This is an edition of The Atlantic Daily, a newsletter that guides you through the biggest stories of the day, helps you discover new ideas, and recommends the best in culture. Sign up for it here.

Quiet luxury, stealth wealth, Succession core. In recent months, these terms have been applied to a fashion phenomenon that’s captured the attention of TikTok and mainstream-media outlets alike. The trend ostensibly describes the style proclivities of America’s 1 percent—but it’s really more of a message about the anxieties of everyone else.

First, here are three new stories from The Atlantic:

ChatGPT is already obsolete. Did scientists accidentally invent an anti-addiction drug? It’s not enough for Ukraine to win. Russia has to lose.

Ludicrously Capacious

“Stealth wealth”—both the concept and the conversation around it—isn’t new. But one week in late March, two capstone events kicked the chatter into overdrive: the start of Gwyneth Paltrow’s trial over a 2016 skiing incident, and the premiere of the fourth and final season of Succession. In a near instant, savvy sartorialists spotted parallels between the actor and Goop founder’s “courtcore” and the subdued opulence of the billionaire Roy family at the center of HBO’s hit series.

“Much has been made of Kendall Roy’s baseball cap,” my colleague Amanda Mull mused in her recent Atlantic article dissecting the so-called trend. Indeed, the $625 Loro Piana cap donned by the troubled second son of the fictional dynastic clan has become an oft-cited exemplar of the discreetly-status-signaling fashion of the wealthiest Americans. As Amanda sums it up, “The textiles and cuts are impeccable, the colors are neutral, and the finishes are subtle and logo-free.”

In other words: If you know, you know. And being in-the-know, while also telegraphing that knowledge, is how elites uphold (and protect) their social codes. Proponents of the stealth-wealth concept insist that toting around a battered, five-figure handbag or swathing oneself in staid cashmere affirms membership to the rarefied class aptly described, by Amanda, as “the genuinely, generationally wealthy.” Quiet luxury—or so the theory goes—says I belong here. And, by extension: You don’t.

The anxiety surrounding the unspoken rules of elite-class membership makes for great entertainment, whether it’s the Gilded Age grandeur depicted in Edith Wharton novels or the “ludicrously capacious bag” that all but guest-starred in a recent Succession episode. But stealth-wealth style—as either a unified aesthetic or a universally understood upper-class membership card—is a myth, Amanda writes. Instead, she notes, the people most preoccupied with the so-called trend’s associated signifiers appear to be those furthest from its reach: the teens and 20-somethings who disproportionately make and consume content on TikTok, and who “[dissect] these looks and [devour] the lessons they seemingly teach.”

She writes:

In one popular type of video, a young woman walks viewers through the tricks to getting the stealth-wealth look—high-quality basics, neutral colors, no logos—or demonstrates how to turn a regular outfit into a signifier of stealth wealth. TikTok’s dominant user base is at exactly the point in life where learning how status functions in the broader adult world becomes very important. They’re thinking about heading off to college or into the professional world, and presenting themselves to new groups of people in these scenarios is a very high-stakes game of dress-up. The Roys are not stylish or well dressed, but they are a pretty good guide for what to look for in a Zara knockoff if you want to blend in at an internship.

As Amanda points out, it makes sense that the covert messaging of quiet-luxury style would resonate with the fledgling adults of TikTok, who are actively figuring out how to self-present for the professional world. But insecurities around status, class, and access aren’t the sole purview of the young. They may, in fact, be symptoms of a more widespread sense of precarity—and an ever-greater distance between most Americans and the hallmarks of ultra wealth.

The timing of today’s stealth-wealth fixation is hardly coincidental. During the pandemic, the income gap between the highest and lowest U.S. earners widened for the first time in a decade. The wealthiest Americans are richer now than ever before. Yet, as the fashion critic Rachel Tashjian recently wrote in The Washington Post, somehow, the uber-monied class seems to have become less visible as its economic power has grown. “Other than the dysfunctional family we see on television every Sunday night, the one percent is almost out of view, especially for those who have spent the past few years learning about clothing (and status) through social media,” Tashjian observed.

As social-media fashion detectives continue their efforts to crack the code of superrich style, they underscore the chasm between one-percenters and everyone else. Because, as Amanda points out, the stealth-wealth rulebook was never really a thing to begin with: The mega-wealthy dress in all sorts of ways, occupying the spectrum from “understated” to “Paris Hilton circa 2007.” It’s not their status anxiety being reflected in the trend, but the fretful ruminations of a have-not majority, straining to hold their grip on much-lower rungs of the ladder.

Related:

There’s no secret to how wealthy people dress. Something odd is happening with handbags.

Today’s News

Debt-ceiling talks between the White House and House Republicans resumed a few hours after they were put on pause. President Joe Biden approved a plan to train Ukrainian pilots on U.S. F-16s, potentially paving the way for sending advanced fighter jets to Ukraine.

Republican Senator Tim Scott quietly filed paperwork to run in the 2024 presidential election.

Dispatches

The Books Briefing: Turning history into a juicy story is a risky endeavor, Nicole Acheampong writes. Can we really know the figures of the past?

Explore all of our newsletters here.

Evening Read

Trent Parke/ Magnum

Growing My Faith in the Face of Death

By Timothy Keller

Note: The pastor Timothy Keller, author of the below essay from 2021, died today at age 72.

I have spent a good part of my life talking with people about the role of faith in the face of imminent death. Since I became an ordained Presbyterian minister in 1975, I have sat at countless bedsides, and occasionally even watched someone take their final breath. I recently wrote a small book, On Death, relating a lot of what I say to people in such times. But when, a little more than a month after that book was published, I was diagnosed with pancreatic cancer, I was still caught unprepared.

On the way home from a conference of Asian Christians in Kuala Lumpur in February 2020, I developed an intestinal infection. A scan at the hospital showed what looked like enlarged lymph nodes in my abdomen: No cause for concern, but come back in three months just to check. My book was published. And then, while all of us in New York City were trying to protect ourselves from COVID-19, I learned that I already had an agent of death growing inside me.

Read the full article.

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Culture Break

Illustration by Ángel Hernández

Read. Jenny Xie’s debut novel, Holding Pattern, focuses on a mother-daughter relationship with resonances of the author’s own. It’s a love letter that her mother won’t be able to read.

Watch. The film Master Gardener (in theaters) takes on neo-Nazism and white supremacy—and is Paul Schrader’s most hopeful work yet.

Play our daily crossword.

P.S.

Years ago, I ran a feminist book club out of the wonderful Type bookstore in Toronto, the city where I spent my peak-TikTok-demographic years and started my journalism career. If memory serves, our first selection was Edith Wharton’s The House of Mirth—an interesting novel to encounter at that formative phase of my life, amid the city’s rapid transformation from a cosmopolitan patchwork of immigrant neighborhoods into a playground for the rich. Of course, not everyone is able to replicate my experience of discovering Wharton as a youngish-adult woman facing the imminent threat of being unable to pay rent. But even though those conditions certainly heightened the novel’s effect, it’s worth a read at any age (or economic bracket). If you haven’t read it, you must.

— Kelli

Katherine Hu contributed to this newsletter.

This is an edition of The Atlantic Daily, a newsletter that guides you through the biggest stories of the day, helps you discover new ideas, and recommends the best in culture. Sign up for it here.

Good morning, and welcome back to The Daily’s Sunday culture edition, in which one Atlantic staffer reveals what’s keeping them entertained.

Today’s special guest is Yasmin Tayag, a staff writer who covers science and health. Yasmin recently reported on the rise of weight-loss drugs such as Ozempic as well as their cheaper, more potent alternatives; the broader implications of the ongoing Adderall shortage; and how climate change is making seasonal allergies worse. She’s also preparing for the birth of her first child next month and, until then, conquering the 2000s indie-band reunion-tour circuit, self-soothing with the Instagram channel of a charming Italian chef, and giggling at the very thought of the new film Dungeons & Dragons: Honor Among Thieves.  

First, here are three Sunday reads from The Atlantic:

What home cooking does that restaurants can’t Can you have a fun vacation on Ozempic? The only way out of the child-gender culture war

The Culture Survey: Yasmin Tayag

The last thing that made me snort with laughter: About three years ago, some friends suggested that we try playing Dungeons & Dragons—mostly as a joke, given that none of us are typical game-playing types—but it took just one session for us to embrace it wholeheartedly. Our campaign lasted through much of the coronavirus pandemic, but we eventually succumbed to Zoom fatigue. With genuine melancholy, I laid Sabrina, my randy level-nine tiefling sorceress, to rest.

But last month, we reunited to watch the new film Dungeons & Dragons: Honor Among Thieves, which left us crying with laughter. The jokes are silly, but as my colleague David Sims put it in his review, they’re also sincere—a crucial element to a good D&D session. Merely thinking of the name Jarnathan, bestowed on a huge and hapless eagle-man, still makes me giggle. The film was so much fun that I actually saw it twice—and it inspired my friends and me to start another campaign. My new character, C. Biscuit, a socially awkward druid centaur, is chafing at the bit. [Related: Ta-Nehisi Coates—The unlikely influence of Dungeons & Dragons (2011)]

The upcoming event I’m most looking forward to: As an aging Millennial, I’ve very much embraced the recent indie-sleaze revival. I grew up in Toronto, and bands such as Metric, Stars, and Broken Social Scene were the soundtrack to my coming of age. Of these artists, Feist was the queen: folksy with an edge, slightly mystical, a melodic genius. I’m seeing her live for the first time next weekend as she tours Multitudes, her transcendent new album about motherhood. [Related: Feist’s Pleasure reworks the passage of time. (2017)]

A good recommendation I recently received: Newborns are top of mind for me these days; I’m expecting my first in about a month. Several friends with young kids have offered child-rearing wisdom for the modern age: Don’t let them watch Cocomelon. Just don’t. It’s “drugs for babies,” one told me. Having now YouTubed a few deranged clips, I see their point. Alternatives I feel better about are Rockabye Baby!’s lullaby renditions of the music of Drake and Lauryn Hill, which I think (or hope!) will be gentler on the baby—and me.

A YouTuber, TikToker, Twitch streamer, or other online creator whom I’m a fan of: Though I’m trying to spend as little time as possible on Instagram these days, I will always stop to watch the Roman chef Max Mariola cook in his dreamy outdoor kitchen. During the height of the pandemic, Searching for Italy, a CNN series about Stanley Tucci nearly orgasming over Italian meals, was my escape. Mariola is like Tucci turned up to 11. For him, even the humblest ingredients seem to rouse carnal pleasure. That he whispers, ASMR-like, in Italian—his recipes are shared like secrets—adds a frisson of excitement. In one video, while whipping up buttered anchovy spaghetti for guests who unexpectedly stay for dinner, he murmurs, “I didn’t have anything in the house, but I’ll always make you feel great!” Pantry cooking was never so racy.

Something I loved as a teenager and still love, and something I loved but now dislike: I recently made an obscure reference to the early-aughts emo band Dashboard Confessional in a dumb tweet about the failed SpaceX launch, and immediately regretted it. My feelings changed, however, when a colleague caught it—“are you a Dashboard person?” she Slacked incredulously—and then introduced me to a secret cadre of Atlantic emo-lovers. My people! In high school, bands such as Something Corporate, Yellowcard, and Taking Back Sunday supported me through suburban angst and adolescent existential ennui (and, as a bonus, taught me to play guitar, if badly). Listening to their songs at 36 has been a welcome reminder that I once had the capacity to feel so much, so earnestly—an ability I’m hoping to recultivate after spending most of this millennium (so far) mired in irony.

But not all earnestness ages well. Garden State and (500) Days of Summer were popular twee indie romances that tried to convince a generation that true love happened when navel-gazing weirdos discovered quirky-cool girls to allay their insecurities, usually in settings involving obscure music. Somehow as a young adult, the fact that those weirdos were relentlessly self-absorbed and cared little for their partners’ personal well-being escaped me. That oversight now makes me cringe; fortunately, I’ve since learned that there’s more to love than a shared fondness for The Shins. [Related: Is Dashboard Confessional still emo? (2018)]

A quiet song that I love, and a loud song that I love: In my attempt to see as many concerts as I can before giving birth, I recently went to see The Walkmen, another favorite band on a nostalgia tour. (Compression socks have helped with all the standing around.) They sounded as great as they did decades ago, but I was disappointed not to hear my favorite song, “Red Moon,” a gorgeous, gentle ballad about missing someone, rich with mournful horns. “But the stars are cold / And the air is bright,” the lead singer Hamilton Leithauser laments. “And I see you now / You shine like the steel on my knife.”

More chaotic moods often take me to “Pain Killer,” a sexy, boisterous song from the Danish punk rockers Iceage, featuring vocals from the elusive American pop star Sky Ferreira. Vigorous drums and angular guitars provide plenty of joyful noise, but it’s the unexpected addition of horns—what can I say; I love that brass!—that elevates this track into glorious pandemonium.

Read past editions of the Culture Survey with Damon Beres, Julie Beck, Faith Hill, Derek Thompson, Tom Nichols, Amy Weiss-Meyer, and Kaitlyn Tiffany.

The Week Ahead

The Making of Another Major Motion Picture Masterpiece: A Novel, the debut novel by the actor Tom Hanks that was a lifetime in the making (on sale Tuesday) The third season of The Great, a raucous reimagining of the reign of Russian Empress Catherine the Great (begins streaming Friday on Hulu) The Mother, an action-thriller starring Jennifer Lopez as a military-trained assassin on a mission to protect her daughter (available to stream Friday on Netflix)

Essay

Illustration by Joanne Imperio / The Atlantic. Source: Marka / Alamy; Trinity Mirror / Alamy; Pictorial Press Ltd / Alamy.

A Rom-Com That Seduces the Old-Fashioned Way

By Jane Hu

It is a truth universally acknowledged that a single, hot woman must be in want of a schlubby man who can make her laugh. This is, at least, the fantasy that romantic comedies have too often sold us, from Woody Allen’s Manhattan to Harold Ramis’s Groundhog Day to Judd Apatow’s Knocked Up. In these films, what’s most valued in a man is not his body—or even his bank account—but his winning personality. When it comes to romancing a woman, humor and a heart of gold turn out to be a foolproof strategy of seduction. And part of the comedy is that an average-looking man who tells good jokes is able to tell them all the way to the bedroom.

This familiar trope is also the opening setup to Curtis Sittenfeld’s latest novel, Romantic Comedy, though Sittenfeld deftly toggles between deconstructing a well-worn genre and leaning into its most predictable beats. She does this, in part, by setting her novel in the entertainment industry—that producer of slick narrative arcs and neat archetypes—and, more specifically, by making her protagonist a professional comedian, someone whose literal job is to poke fun at the scripts that govern our desires.

Read the full article.

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Surfer Kai Lenny rides a wave as a big swell hits Teahupoʻo, on the French Polynesia island of Tahiti, on April 30, 2023.

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Sunny Bryant is only 9 years old—but already an old hand at testifying before lawmakers. The youngster from Houston was 4 when she first asked her mother, “Why did you make me a boy? I wanted to be a girl,” as she was being strapped into a car seat. Since then, Sunny and her mother have spoken at the Texas legislature at least five times, entering the political spotlight amid a nationwide surge in attempts to ban child gender transition. This year, 12 states have passed laws to prohibit or sharply restrict the practice.

On March 27 this year, Sunny missed school and waited until late into the night to speak in front of a Texas House of Representatives committee as it considered H.B. 1686, which would ban puberty blockers, cross-sex hormones, and gender surgery for under-18s in the state. (The bill is currently pending.) “If you pass this bill and we stay in Texas, I’d grow up looking like my dad, and that’s a scary thought,” she told the legislators. “I want to grow up looking like me—nobody else, just Sunny.”

[Read: What’s behind the new wave of transgender ‘bathroom bills’]

How parents and doctors can best support children like Sunny is a fraught question, because of the uncertain medical evidence and the volatile political climate in the United States. A polarized, incendiary debate over child transition is playing out in red and blue states alike: H.B. 1686 is one of more than 450 bills proposed or passed in this year’s state legislative sessions that the American Civil Liberties Union characterizes as anti-LGBTQ. On a single day in Florida two weeks ago, the Republican-dominated House debated limits on drag shows, a bill restricting the provision of trans-inclusive bathrooms, and a ban on youth transition. “I feel like they’re making these kids the ‘other’ and trying to make them out to be bogeymen and bogeywomen,” Fentrice Driskell, the Florida House’s Democratic leader, told me. In a committee hearing last month, for example, Representative Webster Barnaby, a Republican, referred to trans people as “mutants” and “demons.” (He later apologized.) Of the ban on child transition, Driskell added, “This will lead to more transgender youth taking their lives.”

In the United States, then, the debate around child gender medicine has split along partisan lines: Left-leaning activist groups and the White House regularly describe child transition as “lifesaving” and raise the specter of suicide if care is withdrawn. Meanwhile, Texas Governor Greg Abbott and former President Donald Trump have called medical transition “child abuse.” If the most extreme red-state bills go ahead, both parents and doctors could face prosecution for giving a child access to treatment.

I believe that these bans on child transition are unhelpful, illiberal, and in many cases disturbingly punitive—and I say that as someone with serious reservations about the most influential model of child gender care in America.

More than 100 gender-care clinics in the United States treat children, according to Reuters. Because the U.S. health-care system is decentralized, and because a long-awaited study of youth gender care funded by the National Institute of Child Health and Human Development has yet to report its full findings, establishing exactly how patients are being treated in these clinics is difficult. But from the statements of leading practitioners, we do know that many have rejected a model called “watchful waiting,” where extensive talk therapy is preferred to puberty blockers, cross-sex hormones, and surgery—or at least seen as a prerequisite for those medical interventions.

Instead they favor “affirmative care,” which is grounded in the belief that “kids know who they are,” even though a 2016 review of the available studies estimated that, without medical interventions, gender dysphoria in children resolves itself during or after puberty in about 80 percent of cases. (Supporters of medical treatment dispute the validity and relevance of that research.) Seven of the 18 U.S. clinics surveyed in the Reuters investigation said they were comfortable prescribing hormones to minors on their first visit. “Providers and their behavior haven’t been closely studied,” wrote Laura Edwards-Leeper and Erica Anderson, two experienced clinicians in the field, in The Washington Post in 2021, “but we find evidence every single day, from our peers across the country and concerned parents who reach out, that the field has moved from a more nuanced, individualized and developmentally appropriate assessment process to one where every problem looks like a medical one that can be solved quickly with medication or, ultimately, surgery.”

The reason many American liberals give for supporting “gender-affirming care” for children is that they believe the science is settled. Rachel Levine, the assistant secretary for health in the Department of Health and Human Services, has claimed that there is “no argument among medical professionals” about “the value and importance of gender-affirming care.” The truth of that statement depends in part on the definition of gender-affirming care. Every child experiencing distress deserves supportive treatment, which can take a variety of forms. But the statement by Levine, who is herself trans, can be interpreted as suggesting specifically that hormonal and surgical interventions, perhaps even for younger minors, are uncontroversial among clinicians and indisputably backed by sound science. They are not.

In the face of red-state bills, such medical groups as the American Academy of Pediatrics, the Endocrine Society, and the World Professional Association for Transgender Health, or WPATH, have maintained a united front—nothing to see here—even though many pediatricians who oversee care for children are much less certain. Quite understandably, those on the American left who pride themselves on “following the science” on vaccines and climate change take their cues from these powerful institutions on this polarized topic too. Yet as The BMJ’s editor recently said, with scientific understatement, “The strength of [American] clinical recommendations is not in line with the strength of the evidence.” Gordon Guyatt, a physician and professor at McMaster University, in Canada, who coined the term evidence-based medicine in 1991, goes even further. He has called the current American guidelines “untrustworthy.”

To skeptics, the American medical guidelines appear less evidence-based than consensus-based. A sharper way to put that would be that medical associations, under political pressure from activists, may have succumbed to well-intentioned groupthink. The draft version of the latest WPATH guidelines, for example, included minimum recommended ages for surgery. But these were removed from the final version at the very last minute, with no official explanation. (The only such recommendation that remains is a minimum age of 18 for phalloplasty, a surgery after which three-quarters of trans patients suffer complications.) Whatever the reason for the recommended age limits being dropped, the effect is to imply that there is no age at which a patient is not yet ready to make such an important decision. In the U.S., you must be 21 to buy alcohol in a bar. Can it really be taboo to say that 16 is too young for a mastectomy—or 14, or even 12? And yet somehow it is.

Several European countries that once tacked toward affirmative care have recently looked at the evidence and revised their treatment protocols. Sweden’s new guidelines, developed alongside a formal review by that country’s National Board of Health and Welfare, state that the risks of puberty blockers and cross-sex hormones “currently outweigh the possible benefits” and that they should be given only in “exceptional” cases or research settings. Health authorities in England and Finland have also proposed new guidelines that would restrict the use of puberty blockers. Norway’s health-care watchdog states that “the knowledge base, especially research-based knowledge for gender-affirming treatment (hormonal and surgical), is insufficient and the long-term effects are little known.” In France, the National Academy of Medicine now states that, because of the possibility that a social contagion is driving up case counts, doctors should prescribe hormones with “the greatest reserve.” Minors should also be informed about the “irreversible nature” of treatment, and the possibility of “impact on growth, bone fragility, risk of sterility, emotional and intellectual consequences and, for girls, symptoms reminiscent of menopause.”

[Helen Lewis: The twitches that spread on social media]

The U.S. is not a complete outlier in terms of its approach to treatment; medical experts in other developed countries including Italy, Spain, Canada, Australia, and New Zealand still recommend puberty blockers. But some of these are expressing more caution. In August, a leading practitioner in Canada, Joey Bonifacio of Toronto’s St. Michael’s Hospital, called for the country’s doctors to “slow down.” A month later, Charlotte Paul, an epidemiologist and emeritus professor at the University of Otago, wrote in The New Zealand Herald that her colleagues had “pleaded” with her to raise concerns about the treatment, because they feared for their jobs if they did so. “They doubt whether there is sufficient psychological assessment for children with gender dysphoria before they are prescribed puberty blockers,” she wrote. Even in the Netherlands, where the so-called “Dutch protocol” for using puberty blockers was originally conceived, dissent is building about the treatment. “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 the journalist Frieda Klotz for an Atlantic article. “But now I don’t think that any more.”

Across the world, doctors are expressing caution over side effects, acknowledging the experimental nature of medical interventions, and entertaining the possibility that the recent surge in teenage trans identification is socially driven rather than solely evidence of previous underdiagnosis. That has put much of Europe on a different path from the United States. Either these countries—including some of the most progressive and LGBTQ-friendly nations on Earth—are secretly as right-wing as Abbott and Florida Governor Ron DeSantis, or they know something America doesn’t.

With all that said, it can’t be right to prosecute loving parents for seeking care for their children that has been recommended to them by their doctors. Just as we lack proof that current treatments are categorically “lifesaving,” we do not have evidence that they constitute “child abuse.”

The bans are also harmful because of the possibility of unintended consequences, as with abortion restrictions that prevent women experiencing natural miscarriages or molar pregnancies from receiving treatment. Ireland’s abortion ban caused the death of Savita Halappanavar, a 31-year-old woman who developed blood poisoning after doctors refused to give her drugs to complete a miscarriage. Child-transition bans might have similarly unpredictable effects by stopping families in need from seeking help or discouraging doctors from offering any form of support.

Another reason to oppose the bans is that they are fueling what I would call reactive polarization. When red states ban child transition, many on the left instinctively jump to defend medical interventions. This tendency is intensified when youth-gender bills come packaged alongside overtly anti-LGBTQ legislation, as in Florida two weeks ago. Yet child transition should be treated differently from debates over drag-queen story hour—and differently from adult transition, too, where the case for relying purely on informed consent is much more compelling.

[Leo Valdes and Kinnon MacKinnon: Take detransitioners seriously]

The European evidence is part of what persuaded Leor Sapir, a researcher at the right-leaning Manhattan Institute, to testify in favor of the proposed ban in Texas. The other part was his conviction that the American medical system cannot be trusted to moderate itself. “Are these bans the perfect solution? Probably not,” he told me. “But at the end of the day, if it’s between banning gender-affirming care and leaving it unregulated, I think we can minimize the amount of harm by banning it.” Corinna Cohn, a Gender Care Consumer Advocacy Network board member who herself transitioned as a teenager, has also testified in favor of similar legislation. “In a perfect world, the policies would be more nuanced than full bans,” she told me via email. “In practice, there are only two possibilities: a total lack of accountability (status quo), or a ban on the practice entirely.”

These should not be the only two available options. Science is supposed to be a self-correcting process, but that cannot happen when political considerations quash good-faith debate.

Outside of conservative outlets, journalists are reluctant to engage with child transition because of the abuse it generates and the potential for being ostracized by their peers: An open letter to The New York Times by contributors criticizing its coverage of trans issues cited the red-state bills as a reason not to question the progressive consensus. When The BMJ accurately described the flimsiness of the current evidence base, British LGBTQ groups demanded an apology and suggested that the article’s author and the journal’s editor should disclose whether they held “so-called ‘gender critical’ beliefs as this would represent a significant undeclared conflict of interests.” In the five years since the journalist Jesse Singal wrote an Atlantic cover story that aired doubts about the affirmative model, some trans activists have relentlessly demonized him, likening him to Goebbels and accusing him of having blood on his hands.

In the middle of this storm, is there a way forward? I asked Sarah Warbelow, the legal director of the Human Rights Campaign, which fights against the bills, what she believed the ideal regime would be. “We really should be looking towards medical professionals who are well trained in this area of medical care to be working with families to make these decisions,” she told me. I agree—medical decisions are best left to doctors with firsthand knowledge of the patient in front of them, not legislators in a state capital pursuing a culture war.

But persuading politicians on the right to trust physicians will be difficult, because of conservatives’ feeling that the profession has become ideologically blinkered. Critics of the affirmative model often point to the Miami-based surgeon Sidhbh Gallagher, who has 250,000 followers on TikTok and talks about her job as “yeeting the teets,” as an extreme example. (As of last fall, Gallagher’s youngest mastectomy patient, according to The New York Times, was 13 years old.) In the absence of bans, a regime more like the European ones would require doctors to become gatekeepers.

To find a way through this deeply polarized subject—and to make sure that gender-nonconforming children are given the best care, based on the soundest evidence—the only hope is that American medical associations will conduct comprehensive formal reviews of the available studies and take account of the findings of European countries.

A proper systematic review of child-transition care by the American medical establishment might well uncover the same blurry picture now agreed upon by doctors in England, France, Norway, Sweden, and Finland. Clinical guidelines would have to change as a result, stressing the importance of assessment and therapy, and clinics would have to get better at collecting long-term follow-up data. In the meantime, the United States should take after Europe. Requiring medical assessment and counseling before prescribing puberty blockers or hormones to minors would be neither illiberal nor punitive, and insisting that patient outcomes be tracked over several years will give us better data on what works.

That would offer a middle ground between the total bans of the red states and an unregulated, activist-driven regime under which, at some clinics, a minor can obtain testosterone at a first appointment. A more reasoned approach would represent a triumph over partisans on both sides, and—most important of all—do right by the thousands of children seeking care every year.