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Photographs by Justin Maxon for The Atlantic

This winter, I attended a livestock auction on California’s remote northern coast. Ranchers sat on plywood bleachers warming their hands as the auctioneer mumble-chanted and handlers flushed cows into a viewing paddock one by one. Most of the cows were hale animals, careering in and cantering out. But one little brown cow moved tentatively, rheum slicking her left eye and a denim patch covering her right.

That night, I went to take a closer look at her along with a pair of animal-welfare investigators and some of the traders who had participated in the auction. Cow 13039, as her ear tag identified her, was segregated with other sick or injured cattle in a pen near the viewing paddock. A farmhand led her into a squeeze chute, so that I could see her udders and feel her bony sides and scratch her head.

The denim patch had been glued straight onto her right orbital rim. I helped work up the patch’s edge; when a rancher finally ripped it off, her eyeball swelled from its socket, tethered to her skull by muscle and sinew and skin. Unable to focus, the eye rotated wildly. It had ruptured, its wet inner contents extruding from the broken membrane; blood and green pus suppurated from its edges, smelling of copper and must. The cow had “cancer eye,” the rancher who had purchased her guessed, the most common bovine cancer.

Cow 13039, the auction affidavit showed, came from one of the country’s preeminent dairy farms: Alexandre Family Farm, a nationwide supplier to stores including Whole Foods. Alexandre cows are pasture-raised, and the operation is validated by California Certified Organic Farmers (CCOF), Certified Humane, and the Regenerative Organic Alliance. Its owners, Blake and Stephanie Alexandre, won the Organic Farmer of the Year award a few years back and have been profiled by The New York Times. For $8, you can buy about a third of a gallon of its top-shelf milk.  

[Annie Lowrey: Radical vegans are trying to change your diet]

The Alexandres sold dozens of grievously ill and injured cows at auction over the past four years, according to a sprawling whistleblower report published by the nonprofit advocacy group Farm Forward. On the farm, the report charges, mismanagement led to “the extreme suffering of hundreds of cows.” One whistleblower contacted the local sheriff and the United States Department of Agriculture, among other organizations, to report animal-welfare violations, but without results. The report is based on hundreds of location- and date-tagged photographs and videos collected over a four-year period by people who worked either with or for Alexandre Family Farm, as well as on affidavits, veterinary reports, and interviews.

(Justin Maxon for The Atlantic)

Alexandre Family Farm really is a family farm, run by the Alexandres and staffed by some of their children, on multiple sites in Del Norte and Humboldt Counties. Blake and Stephanie met while studying at Cal Poly San Luis Obispo in the early 1980s, and from there built a pasture-raised empire. Alexandre’s 4,500 cows, which give birth to 4,000 calves a year, make it one of the largest organic dairy farms in the country.

In March, I visited the farm to ask the Alexandres about the report. In that conversation, they questioned the motivations of the whistleblowers, speculating that they were disgruntled former employees and associates, and ventured that some of the photographs might have been staged or doctored. They described some of the depicted incidents as false, implausible, or exaggerated, while saying that others were tragedies or accidents to which they had responded with corrective action. “Stuff happens,” Blake told me, as we sat at his kitchen table. “Employees make mistakes. We make mistakes. We try to fix them when we become aware of them.”

Alexandre is not just any farm; it is esteemed by chefs, politicians, and advocates for humane agriculture, and consumers seek out its products. The report implicates not just the farm but also the certification programs that farms like it use to assure consumers that the food they are eating is ethically sourced and cruelty-free. And it implicates the government, which does little to protect the welfare of farm animals. Laws are lax and enforcement is even more lax, despite widespread public support for animal protection.

When I met Cow 13039, a dying animal sold to the highest bidder, I thought that the system had failed her. But in reporting this story, I found something far more disconcerting. No system had failed her, because there was no system to protect her in the first place.

one thing is not in dispute: Alexandre cows live a life far better than those on the mega-operations that produce most of the country’s milk. They eat grass and hay instead of pellets made from corn and soybeans. They have daily access to pasture and live in herds, rather than being isolated in stalls. (Cows are sociable animals—personality-wise, they’re a lot like dogs.)

The promise of happy, healthy cows has fueled the company’s success. The farm won an award from Whole Foods in 2020 and is one of only six Certified Humane bovine-dairy operations in the United States. The Alexandres have become outspoken advocates of back-to-the-earth farming; Blake was appointed to a state agricultural committee and is now on a California regenerative-farming commission.

But many Alexandre cows are neither happy nor healthy, the Farm Forward report concludes. “Most of the whistleblower or undercover investigations that are done on animal farm operations are a couple of videos … maybe one whistleblower coming forward,” Andrew deCoriolis, Farm Forward’s executive director, told me. “The thing that makes this unique is the totality of the evidence.”

[Annie Lowrey: What’s different about the Impossible Burger?]

The details in the report are horrifying: a cow with mastitis having her teat cut off with a knife. A cow sent to auction with a spinal-cord injury that had left her incontinent and partly paralyzed. A live, alert cow being dragged by a skid steer. A cow that could not walk being left in a field for two weeks before being euthanized. Cows sprayed with a caustic combination of mineral oil and diesel fuel to tamp down on a fly infestation (which, a whistleblower says in the report, they were told to lie about to an inspector).

At their farm, in a written response, and in a follow-up conversation, the Alexandres described such incidents as improbable, given the farm’s protocols. “Cutting teats off” has “never been a practice on our dairy farms,” they told me. They said that injured cows received medical treatment and when necessary were moved safely, without dragging. A farm worker had mixed red diesel into a fly spray, they told me, because that made it easier to see where the spray had been applied, and the farm stopped the practice when management learned about it.

Former employees said that sick cows were regularly denied antibiotics for mastitis and hoof infections, at least in part to maintain their milk as organic—a charge corroborated by an Alexandre farm worker not involved in the report. (Once a cow is given antibiotics, her milk must be sold as conventional for the duration of her life.) The farm has “natural” treatments that “allow us to not need synthetic antibiotics,” Vanessa Nunes, Blake and Stephanie’s daughter and a dairy manager at the operation, told me. “We don’t need to give an antibiotic for mastitis. We have a tincture that we’ll use.” (Mastitis can be debilitating when not treated with antibiotics.)

Whistleblowers also said cows with infections had their eyes packed with salt and had denim patches glued to their skulls. The farm responded that cows with pink eye were treated using a saline solution with cod-liver oil, and sometimes with apple cider vinegar. The farm said that the denim patch was a “gold standard” method to cure pink eye.

Jim Reynolds, a large-animal veterinarian, told me that salt would be “horrible” to use in any animal’s eye and that patches had no medical benefit, and could worsen an infection by trapping dirt and irritating the eye. “I don’t know that it’s been recommended since the 1980s,” he said. He told me that the farm’s treatment for eye infections was “nonsense.”   

Dairy cows generally have their horn buds destroyed with a caustic paste or a hot iron in the first weeks of life. But the report describes an incident in which Alexandre let hundreds of calves grow horns and then dehorned them as adults with a sawzall, a handheld construction tool. Horns are innervated, like fingers, not inert, like fingernails; the cows were not given anesthetic. The Alexandres said that the employees cut off only the tips of the cows’ horns, which are not sensitive, to prevent them from injuring people or other animals, and that it was a onetime event.

Left: The auction yard where Alexandre Family Farm cows are sold. Right: Cow 13039, with the denim patch over her eye. (Justin Maxon for The Atlantic; courtesy of the author)

Mismanagement at least once led to mass death, the report charges, when hay deliveries ran late. The whistleblowers said the animals were so famished by the time the feed truck arrived that they stampeded, and many were trampled to death or needed to be euthanized soon after. The Alexandres described this as a “tragic accident” involving 30 cows who were without food for only a few hours after an equipment breakdown; the farm said it had implemented new protocols to prevent anything similar from happening again.

The farm also contested the notion that it would send ailing cows to auction, rather than euthanizing them; the auction facility would not accept such animals, the Alexandres told me, something Leland Mora, the head of the auction house, confirmed. Still, on a random Wednesday, I went to that auction. And I met an Alexandre cow with what looked like metastatic cancer, her eyeball swelling out of her head.

Most American consumers abhor animal cruelty and support laws preventing it. In a recent ASPCA survey, three-quarters or more of respondents said they were concerned about farm-animal welfare and supported a ban on new factory farms. Yet cruelty, even egregious cruelty, against farm animals is often legal, provided that the suffering is “necessary” and “justifiable” by the need for farms to produce food, David Rosengard of the Animal Legal Defense Fund told me.

To determine what is “necessary” and “justifiable,” lawyers and juries often look at what farms are already doing, what agricultural schools are teaching, and what Big Ag publications recommend. In effect, I gathered, animal-welfare law is slanted toward the needs of farms much more than the experience of animals.

Even gratuitously abusive treatment often goes unpunished. Local authorities have jurisdiction over most animal-cruelty complaints. But cows, pigs, and chickens are not great at picking up the telephone to call those authorities. Animal-rights activists are able to perform investigations only sporadically, and at significant legal risk to themselves. Farm workers, many of whom are undocumented immigrants, rarely report violations.

[Peter Singer: The meat paradox]

Plus, as I learned from speaking with the Alexandres and interviewing the whistleblowers, agricultural communities are tight-knit. The people involved in this story have long, complicated histories with one another—personal grievances, financial entanglements, legal disputes. The whistleblowers declined to be quoted by name, fearing for their livelihoods, save for one, a rancher named Ray Christie, who has bought hundreds if not thousands of Alexandre cattle. In 2009, after a raid, he was put on two-year probation for possessing cockfighting instruments; in 2018, he was charged with felony animal cruelty himself over the state of his cows. (He recently accepted a plea bargain, agreeing to misdemeanor littering charges for improperly disposing of animal carcasses.) Given the personalities involved, I focused on the documentary evidence about the cows themselves.

The condition of some Alexandre cattle spurred one of the whistleblowers to try to get law enforcement involved. In January 2021, the whistleblower told Humboldt County Sheriff William F. Honsal that mistreated Alexandre cattle were being sold at auction, and sent him photos and videos of the cows. The sheriff responded, saying that he would send a deputy to the auction house; the sheriff’s office later referred the whistleblower to animal control. (The sheriff did not respond to requests for comment, and the Alexandres told me they had never been visited by a police officer.)

The whistleblower also attempted to involve a local state veterinarian, Meghan Mott. Mott is a mandated reporter of animal abuse, and frequently attended auctions at the facility I visited. Why hadn’t she intervened? I could not reach her for comment, but Steve Lyle, the director of public affairs at the California Department of Food and Agriculture, told me that the head state veterinarian “tries to convey the idea of ‘if you see something, say something’ to staff.” But he explained that state veterinarians are functionally epidemiologists, checking for conditions like influenza. “If an animal is sick and the cause is not one of the emergency or regulated diseases requiring CDFA action,” care would be the responsibility of the animal’s owner, and negligence the responsibility of law enforcement.

Finally, the whistleblower went to the USDA. The agency has regulatory authority over American farms, but does not perform animal-welfare inspections. “There’s a regulatory system in place to make sure that if we eat a cheeseburger from McDonald’s, we’re not going to get E. coli,” Amanda Hitt, the founder of the Food Integrity Campaign at the Government Accountability Project, told me. “That doesn’t happen in animal welfare.”

That said, the USDA does administer the National Organic Program, which mandates that animals have “sufficient nutrition,” are given “medicines to minimize pain, stress and suffering,” and are “fit for transport” when they are sent to slaughter. But the NOP is mainly aimed at environmental stewardship. Its humane standards are low, and sometimes counterproductive. The program’s restrictions on the use of antibiotics, for instance—intended to prevent farmers from providing the drugs prophylactically, which facilitates overcrowding and contributes to antibiotic resistance—leads farmers to withhold medicine from sick animals, too. That’s particularly cruel for newborns and recently delivered mothers, who are especially vulnerable to infection. (Other countries do things differently: The European Union allows organic dairy cows to get antibiotics up to three times a year.)  

Ag agencies don’t make great cops. The NOP does not audit farms directly, instead relying on third-party certifiers that farms themselves sometimes pick, accommodating widespread fraud. California Certified Organic Farmers performs surprise visits, tests for pesticide residue, does intensive paperwork audits, and sometimes stakes out farms to make sure animals are really living outside, April Vasquez, CCOF’s chief certification officer, told me. But it is also a trade group that promotes organic agriculture and financially supports at-risk farms; its board is made up of organic farmers. Stephanie Alexandre sat on it for years.

The USDA passed the whistleblower’s complaint to the CDFA, which sent a state special investigator to the Alexandre farm sites in May 2023. A USDA document obtained by a Freedom of Information Act request shows that the investigation found no wrongdoing. Talking about fraud in the organic program with a USDA officer, the whistleblower became incensed on behalf of the cows and the consumers shelling out for supposedly high-quality products. “You got these single-parent homes, the moms, the young couples, struggling with all the inflation going up,” the whistleblower said. “They’re going to the store, spending their money on this stuff, thinking it’s the best thing for their kids. And it’s all bullshit!”

A compost pile with cow carcasses at Alexandre Family Farm (Justin Maxon for The Atlantic)

The regulatory void around animal welfare has been filled by dedicated nonprofits offering their own certifications for farms meeting high standards. The godparent of this private system is Adele Douglass Jolley, a former employee of the American Humane Association. In 2000, while touring pig farms in the U.K., Jolley learned about the animal-welfare verification program run by the Royal Society for the Prevention of Cruelty to Animals. She cashed out her 401(k) to set up a similar program stateside.

Now called Certified Humane, it gives its seal of approval to hundreds of operations caring for 417 million animals in 25 countries. Auditors ensure that farms are meeting its standards, which are set by an independent panel of experts. Farms pay a monthly fee, and they (or the companies packaging the food they produce) get to put the Certified Humane logo on their products—and charge consumers more. But the whistleblower report indicates that Alexandre was far out of compliance. Why hadn’t Certified Humane caught the cruelty?

Perhaps because Alexandre does meet the program’s general standards. Its cows live in herds on pasture; they eat grass and hay; they are not given preventive antibiotics. Perhaps because the private certification system is based on trust and support as much as verification and skepticism. Audits generally happen only once a year, in consultation with the farms in question. Farmers sometimes know their auditors. Producers found to be out of compliance are given a chance to correct the problems.

Certified Humane provided Alexandre with its stamp of approval in early 2021. (Some of the incidents in the whistleblower report predate the farm’s relationship with the nonprofit.) In 2022, Certified Humane received a complaint from one of the whistleblowers about cruelty on the farm. The complainant had taken photographs of two cows they said had eye injuries, Mimi Stein, the group’s executive director, told me in an interview. “These were some very strange pictures,” she told me. “They were not high quality.”

[Read: ‘Plant-based’ has lost all meaning]

When Stein called the Alexandres to ask what had happened, they were “upset” and “passionate,” she told me. They said one cow had had an eye damaged after sale and the other was “fine, as much as anybody could tell.” Stein’s sense was that the Alexandres “would have taken care of them and euthanized them on site” had they been severely injured or ill, as Certified Humane requires.  

The organization followed up with an in-person audit, which found no problems. Basically, Stein told me, “if animals were that damaged, chances are they wouldn’t sell them, because they wouldn’t have any value. It just wouldn’t make any sense.”  

Alexandre also touts its certification from the Regenerative Organic Alliance, which holds farms to even higher animal-welfare standards. Elizabeth Whitlow, its executive director, told me that the incidents and practices depicted in the report would represent gross violations of its rules. But I was surprised to learn that only a small share of Alexandre cows are actually certified by the group.

You couldn’t blame a consumer for being bewildered—about what is going on with Alexandre products or any others bearing a claim about the conditions in which the animals are raised. There are more than a dozen humane certifiers, some with rigorous standards, some that are just industry fronts. “It has this patina of a Yelp review: five stars for this processor!” Hitt, the founder of the Food Integrity Campaign, told me. “This is a certification to make you feel better about eating a certain product. But it has no basis in any kind of reality.”

In addition to certification logos, products feature wholesome-sounding but hard-to-parse terms: free-roaming, naturally grown, ethically raised. For some, such as free-range, the USDA sets a standard and asks companies for evidence of compliance. But enforcement is patchy, and the USDA has in the past accepted applications with little or no substantiation. For others, the USDA sets no standards at all. Food manufacturers know they can charge more for products that consumers think are ethical, Dena Jones, who directs the farmed-animal program at the Animal Welfare Institute, told me. So companies just “start slapping” words and logos on things.

The USDA, to its credit, is tightening up its rules and enforcement. Yet dairy will still “fall through the cracks,” Jones told me. The labels on milk and yogurt are the purview of the Food and Drug Administration, not the USDA. And the FDA holds that it has no role in validating animal-raising claims. As far as the federal government is concerned, when it comes to milk and the cows that produce it, anyone can claim almost anything.

(Justin Maxon for The Atlantic)

The Alexandre farm I toured with the family occupies a damp flat between the Pacific Ocean and an old-growth redwood forest. Hundreds of fat, calm cows chewed emerald grass and slept in the mist alongside a herd of wild elk. Heavily pregnant cows idled in a spacious barn, overseen 24 hours a day by a herdsman. Younger cows rushed up to meet me.

The farm appeared to provide as close to perfect conditions as possible, I thought. Yet dairy is hard—that was something I heard again and again while reporting this piece. On ranches, beef cattle live outdoors, mostly undisturbed, before being moved to feedlots; mothers and calves spend months together. In contrast, dairy cows are repeatedly inseminated or bred, calved, and separated from their babies. They are milked twice a day. And when their bodies begin to give out, they keep getting milked until they are euthanized or slaughtered.

Jorie Chadbourne, a retired brand inspector (a government official who verifies an animal’s ownership at the point of sale or slaughter), told me the Alexandre cows she had encountered over the years were no better or worse than those from other organic farms in the region. But, she added, at auction, organic cows were usually in worse shape than conventional cows, because of the program’s medication restrictions: “It is like an older person, at the end of their life, not having medicine to comfort them or make them well.” (She told me the antibiotic rules are why she raises her own animals conventionally.)

The best certifiers, like Certified Humane, are great at validating farms’ general conditions. But, as Mimi Stein noted, the program certifies the farm—not the animal. Cows get sold off. Cruel incidents happen. And many other certifiers are less rigorous.

[Read: The evidence for a vegan diet]

What is a consumer who wants to support a gentle, green system of agriculture to do? DeCoriolis of Farm Forward had a blunt answer: Give up dairy. “As a consumer, you’re just playing roulette,” he told me. Yet the overwhelming majority of American consumers are unwilling to give up milk or cheese for ethical reasons. What they are willing to do is support stricter rules for agricultural producers and pay more for milk and cheese from farms that treat their animals well. The country is failing to provide those consumers with a reliable and navigable system. That’s a policy problem, and a solvable one.

At a minimum, the USDA should require third-party certification of animal-welfare and animal-raising claims, and apply strict regulations to certifiers: preventing conflicts of interest, requiring surprise inspections, and cracking down on rubber-stamping of industry norms. To meet American consumers’ more ambitious demands, Congress should create a farmed-animal welfare standard and an agency separate from the USDA to enforce it, akin to the Consumer Product Safety Commission.

Such changes would improve the welfare of billions of animals in our food system. Yet any changes would be too late for one. In the end, nobody stepped in to aid Cow 13039—not law enforcement, not the state veterinarians, not the auction employees. Alexandre Family Farm gave her vitamins and an eye patch, Nunes told me. They should have sold her sooner, she said. Cow 13039 was ailing. And ailing cows are not worth much.

They are worth something, though. At auction, Cow 13039 got 10 cents a pound. For $119, less auction fees, she spent the final moments of her life not grazing on pasture with her herd but isolated, hungry, terrified, and in pain. Ray Christie’s brother, also a rancher, had purchased her. But she was too sick to have her eye excised. At the slaughterhouse, her carcass would have been condemned.

The morning after I met her, a farmhand shot her between her blighted eyes.

Gisela Salim-Peyer contributed reporting to this story.

In a world without partisan politics, the Cass report on youth gender medicine would prompt serious reflection from American trans-rights activists, their supporters in the media, and the doctors and institutions offering hormonal and surgical treatments to minors. At the request of the English National Health Service, the senior pediatrician Hilary Cass has completed the most thorough consideration yet of this field, and her report calmly and carefully demolishes many common activist tropes. Puberty blockers do have side effects, Cass found. The evidence base for widely used treatments is “shaky.” Their safety and effectiveness are not settled science.

The report drew on extensive interviews with doctors, parents, and young people, as well as on a series of new, systematic literature reviews. Its publication marks a decisive turn away from the affirmative model of treatment, in line with similar moves in other European countries. What Cass’s final document finds, largely, is an absence. “The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” Cass writes. We also don’t have strong evidence that social transitioning, such as changing names or pronouns, affects adolescents’ mental-health outcomes (either positively or negatively). We don’t have strong evidence that puberty blockers are merely a pause button, or that their benefits outweigh their downsides, or that they are lifesaving care in the sense that they prevent suicides. We don’t know why the number of children turning up at gender clinics rose so dramatically during the 2010s, or why the demographics of those children changed from a majority of biological males to a majority of biological females. Neither “born that way” nor “it’s all social contagion” captures the complexity of the picture, Cass writes.

What Cass does feel confident in saying is this: When it comes to alleviating gender-related distress, “for the majority of young people, a medical pathway may not be the best way to achieve this.” That conclusion will now inform the creation of new state-provided services in England. These will attempt to consider patients more holistically, acknowledging that their gender distress might be part of a picture that also includes anxiety, autism, obsessive-compulsive disorder, eating disorders, or past trauma.

This is a million miles away from prominent American medical groups’ recommendation to simply affirm an adolescent’s stated gender—and from common practice at American gender clinics. For example, a Reuters investigation found that, of 18 U.S. clinics surveyed, none conducted the lengthy psychological assessments used by Dutch researchers who pioneered the use of medical gender treatments in adolescents; some clinics prescribe puberty blockers or hormones during a patient’s first visit. Under pressure from its members, the American Academy of Pediatrics last year commissioned its own evidence review, which is still in progress. But at the same time, the group restated its 2018 commitment to the medical model.

The Cass report’s findings also contradict the prevailing wisdom at many media outlets, some of which have uncritically repeated advocacy groups’ talking points. In an extreme example recently noted by the writer Jesse Singal, CNN seems to have a verbal formula, repeated across multiple stories, to assure its audience that “gender-affirming care is medically necessary, evidence-based care.” On a variety of platforms, prominent liberal commentators have presented growing concerns about the use of puberty blockers as an ill-informed moral panic.

[Alia Wong: The power struggle over transgender students]

The truth is that, although American medical groups have indeed reached a consensus about the benefits of youth gender medicine, doctors with direct experience in the field are divided, particularly outside the United States. “Clinicians who have spent many years working in gender clinics have drawn very different conclusions from their clinical experience about the best way to support young people with gender-related distress,” Cass writes. Her report is a challenge to the latest standards of care from the U.S.-based World Professional Association for Transgender Health, which declined to institute minimum-age limits for surgery. The literature review included with her report is notably brutal about these guidelines, which are highly influential in youth gender medicine in America and around the world—but which, according to Cass, “lack developmental rigour.”

The crux of the report is that the ambitions of youth gender medicine outstripped the evidence—or, as Cass puts it, that doctors at the U.K. clinic whose practices she was examining, although well-meaning, “developed a fundamentally different philosophy and approach compared to other paediatric and mental health services.” How, she asks, did the medical pathway of puberty blockers and then cross-sex hormones—a treatment based on a single Dutch study in the 1990s—spread around the world so quickly and decisively? Why didn’t clinicians seek out more studies to confirm or disprove its safety and utility earlier? And what should child gender services look like now?

The answer to those first two questions is the same. Medicalized gender treatments for minors became wrapped up with a push for wider social acceptance for transgender people, something that was presented as the “next frontier in civil rights,” as Time magazine once described it. Any questions about such care were therefore read as stemming from transphobic hostility, full stop. And when those questions kept coming anyway, right-wing politicians and anti-woke comedians piled on, sensing an area where left-wing intellectuals were out of touch with popular opinion. In turn, that allowed misgivings to be dismissed as “fascism,” even though, as the British journalist Sarah Ditum has written, “it is not damning of feminists that they are on the same page as Vladimir Putin about there being two sexes. That is just how many sexes there are.”

In Britain, multiple clinicians working at the Gender Identity and Development Service (GIDS) at the Tavistock and Portman Trust, the central provider of youth gender medicine, tried to raise their concerns, only to have their fears dismissed as hostility toward trans people. Even those who stayed within the service have spoken about pressure from charities and lobbying groups to push children toward a medical pathway. As Cass notes, “There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour.”

This hostile climate has hampered attempts to collect robust data about real-world outcomes. The report’s research team at the University of York tried to follow up on 9,000 former GIDS patients but was informed by National Health Service authorities in England in January that “despite efforts to encourage the participation of the NHS gender clinics, the necessary cooperation had not been forthcoming.” Cass has since wondered aloud if this decision was “ideologically driven,” and she recommends that the clinics be “directed to comply” with her team’s request for data.

As I have written before, the intense polarization of the past few years around gender appears to be receding in Britain. Kamran Abbasi, the editor in chief of The BMJ, the country’s foremost medical journal, wrote an editorial praising the report and echoing its conclusion that many “studies in gender medicine fall woefully short in terms of methodological rigour.” The country’s left-wing Labour Party has already accepted that feminist concerns about gender self-identification are legitimate, and its health spokesperson, Wes Streeting, welcomed the Cass report as soon as it was published. (The ruling Conservatives have also enthusiastically embraced its conclusions, and the former health secretary Sajid Javid pushed through a law change that made its data collection possible.)  The LGBTQ charity Stonewall responded to the report by saying that some of its recommendations could be “positive,” and urged politicians to read it. Even Mermaids, the charity most associated with pushing the affirmative model in Britain, offered only lukewarm criticism that more gatekeeping could further increase waiting times.

The Cass report is a model for the treatment of fiercely debated social issues: nuanced, empathetic, evidence-based. It has taken a political debate and returned it to the realm of provable facts. And, unlike American medical groups, its author appears to have made a real effort to listen to people with opposing views, and attempted to reconcile their very different experiences of this topic. “I have spoken to transgender adults who are leading positive and successful lives, and feeling empowered by having made the decision to transition,” she writes in the introduction. “I have spoken to people who have detransitioned, some of whom deeply regret their earlier decisions.” What a difference from America, where detransitioners are routinely dismissed as Republican pawns and where even researchers who are trans themselves get pushback for investigating transition-related regret—and where red states have passed laws restricting care even for transgender adults, or have proposed removing civil-rights protections from them.

[Daniela Valdes and Kinnon McKinnon: Take detransitioners seriously]

Has the Cass report gotten everything right? The methodology and conclusions of its research should be open to challenge and critique, as with any other study. But it is undoubtedly the work of serious people who have treated a delicate subject seriously. If you still think that concerns about child medical transition are nothing more than a moral panic, then I have a question: What evidence would change your mind?

On March 29, a friend of mine, the Iranian journalist Pouria Zeraati, was crossing the road outside his Wimbledon home in southwestern London, to get his car. A man approached him and asked for change; then another man, with his face covered, gave Zeraati a bear hug while the first man stabbed him several times in the back of his thigh.

This was no petty street crime. The assailants left Zeraati’s iPhone, brand-new AirPods, pricey watch, and wallet full of cash untouched. With the help of a driver, they fled the scene and then the country, to an undisclosed destination, according to British authorities. The London police are investigating the attack as a potential case of terrorism. Its methods suggest that the assailants’ intention was not to kill Zeraati but to hurt him in a way that would warn all of us Iranian journalists working in the West: You could be next.

[Mary Louise Kelly: Why I went to Iran]

The Islamic Republic chose Zeraati as a target for a reason. For the past three years, he has been a lead anchor on Iran International, a Saudi-funded Persian-language broadcaster based in London and Washington. Launched in 2017, the channel has made itself a thorn in the side of the Iranian regime. (Some of my friends were among the channel’s founders, and I have done occasional work for it as a writer and commentator.) Iran International was an unapologetic champion of the nationwide protests that broke out in Iran in September 2022; the network spread the opposition’s message and gave airtime to its would-be leaders. In short, it played a similar role to that of Al-Jazeera during the Arab Spring of 2011.

The regime’s response was ferocious. The minister of intelligence declared that Tehran considered the channel to be a terrorist organization. In November 2022, with no hint of subtlety, a major Iranian news agency published a wanted: dead or alive poster emblazoned with faces of four anchors from Iran International. Zeraati was one of them. Since then, he has only added to the government’s fury: He interviewed Prime Minister Benjamin Netanyahu in Israel in March of 2023 and continues to host harsh critics of the regime on his show.

Another face on the poster was that of Sima Sabet, a journalist who had worked for BBC Persian for more than a decade before joining Iran International in 2018 as a lead anchor. Back in December, an ITV News investigation uncovered a plot, commissioned by associates of Iran’s closest ally, Syria’s Bashar al-Assad, to assassinate Sabet and a fellow anchor on the channel, Fardad Farahzad (also a friend of mine). Sabet and Farahzad got lucky: The people-smuggler hired to do the job turned out to be a spy working for a Western intelligence agency, and he broke the story to a British outlet.

When Sabet first heard about the attack on Zeraati, she felt “shock and rage,” she told me in a phone conversation. “An indescribable anger: How can you be in your own home in Britain and be attacked right outside it?” Shortly afterward, police told her to leave her residence. I spoke with her more than a week later, and she still hadn’t been able to return home.

Farahzad now runs a popular Iran International show from Washington, where we met for coffee recently. “To be honest,” he told me of the London attack, “I was hoping that this was just a criminal action by local gangs. But the evidence so far shows that this is probably not the case.”

This month, the Indian-born British American novelist Salman Rushdie will publish Knife: Meditations After an Attempted Murder, his first book since the attempt on his life in August 2022. Hadi Matar, the young man who tried to kill Rushdie with a knife and cost him his left eye and use of one hand, was from New Jersey, born to immigrant parents from Lebanon. But his inspiration was unmistakable: a 1989 fatwa by the founder of the Islamic Republic, Ayatollah Ruhollah Khomeini, which continues to be supported by Tehran, complete with a promised bounty of $3.3 million.

With all the murder and mayhem that the Islamic Republic causes inside and outside its borders, the thankfully unsuccessful attempts on the lives of Rushdie and my friends from Iran International might seem secondary. But the fact that such attacks could take place on Western soil, in leafy Wimbledon or sedate Chautauqua, makes them especially harrowing.

They also fit a disturbing but familiar pattern. The Islamic Republic has tried to kill its opponents abroad ever since its founding in 1979. In 2020, the State Department counted that the Iranian regime had carried out as many as 360 assassinations in about a dozen countries over the past 45 years. Most of the victims were Iranian dissidents who threatened the Islamic Republic in one way or another: A social-democratic former prime minister, diplomats from the Shah’s regime, Marxist leaders, and a TV showman are on the long list. In 2019, the regime shocked Iranians by luring Ruhollah Zam, a prodemocracy journalist based in Paris, into Iraq before kidnapping him and sending him to Iran. He was executed two years later.

Attempting to gun down opponents abroad is very on brand for the Islamic Republic. The pace of such activities slowed for several years but then picked up again over the past decade, during which time the regime has kidnapped or assassinated several of its opponents on European soil as well as plotted to bomb an opposition gathering. A Belgian court sentenced the Iranian agent responsible for the bombing plot to 20 years in prison, only to release him last year as part of a prisoner exchange.

On U.S. soil, perhaps no one has been the target of more Iranian plots than the activist Masih Alinejad, who is best known for her effort to organize Iranian women against the compulsory hijab. The FBI has documented at least two plots to kidnap or kill Alinejad since she moved to the United States in 2014. These have included a plan to send her on a fast ship to Venezuela, or for mercenaries to simply kill her in the United States. Hired killers even showed up at her apartment in Brooklyn and were caught on CCTV. In 2021, the U.S. Congress passed the Masih Alinejad HUNT Act, imposing sanctions on foreign nationals who harass human-rights activists on behalf of Iran’s government.

The Iranian regime’s renewed interest in pursuing its opponents abroad is an ominous sign of the times. Authoritarian regimes—Vladimir Putin’s Russia is a prime example—are leaving nothing to chance, preferring instead to chase down their critics even far from their borders. And the Islamic Republic in particular may well imagine that, having mired the West in multiple interlocking disputes, including those over its nuclear program and its support for terrorist groups in the wider Middle East, it has exhausted the energy or attention its rivals might pay to the abuse of Iranian citizens at home and abroad.

[From the December 2021 issue: The bad guys are winning]

Iran’s regime clearly feels threatened by the journalism of exiled reporters who break its monopoly on truth. And yet, if the threat of assassination was meant to silence these voices, it has failed, and even invigorated those targeted instead. Zeraati is already back on the air. The very fact the Iranian regime is attacking journalists, Farahzad told me, shows how necessary their work is. Sabet has since left Iran International but continues to report; she told me, “We know that the spread of information is the biggest threat for the Islamic Republic. Thanks to the media outlets abroad, there is little that goes on in Iran today without people knowing about it.”

She’s right. Millions of Iranians count on satellite channels based abroad for news because they can’t trust the state media. When I was an anchor on one such London-based channel, a traffic official from northern Iran once contacted me and begged for us to share relevant information about road closures on the air. “It’s on the state broadcaster, but no one watches that!” he said. The Islamic Republic knows that Persian-language media operating abroad have reach and power, and so it now seeks to intimidate these journalists, to injure them, kidnap them, and perhaps to kill them.

When I think of what Western countries might do to counteract Iran’s campaign of terror against its citizens abroad, I recall one of Tehran’s most egregious acts on European soil. In 1992, in a Greek restaurant in Berlin, agents of the Islamic Republic killed Sadegh Sharafkandi, the leader of the Kurdistan Democratic Party of Iran alongside three of his associates. Sharafkandi was there to meet some leaders of the Swedish Social Democratic Party, including a former prime minister, but the Swedes canceled at the last minute. If they hadn’t, the Iranian regime might have killed them, too. Perhaps for that reason, in April 1997, a German court issued arrest warrants, not just for the perpetrators at the scene, but for their masters in Tehran. The verdict implicated Iran’s foreign minister, intelligence minister, then-President Ali Akbar Hashemi Rafsanjani, and Supreme Leader Ayatollah Ali Khamenei. That ruling was a devastating blow to the regime and likely changed its calculus. A long lull in state-sponsored assassinations abroad followed, ending only around 2015.

The German response offers a model for other Western countries to follow when the Islamic Republic violates their sovereignty in order to persecute its enemies. As Farahzad told me after the knife attack on his colleague, Iran’s authorities are watching to see whether Western governments will play along with their games of deniability or make Tehran pay for its role: “If they know it comes with a high cost, they’ll probably think twice before doing anything.”

For the first several decades of my life, most of the meals I ate involved at least one piece of Tupperware. My mom’s pieces were mostly the greens and yellows of a 1970s kitchen, purchased from co-workers or neighbors who circulated catalogs around the office or slipped them into mailboxes in our suburban subdivision. Many of her containers were acquired before my brother and I were born and remained in regular use well after I flew the nest for college in the mid-2000s. To this day, the birthday cake that my mom makes for my visits gets stored on her kitchen counter in a classic Tupperware cake saver—a flat gold base with a tall, milky-white lid made of semi-rigid plastic. Somewhere deep in her cabinets, the matching gold carrying strap is probably still hiding, in case a cake is on the go.

If you’re over 30 and were raised in the American suburbs, you can probably tell a similar story, though your mom’s color choices might have been a little different. As more and more middle-class women joined the workforce, new products that promised convenience in domestic work, which largely still fell to them, became indispensable tools of the homemaking trade. Reusable food-storage containers kept leftovers fresher for longer, made packing lunches easier, and, when combined with the ascendantly popular microwave, sped the process of getting last night’s dinner back onto the table. Tupperware became such a dominant domestic force that its brand name, like Band-Aid and Kleenex, is often still used as a stand-in for plastic food-storage containers of any type or brand.

In theory, Tupperware should be even more popular now than it was decades ago. The market for storage containers, on the whole, is thriving. Practices such as meal-prepping and buying in bulk have further centered reusable food containers in America’s eating habits. Obsessive kitchen organization is among social media’s favorite pastimes, and plastic storage containers in every conceivable size and shape play an outsize role in the super-popular videos depicting spotless, abundant refrigerators and pantries on TikTok, Instagram, and YouTube. But Tupperware has fallen on hard times. At the end of last month, for a second year in a row, the company warned financial regulators that it would be unable to file its annual report on time and raised doubts about its ability to continue as a business, citing a “challenging financial condition.” Sales are in decline. These should be boom times for Tupperware. What happened?

[Read: Home influencers will not rest until everything has been put in a clear plastic storage bin]

The Tupperware origin story is a near-perfect fable of 20th-century American ingenuity. Earl Tupper, the product’s namesake, was a serial inventor who used mid-century advances in plastics technology to develop the first range of airtight food containers affordable for middle-class households. Tupperware debuted in 1946, but it didn’t really take off until a few years later, when Brownie Wise, a divorced mom from Michigan, began selling the stuff to friends and neighbors she invited to her home. Her success caught the attention of Tupperware, and then of women across America who had gotten a taste of the working life during World War II but had been displaced from their wartime jobs by men returning from military service. Many of them began selling the food containers to their friends and neighbors in the living-room showcases that became Tupperware parties.

In the following decades, the range of plastic tubs, matte and mostly opaque, expanded in color, shape, and size—1960s pastels gave way to the citrus oranges, goldenrod yellows, and avocado greens of the ’70s and ’80s, and then to the rich reds and hunter greens of the ’90s. Modestly sized lidded bowls were joined by dry-goods canisters, pie keepers, pitchers, and measuring cups. A kitchen full of Tupperware products became a symbol of social and domestic success: Practical but a little pricey, the storage containers were trafficked through women’s community bonds, and owning them telegraphed a commitment to order, cleanliness, and sensible stewardship of the family’s time and food budget. Particularly stylish moms matched their Tupperware collections to their kitchen decor.

Tupperware did not respond to an interview request on the company’s current woes, but the problems it faces are not difficult to see. The first is that, in a lot of ways, its products are still those products. Much of Tupperware’s range still looks at least a little bit like it did decades ago—textured, pliant plastic that obscures what’s inside. Some of these products are a clear nostalgia play to tempt younger shoppers with the retro, rainbow-colored bowls and tubs their mom used, but many of the products just look dingy, clunky, old. And nostalgia is not necessarily something buyers want in plastic kitchenware. Since Tupperware’s heyday, what we know about the safety of plastics that were commonly used in food storage has changed, and the public’s buying preferences along with it. Like most older plastic containers, Tupperware made before 2010 contains a type of chemical called BPA, which is associated with a host of health problems including infertility, fetal abnormalities, and heart disease. Tupperware has since removed BPA from its products, but on a visual level, many of them still appear to be the bowls you might now wish your mom hadn’t microwaved so frequently when you were a kid.

Tupperware’s competitors have multiplied in recent decades, and most of them have been more adept at signaling newness and cleanliness to customers. OXO, Pyrex, and Rubbermaid, for example, all sell popular lines of containers that use crystal-clear hard plastic or glass and have mechanical latches or seals to prevent spills and keep food airtight. They look neat and orderly—even expensive—in the bright, cool-toned LED lighting of modern refrigerators. At $50 to $80 for a modestly sized set, they actually tend to cost less than their Tupperware equivalents, which can top $90 for a set of basic plastic bowls. For buyers more concerned about price than beauty, Ziploc and Glad make sets of cheap, thin plastic containers that can be bought for $10 or $12 at most grocery stores.

Where exactly one buys Tupperware has also become an issue over time. The bulk of the company’s dwindling sales volume still comes from women selling to their social circles, which is now more of a liability in the United States than it was a generation or two ago. This type of “direct sales” model has proliferated widely in the social-media era, with distant Facebook friends pestering people to buy things like essential oils and cheap leggings. It has prompted a significant backlash, creating a consumer base that’s tired of sales pitches from acquaintances and suspicious of products sold in that format. Tupperware parties still work for the brand in some parts of the world, but for mainly the same reason that they worked in mid-century America: In 2013, Indonesia became Tupperware’s biggest market, thanks in large part to a growing population of workforce-curious women who embraced the opportunity to make some extra cash for their family by doing business with other women in tight-knit social communities. Sales in North America have continued to decline, and they now make up only a little over a quarter of the company’s total volume, according to its most recent annual report.

Instead of changing with the times, Tupperware has clung to its old ways for decades longer than it probably should have. The company brought in a new CEO late last year, and she has said she will modernize both the products and the company’s sales structure. But those efforts now seem likely to be too little, too late. Other than a brief dalliance with what were then called SuperTarget stores in the early 2000s, the brand didn’t make a serious push into traditional retailing until 2022, and its products are now stocked alongside more modern-looking and frequently less expensive competitors at Target and Macy’s. You can also now buy Tupperware online directly from the brand, but when you arrive at its website, a bright-orange banner across the top alerts you that you’re not shopping with a representative, in case you should want to remedy that and give a co-worker or neighbor the credit for whatever you buy.

None of these issues takes a keen retail or product-development mind to detect. Tupperware’s woes don’t seem to be the result of unpredictable market changes or fickle consumers. Instead, like many once-prosperous 20th-century American companies, Tupperware’s downfall appears to land squarely at the feet of its management. As far back as the 1980s, according to The Wall Street Journal, it was clear to executives at Kraft, then the company’s owner, that high workforce participation among American women was making the direct-sales model less viable; if women had full-time jobs, they mostly didn’t need side hustles or want to go to buying parties, even if they still wanted storage containers and kitchen gadgets. At the same time, Tupperware’s patents began to expire, which created new competition for a brand that had long had very little. At that time, the company still had decades of goodwill in front of it, and it had a direct line to an army of women who could have helped guide the company’s development of newer, better products that people would have been excited to continue stocking their kitchens with. Instead, those products are now made by its competitors and available virtually anywhere that food or home goods are sold. Tupperware, meanwhile, is still waiting for the return of a glorious past that is never coming back.

The head of the United States Agency for International Development (USAID), Samantha Power, said she accepted "credible" reports that famine is already occurring in northern Gaza.