor or psychologist who is involved in transgender care should feel the obligation to do a good pre- and post-test,” one of de Vries’s co-authors on the 2011 and 2014 studies said to a Dutch newspaper in 2021. “The rest of the world is blindly adopting our research.”

De Vries is now working on a research project, funded by an $864,000 grant, that will try to answer newly forming doubts about the Dutch protocol. Her proposal for the grant, filed in 2021, described its subject as a “once so welcomed but now sharp[ly] criticized approach.”

That such criticisms are becoming mainstream even in her own country is itself a startling development. After all, the Netherlands has long been at the vanguard of progressive health-care practices. When the Dutch approach to transgender care for adults first started taking shape during the 1970s (many years before the protocol for kids would be established), the country’s politics were dominated by a steadfast opposition to taboos. James Kennedy, an American-born professor of modern Dutch history at Utrecht University, has described this as the country’s “compassionate culture”: In a radical departure from its traditional Christian conservatism, long-standing policies were being spurned; and even touchy subjects such as death and sex were made the subject of broad public-policy debates. Sex work, for example, was widely tolerated, then legalized in 2000. Similarly, the Royal Dutch Medical Association offered formal guidelines for the practice of euthanasia in the 1980s, and a corresponding national law—one of the world’s first—codified the rules in 2002.

Against this backdrop of openness, in which doctors were seen as authoritative figures who were well equipped to decide what was best for their patients, one of the first dedicated clinics for transgender people was established in Amsterdam in 1972. It offered an array of services—blood tests, hormone therapy, and surgeries—to trans adults. According to a recent book by the historian Alex Bakker, Dutch surgeons, some of them inspired by their Christian beliefs, developed techniques that would reduce patients’ psychological suffering. “Helping those in need trumped ‘taboos’ about the sanctity of life or fixed gender roles,” Kennedy told me. The Dutch protocol for treating gender dysphoria in children, as established in the 1990s, reflected a further extension of this philosophy, aiming to smooth adult transitions by intervening early.

[Read: Take detransitioners seriously]

Nevertheless, in December, a journalist named Jan Kuitenbrouwer and a sociologist named Peter Vasterman published an opinion piece in a leading daily newspaper, NRC, that took aim at the Dutch protocol and its “shaky” scientific foundations, and alluded to the international scrutiny of the past few years. “It is remarkable that the media in our neighboring countries report extensively on this reconsideration,” the article said, “but the Dutch hardly ever do.” Like critics elsewhere, Kuitenbrouwer and Vasterman pointed to the rising numbers of children seeking care, from 60 to 1,600 in the Netherlands across a dozen years, and the unaccounted rise in those assigned female at birth; and they suggested that this new generation of people seeking treatment is not analogous to those included in the studies conducted by de Vries a decade ago. De Vries and some colleagues countered that their more recent research addresses this concern. “Scientific evaluation has always been an integral part of this challenging model of care, where young people make early decisions about medical interventions with lifelong implications,” they wrote in the same newspaper.

Also in December, a clinical psychologist at Radboud University’s gender clinic in Nijmegen named Chris Verhaak told a different Dutch outlet that puberty blockers affect children’s bones, and maybe also their brain development. “It is not nothing,” she said. Verhaak is currently running a government-funded study to understand the source and nature of the increase in the number of patients. (Results are due to be presented to the Dutch House of Representatives this year.) In another interview that month, she said that for up to half of cases, the gains in suppressing puberty are not clear. “I worry about that,” she told the newsweekly De Groene Amsterdammer. “Especially because we also experience enormous pressure to provide these puberty inhibitors as quickly as possible.”

Verhaak’s comments in particular sparked dismay among trans groups, which saw them as promoting destructive narratives about social contagion. Verhaak and her direct collaborators say that they are no longer speaking to the media until their study is released, but Hedi Claahsen, a professor and principal clinician on the Radboud center’s gender team, told me that practitioners are cautious and follow national guidelines. When I asked if her center’s approach differed from the one used in Amsterdam, she told me, “No clinic is exactly the same.” Individual providers, who are working at different institutions, may end up providing care that reflects “a different vision.”

Another, more significant round of criticism arrived at the end of February, when another widely read Dutch newspaper, de Volkskrant, published a 5,000-word article under a headline reading: “The treatment of transgender youth in the Netherlands was praised. Now the criticism of ‘the Dutch approach’ is growing.” The authors spoke with Iris, a 22-year-old woman who spent five years on testosterone and had a double mastectomy that she now regrets; they pointed to a new population of kids assigned female at birth seeking care only in their teens; and they noted reservations about the protocol in Finland and Sweden. “Is the ‘Dutch approach’ still the way to go?” the story asked.

The article prompted debate on Twitter, where Michiel Verkoulen, a health economist working with the government of the Netherlands to address the long-standing problem of ever-expanding waiting lists and their impact on young people’s mental health, accused the Dutch protocol’s critics of ignoring what he described as the elephant in the room. “What to do with the people for whom transgender care is critical?” he asked. “You can put every research aside, keep asking for more, and argue that diagnostics and treatments should be stricter … But the question remains: What then?”

“In the Netherlands there are more and more people saying that gender diversity is woke and it’s nonsense and it’s bullshit,” Visser, the consultant for parents of trans teens, told me. Sam van den Berg, a spokesperson for an Utrecht-based trans-rights organization called Transvisie, argued that this debate does not need to happen. The quality of care for children with gender dysphoria is better in the Netherlands than almost anywhere else, she said. “We don’t feel it’s necessary to change anything.” Indeed, doctors in the Netherlands are still free to provide gender-affirming care as they see fit. The same is true of their colleagues in Finland, Sweden, France, Norway, and the U.K., where new official guidelines and recommendations are not binding. No legal prohibitions have been put in place in Europe, as they have been in more than a dozen U.S. states, where physicians risk losing their medical license or facing criminal sanctions for prescribing certain forms of gender-affirming care.

But the trend toward more conservative application of the Dutch protocol is likely to have real effects in European countries, in terms of which kids get treatment, and of what kind. Louise Frisén, an associate professor at Karolinska Institute and a pediatric psychiatrist at the child and adolescent mental-health clinic in Stockholm, Sweden, told me she worries that under her country’s new guidelines, many of her teenage patients will find it harder to access medical care. The benefits of treatment are clear, she said, and she further claimed that the policy change has caused anguish for some patients who are panicking at the looming prospect of puberty.

As for de Vries, when I spoke with her a few weeks before the article in de Volkskrant was published, she agreed that clinicians should be cautious, but not to the point where treatment becomes inaccessible. Outcomes for those with later-onset dysphoria do need to be investigated further, she acknowledged, but “if we are going to wait ’til the highest-standard medical evidence provides us the answers, we will have to stop altogether.” In that sense, Europe’s brewing disagreement over treatment could turn into paralysis. “That’s what worries me,” she said. “You will always have to work with uncertainties in this field.”

The GOP’s Imaginary Consensus on Abortion

The Atlantic

www.theatlantic.com › politics › archive › 2023 › 04 › republicans-nikki-haley-abortion-ban › 673889

Republicans have had 10 months to hammer out a coherent post-Roe message on abortion. You would think they’d have nailed it by now.

Yet on Tuesday, Nikki Haley set out to declare her position on the issue—and proceeded to be about as clear as concrete.

She began with plausible precision. “I want to save as many lives and help as many moms as possible,” the former South Carolina governor and ambassador to the United Nations told reporters gathered at the Susan B. Anthony Pro-Life America headquarters, in Northern Virginia—a press event billed as a “major policy speech.” But her statements quickly got squishier. It’s good that some states have passed anti-abortion laws in the past year, she said. And as for the states that have reacted by enshrining abortion-rights protections? Well, she wishes “that weren’t the case.”

And then she seemed to channel Veep’s Selina Meyer. “Different people in different places are taking different paths,” Haley said, with a self-assurance that belied the indeterminacy of her words.

[Read: Abortion pills will be the next battle in the 2024 election]

Questioning whether any national anti-abortion legislation would ever pass, Haley did gesture at a need for some action. “To do that at the federal level, the next president must find national consensus,” she said. As for what that might look like, she had no words. And she took no questions.

Some people seemed to like Haley’s speech, in a tepid way. She sounded human when she described how her husband had been adopted, and how she’d struggled with infertility. “Ms. Haley deserves credit for confronting the subject head on, with a speech that wasn’t sanctimonious or censorious,” The Wall Street Journal’s editorial board wrote, before concluding, “The party could do worse than Ms. Haley’s pitch.” But it could do better—or at least do with something more specific.  

Leaders of the self-described pro-life movement were predictably annoyed at Haley’s conciliatory-sounding vagueness. “Disappointing speech by @NikkiHaley today. Leads with compromise & defeatism, not vision & courage,” Lila Rose, who heads the group Live Action, tweeted. “We agree that consensus is important, but to achieve consensus we will need to stake out a principled position,” wrote Kristan Hawkins, the president of Students for Life of America.

Even Haley’s hosts seemed on the wrong page. “We are clear on Ambassador Haley’s commitment to acting on the American consensus against late-term abortion by protecting unborn children by at least 15 weeks,” Marjorie Dannenfelser, the president of Susan B. Anthony Pro-Life America, said in a statement sent to me. But a few hours later, Team Haley emailed me to correct the record: “She committed to working to find a consensus on banning late-term abortion. No specific weeks,” Nachama Soloveichik, Haley’s communications director, wrote. Not only did Haley alienate both sides—she confused them!

[Mary Ziegler: Abortion restrictions targeted at minors never stop there]

Haley is in a tough spot, as are all of the Republican presidential wannabes. They each have their own personal convictions on abortion; former Vice President Mike Pence, for example, has been outspoken in his support for a national ban. But they’re up against an issue that seems to have cost their party a string of recent elections. Most Americans believe that abortion should be accessible, with some limits.

The “consensus” position, then, is somewhere in the foggy zone between no abortion ever and abortion whenever. But primary elections tend to push candidates toward one extreme or another. “The gap between what the base demands and what swing voters will tolerate has gotten really wide,” Sarah Longwell, the publisher of the Never Trump site The Bulwark, told me. “Nowhere is this more true than on abortion.”

What all politicians need to do “is settle on a position they believe they can defend, and they need to repeat it consistently and clearly,” Whit Ayres, a Republican strategist, told me. “Any politician whose position on abortion is vague will be wrapped around the axle eventually with questions and doubts about where they actually stand.”

Some GOP candidates have followed Ayres’s advice. But much axle-wrapping has occurred already in the early days of the 2024 primary season.

Asked on the campaign trail whether he’d support a 15-week federal ban on abortion, Senator Tim Scott of South Carolina told CBS, “I do believe that we should have a robust conversation about what’s happening on a very important topic,” before pivoting so hard to an anecdote about Janet Yellen that I thought he’d need a neck brace. In a follow-up interview, Scott backtracked, clarifying that as president, he would “literally sign the most conservative pro-life legislation” Congress sent to his desk.

Florida Governor Ron DeSantis, who is expected to mount a presidential bid, did approve a very conservative state law recently—a six-week abortion ban. But he signed that legislation in the dead of night earlier this month, while most people in Tallahassee were probably in bed. (By contrast, last year, he celebrated the signing of a 15-week ban with a big party at a church.) The following day, DeSantis gave a speech at a Christian university full of students who are opposed to abortion, yet said nothing about his major legislative achievement. He’s mostly stayed quiet about it since—even at glad-handing events in early primary states.

So far, the only confirmed presidential candidate who seems clear on his position and keenly aware of the political optics is Donald Trump. Despite being hailed by anti-abortion activists as the “most pro-life president” in history, Trump has never been rigid on abortion (probably because he supported abortion rights for most of his life as a public figure), and he doesn’t talk much about the issue now. But a spokesperson told The Washington Post recently that Trump “believes that the Supreme Court, led by the three Justices which he supported, got it right when they ruled this is an issue that should be decided at the State level.” Shorter Trump: I’ve done my bit—it’s up to the states now. God bless.

If any national consensus on abortion exists, the GOP strategist Ayres said, Trump’s position “is pretty close” to it. Trump has always seemed to have “a lizard-brain sense of where the voters are,” Longwell said. “He has a relationship to the base, and he doesn’t have to pitch what he believes.” And, unlike DeSantis, Trump has never signed a law banning abortion at any stage, so it’ll be harder to pin him down. Sure, there’s an activist class that would like to see abortion banned in all cases. To them, Trump could reply, You got your justices. You’re welcome.

[Read: The new pro-life movement has a plan to end abortion]

Right now Trump and his lizard brain have a commanding lead in the GOP primary. His victory would set up an interesting general-election situation—a fitting one for our complicated post-Roe country: a former president who once personally supported abortion rights and is now politically opposed to them running against a sitting president whose own position on abortion is the exact opposite.

Until a Republican presidential nominee emerges, we’ll hear many more Haley-esque platitudes that sound thoughtful and weighty but ultimately aren’t.

“Whether we can save more lives nationally depends entirely on doing what no one has done to date,” Haley told reporters on Tuesday, before wrapping up her speech with—you could almost hear a drumroll—“finding consensus.” The waffling will continue, in other words, until the primary concludes.

MAGA Is Eating Its Own

The Atlantic

www.theatlantic.com › ideas › archive › 2023 › 04 › trump-e-jean-carroll-rape-case-tucker-carlson-fox › 673857

It’s been a difficult and disorienting four weeks in MAGA world.

On March 30, former President Donald Trump was indicted by a Manhattan grand jury for his alleged role in participating in a scheme to cover up potential sex scandals during the 2016 presidential campaign. Trump is the nation’s first former president to face criminal charges, and more serious charges may well follow.

Last week, Fox News, the highest-rated and most influential cable news network in America, agreed to pay more than three-quarters of a billion dollars to resolve a defamation suit filed by Dominion Voting Systems over the network’s promotion of deranged conspiracy theories about the 2020 election. It was, according to The Washington Post, the largest publicly disclosed monetary settlement ever in an American defamation action. There are more, and potentially more expensive, lawsuits pending.

And on Monday Fox abruptly cut ties with its biggest prime-time star, Tucker Carlson, one of the most mendacious and poisonous figures in the history of American television.

[David A. Graham: Tucker’s successor will be worse]

“I’m shocked. I’m surprised,” Donald Trump told Newsmax’s Greg Kelly. “I think Tucker’s been terrific,” the former president added. “He’s been, especially over the last year or so, he’s been terrific to me.” Other key figures on the MAGA right, like Donald Trump Jr., described the network’s decision as “mind-blowing,” and called Carlson “an actual thought leader in conservatism” and a “once-in-a-generation type talent.”

Republican Senator J. D. Vance, in a text message to The New York Times, said, “Tucker is a giant, and the most powerful voice against idiotic wars and an economy that placed plutocrats over workers. This is a huge loss for a conservative movement that hopes to be worthy of its own voters.” Representative Matt Gaetz, a MAGA star, lavished praise on Carlson during an appearance on Newsmax. And Megyn Kelly, a former Fox News host, said it was a “sad day for Fox News” but a “great day for Tucker,” because he no longer had to “answer to a corporate power.”

What used to rule the day on the American right was “owning the libs.” But now they are owning one another.

Some of us have spent the better part of eight years warning about the incalculable damage that would be done to the United States, to its politics and culture, and to the Christian witness by those who embraced a Trumpian ethic, defined by cruelty, lawlessness, the shattering of norms and traditional boundaries, and an eagerness to annihilate truth and trust in institutions. Those warnings have been validated, those concerns vindicated. What happened on January 6 wasn’t an anomaly; it was an apotheosis.

Now this movement, which has taken such delight in aiming its nihilistic arrows at the Democratic Party and the Republican establishment, at media outlets and scientists, is in the process of devouring itself. A l’exemple de Saturne, la revolution devore ses enfants.

It is a lesson nearly as old as time itself: Those whose passions are inflamed—and Trump supporters are nothing if not perennially inflamed—are drawn to destruction. “Rage and phrenzy will pull down more in a half an hour, than prudence, deliberation, and foresight can build up in a hundred years,” the 18th-century conservative statesman and philosopher Edmund Burke warned.

Lack of restraint is the essence of the Trump movement. Shattering guardrails is what they find thrilling. But what MAGA adherents forget is that those guardrails exist to protect not only others, but also ourselves from excess, self-indulgence, and self-harm. There’s a reason that temperance—self-mastery, the capacity to moderate inordinate desires, balance that produces internal harmony—is one of the four cardinal virtues.   

The extremism, aggression, and lack of restraint in MAGA world are spreading rather than receding. They are becoming more rather than less indiscriminate. Those who are part of that movement, and certainly those who lead it, act as if they’re invincible, as if the rules don’t apply to them, as if they can say anything and get away with anything. That has certainly been true of Trump, and it is often true of those who have patterned themselves after Trump, which is to say, virtually the entire Republican Party.

But it goes even beyond this. MAGA world directs its ridicule at those who exercise temperance, who embrace restraint, and who ask themselves what they should do rather than what they can get away with. Those who reject the ethic of Thrasymachus—the cynical Sophist in Plato’s Republic who believes might makes right and injustice is better than justice—are dismissed as weak and delicate. The denizens of MAGA world not only relish discarding guardrails; they scorn those who abide by them.

The priority for those who love our country is to contain the wreckage and defeat the MAGA movement. We’re still in mid-drama, so that day is a ways off. But it will come. Because in the end, those who live without limits are destroyed by them.


Supreme Court seems sympathetic to postal worker who didn't work Sundays in dispute over religious accommodations

CNN

www.cnn.com › 2023 › 04 › 18 › politics › groff-dejoy-supreme-court-religious-liberty › index.html

The Supreme Court seemed to side with a former mail carrier, an evangelical Christian, who says the US Postal Service failed to accommodate his request to not work on Sundays.

The Great American Poet Who Was Named After a Slave Ship

The Atlantic

www.theatlantic.com › books › archive › 2023 › 04 › phillis-wheatley-biography-david-waldstreicher › 673824

The small, sickly African girl who arrived in Boston on a seafaring vessel in 1761 had already been stripped of her family and her home. She missed her father, who suffered after having his young child “snatched,” she would later lament in writing. She longed for her mother, whose morning libations to the sun had imprinted on her an enduring memory. She was naked beneath her only physical covering, a “dirty carpet.” She owned nothing, not even herself.

A little over a decade later, this same girl, named Phillis Wheatley after the slave ship that had transported her (the Phillis) and the enslavers who had purchased her (Susanna and John Wheatley), was an author. Her widely read 1773 book of verse, Poems on Various Subjects, Religious and Moral, was striking in its creativity and spoke up for Black humanity. In his erudite, enlightening new biography, The Odyssey of Phillis Wheatley, the historian David Waldstreicher points out that the remarkable and unlikely story of this Revolutionary-era Black celebrity, who was both highlighted and castigated for her race, turns on such reversals and contradictions. Wheatley emerges in these pages as a literary marvel. Waldstreicher’s comprehensive account is a monument to her prowess.

Wheatley was a child prodigy. This is immediately and abundantly clear in Waldstreicher’s treatment and that of others, such as the soaring series of poems about Wheatley written by the poet Honorée Fanonne Jeffers, The Age of Phillis. Jeffers’s deeply researched work of visionary verse begins with a tribute line by Langston Hughes: “This is a song for the genius child.” Phillis (and it is still painful to refer to her by that slave-ship name) had the kind of nimble mind that seems rare in any time period. Soon after she was brought to the Wheatleys’ fine house on King Street to work as a personal maid to Susanna (who had recently lost her 7-year-old daughter and was likely seeking some sort of replacement in the captive African girl), she showed an interest in the shape of letters and exhibited a hunger for learning. Susanna doted on the child, who was also her servant and property. Either Susanna; her eldest surviving daughter, Mary Wheatley; or both tutored Phillis in the lingua franca of the British empire.

Wheatley became a wordsmith of English—the language that had been used by her captors to catalog and register her, to record her sale on Boston’s shore, to exclude her from inheritance in the Wheatley estate after she had served the family for decades and brought them more glory than they ever would have achieved on their own. Through her mastery of language, her consciousness of political developments, and her astute sense of timing, Wheatley became, as Waldstreicher’s treatment shows, an informal poet laureate of the American Revolutionary age.

The greatest achievement of Waldstreicher’s biography is the portrayal of Wheatley as a serious poet. She wrote elegies for the dead, lyrics of Christian salvation, tributes to great figures, dramas of storms and sea travel, and, charmingly, riddles with political punch lines. She was an artist who seems to have answered an inner drive to create on the page, even as she was compelled to comply with the calls of her owners and members of their social set for poems on specific subjects and to respond to her own savvy sense of who in the Boston and British orbits should be commemorated.

Wheatley was a student who read classic works of European literature, from the ancient verse of Homer to the early-modern writings of Alexander Pope. She was a craftsperson who selected her subjects, attended to form, traded in classical references and literary allusions, and engaged in wordplay and ironic misdirection. She was a political commentator who saw words and ideas as battlegrounds for the high-stakes issues of her day. And she never forgot her African family or abandoned the cause of Black freedom. Wheatley wrote from her whole experience, out of fractured memory, and with a compassionate heart, asserting with every stroke of her quill that she was a thinking, feeling, political subject who should not be enslaved.

[Read: Eight books that reevaluate American history]

But Wheatley made this daring assertion about herself and her race at a time when the sale and purchase of Black people was a bustling trade in Boston, when Black intellectual incompetence was assumed, when an escalating crisis between the American colonies and Great Britain heightened debate about the future status of slavery itself. As an owned person belonging to a subjugated racial caste who had to please her captor-benefactors, the poet Wheatley faced an impossible task. Waldstreicher teases out these tangled threads and more, demonstrating Wheatley’s constrained position and how, from that tight spot, she waged ideological and political warfare with her words. “Writing is fighting by other means,” Waldstreicher contends. And Wheatley, Boston’s well-armed bard, was “a patriot poet and a political subject of Britain and New England.”

The version of Wheatley that Waldstreicher paints is the one I’ve always wished I’d known. What Black student (especially if she aspires to be a writer) can forget the first encounter with Wheatley’s famous (or infamous) poem, “On Being Brought From Africa to America”? I met this poem during college in a challenging African American–literature survey course, in which our lectures emphasized the complexity of African American subjectivities and the double-voiced discourses of the Black literary tradition. Nevertheless, I cringed when reading it silently to myself in a dorm room, and again when hearing it read aloud, the words echoing through the lecture hall. “’Twas mercy brought me from my Pagan land / Taught my benighted soul to understand / That there’s a God, that there’s a Saviour too, ” Wheatley had professed. I pleaded with Wheatley, the first African American to publish a book and one of the first North American women to publish a book of poetry: Certainly, you could not mean you were glad to be enslaved. Surely, you must not mean that slavery was a saving grace. Wheatley did not answer, so I argued with myself as I parsed her line describing “Negros, black as Cain.” This cannot be right. This cannot be all. This cannot be. Something was amiss beneath the surface of her seemingly placid poem, but it was hard for me to pinpoint what or where, to name the mechanics of literary resistance.

As a senior historian of early America with a love of poetry (which runs in the family, according to the book’s acknowledgments) Waldstreicher possesses the right tool kit for disassembling Wheatley’s words. He argues with absolute and convincing confidence that Wheatley harbored a political as well as poetical will, which she directed toward securing her survival, her emancipation, and the freedom of what she called her “sable” race—even as she came to side with the imperfect American colonies against Great Britain. Hers was political poetry. She successfully navigated her social context, in which one wrong move, one misplaced word, could lead to the withdrawal of her owners’ support for her writing, or even to her sale. She wielded her words with exacting control out of necessity. Many of Wheatley’s phrases and lines that seem disparaging of Africa or Black people can be read as sarcastic or sardonic, Waldstreicher shows, especially when placed beside her other writings, such as letters to friends and associates of color—like the enslaved woman Obour Tanner and the Mohegan preacher Samson Occom—and rediscovered poems.

Through close readings of Wheatley’s known work and an astonishing retrieval of several poems published anonymously (which Waldstreicher acknowledges may or may not have been written by Wheatley), Waldstreicher slowly unveils the person behind the pen. I needed to dust off my metaphorical handbook of literary terms to follow Waldstreicher’s references, but the effort was worth it. He seems to have done the same while reading Wheatley in order to catalog and address an array of classical and early-modern figures she references, ancient gods and goddesses she names, and lyrical formulations she adopts.

While tracing Wheatley’s evolution as a poet, Waldstreicher also explains why her writing has been devalued over time. Many modern readers find the rhyming-couplet form (one of Wheatley’s favorites) trite and simplistic, when this was an appreciated type of verse in Wheatley’s time. Beyond this, poetry overall has ceased to be the dominant form of private and public expression that it once was. As Waldstreicher puts it, poems of the late 18th century were like the tweets of today: omnipresent, constrained by form (rhythmic schemes then, 280 characters now), part of public culture. His painstaking interpretations equal Wheatley’s own intentional verse, making it a joy to follow along as he unpacks her words and their arrangement, instructing us to read a line of Wheatley’s and then read it again with an eye roll to see how the meaning changes. When Wheatley writes about race, Waldstreicher shows, she is often mocking a racist or hypocritical point of view that she personally disavows.

If The Odyssey of Phillis Wheatley is principally a literary biography, it is simultaneously and forcefully a political history of race and slavery in Revolutionary-era America. It is full of illuminating and specific insights about how slavery figured into colonial politics and how individual Black people played significant roles in events as they unfolded. Waldstreicher routinely points out the “countervailing trends” in Boston and New England that indicated both a weakening and strengthening of the rationale for and practice of slavery as the political winds changed. He compares the “stranger” status of outcast enslaved people in Boston to that of the reviled British soldiers sent to occupy the city. He highlights the ways that patriot leaders began to assume Black collusion with the British and projected fears about a Black fifth column that made Black residents more vulnerable. He notices that the street soldiers of Boston’s defense during the siege, those who taunted British soldiers and caused public ruckuses, were young people of Wheatley’s generation, and that age was a demographic factor that meaningfully intersected with race and class—young people in general being more willing to openly resist colonial rule. In showing how deeply enmeshed Wheatley was with Boston, Waldstreicher also illustrates how tightly woven the story of American liberty and Black American slavery truly were.

Slavery informed Americans’ understanding of the meaning of freedom. The fact of Black captivity at the hands of American colonists made the British threat of unfettered control seem all too real, even as their subjugation of Black people weakened the patriots’ argument in defense of liberty. American freedom and Black slavery were bound together. And, as Waldstreicher shows, Black patriots like Wheatley, who was both African and American, knew this to be the case.

Wheatley observed and recorded in verse the great swirl of events in the Revolutionary hub that was Boston. She wrote poems about youth killed in the Boston streets, fallen patriot soldiers, British naval commanders, and George Washington. She wrote a poem titled “America,” and if Waldstreicher’s attribution of an exciting unsigned work is correct, she wrote a poem about the Boston Massacre and therein named Crispus Attucks, the Afro-Native man who was the first to fall in the conflict. She commented with sophistication on the occurrences of her times and somehow managed to fold in rhyme. After the publication of her book and a visit to London, Wheatley gained her freedom.

[Read: A view of American history that leads to one conclusion]

By the time Waldstreicher recounts Thomas Jefferson’s snide attack on Wheatley in Notes on the State of Virginia (she died before its publication), he has shaped a biography that makes Wheatley’s gifts clear and Jefferson’s desperation palpable. Jefferson was a slaveholder who recognized the practice as a moral wrong and yet needed to justify chattel slavery and Black exclusion by asserting racial inferiority. When Jefferson besmirched Wheatley by saying she lacked originality of thought and was merely an imitator of others as evidence of his inferiority theory, he was being disingenuous. Or perhaps Wheatley’s sly insertion of penetrating insights in seemingly accommodating verse went over Jefferson’s head, as it has so many of ours.

Like that of other Black geniuses in earlier eras, Wheatley’s life was no crystal stair. When John Wheatley died in 1778, he left her nothing. Her most valuable piece of property was the book she had written. Soon after, she married a free Black merchant and took his name, becoming Phillis Wheatley Peters. The couple seem to have had at least one child; they then fell into debt and poverty. Wheatley may have died in a boardinghouse alone. Even as he retells this last phase of Wheatley’s life, Waldstreicher warns that this tragic version of events, which comes mostly from the white Wheatley family line, is far from complete.

The same cannot be said for The Odyssey of Phillis Wheatley. This book does the complexity of Wheatley’s life and work justice. But while thorough, the narrative is not immersive in the way of some other historical biographies swimming in setting and character sketches. One never feels as though the texture and verve of 18th-century Boston are fully captured. Waldstreicher speaks, at times, with a utilitarian directness that may have stemmed from a desire to write accessibly, especially as a means of balancing out the thick passages of literary criticism. Sometimes this leads him to turns of phrase that diminish the gravity of his subject matter, such as his indelicate suggestion that children like Wheatley were “pawned” by their African parents, his reference to “Boston-baked slavery” (which brings to mind baked beans), and his comment that Wheatley seems to (but does not) throw Africa “under the proverbial bus.”

There is, besides these minor slippages, another instance that seems askew. Although Waldstreicher spends hundreds of pages meticulously portraying Wheatley in the richness of her context and tracing the intricacies of her intellectual contemporaries and antecedents, he chooses not to do the same for his own predecessors and interlocutors. It is possible to read this book without realizing that the author is building on the work of others, as all scholarship does. Only at the very end, nearly on the final page, do readers learn any real detail about the generations of Black clubwomen and Black women writers, and about the modern-day Black poets, whose revival of Wheatley’s legacy and engagement with her poetry made Waldstreicher’s investigation possible. Given that this book is about the historical importance, impact, and dismissal of Black talent, the editorial decision to drop these names in at the end is disappointing.

Still, Waldstreicher has done more than his part. There can now be no doubt of Wheatley’s importance not only to African America but also to the country and culture as a whole. She was a learned, dexterous wielder of the written word in a taut political and racial moment. “Hers is an African diaspora story, a British story, a New England story, and an American story,” Waldstreicher writes. With patient skill, Waldstreicher demonstrates what we should have seen all along. Wheatley is among the greatest thinkers of her age, and her writing should join the American canon of Revolutionary literature alongside the works of Thomas Paine, Thomas Jefferson, Benjamin Franklin, and the rest, as a testament to the entwined contestations of that consequential era.

The Justices Pass on an Abortion-Pill Ban

The Atlantic

www.theatlantic.com › ideas › archive › 2023 › 04 › supreme-court-mifepristone-abortion-pill-ban › 673825

After extending its self-imposed deadline from Wednesday to today, the U.S. Supreme Court finally weighed in on the fight to limit access to mifepristone, a pill used in more than half of all abortions. The Court stayed the ruling of the Fifth Circuit Court of Appeals and preserved existing access to the drug as litigation continues in the lower courts. This ruling came on the heels of those from both Texas District Court Judge Matthew Kacsmaryk and the Fifth Circuit, both of which not only second-guessed regulators’ careful parsing of scientific evidence, but also hinted that an anti-vice law from the Victorian era, the Comstock Act, had created a de facto nationwide ban on abortion.

The Court stepped back in this latest order, preserving the pre-lawsuit status quo when it comes to mifepristone. But we can read only so much into the Court’s decision. For 50 years, anti-abortion-rights groups have shown that they are willing to play the long game, and with a Court as conservative as this one, they have no reason to cease their efforts.

The case began when the Alliance for Hippocratic Medicine, an anti-abortion-rights group represented by the Alliance Defending Freedom, a powerhouse of the Christian right, argued that the Food and Drug Administration lacked the authority to approve mifepristone back in 2000—and that the agency had no power to lift restrictions on access to the drug in the years since. In a ruling seeded with anti-abortion rhetoric and studies, Judge Kacsmaryk issued an unprecedented ruling, blocking approval of mifepristone and suggesting that the Comstock Act banned the mailing of any drug or device intended or adapted for abortion.

[Mary Ziegler: The Texas abortion-pill ruling signals pro-lifers’ next push]

The Fifth Circuit weighed in less than a week later in an opinion that could be considered reasonable only in comparison to Kacsmaryk’s mind-bender. The appellate court’s order would have turned back the clock to 2016, when access to mifepristone was possible only after multiple doctors’ visits, and when telehealth abortions were off the table. As with Kacsmaryk, the Fifth Circuit seemed open both to arguments about the applicability of the Comstock Act and to extremely broad interpretations of the law.Anti-abortion-rights activists had reason to feel optimistic about how the Supreme Court would react when presented with these plaintiffs’ case. The conservative justices have a track record of hostility to administrative agencies such as the FDA and have questioned the constitutionality of their actions (and even of their basic structure). And, of course, the same conservative justices last year reversed Roe v. Wade in an opinion that scorned the views of those who disagreed.

Abortion-rights opponents’ optimism about the abortion-pill cases may have been unjustified. By a seven-to-two vote, the Court decided to issue a full stay. This means that, as litigation continues in the lower courts, Americans will continue to have the same access to mifepristone they had before this lawsuit began. Only Justices Samuel Alito and Clarence Thomas dissented, and not even Alito (the only dissenting justice who wrote anything) expressed any support for the plaintiffs’ arguments. Rather than discuss the plaintiffs’ standing or the merits of their case, Alito preferred to complain that the FDA had not shown that it would have been injured had the Fifth Circuit ruling gone into effect, because regulators would likely have used their discretion not to go after unapproved uses of mifepristone.

This was an archetypal shadow-docket ruling: short and cryptic, while the Court has yet to address the merits of the case. But in evaluating such a stay, the Court considers whether the plaintiffs are likely to win. In that respect, a seven-to-two loss is hardly good news for the plaintiffs: Right now, it seems that most of the conservative justices on this Court have their doubts.

[Read: The new pro-life movement has a plan to end abortion]

Abortion-rights supporters can draw an optimistic reading from this stay. The Court’s reputation sustained major damage after last summer’s decision in Dobbs v. Jackson Women’s Health Organization. Since then, the abortion conflict has escalated in the states and in the federal courts. One has to wonder whether the justices are sick of wading into this controversy. In June, Alito vowed to return the abortion question to the “people’s elected representatives,” but it’s reasonable to question whether the aftermath of Dobbs may have given any of them second thoughts.

But we cannot read too much into what the Court just did, because there were deep problems with the plaintiffs’ case. It was hard to argue with a straight face that these plaintiffs had standing to sue. In addition, this lawsuit came a full 23 years after the FDA approved mifepristone—a delay that made even the ultra-conservative Fifth Circuit ask questions about the timeliness of the lawsuit.

If the Supreme Court ultimately sides with the FDA, the pessimistic take for abortion-rights supporters is that this was simply a rotten case. If it fails, and the FDA prevails, other anti-abortion-rights cases will soon be filed with the hope of reaching the Supreme Court. Kacsmaryk and the Fifth Circuit prepared the way for a reading of the Comstock Act as a nationwide abortion ban, and abortion-rights opponents will file other suits to take advantage. Already, Idaho passed a law limiting interstate travel for an abortion—the first such state restriction and part of a strategy that, if successful, could empower conservative states to limit the ability of progressive ones to treat patients from elsewhere.

The Supreme Court has not become any less conservative, or any less hostile to abortion. This order simply suggests that when it comes to undermining abortion, the conservative justices still know how to pick their cases.

Is Meloni's government europhobic and neo-fascist? Her first six months in power examined

Euronews

www.euronews.com › 2023 › 04 › 21 › is-melonis-government-europhobic-and-neo-fascist-her-first-six-months-in-power-examined

Giorgia Meloni came to power at the helm of Brothers of Italy, a party with neo-fascist roots which promised to turn its back on the European Union and promote Christian values, nationalism and family. Six months later, has she fulfilled her electoral promises?

America Fails the Civilization Test

The Atlantic

www.theatlantic.com › ideas › archive › 2023 › 04 › america-mortality-rate-guns-health › 673799

This is Work in Progress, a newsletter by Derek Thompson about work, technology, and how to solve some of America’s biggest problems. Sign up here to get it every week.

The true test of a civilization may be the answer to a basic question: Can it keep its children alive?

For most of recorded history, the answer everywhere was plainly no. Roughly half of all people—tens of billions of us—died before finishing puberty until about the 1700s, when breakthroughs in medicine and hygiene led to tremendous advances in longevity. In Central Europe, for example, the mortality rate for children fell from roughly 50 percent in 1750 to 0.3 percent in 2020. You will not find more unambiguous evidence of human progress.

How’s the U.S. doing on the civilization test? When graded on a curve against its peer nations, it is failing. The U.S. mortality rate is much higher, at almost every age, than that of most of Europe, Japan, and Australia. That is, compared with the citizens of these nations, American infants are less likely to turn 5, American teenagers are less likely to turn 30, and American 30-somethings are less likely to survive to retirement.

Last year, I called the U.S. the rich death trap of the modern world. The “rich” part is important to observe and hard to overstate. The typical American spends almost 50 percent more each year than the typical Brit, and a trucker in Oklahoma earns more than a doctor in Portugal.

This extra cash ought to buy us more years of living. For most countries, higher incomes translate automatically into longer lives. But not for today’s Americans. A new analysis by John Burn-Murdoch, a data journalist at the Financial Times, shows that the typical American is 100 percent more likely to die than the typical Western European at almost every age from birth until retirement.

What if I offered you a pill and told you that taking this mystery medication would have two effects? First, it would increase your disposable income by almost half. Second, it would double your odds of dying in the next 365 days. To be an average American is to fill a lifetime prescription of that medication and take the pill nightly.

According to data collected by Burn-Murdoch, a typical American baby is about 1.8 times more likely to die in her first year than the average infant from a group of similarly rich countries: Australia, Austria, Switzerland, Germany, France, the U.K., Japan, the Netherlands, and Sweden. Let’s think of this 1.8 figure as “the U.S. death ratio”—the annual mortality rate in the U.S., as a multiple of similarly rich countries.

By the time an American turns 18, the U.S. death ratio surges to 2.8. By 29, the U.S. death ratio rockets to its peak of 4.22, meaning that the typical American is more than four times more likely to die than the average resident in our basket of high-income nations. In direct country-to-country comparisons, the ratio is even higher. The average American my age, in his mid-to-late 30s, is roughly six times more likely to die in the next year than his counterpart in Switzerland.

[INSERT CHART HERE]

The average U.S. death ratio stays higher than three for practically the entire period between ages 30 and 50, meaning that the typical middle-aged American is roughly three times more likely to die within the year than his counterpart in Western Europe or Australia. Only in our late 80s and 90s are Americans statistically on par, or even slightly better off, than residents of other rich nations.

“One in 25 American five-year-olds today will not make it to their 40th birthday,” Burn-Murdoch observed. On average, a representative U.S. kindergarten class will lose one member before their fifth decade of life.

What is going on here? The first logical suspect might be guns. According to a recent Pew analysis of CDC data, gun deaths among U.S. children and teens have doubled in the past 10 years, reaching the highest level of gun violence against children recorded this century. In March, a 20-something shooter fired 152 rounds at a Christian school in Nashville, Tennessee, killing three children and three adults, before being killed by police. In April, a 20-something shooter killed six people at a Louisville, Kentucky, bank, before he, too, was killed by police.

People everywhere suffer from mental-health problems, rage, and fear. But Americans have more guns to channel those all-too-human emotions into a bullet fired at another person. One could tell a similar story about drug overdoses and car deaths. In all of these cases, America suffers not from a monopoly on despair and aggression, but from an oversupply of instruments of death. We have more drug-overdose deaths than any other high-income country because we have so much more fentanyl, even per capita. Americans drive more than other countries, leading to our higher-than-average death rate from road accidents. Even on a per-miles-driven basis, our death rate is extraordinary.

When I reached out to Burn-Murdoch, I expected that these three culprits—guns, drugs, and cars—would explain most of our death ratio. However, on my podcast, Plain English, he argued that Americans’ health (and access to health care) seems to be the most important factor. America’s prevalence of cardiovascular and metabolic disease is so high that it accounts for more of our early mortality than guns, drugs, and cars combined.

Disentangling America’s health issues is complicated, but I can offer three data points. First, American obesity is unusually high, which likely leads to a larger number of early and middle-aged deaths. Second, Americans are unusually sedentary. We take at least 30 percent fewer steps a day than people do in Australia, Switzerland, and Japan. Finally, U.S. access to care is unusually unequal—and our health-care outcomes are unusually tied to income. As the Northwestern University economist Hannes Schwandt found, Black teens in the poorest U.S. areas are roughly twice as likely to die before they turn 20 as teenagers in the richest counties. This outcome is logically downstream of America’s paucity of universal care and our shortage of physicians, especially in low-income areas.

There is no single meta-explanation for America’s death ratio that’s capacious enough to account for our higher rates of death from guns, drugs, cars, infant mortality, diet, exercise, and unequal access to care. I’ll try to offer one anyway—only to immediately contradict it.

Let’s start with the idea, however simplistic, that voters and politicians in the U.S. care so much about freedom in that old-fashioned ’Merica-lovin’ kind of way that we’re unwilling to promote public safety if those rules constrict individual choice. That’s how you get a country with infamously laissez-faire firearms laws, more guns than people, lax and poorly enforced driving laws, and a conservative movement that has repeatedly tried to block, overturn, or limit the expansion of universal health insurance on the grounds that it impedes consumer choice. Among the rich, this hyper-individualistic mindset can manifest as a smash-and-grab attitude toward life, with surprising consequences for the less fortunate. For example, childhood obesity is on the rise at the same time that youth-sports participation is in decline among low-income kids. What seems to be happening at the national level is that rich families, seeking to burnish their child’s résumé for college, are pulling their kids out of local leagues so that they can participate in prestigious pay-to-play travel teams. At scale, these decisions devastate the local youth-sports leagues for the benefit of increasing by half a percentage point the odds of a wealthy kid getting into an Ivy League school.

The problem with the Freedom and Individualism Theory of Everything is that, in many cases, America’s problem isn’t freedom-worship, but actually something quite like its opposite: overregulation. In medicine, excessive regulation and risk aversion on the part of the FDA and Institutional Review Boards have very likely slowed the development and adoption of new lifesaving treatments. This has created what the economist Alex Tabarrok calls an “invisible graveyard” of people killed by regulators preventing access to therapies that would have saved their life. Consider, in the same vein, the problem of diet and exercise. Are Americans unusually sedentary because they love freedom so very much? It’s possible, I guess. But the more likely explanation is that restrictive housing policies have made it too hard for middle- and low-income families to live near downtown business districts, which forces many of them to drive more than they would like, thus reducing everyday walking and exercise.

America is caught in a lurch between oversight and overkill, sometimes promoting individual freedom, with luridly fatal consequences, and sometimes blocking policies and products, with subtly fatal consequences. That’s not straightforward, and it’s damn hard to solve. But mortality rates are the final test of civilization. Who said that test should be easy?

Little Richard and the Truth About Rock and Roll’s Queer Origins

The Atlantic

www.theatlantic.com › culture › archive › 2023 › 04 › little-richard-i-am-everything-documentary-review › 673746

“What would it do to the American mythology of rock music to say that its pioneers were Black, queer people?” the ethnomusicologist Fredara Hadley asks in the new documentary Little Richard: I Am Everything, out Friday. It’s a valid question, and the film offers an exuberant answer. In order to tell the story of the pathbreaking piano-rocker whose work still pulses in roadside diners and on wedding dance floors, the director, Lisa Cortés, uses animated sparkles and montages of rainbow fringe and high heels. Along with Hall of Famers such as Mick Jagger, commentary comes from the ever-fabulous actor Billy Porter and a few Black scholars of gender, race, and the arts. They argue that “Tutti Frutti” was not just a hot song; it was a Molotov cocktail lobbed at the heteropatriarchy.  

All of this may sound like a provocation, but it’s mostly an assertion of fact. In addition to popularizing the combo of chugging-train drum beats and lusty wails, Little Richard personally tutored the Beatles and the Rolling Stones, and directly inspired James Brown and David Bowie. A wearer of eyeliner who variously described himself as gay or omnisexual over the years, he built upon a preexisting queer lineage. When Richard’s father threw him out of his Macon, Georgia, home at an early age, Richard was taken in by the owners of a queer-leaning nightclub. He’d soon learn from drag queens, bawdy chanteuses, and a few Black singers now legendary for defying gender norms: the gospel guitarist Sister Rosetta Tharpe, who brought Little Richard onstage for the first time; the bouffant-wearing Esquerita, who taught him to play piano; and the “Prince of the Blues,” Billy Wright, who inspired his love of makeup.

Little of this history is unknown or hidden. Indeed, the energy coursing through this essayistic documentary comes in large part from Richard’s own self-mythologizing. He often touted his own importance as the “architect,” rightful “king,” and “quasar”—brightest star—of rock and roll. He spoke matter-of-factly about sex and sexuality (he was also, he said, the “queen” of rock and roll). As it retells his rise, Cortés’s film suggests how so flamboyant a figure became widely beloved in the face of racism and homophobia: To some white audiences, a feminized Black man was less threatening than any other kind. The movie also explores how cultural appropriation—or “obliteration,” as the writer and sociologist Zandria Robinson calls it—long kept Richard from getting his due (recent years have begun to see broader recognition of the debt that Elvis and other white rockers owed him).

[Read: Little Richard set the mold by breaking it]

Really the film wants to argue for an inextricable, even metaphysical, connection between Richard’s impact and his identity. “Queerness is not just about sexuality but about a presence in a space that is different from what we require or expect—different from the norm,” Robinson says at one point. According to this framework, Richard’s musical breakthroughs had revolutionary social effects, inviting segregated and repressed audiences to integrate and loosen up. His example liberated Paul McCartney to scream and Jagger to shimmy, and made it possible for Lil Nas X and Miley Cyrus to simultaneously scandalize and seduce audiences today.

This view of Richard is inspiring and convincing. But it squares awkwardly with the fact that Richard, at various times throughout his life, aligned with conservative Christianity and renounced his past work. The first epiphany happened in 1957, when Richard witnessed what he believed to be apocalyptic omens while on tour. He then enrolled at a Seventh-day Adventist college in Alabama, where he reportedly told students that he would buy back and destroy any records of his that they owned. He would return to, and escape from, the secular musical world a few times in the decades to come. The final years of his life were spent ensconced in church life. His public speaking emphasized the incompatibility of rock and roll—and his formerly gay lifestyle—with the teachings of Jesus.

What happened? A few reasons for his religiosity seem apparent. As a kid, Richard dreamed of becoming a minister like his father. As Jagger notes in the documentary, if you have the idea that secular music is the devil’s music drilled into you during childhood, you’re going to have a complicated adulthood as a secular musician. Watching the film, it also becomes apparent that many of Richard’s Christian awakenings coincided with moments when the excesses of his rock-star life were especially pronounced: a long-haul tour in the ’50s, a period of heavy drug use in the ’70s.

[Read: ‘Rock and roll ain’t what it used to be’]

What the documentary doesn’t note are the familiar, even poignant, dimensions of Richard’s seemingly shocking reversals. Many other iconoclastic musicians—Prince, Ye (formerly Kanye West), Bob Dylan—have, at various points, found God and begun reevaluating or neglecting their earlier work. The history of popular music is in part a history of bold people changing the world, being rewarded with riches, and then facing the question of how to survive burnout, addiction, and the waning of public affection. Endless rebellion is taxing and has, for many stars, proved fatal—is it that surprising for religion to beckon as a refuge? To a viewer of the film, Richard’s spiritual journey raises questions about him as a human, not a symbol. I wanted to understand his significance to the church communities he joined; I wanted to know whether those around him found him to be at peace in his later years.

The documentary, however, mostly treats Richard’s sanctified chapters as a disappointment, a counterrevolutionary subplot. Robinson notes the “harm” Richard caused when he started spouting homophobia. Sir Lady Java, a trans performer who was a good friend of Richard’s, says, “I feel he betrayed gay people ... But I do understand. You’re not strong enough to take it. I understand that.” “Harm” and “betrayed” aren’t overstating the case: As today’s legislative and cultural campaigns against queer rights show, what public figures say matters. Still, it’s hard not to also read a tinge of personal judgment in the movie’s appraisals. The scholar Jason King puts Richard’s trajectory this way: “He was very, very good at liberating other people through his example. He was not good at liberating himself.” The film sometimes takes an elegiac, near-tragic tone—which is a bit strange when you consider that Richard died at the ripe old age of 87, with his cultural renown secure and his energies having been devoted to personal salvation.

As the title I Am Everything hints, the film wants to do what Richard once did: make space for complex, unruly expression. But conflating personal identity with political projects, construing queerness so broadly that it becomes a synonym for subversive, sometimes flattens reality. Queer people can be revolutionaries, but they’re also negotiators, crowd-pleasers, survivors. How telling that the “Tutti Frutti” that changed the world was not the bawdy version that Richard originally wrote—“If it don’t fit, don’t force it”—but the one he allowed to be toned down by the songwriter Dorothy LaBostrie, who’s shown in full church-lady regalia in I Am Everything. Little Richard’s life was no tidy story of transcendence from his times and circumstances, because no one’s is. What he showed is that rock and roll, like queerness, is not a break from the past; it’s a dance with it.