do you remember
all the times we’ve been right here
knowing exactly enough to thrive
but slowly surrendering the garden
to private cruelties, made loud

every split rock holds 
one mother bent over one precious child 
amethyst joy, ruby sacrifice
she blesses the fragrant crown
how dare you not worship?

don’t you remember
with time they always lose this war
nothing is cooler than true love
the darkness is canal and portal
and we can all be doulas

repeat after me��
crush supremacy in the palm of your hand
and then bite down on your fist
the new world is coming through you
breathe in, yes

now scream

“It does affect the dogs when they are caged like that, without getting walks, or exercise or any stimulation or any human contact,” the volunteer told NBC Los Angeles. “It’s not natural for them to live like that. It’s inhumane.”

Corea, who underwent three surgeries for the injuries she sustained in the attack, left the field after the incident, but the incident still highlights the consequences of the crowding crisis spreading through animal shelters in the U.S.—and as a geographically, culturally, and socioeconomically diverse state, California’s approach to this overcrowding crisis could be an incubator for other states facing similar issues.

“We are very overcrowded right now,” an animal control officer in Southern California who asked to remain anonymous tells YES!. “It’s resulted in a dangerous working environment, not just for staff but for the people who have to do business in the shelter, the public, the volunteers, our own animals. We’re having to jam them into cages with other animals. Sometimes there’s fights, or they’re not being cleaned as often as they should be.”

Data organization Shelter Animals Count estimates , with 69,988 non-live outcomes such as euthanasia or unassisted death in care and 302,698 live outcomes, including adoption, transfer, and return to owner. The remainder are still in the care of shelters, rescues, or fosters.

Lisa Young, a veteran of animal welfare and executive director of Rescue Train, a Los Angeles–based organization, describes the current situation as “the worst I’ve ever seen.” It has been compounded by the state’s, and , a , and the dramatic .

A looking at national trends found 43 percent of respondents cited costs as a concern for prospective adopters, with people making less than $75,000 annually experiencing increased financial barriers. Vet care in particular is a serious issue, according to the report, which identifies a growing number of veterinary “deserts” where care is not simply not available at any price.

“In East Valley,” a shelter Rescue Train partners with, “they have animals in crates in the hallways,” Young shares. “It’s disgusting, it’s inhumane. I’ve never seen animals in the hallways living in crates.” Young is quick to note that this is not the fault of shelter workers, who are “just here trying to clean up the mess of our community,” but is instead a symptom of how dire the issue is.

Nina Thompson, director of public relations at the San Diego Humane Society, which operates a shelter that also manages animal care services contracts from 13 cities in San Diego County, explains that overcrowding has serious consequences for shelter animals. “Any time that you have too many animals in kennels, there are disease outbreaks, and also the stress of sitting in a kennel for long periods of time increases with time.”

San Diego Humane is experiencing an uptick in upper respiratory illnesses and a rise in the number of “behavior dogs” who are not coping well with life in the kennels, especially young, large dogs with high energy who aren’t getting adequate exercise and enrichment. Length of stay for at least 100 dogs at the shelter was more than three months, and large dogs across the state and country are similarly lingering longer in shelters. Shelter Animals Count reports the has doubled since 2019.

Organizations such as , founded in 2020 by Austin Pets Alive! and a coalition of animal welfare partners, propose investing resources in keeping animals out of shelters altogether. Shelter intervention programs, a relatively recent innovation in animal welfare, include pet food pantries, free and low-cost veterinary care, spay/neuter programs, help with pet deposits and landlord disputes, behavior counseling, and assistance with self-rehoming.

Models that approach animal sheltering as part of a larger community care program are working; San Diego Humane, for example, has managed to fulfill its pledge to “,” with no euthanasia of healthy, treatable animals. Pasadena Humane’s program has been similarly successful.

High-volume spay/neuter, which streamlines surgical processes to alter as many animals as possible while still maintaining quality, may also be a part of the solution. This approach involves coordination to keep animals constantly moving through the various stages of surgery, from initial induction to recovery. It’s particularly valuable for and can be done as a mobile or pop-up event to eliminate barriers such as transport and travel.

Related community clinics such as that at can also decrease barriers to access to veterinary care; on a tour of the facility in August, staff highlighted the clinic’s critical role in keeping pets and people together by providing affordable vet care to families who might otherwise surrender their animals.

However, shelters are in critical need of more funding to reduce intake, administer these creative community programs, and safely house the animals who will inevitably need care. While there are some grant programs such as those offered by or , a state-funded program administered by the University of California, Davis’ Koret Shelter Medicine Program, it hasn’t been enough to meet the need.

Increasing government contracts (which can seem large as budget line items—in San Francisco, Animal Care and Control ) could help shelters expand their services and capacity.

And, Young argues, more philanthropists need to open their pockets: Despite a growing awareness of , a found that just 3 percent of philanthropy in 2020 went to the environment and animals, a small slice of the $471.44 billion donated by individuals, foundations, corporations, and bequests. “Of all the money donated in this country”—a nation of animal lovers with 90 million dogs and 74 million cats, according to the —“and with all these foundations closing, it’s a scary time.”

Community buy-in is also key to any solution, says Lisa Kauffman, a campaign strategist at . She’s working on the , which is pressuring county officials to improve conditions at three municipal shelters, including “one of the highest-intake shelters in the United States.” The grassroots campaign encourages residents to show up at community meetings and includes extensive Spanish-language outreach to connect with stakeholders who are sometimes overlooked.

An engaged community doesn’t just adopt animals and create more space in shelters for animals who vitally need it. It’s also more likely to foster, getting vulnerable animals such as neonates, seniors, and long-stay dogs out of the shelter and into homes where they can decompress and experience socialization. Large foster programs are especially valuable for rescues, which can serve the community without a physical shelter location. In addition to fostering, community members who volunteer also relieve pressure on underfunded, overcrowded shelters and their staff.

For California’s animals, this moment may feel bleak, but, Young says, “like any storm, it will pass.” They just need a helping hand, from lawmakers drafting policies that help animals such as , which would restrict “no pets” housing policies, to the workers who creatively utilize resources for the animals in their care, to the volunteers who show up every day, rain or shine.

When I played for the first time, the feeling was transcendent. For a brief moment, the oil masquerade granted anonymity to engage in bacchanal and revelry, a direct to the expectation of respectability and decorum demanded specifically from women. J’ouvert strips back the fanfare and glamor of feathered costumes, compelling participants to surrender themselves to the collective prerogative of the mas.

J’ouvert restored me. When I finished playing, I hopped into a motorboat water taxi and headed to Grenada’s Grand Anse beach. The sands were lined with people washing off themselves with water after an energizing morning of marching on the road. It was a shedding—and I reemerged feeling revived.

Connecting to the Past

Though J’ouvert is commemorated across the Caribbean—particularly in countries subjected to French colonial rule—the celebration is unique in Grenada because its participants transform into the Jab or Jab Jab character. The procession is creolized with and , but playing Jab during J’ouvert also has roots in enslavement.

According to the , “[t]he Jab Jab portrays the spirit of a slave who met his [death] when he accidentally fell (or may even have been pushed by his white master) into a copper vat of boiling molasses. His ghost comes back every year during Carnival to torment his former master.”

Prior to Grenada’s emancipation from slavery in 1838, enslaved Afro-Grenadian people were referred to as devils. As an act of satire, the enslaved rubbed any substance that would blacken their skin—molasses, tar, mud, or soot—over their bodies, made helmets emulating the devil with cattle or goat horns fastened onto a construction helmet (early iterations of the helmet were made from found materials such as the large posey bowls found on plantations), and walked around with chains. The Jab turned any descriptor deemed to be transgressive—being Black, being in chains, being the devil—into a symbol of rebellion, resilience, liberation, and freedom.

Now, on J’ouvert morning, Grenadians of all ages gather right before day break—“J’ouvert” is a combination of the French words jour, which means “day,” and ouvert, which means “open”—to march through town to a percussive beat (in St. Georges, Grenada, it is often paired with sound systems) and remind themselves of who they are and what their people have overcome.

For Kered Clement, a United Kingdom–born journalist currently residing in Grenada, Jab is a structured ancestral practice. When she moved to Grenada 10 years ago, she attended J’ouvert with her cousin. But it wasn’t until she played Jab with a family friend that she realized the ritualistic nature of the procession. “There were rules I didn’t even know [when I played] with my cousin,” she says. “As Jab Jabs, we don’t laugh, we don’t smile. We’re having fun, but this is serious business.”

Outside of its ancestral heritage, J’ouvert is also accessible: Costumes aren’t required, so participants are encouraged to wear old clothing. However, as Carnival in Grenada has become more popular and attended by celebrities and influencers, the once-insular celebration is now a shared experience with those who aren’t native to the island.

Given this expansion, Clement sees the importance of reminding people that their engagement with J’ouvert derives from a structured cultural practice. She describes her process of getting ready saying, “Everyone’s in the same place. Together, we put lard on, but we don’t apply the oil yet. We take our bucket of oil down Tanteen Road where the real Jab Jab band leaves off, and that’s where we put on our oil. We march through the streets with a band. When the sun gets intense, we depart. We walk through the streets back to the same location where there’s bakes and saltfish waiting for us.”

Clement’s reverence for J’ouvert extends to what she wears on the road. This year, , released the song “,” whose title references a burlap sack . Clement also decided to this year. “I’m gonna get a Grenadian designer [named] Ali Creations to design me a crocus bag dress,” she says. “Initially, [wearing the dress] was about the song and doing something different, but a lot of people messaged me and said, ‘Wow, I feel like you brought back the culture and the uniqueness.’”

For this year’s Spicemas, also created a costume, , inspired by Grenada’s connection to Africa, Jab, and the Black women who play it. Nevlyn John, a representative with ORO, says Mecca is indicative of “the strength of women, and the appreciation of our African heritage and [its] influence in our Carnival and our society. So, when we speak about [Mecca] being the ‘queen of queens,’ it is about celebrating our womanhood where the Blackness and authenticity stems from.”

In the Land of 100,000 Jabs

Though J’ouvert’s visual economy of imagery is dominated by men, women also take part in the celebration. For Black women who play Jab, there are a variety of benefits that contribute to their overall cultural, mental, physical, emotional, and spiritual wellness. “When I talk to folks about Jab Jab, they felt that spiritual connection even more deeply,” says Sherine Andreine Powerful, DrPH. “It recruits so many different emotions for people that you can’t help but feel very present and even more connected in that moment.”

For her , Dr. Powerful explored how the quarantine impacted the ability to play mas and what this meant for Caribbean people in the region and the broader diaspora. Ninety percent of her research participants were Black women who described their involvement as a “collective social self-care ritual,” she shares. “[Playing Jab mas] provides a space for catharsis, a space for joy, a space for release and space for healing.”

After Saharrah Green, who was born in Grenada, moved to Toronto at the onset of COVID-19 to pursue a degree, she felt disconnected from J’ouvert. But playing J’ouvert in 2024 helped her re-ground herself in her heritage. “You really get a chance to just be free,” she says. “I don’t have to think. I just get to be myself. I get to just be home, allow myself to fully be in that moment around people that truly get me.”

Tamika Nelson, who is based in the United Kingdom, agrees. She began playing J’ouvert when she was around 13. Now, she describes her participation in J’ouvert as a way to improve her mental health. “Playing mas, no one cares really what you look like,” she says. “You just go out there to have a great time. … You always find like-minded people on the road and without even thinking, you’re in a better mental state.” 

For Black women, Jab is something to look forward to that embraces body positivity. It is also an opportunity to reconnect with heritage or continue Caribbean cultural practices that celebrate individual expression. 

When Black women play Jab, it offers both great comfort and great power—an opportunity to free themselves. “Our ancestors have these healing practices that combine body, mind, and spirit,” Dr. Powerful concludes. “That connection has never been severed. From what I’ve experienced … Carnival brings us back to that ancestral body, mind, and spirit are all connected. People feel all of that on the road.”

CORRECTION: This article was updated at 12:23 p.m. PT on December 9, 2024, to update the honorific for Sherine Andreine Powerful, DrPH and correct the spelling of Kered Clement’s name.��Read our corrections policy here.��

Many of us are experiencing election grief, defined by as an “unresolved grief” that shows up in “the loss of hopes and dreams and plans that [people] thought were coming from the other candidate, a loss of certainty in the future that was what they wanted, loss of trust in the world as a safe place, loss of feelings of freedom over your own body, the loss of support for people who have lesser means than the rest of us do, the loss of support for your neighbor and people who are different from you.”

Election grief has a tendency to debilitate us, leaving us in a frozen or shutdown state. This information is worth paying attention to, especially when it is critical to stay focused and mobilized as the state of democracy is increasingly threatened. As we participate in more collective actions, we need to find places of retreat to sustain our commitments to social justice.

With , Filipinos in the diaspora have been co-creating places of healing and restoration. Three of these community spaces have been actively seeding and tending cultures of both rest and solidarity. Who are they, and what can we learn from them?

Centering International Solidarity

Pinay Collection is a feminist brand with a team of 15 Filipino members from both the homeland and the diaspora. The social enterprise helps diasporic Filipinos reconnect with Filipino culture by , , and writing articles about the struggles in the motherland, including , , and .

Founder Jovie Galit created Pinay Collection in 2019 to “amplify [the] voices of the masses” and to “rethink [the] ways we tell stories [about Philippines-based Filipinos] that resonate with the people of the diaspora so that they [take] action.” Galit dreams of using Pinay Collection to create a more grounded form of reconnecting in which diasporic Filipinos do not neglect the struggles of the exploitation and state violence in the homeland.

“There’s so much urgency in the work,” Galit shares. “Doing this work with Pinay Collection, I’ve come to understand how activists back home [in the Philippines] do their work. I see the need to be out there [on the ground].”

Galit, who was raised in the Philippines, migrated to Canada at 19. When she relocated, she noticed some diasporic Filipinos were reclaiming Filipino culture and identity without developing an awareness about systemic issues within the Philippines.

“There’s beauty in [decolonization], [but] there’s also the privilege of being able to reflect on who we are, our identity, and our connection to Filipino culture versus Filipino people [in the Philippines] who are organizing to survive,” Galit says. “As much as it’s important to understand who we are, it’s also important for us to [turn] that understanding into mobilizing and organizing.”

Galit believes international solidarity is essential to reclaiming Filipino identity, especially for those living in North America. As the archipelago country faces incessant and , Galit says it becomes “dissonant not to address [these] real issues.” That’s the reason Pinay Collection has an emergency fund for typhoon relief as well as , farmers, impoverished people, and other marginalized groups in the country.

Galit hopes for a time when Pinay Collection doesn’t need to exist because the work of liberation is more realized. “That means we created a more sustainable structure for community organizations to thrive or maybe that means that communities of the diaspora are really honed in doing international solidarity work with Filipinos back home.”

Ultimately, A Resting Place, the Reimagination Lab, and Pinay Collection are offering spaces that, as Rodriguez explains, are “less in the space of a resistance and dismantling an unjust system but really in the space of creatively imagining, manifesting a different kind of future.”

While enslaved people were intentionally kept illiterate, the abolitionist movement still treated these pamphlets—and antislavery newspapers—as signposts, signaling that even amid their suffering, enslaved people were being fought for. Their human condition wasn’t being disregarded in favor of profit; instead, there was a growing movement advocating for their freedom and for their right to lead a self-determined life. 

In her new book, , Tricia Hersey calls upon some of these same abolitionist tools, including pamphlets, hymnals, poetry, and imagery, to convey a similarly urgent message: If we do not take rest seriously and divorce ourselves from capitalism, we will die much sooner than we should. While that might feel alarmist, it’s a message Hersey has been conveying for years as the . The “” uses her own life as a model for how we can collectively escape “grind culture” and embrace rest as a spiritual practice. 

“I thought I would die,” Hersey writes in We Will Rest!, an unconventional manifesto and meditation about how she learned to care for herself in a world that doesn’t allow us to slow down. “I thought the exhaustion of capitalism would crush me. Rest saved my life.” As Hersey often reminds us: Rest is a matter of life and death. 

Rest is essential to our long-term survival as individuals and a collective. Birthing a creative renaissance requires rest that isn’t reliant on productivity. Hersey’s book calls upon our ancestors, including Harriet Tubman, the Underground Railroad conductor who , to become escape artists ourselves—to help unchain our imaginations from the bounds of capitalism and embrace new possibilities. “A�Բ�DzԱ� in this culture who believes and feels they are enough right now has begun the escape artist transformation,” Hersey writes. “To know in the deepest parts of your soul that your birth grants you divinity, rest, care, and power is a seed planted in fertile ground.” 

Much like those abolitionist pamphlets, We Will Rest! serves as a guidepost for those who seek rest but are unsure if it’s available to them. The book begins with a thought-provoking question: “How do you find rest in a capitalist, white supremacist, patriarchal, ableist system?” This system teaches us that rest must be earned through work, and received with humble gratitude. But Hersey offers an alternative: If we become “escape artists” or “tricksters” who defy systems that discourage us from rest, then we can prioritize our needs. 

For Black people, in particular, Hersey accurately argues that rest is our ancestral inheritance and must be protected at all costs. “The first step for morphing into an escape artist is belief,” she writes. “You must believe you have the power to refuse. You must believe you have been gifted with everything necessary. You must be a trickster. No matter what, you must not show fear. We are abundant.” 

Once we believe we’re entitled to rest and our ancestors have paved the way for us to claim this birthright, then we must imagine the life we desire for ourselves. “Create community,” Hersey writes. “Be community. Community care can seem impossible when you are exhausted. It is possible.” It is only through crafting this community— day by day, moment by moment, and person to person—that change can come. 

It’s not as complicated as we might make it out to be. The world we imagine will come to us through silence, through daydreaming, and through unwavering belief. “Every day, morning or night, or whenever you can steal away, find silence,” she writes. “Even if for only a few minutes.” 

We don’t need to have it all figured out to begin this personal and collective rest revolution. “Capitalism has a choke hold over our lives right now,” Hersey writes. “The next second, the next minute, the next hour, is ours to refuse the grind. We can craft and build temporary spaces of joy and freedom here now.” 

Like those abolitionist pamphlets, We Will Rest! offers encouragement in times of uncertainty—a reminder of our fundamental humanity, and affirms the truth that rest is ours for the taking. And we’ve already done all we need to do to “deserve” the freedom it brings. 

This is Patrick Blindauer’s last puzzle for YES! as he moves on to new projects. We would like to thank Patrick for all the engaging and thoughtful puzzles he’s contributed since our Spring 2018 issue. 

A sus 19 años, se dirigía a Canadá. Ella sería la primera de su familia en ir a la universidad en el extranjero. Todos sus familiares vinieron al aeropuerto para la despedida. Ella recuerda el adiós como un momento desgarrador. En ese momento, a Chavan y a su familia les resultó difícil comprender plenamente el sacrificio que implica migrar. “No teníamos idea de lo que significa dejar tu hogar,” dijo.

Una nota de los editores: Esta historia ha sido traducida al español por . Puede leerla en inglés �����í.
(Editor’s note: This story has been translated into Spanish by . You can read the story in English here.)

Pero inevitablemente, el duelo llegó a sus vidas. Casi doce años después de la partida de Chavan, mientras se encontraba sentada en su departamento en Winnipeg a principios del 2020, Chavan sintió un nudo en el estómago cuando su mamá le llamó por teléfono para compartir la noticia. La abuela de Chavan, quien vivía en Sidney, Australia, se había enfermado y, tras unas cuantas semanas, había fallecido. Su abuela había sido una de las personas más importantes en su vida, pero Chavan no tenía manera de ir a Australia para llorarla en persona. Además del costo de los boletos de avión, no contaba con la visa necesaria para ingresar al país, ni con el presupuesto necesario para solicitarla. Ante esta situación, Chavan se apagó emocionalmente. “Me sentí congelada por un largo tiempo,” explicó.

Los expertos en temas de migración y psicología usan los términos “duelo transnacional” o “luto transnacional” para describir esta experiencia, la cual se refiere a la pérdida de un ser querido estando en otro país. Aunque el duelo en sí es un proceso difícil, los inmigrantes que experimentan el duelo transnacional frecuentemente enfrentan sentimientos adicionales de culpa, negación y sufrimiento, ya que les es imposible asistir a los rituales de luto de sus seres queridos. 

La imposibilidad de ver a sus seres queridos en persona complica lograr una sensación de cierre, y el doliente puede sentirse incapaz de procesar la pérdida y seguir con su vida de una manera sana. En años recientes, esta experiencia se ha vuelto más común, ya que el COVID-19 acabó con millones de vidas, y simultáneamente causó que aumentaran las restricciones fronterizas. La pandemia resaltó la importancia del apoyo comunitario y los cambios a las políticas migratorias para ayudar a aquellos que enfrentan sus duelos desde lejos.

El Dolor de la Pérdida a Larga Distancia

Desde hace mucho tiempo, experimentar el duelo a larga distancia ha sido la realidad de muchos inmigrantes. Cualquiera que deja a su familia atrás también corre el riesgo de estar separado de sus seres queridos durante tiempos de pérdida. Esto frecuentemente conlleva un torbellino de emociones complicadas.

“Hay un fuerte sentimiento de culpa. Hay un fuerte sentimiento de arrepentimiento de no haber podido estar con su ser querido al momento de su muerte,” explicó , una investigadora del duelo, de la Universidad de Alberta. Ella recuerda una conversación que tuvo cuando entrevistó a un inmigrante Iraní-Canadiense, quien había perdido a su hermano durante las cuarentenas de la pandemia del COVID. Porque no le fue posible viajar a Irán, o siquiera ver su cuerpo antes de que fuera enterrado, se negaba a aceptar la muerte de su hermano.

Chavan recuerda experiencias similares que sufrió al estar separada de su familia por fronteras después de la muerte de su abuela. “Sentía que no tenía derecho a llorar su muerte, porque no había estado ahí,” dijo.

Sin este espacio para llevar luto, el duelo puede volverse difícil de superar; especialmente para los inmigrantes indocumentados. , una socióloga en el Center for Racial Justice de la Universidad de Michigan, trabaja con estas comunidades, y contínuamente escucha sobre cómo el duelo afecta la vida cotidiana. “Las personas describen estas experiencias de duelo y luto a larga distancia como una de las partes más difíciles de estar indocumentado en Estados Unidos,” explicó.

Por ejemplo, mientras estudiaba entre el 2017 y el 2023, Fullerton Rico conoció a una mujer a quien llama Florencia (un pseudónimo usado para proteger su privacidad), quien dijo: “Era algo que no había de qué manera poderlo arreglar. No queda de otra más que aceptar que no puedes hacer nada.” Fullerton Rico también comparte una conversación que tuvo con un hombre a quien llama Felipe: “Felipe me dijo que el duelo te cambia profundamente.” La distancia aumenta el dolor del duelo porque es imposible decir adiós o asistir a un funeral, y esto impide obtener una sensación de cierre. “Hay un capítulo que no se cerró, que está como abierto,” explicó Felipe. 

 El peso del duelo transnacional frecuentemente es una carga soportada en soledad, lo cual agrava la situación. “No es algo que se suele reconocer abiertamente,” explicó Fullerton Rico.

Acortando la Distancia

Los rituales sociales, en cualquier cultura, son una parte importante del proceso del duelo. Los velorios y otras conmemoraciones pueden ayudar a la gente a pensar activamente en la persona difunta, dice , una neurocientífica que estudia el duelo en la Universidad de Colorado en Boulder. “Pensar en estas memorias le permite a tu cerebro como… remodelar y pensar en cómo encajan esas memorias ahora en tu vida,” dice ella. Pero para aquellos quienes están lejos al momento de la muerte y no pueden asistir al funeral en persona, este proceso puede ser mucho más difícil o quedar inconcluso.

, una psicóloga que trabaja con expatriados, ayuda a sus clientes a crear sus propios rituales para que cada uno pueda conmemorar su relación con su ser querido de una manera única. Ella los guía a través del proceso del duelo a larga distancia, usando acciones como escribir cartas, comer la comida favorita de un ser querido, o participar en una actividad que solían hacer juntos. El proceso toma tiempo. Frecuentemente son necesarias varias sesiones de adioses y rituales para que alguien haga las paces con una muerte repentina, dice Encina.

Similarmente, durante la pandemia, Chavan encontró su propia manera de enfrentar el duelo a través de la escritura. Ella había perdido su trabajo en ese tiempo y decidió asistir a una clase de escritura. Así inició un proyecto de “no-ficción creativa” que le permitía sumergirse en sus experiencias con el duelo transnacional. Chavan lentamente rompió el hielo que había encerrado a su corazón por ocho meses. Sollozaba mientras recordaba todos los detalles de su abuela: los debates enérgicos que juntas tenían, cómo dominaba los lugares a pesar de su pequeño tamaño, cómo reforzaba los lazos familiares con su amor.

“Fue horrible. Fue devastador. Se sintió como perderla de nuevo,” Chavan dijo.

Pero fueron estos actos de escribir y recordar los que le permitieron reconectarse a sus memorias… Y empezar a sanar.

Soluciones Sistémicas

Apoyar el duelo transnacional requiere que reconsideremos la forma en la que pensamos acerca de la inmigración y la pérdida. Actualmente, pocos inmigrantes indocumentados pueden ajustar su estado migratorio en los Estados Unidos. Los pocos que son elegibles típicamente reciben una autorización de trabajo antes de tener la opción de viajar de visita a su país de origen, y toma años para que obtengan la residencia permanente legal, explicó Fullerton Rico.  Es así que la oportunidad de visitar a sus seres queridos se vuelve una espera alargada, incluso mientras ellos envejecen o fallecen. Para muchos, es una espera sin fin.

“Si aprobamos leyes que le den prioridad a crear un camino rápido hacia la ciudadanía, podríamos evitar que las personas tengan que vivir estas experiencias,” dijo Fullerton Rico.

Muchos inmigrantes indocumentados también tienen trabajos inflexibles y de salarios bajos, lo cual los presiona a tomar decisiones dolorosas, como ver los funerales de sus seres queridos a través de su celular mientras ayudan a los clientes o preparan comidas en un restaurante. “En lugar de estar ahí en persona, ellos tuvieron que escaparse al baño, o esconderse en una cámara frigorífica para tener vistazos de uno de los rituales más significativos en la vida de una persona,” dice Fullerton Rico.

El permiso remunerado beneficia a las personas que están procesando un duelo. Esto les permite a los dolientes tomarse tiempo libre de sus trabajos sin tener que asumir las consecuencias potenciales de perder un cheque de pago o sus mismos trabajos. Chavan recuerda la presión de continuar su trabajo en medio de su duelo porque no tenía la flexibilidad financiera para perder horas de trabajo pagadas, lo cual gradualmente degradó su salud mental. En la actualidad, solo cinco estados de los E.E.U.U. requieren que los empleadores den permiso de faltar a causa de duelo, dice Fullerton Rico, y solo dos de esos estados requieren que los empleados sigan siendo pagados durante este periodo.

También es crucial “hacerle saber a las personas que no están solas en este dolor,” dice Fullerton Rico. Ella considera que es necesario que más organizaciones que apoyan a los inmigrantes reconozcan esta realidad y brinden apoyo para lidiar con el duelo transnacional. Por ejemplo, podrían ayudar a los inmigrantes a tener acceso a terapia, ofrecer otros recursos de salud mental, o ayudar a organizar rituales religiosos para que puedan conmemorar a sus seres queridos desde lejos. Así, los dolientes enfrentando el duelo transnacional correrían menos riesgo de condiciones como la depresión clínica. Ella comparte el ejemplo de un sacerdote católico que entrevistó en la ciudad de Nueva York, quien ha ayudado a realizar misas memoriales para dolientes transnacionales desde los 1990s. Hoy en día, estas ceremonias funerarias son transmitidas a través de Facebook Live, YouTube o Zoom, ayudando a las familias a sentir algún grado de cercanía.

Los expertos coinciden en que la formación de este apoyo social es un factor clave en el proceso de duelo. “El duelo es algo así como una experiencia social,” dice Bayatrizi. “Es una experiencia emocional que es formada a través de nuestras interacciones sociales.”

Chavan dice que la única razón por la cual ella finalmente se sintió lista para afrontar las emociones fue gracias a que su pareja y sus suegros fueron solidarios, proveyéndole una comunidad pequeña pero fuerte en un tiempo aislante. Tras escribir acerca de la experiencia, ella también comenzó a tener más conversaciones con familiares y amigos alrededor del mundo quienes habían leído su artículo, sobre el dolor del duelo a larga distancia y cómo lo habían afrontado ellos.

“Esencialmente, llegué a tener una comunidad, una comunidad global a la cual yo podía recurrir,” dice ella. “Comprender que no eres la única persona que ha pasado por una situación difícil puede ser una gran ayuda.”

CORRECTION: This article was updated at 3:29 p.m. PT on Nov. 11, 2024, to correct a few translation and production errors.��Read our corrections policy here.

Tattooing is a reclamation of my body, 
where I consensually welcome a wound 
as opposed to the ones that violently invaded my being, 
physical and otherwise. 

Tattooing is a sacred “fuck you” to colonizers and their attempted erasure of us,
while labeling the ink on our skin as dirty and demonic

Tattooing is a holy permanence on my brown skin,
a deliberate reverence to Indigenous ancestors, whose tattoos 
symbolized honor, achievement, and beauty.

Tattooing is a reiteration of “by [my] wounds, [I] am healed.”

—personal notes from the evening I got my first tattoo in 2022

Our bodies carry stories and there are many ways to tell them, with various types of ink and alternatives to paper.

For centuries, tattooing has represented much more than mere aesthetic or a tough facade. The majority of Western cultures and religious traditions have associated tattoos with criminality, primitivity, and other forms of unsophistication. For most Christians, tattoos are biblically forbidden, with verses like Leviticus 19:28 instructing to “not cut your bodies for the dead or put tattoo marks on yourselves.” The case is vastly different for communities outside the West—especially to Indigenous peoples. Tattooing is medicinal and sacred, symbolizing a person’s great milestones, beauty, and bravery. Tattooing is more than decorative: It is a form of devotion to one’s true self and community.

Artistically and resolutely, many of the colonized today counteract the violence of cultural and religious erasure by getting inked. For others, tattooing is a form of body liberation and healing: Choosing to mark one’s body and determining which designs to be permanently marked with is a reclamation. 

One Saturday morning, I had breakfast with tattoo artists and at , a tattoo and piercing studio in Manila, Philippines. We gathered to have conversations on tattooing, which began with the topic of body autonomy. Lacsamana, who is also an illustrator and author, shared that growing up in a Catholic and conservative academic family, she got her tattoos in secret. This shifted over time when Lacsamana started choosing body placements that appeared more visible to others. But early in her tattoo journey, she recognized the courage that younger Wiji already had before getting inked, even while hiding. Every tattoo was a declaration of self: “This is my body.” Similarly, Lacsamana believes that whenever a person gets a tattoo, “You are becoming more ‘I am’—more yourself.”

Indigenous communities across the globe also consider tattooing as a preservation and amplification of cultural integrity and belonging.

This coincides with co-founder of ’s words on the connection between tattooing and body reclamation. In an interview with Welcome to Chinatown, :

“Tattooing is a tradition that has been alive and breathed in new life in our generation. As a queer Asian American, I found a community in tattooing that is all about reclaiming our bodies and our identity. The generational trauma of feeling like our bodies belong to our parents, or belong to the male gaze all fall apart when we are in a space that accepts our nuance in a collective embrace. Being able to hold a physical space for that feels sacred.”

The connection between body agency and tattooing isn’t just about separating from oppressive social conditions but also includes the choice to (re)connect to one’s community or lineage.

In the powerful documentary , Sāmoan tattooist Rosanna Raymond shares her experience with the art of the tatau, and specifically, the malu for women. She shares that the cultural symbols tattooed by and for women are not to be easily “put away in the cupboard.” Once tattooed, “you are present with your ancestors every day,” because of how these symbols are infused with history and heritage.

Dulcie Stewart of when she had her tattoos done with Julia Mage’au Gray at —veiqia, or weniqia, is a tattooing practice in Fiji where young, pubescent women receive veiqia by the daubati, elder women tattooists, as an initiation to womanhood. Stewart shares her experience:

“At my first session with her, Julia marked me by reconstructing weniqia (tattoo patterns and designs) based on 1870s sketches of Fijian women that we both had seen online. Over the years the process changed, the marks became personal and were based on familial designs. Being marked by Julia is an emotional and personal process, with each marking telling a story relating to different parts of your life; each tap revealing a memory and healing the soul.”

Indigenous communities across the globe also consider tattooing as a preservation and amplification of cultural integrity and belonging. Recently, , the venerable Apo Whang-Od. The article not only decentralized beauty standards (“unmarked women were considered imperfect, undesirable”) that are widely imposed and commodified, but also recognized the tradition of , marking the skin through hand-tapping, as a sacred heritage of the Kalinga tribe. remarked in one of the episodes of the series that the sound of hand-tapping is like a “rhythm that wakes the ancestors.” The Onaman Collective, on the other hand, revitalizes the tradition of tattooing as a way to subvert the shame imposed by the church and government by marking the skin with sacred symbols to commemorate their achievements, healing, and visions. A member of the collective, Alethea Arnaquq-Baril, calls on non-Indigenous folks not to use the same spiritual symbols of their tradition. She says, “There are many other ways to honor our culture without appropriating it.”

For those of us who are non-Indigenous, we can still get tattoos as a way to honor ourselves and our lineages without culturally appropriating Indigenous traditions. For example, I was at a coffee shop one day and noticed a beautifully detailed illustration of a piece of , the cheese-filled pretzel snack, on the barista’s arm. At first, I thought it was such a unique and quirky image to have on his skin. I inquired more and learned that Combos were the snack he and his grandmother shared during his childhood. Now that she has passed, my new barista friend honors her memory with this permanent mark that represents their bond. This encounter shows how we can still honor our heritage without appropriating that of another, especially when the sacred symbols are only tattooed when earned and/or inherited within a specific tribe.

There is something medicinal in choosing the kinds of scars that mark us.

Alaga, a tattoo apprentice and artist, considers tattooing a form of ceremony and celebration. As someone who was raised surrounded by strict conditions of what it means to be accepted, Alaga’s first experience with tattooing was an introduction to empathy: the kind of empathy that softens the internalized rules and the need to defend themself and their identity. Serendipitously, their first tattoo was placed on the throat, which, based on Chinese medicine, indicates that the tattoo will activate healing for the closest meridian. Similar to acupuncture, tattooing uses needles, thus stimulating this channel of energy via penetration of the skin. Alaga’s tattoo then stimulated and released the blockage residing in their throat, enabling them to speak their truth and take back their power from a life that formerly hid their identity and denied their reality. They say that tattooing offers “the beautiful potential [for the] physical wound to open up a portal,” enabling the spiritual and physical wound to heal in tandem. Other that tattooing has the potential to build immunity because of the body’s strengthened agility and immunological defenses. (However, this is not always the case for all bodies, especially for the immunocompromised and those with certain autoimmune conditions.)��

Toward the end of our time together, I asked Alaga and Lacsamana about their hopes in the world of tattooing. Alaga reflected on a future where tattooing “was more accessible to everyone. Art doesn’t choose, especially among class. It’s the studio’s responsibility to have a sliding scale.” In addition to this, I also wonder what it’s like for tattoo artists to use their work as a platform for solidarity in social movements. For instance, is a Filipino organizer who was incarcerated for defending land and human rights. Tattoo artists in Manila have joined the by offering , with a portion of their proceeds redistributed to free Echanis, whose three-year-old child joins her in prison. The tattooing campaign will continue on until Echanis is freed.

Alaga and Lacsamana share a similar hope to have more women and queer folks in the tattooing world, as studios have been predominantly masculine in the Philippines. Because tattooing is a vulnerable endeavor for the client, a warmer and perhaps more nurturing energy can provide safer spaces that honor the client’s trust and boundaries. Lacsamana also desires to reframe ideas surrounding femininity and tattoo designs. Floral and soft designs are often mocked and belittled, to which she responds, “Why is girliness a bad thing? I love stepping into my femininity.” She hopes that the tattoo world may welcome the interplay of softness and fierceness, power and gentleness, when it comes to tattoo design selection.

Lacsamana imagines tattooing as a way to give talismans to her clients. She shares that the process turns the client’s vision into something tangible, and, by embedding it onto the skin, “alchemizing tattoos into a talisman.” As a tattoo artist, she understands the mutual healing of this process, being a witness and creator who illustrates chapters of other people’s lives on their bodies. 

There is something medicinal in choosing the kinds of scars that mark us. In these practices, we get to decide on these wounds and welcome them, as opposed to the ones that invade us without our consent. Through catharsis and colors, we are free. By our own wounds, we heal.

As both a facilitator and a participant in group experiences, I’ve witnessed firsthand the transformative power of well-held containers. I remember one particularly memorable session when I unintentionally triggered traumatic memories for some participants. That was a wake-up call for me. It underscored the importance of taking people only as far as I’ve gone, and being mindful of my social location and privileges and their potential impact on group dynamics. It reiterated and the need to create resilient and supportive spaces for all, in ways that honor everyone’s identities and prioritize their well-being.

I’ve also experienced the profound benefits of well-held containers. A guided visualization that asked me to imagine saying final goodbyes to loved ones was particularly transformative. In that session, the facilitators created a sacred space among us participants and gradually increased the risk we took while building trust. This showed me the power of building trustworthy relationships, facilitated rituals, and consensual boundaries in fostering deep exploration and growth.

Creating a transformative container—a space where magic can unfold and meaningful change can occur—is something I approach with deep intentionality, wisdom, and an understanding of the principles that guide such a process. For me, it’s not just about setting the stage; it’s about cultivating an environment where individuals can safely explore, grow, and transform. Here’s how I approach this work:

1. Set a Vibe—and Keep It Going

The energy I bring to a space sets the tone for everything that follows. Whether through lighting, music, scent, or even the way I greet participants, I am creating an atmosphere that signals what’s possible. Setting a vibe isn’t a one-time act; it’s an ongoing practice throughout the experience. I work to maintain that energy, ensuring that it aligns with the goals of the session, and I adapt as needed to keep everyone in the right headspace and heartspace. For instance, I’ve found that a carefully chosen playlist can guide the emotional flow of a session, from energizing participants at the start to creating moments of introspection and reflection later on.

2. Reveal the Context and Beware of Assumptions

Transparency is critical in creating a container for transformation. I make it a point to reveal the context—why we’re here, what the goals are, what’s at stake—to help participants understand the bigger picture and feel more connected to the process. This helps to minimize misunderstandings and assumptions that could lead to tension or disengagement. I strive to be clear about my intentions, the purpose of the session, and any background information that could influence the direction of our work. The more context I provide, the more equipped participants are to engage fully and authentically.

3. Containers Need Boundaries to Be Able to Contain

A container without boundaries can’t hold the energy, emotions, and transformations that occur within it. I believe boundaries define the space—physically, emotionally, and energetically. They create safety by delineating what is acceptable and what is not, allowing participants to explore and take risks within a defined framework. Clear boundaries prevent the container from becoming chaotic or overwhelming, ensuring that the energy within is focused and purposeful.

4. Consent Is Key 

For boundaries to be effective, there must be mutual consent. Everyone involved needs to agree on the rules of engagement. I usually start sessions by co-creating explicit agreements, where participants commit to respecting the space, each other, and the process. This ensures that everyone is on the same page and feels respected, which is essential for maintaining trust and safety within the container. Without consent, boundaries can feel imposed and restrictive rather than supportive and empowering.

5. Face the Tensions in Justice-Loving Ways

Transformation often involves surfacing tensions—unspoken conflicts, buried emotions, or systemic injustices. I see these tensions not as obstacles but as opportunities for growth and healing. To navigate them effectively, I prepare myself to face them with love, justice, and a commitment to liberation for all. This means creating space for difficult conversations, acknowledging power dynamics, and addressing issues in ways that honor the dignity and humanity of everyone involved. Justice-loving practices ensure that the process of transformation isn’t just about personal growth but also about collective liberation.

6. Shape Change and Be Changed

I’ve learned that transformation isn’t a linear process but an emergent one. It evolves as the group evolves, adapting to new insights, challenges, and opportunities. I draw from the principles and elements of emergent strategy, which emphasizes the importance of being responsive and flexible in the face of change. Rather than imposing a rigid plan, I allow the process to unfold organically, shaping change as it happens. This requires me to be open to being changed myself—learning from the process, adapting my approach, and growing alongside the participants. It’s about co-creating the path forward, guided by the collective wisdom of the group.

7. Bring Everything and Everyone With You

When I’m creating a transformative container, I bring all of myself—my knowledge, experiences, skills, and even my personal quirks. This includes everything from my outfit selection to my playlist, my understanding of feng shui, my knowledge of Indigenous circle practices, and my love of Latin root words. Each element I bring adds richness and depth to the space, making it uniquely mine—and uniquely capable of holding the transformation that needs to happen. By bringing everything and everyone with me, I create a space that’s not only authentic but also inclusive, where every aspect of the self—both mine and others’—is welcomed and valued.

8. Be Trustworthy

Trust is the foundation of any transformative container. Participants need to know that they can rely on me to hold the space with integrity, care, and consistency. Being trustworthy means showing up fully, honoring my commitments, and being transparent about my intentions and limitations. It also involves creating an environment where participants can trust each other, fostering a sense of safety and mutual respect. Trust allows participants to take the risks necessary for deep transformation, knowing that they are supported and held throughout the process.

9. Practice Till Presence

Presence is the ability to be fully in the moment, attuned to what is happening within the container. It’s about listening deeply, observing closely, and responding authentically to the needs of the group. Achieving this level of presence requires practice—cultivating mindfulness, grounding myself, and honing my ability to stay focused and connected. The more I practice, the more naturally presence will come to me, allowing me to be fully available to the group and the process. Presence is the key to facilitating transformation with grace, fluidity, and impact.

As I reflect on these principles, I encourage you to think about how you can incorporate them into your practice—whether you’re creating formal containers for group participation, or informal ones as you build and co-create community. What unique elements do you bring to the table? How can you cultivate a sense of trust, presence, and adaptability in your work? By integrating these principles, we can create containers that not only hold space for transformation but actively foster it, allowing magic to unfold and change to take root in profound and liberating ways.

“We always say that art ignites change,” says Jane Golden, the organization’s executive director. “There is something deeply catalytic about the work.”

Researchers agree: Studies show that public art has a host of benefits for communities. Its community-building powers can . When locals participate in creating public art, these effects are amplified. A 2018 London-based survey found that believed participating in public art projects benefited their well-being. 

Murals, in particular, are great for artistic placemaking and city marketing.

Public art also provides economic benefits, including new jobs and increased tourism. Murals, in particular, are great for artistic placemaking and city marketing. It’s no surprise that art-focused bus and walking tours have grown popular in dozens of cities in recent years, from London, England, and Sao Paulo, Brazil, , where the city-led program has been funding public art for more than 30 years. 

Elsewhere, public art is used to . For example, last year in Cincinnati, Ohio, nonprofit organization created a to light a popular walking trail in the Avondale neighborhood. The installation has aesthetic benefits, but it has also improved the neighborhood’s walkability and residents’ safety after dark.

ArtWorks also provides economic benefits to Cincinnati residents. It creates jobs and fosters youth development through an apprenticeship program. Since its founding in 1996, the organization has employed more than 4,000 young people, ages 14–21, and 3,000 professional artists and creatives in art projects throughout the city. 

“Our apprentices are being mentored by professional artists on the job,” explains Sydney Fine, senior director of impact at ArtWorks. “So beyond being an arts nonprofit, we are also in many ways a career-readiness, positive youth development organization.”

​​Often, we look to public art as a way to address a challenge that a city is looking to solve.

However, one of the most meaningful effects of public art is that it creates what urban designer Mitchell Reardon calls “community fingerprints”—spaces that make people feel represented, foster community ties, and give people a sense of ownership and belonging in their neighborhoods.

As a senior planner at Vancouver-based urban planning and design consultancy , Reardon has seen how public art serves communities. “​​Often, we look to public art as a way to address a challenge that a city is looking to solve—say, a transportation issue or safe streets—while doing so in a way that is going to be meaningful for a broader cross section of people,” he explains. 

In the United States, public art depicting American communities carries on an artistic tradition that blossomed almost a century ago, when the Works Progress Administration, a Great Depression-era New Deal agency, began funding the visual arts. Through a program called the , the Works Progress Administration employed more than 10,000 artists, who created a significant body of public art, , between 1935 and 1943. 

According to Victoria Grieve, a historian of visual culture in America and author of , supporters of the Federal Art Project shared a belief in “the relationship between the arts and the daily lives of the American people, and the educational, social, and economic benefits of widespread cultural access.” 

Many of the murals produced during the period represented this ethos and belonged to an emerging artistic tradition called “American Scene Painting,” a style of realism inspired by American history, mythology, and culture. Federal Art Project murals commissioned for airports, post offices, and public schools depicted the everyday lives and contributions of , American immigrants, and , meant to foster a shared “American” cultural identity.

While the representation of people of color in public art during the period was often problematic, and New Deal programs , the Federal Art Project still had some upsides for the nation’s marginalized communities. According to Lauren Rebecca Sklaroff, author of , the program created needed opportunities for interracial cultural exchange and allowed artists of color to exercise “cultural self-determination.” 

In other words, New Deal funding and increased attention to public art allowed more artists—Native American, Chicano, Black, and Asian American—than ever before to paint their communities into American art. Those artists’ creations also allowed underrepresented communities to see themselves, perhaps for the first time, on the walls of their cities. Today, Mural Arts Philadelphia and ArtWorks honor the spirit of this work. 

James Daniel Burns, a staff artist at Mural Arts Philadelphia, has experienced this firsthand. “Sometimes, [a mural] can propel the identity of a place into fruition,” he says.

Fine agrees. She says Louise Shropshire on the side of Avondale’s main recreation center has helped turn the location into a vibrant community hub. The mural was created in 2019 as part of a new quality-of-life plan for the neighborhood. “The main focus of the plan is increasing safety and wellness,” explains Fine. “And so, murals have been a part of that. Documenting the important historical figures that have come from a neighborhood and increasing that pride, which then further activates that neighborhood in that space,” she explains.

Both Mural Arts Philadelphia and ArtWorks take great care to ensure locals feel represented in the murals in their neighborhoods. The organizations partner with local community leaders, organizers, and activists to plan and implement new projects. In Cincinnati, this process takes an average of eight months. At Mural Arts Philadelphia, things move much faster. Most of its murals begin with an application filed by someone living in the community where a project will be implemented. They’re expected to rally a community around the proposed project before applying. After that, creating a mural takes only 4 to 8 weeks. ​​At the end of the process, Golden says people feel real ownership of the work.

The mural created a community of love, a community of care.

These collaborative planning processes also forge strong relationships within and between communities. Staff artist Burns says he has a trove of personal stories for each of the projects he has completed in Philadelphia, “rooted in the relationships with people who shape these projects.” ​​

Those relationships last long after the paint has dried. Golden says that Mural Arts Philadelphia also remains a fierce advocate for its art and the communities its projects foster after completion. A mural is an excellent example. The mural depicts a person alone in a small raft on a turbulent sea—a metaphor for the feelings that locals who had contemplated suicide described to Burns, the lead artist on the project. 

The mural, completed in 2012, resulted from a two-year-long collaboration between Mural Arts, the Department of Behavioral Health and Intellectual disAbility Services, and the American Foundation for Suicide Prevention. The project also engaged more than 1,200 community members. It was meant to shed light on youth suicide rates in Philadelphia, which were rising at the time, and provide a voice for survivors, attempters, and their families and friends. 

“The mural created a community of love, a community of care, where people kept coming together long after the mural was created and finished,” Golden says. “It was really inspiring.”

When Mural Arts got word that a new dorm would be built in front of the mural, obstructing the view of it from the street, Golden says her team organized with the community that had contributed to the project and others in West Philadelphia. They sent a strong message to the developer. “‘Look,’ we said, ‘this project is really important,’” Golden says. The group was able to secure a donation from the developers to create a new mural. The new project, which is still in its early stages, will bring the same collaborators together again to create a mural with a similar vision in a central location. 

By holding developers accountable and addressing practical problems, such as street safety, organizations like Mural Arts Philadelphia and ArtWorks create clear value for their communities through their work. The same is true of dozens of other public art organizations, including the in Oakland, California; the in Portland, Oregon; and the in Chicago, Illinois. The work itself also fosters a sense of communal ownership over space, strengthens neighborhood ties, and allows folks to see themselves represented on the walls of their cities. The message it sends is clear: Public art is good for us and our cities. 

“I think a city that is vibrant and thriving has art right at the center,” Golden says.

CORRECTION: This article was updated at 8:46 a.m. on Dec. 7, 2021, to correct the spelling of Sydney Fine’s name.��Read our corrections policy here.

Let me make it clear at the outset that this is a family affair; the whales about whom and on whose behalf I write are part of said family, as are you. I’ve been building relationship with the community of whales who migrate from Bahia, Brazil, to Antarctica for the past seven years and sharing that process through my project, . It is from the depths of our shared oceanic origins that I bring you this offering.

Whale Whispering is an ancestral commission, an ode to water, a work of interspecies translation and co-creation between me, humpback whales, and other cetaceans and people. It is a diasporic healing quest, an exploration and transmutation of the legacy of transatlantic enslavement through music. Based in Praia do Forte, Bahia, Brazil, it is a soundtrack for personal, communal, and global transformation, a love song for whales, for Bahia, for Earth, for the ancestors, and for life. 

I’m listening to and singing with the whales to tap into the echoes of the Middle Passage contained within their songs, to bring forth sounds that honor Nature’s prescription for this time of reckoning and share water’s wisdom as it is relayed to me. Through underwater and studio recordings, filmed documentation, blog posts, and community gatherings focused on collective singing and water blessing rituals, Whale Whispering serves as a way of dreaming forward via the lens of the so-called past.

As I address the womb sickness that has affected my own womb and those of so many Black womb-carriers due to generations of sexual trauma, I’m learning to wail with the whales as a form of curative release, just as the Africans who crossed the Atlantic in slaving vessels surely did. This siren call, summoning awareness of the unity of all being(s), and resonating with the movement in support of planetary healing, is a vibrational antidote to the violence that threatens to engulf the planet right now. These messages, shared through waves of water and sound, affirm that, for those who are listening, Love’s song is stronger. 

has emerged as the central theme of this collaboration. With this echoing phrase the whales affirm that there is no reality in which we are not all connected to every other being, every other particle in existence—through our breathing, our intake and transpiration of water, our dreaming. Among their many offerings to the human members of their extended family is the gentle nudge to ask ourselves if we are dreaming big enough.

This is a question adrienne maree brown and I were exploring during one of our near the end of the Pandemic Pause, just as the wheels of the global economy (i.e., racial capitalism) were starting to churn back into gear. Via that conversation, I first relayed the whales’ message from the 2022 season. Clearly, the reduction in sonic, vibrational, and chemical interference in the oceans as a result of diminished shipping traffic had proven beneficial to them, and their perception of the retrograde slide toward pre–COVID-19 levels had moved them to make their most forceful, emphatic declaration thus far: “We Will Run This World.”

It is not lost on me that whales everywhere have proceeded to occupy increasing amounts of space in international news, asserting and claiming visibility and acknowledgement, demanding to be seen and heard. While I’ve repeated their declaration a few times publicly since that interview, I’ve mostly been listening and observing, wanting to be sure that any further details I bring forth about that statement are rooted in the clearest and sincerest point of connectivity between me and the whales. In my experience, this clarity requires time. Given their size, lifespan, and range of movement, it’s no surprise that the whales have their eyes on the long game with regard to guiding their human kin, as they watch what, to many, looks scarily like our imminent self-destruction.

Speaking of eyes, anyone who has had the rare and singular experience of gazing into the eye of a whale can attest to having met with a being of far vaster intelligence, sensitivity, and wisdom than most human minds can begin to fathom. Since living that wonder myself, I’m convinced that whales are capable of feats that would qualify as miraculous in any context. In considering the meaning behind the declaration that they will run this world, I’m compelled to lead with miracles. They could be as fantastical as the whales adjusting and accelerating their evolution in the blink of one of those knowing eyes, making them suddenly capable of living on land, communicating through language with humans as a whole, and deconstructing and restructuring the systems that have brought us to this point of global upheaval through direct intervention. My sense though, is that, per their nature, the whales intend something more nuanced and easily absorbed. 

Looking to the (technically dolphins, but whales by association) in the Strait of Gibraltar as an example, I see not as some type of revenge or retribution for human destructiveness, but as intentionally headline-grabbing activity drawing our attention to the rudders they have consistently disabled. They are pointing out faulty steering by humans, the ones who have been driving the planet to destruction, suggesting that a new way is needed. As far as I know, no one has died as a result of these encounters, but they have definitely put whales on many people’s minds.

By overturning boats, then , leaping onto and stealing the scene , among other shenanigans, the whales are impressing themselves upon collective human awareness. They are infiltrating our conscious and subconscious minds with suggestions to listen to their subaquatic songs and sounds. Through both our listening and the vibrational reverberations that result from playing their songs above water, the whales can infuse us with massive doses of compassion, pour into us and other species from the fount of grace to which they have access. 

Based on what the whales have shown me, their songs have the capacity to reverse so much of the damage caused by humans—they could dissolve microplastics and oil spills, deactivate the harmful properties of chemical and other pollutants threatening the world’s water supply, and perhaps most importantly, soothe the indignation of our mothering planet, preventing her from wiping us out completely. But because fear, doubt, and subjugation to the nightmare spell of our current moment are so pervasive, and because most humans are living unaware of their own psychic impact, there has been a block on the extent to which the whales can wield their miracles—and to which we can wield our own. From our fitful slumbering, the whales are calling us to lucidity, on behalf of all the species smaller and thus more easily ignorable than they are. They have visions of healing technologies that they can float into our imaginations, infusing them with solutions to such pressing issues as how to ensure safe, viable water for all, for example. Like so many plant spirits and human stewards, they are calling us to exalt the connective practices that Indigenous peoples worldwide have been preserving: to gather at and with water, joining our sung voices as sources of generative and regenerative force, engaging the Oneness that is the origin of all possibility.

It’s unlikely that every human will hear or answer this call. Only a critical mass of deeply engaged, genuinely receptive and open-hearted individuals is required to make way for the whales to steer us into a new dream. This whale-sized waking dream is one in which life on this planet is more balanced, healthy, just, and sustainable. It is one where the expansive generosity and compassion of these ancient beings have permeated the modus operandi of the planet’s powerful problem children—humans. 

While people will continue to hold—and debate—a diversity of beliefs about spirituality, divinity, and the supernatural, everyone can agree that whales exist. And each one who opens themselves to imbibe the medicine the whales pour forth can taste the truth, can become imbued with the knowing that there is indeed a Higher Love, one that scales beyond what this current, shared reality suggests is real. Each one who receives that medicine and deepens into that knowing becomes a conduit for that Love—one among the countless channels through which it flows, hydrating them with real magicalisms that have only awaited the acceptance of their own sublime potential in order to come true.

Are you One?

Jones pauses and clears his throat, wiping his eyes. “I get emotional about it,” he says quietly, looking down at the black Labrador retriever sleeping at his feet. “Midnight has done so much for me. I really don’t know what I’d do without him.”  

serves individuals experiencing homelessness in Upper Darby, a township on the outskirts of Philadelphia. It is the only shelter in the area to welcome guests along with their “Three P’s”: pets, possessions, and partners of all genders. 

A few years ago, Jones was in a car accident that left him unable to work. As a result, he lost his apartment and began living on the streets. During this time, Jones left his service dog, Midnight, in the care of a friend. Every day, for months, he would take the bus to visit Midnight.  

In addition to his role as an emotional support dog, Midnight is also trained to care for Jones in the event of a medical emergency. Jones suffers from hypertrophic cardiomyopathy and relies on Midnight to bring him his medication and phone during cardiac episodes when Jones is unable to stand.  

When Jones finally secured a spot at a shelter that allowed service animals, he found the staff to be confrontational about Midnight’s presence, despite the dog’s status as a service animal. Eventually Jones was evicted from the facility. 

After sleeping in a storage unit for two nights, Charles and Midnight visited the Breaking Bread Community Shelter in search of food. They were immediately invited in for coffee and a meal. Soon after, Charles and Midnight secured a room in the shelter, shared with two other guests, and were able to move in.  

“The first day we came, the staff called us by name, even Midnight,” Jones shakes his head, emotional once again. “They told me they had my back. I felt like I was in heaven.”

Once securing a bed at Breaking Bread, Midnight was given vaccines and other medical care from volunteer veterinarians in the community. “I owe this place everything,” says Jones. “We’ve got a whole new family here.” 

An Impossible Decision

“Approximately 10% of people experiencing homelessness do so with service animals, emotional support animals, or companion animals,” according to the . However, very few homeless shelters currently accept pets. This means that many unhoused people are forced to make the often impossible decision between safe shelter and staying with their pet. 

Additional research by the Alliance indicates that many choose to remain with their animal, even if that means sleeping on the street or staying in a violent situation. According to the , “50% of domestic abuse survivors would not leave an abusive home unless they could take their pet with them.” 

Biana Tamimi, a veterinarian and the director of shelter medicine at the Animal Care Center of New York City, believes this decision is only natural. Tamimi explains that for many people, an animal is more than a pet—they are a member of the family. Over her years of veterinary care in New York City, Tamimi has witnessed animals providing critical companionship, comfort, and trauma healing to people experiencing homelessness or poverty.  

“I have met so many unhoused people who say there’s no way on Earth they would give up their animal. [Their pet] is their reason to get up in the morning, a reason to go out and look for food,” Tamimi says. “We all know what it feels like to come home after a hard day and pet your cat or have your dog jump on your lap and give you licks. Imagine in the darkest time of your life, having a companion that’s been with you for years suddenly taken away. We never want that to happen to people.”

The Interconnected Health of Pets and their Owners

In addition to her role at the Animal Care Center of New York City, Tamimi serves as a co-lead at , an organization that believes the well-being of the pet and the owner are inextricably linked. At pop-up street clinics across the nation, the Coalition provides free veterinary care to pets of people experiencing or at risk of homelessness, while also offering social services and medical resources to owners. This model of care is known as the “” approach. Attributed by many to 20th-century veterinary epidemiologist , the One Health movement has gained popularity in recent decades. 

“One Health is a way of providing care that recognizes the connection between human health and animal well-being,” Tamimi explains.  “Practically, what these clinics look like is a veterinary team working alongside human health care providers. For example, I’ll be examining the animal, and maybe there’s a psychiatrist with us, and we’re having a conversation as a group.”

Tamimi shares that, often, the focus of the appointment is first on the pet, utilizing the human-animal bond to help the owner feel comfortable. 

“People want their animals to get the care they need,” Tamimi says. “One of the biggest benefits [of One Health clinics] is getting someone through the door who might have a lack of trust with housing providers, with health care. … We use that bond with the pet to facilitate the human getting care for themselves as well.” 

At a recent New York City pop-up clinic, Tamimi recalls a man who brought his cat to the clinic, concerned that she was developing asthma. Through conversation with the man, Tamimi and the volunteer social workers at the clinic discovered he was a heavy smoker, which was likely causing his cat’s breathing issues.

“That was a great opportunity to discuss how the owner could smoke a little less,” Tamimi says. “He didn’t realize his smoking was causing this problem, and he said he didn’t want to do that to her. … Our team was able to say, ‘Let’s tackle this problem together, because you’re going to be helping your cat and ��dzܰ��������.’�ĝ

To Tamimi, this illustrates the effectiveness of the One Health model and the power of the human-animal bond to positively influence a person’s life. 

“Pets keep their owners grounded. They keep them well, especially in really dark times of isolation and stress,” she continues. “Humans can get through the most challenging times of their lives because they have an animal there with them that relies on them. … That interconnectedness is really valuable.”

In Texas, a Safe Space for Pets and Owners

in Dallas is also working to keep unhoused people with their pets. The nonprofit has 20 dog kennels in its 750,000-square-foot center, along with shaded walking areas and a full-service grooming room. Recovery center clients are also provided with free dog food, leashes, and toys. 

David Woody, a social worker and the president and CEO of The Bridge, says that in his experience, if a client is offered a spot in a shelter that does not welcome their animal, they often refuse services.

“Here at The Bridge, we’ve developed a real sensitivity to that kind of experience,” Woody says. “Through the kennel program, we offer dogs a safe space while the guest gets their needs met as well. We take care of the whole person, and the canine is just as important as anything else.”

Channon Cavazos, kennel manager at The Bridge, explains that often, guests open up to her about their trauma while talking about their pet. This allows the team at The Bridge to better serve the client’s individual needs. 

Cavazos says there is nearly always a waitlist for The Bridge’s pet-friendly shelter services. In the coming years, she hopes to expand the kennel program, allowing more Dallas residents to receive shelter without being separated from their animal. 

“There are people who will wait on our waitlist for weeks at a time because they can’t part with their animals. A lot of these people have been through a lot. The last thing they want to do is get rid of their animal,” Cavazos says. “I would love to see a kennel in all homeless shelters so that no one has to part with their animal to receive shelter.”

Mobilizing the Public

a nonprofit working across all 50 states, provides food and medical services to the animals of unhoused people. Since it got its start in 2008, the nonprofit has provided more than 2 million pounds of food as well as medical care to more than 30,000 pets.  

“When we first started, our clients would tell us they were giving their pet half of whatever food they could find,” says founder Geneveive Frederick. “And we knew this wasn’t healthy for the person or the pet.”  

Feeding Pets of the Homeless relies on donation sites across the country to collect pet food and supplies from the public. These donation sites are located in hair salons, doctors’ offices, pet shops, and other small businesses. The food and supplies collected then gets distributed by social service centers like domestic violence shelters and food banks. Feeding Pets of the Homeless also offers financial support to unhoused clients whose pets need urgent medical care. 

The majority of the organization’s clients are women, Frederick shares. She highlighted that, many times, unhoused women are at and rely on their animals for safety.

“Even the smallest dog can alert them that danger is coming,” she says. 

Additionally, she mentions the among people experiencing homelessness. For some people, pets can provide a reason to seek help, even when they feel hopeless.  

“For many [unhoused people], they’ve lost all hope … but they reach out to us because they feel responsible for their animal,” Frederick says. “Programs like ours can give people hope that somebody out there wants to help them, and their pet, in their time of need.”

I imagine my dad’s disappointed spirit hovering over the Dodgers as they lost in the World Series. I invoke my mom’s stovetop magic as I figure out what to do with a bag of zucchini that must be cooked tonight. I remember the mothers who grieve their sons’ vibrant spirits every day, and I take a moment to send Snapchats to my beloved cuates. Día de los Muertos is so ingrained in my being that I am startled to see people in costume; my mind wonders for a second, “What’s that all about?” This is amazing because I was so involved in Halloween while my children were growing up—making costumes, figuring out the healthiest candy to hand out, trading my children’s candy for money so they were not overloaded with sugar (and I could store their loot for the next Halloween). In years past, I have hosted gatherings to decorate sugar skulls, loving this tradition of blending death with creativity. I treasured giving my children and their friends the chance to be playful and imaginative with something that so many people fear. As a writer, I live in that crevice of light and shadow, writing drafts only to end their existence for another version and then another and then yet another. I love the transparency of life and death, the calaveras that dance and meditate and watch TV. Each skeleton could be anyone of us, and one day we will know what our antepasados experienced after their last out-breath. One day we will see there is no separation between any of us, alive and dead.

The first and only altar in my �貹����Գٲ�’ home was the one we created on a cake after my dad’s funeral, laying out the detallitos of his life that he allowed to be visible. The secrets were still within him, wisps of energy that over the years encircled us with cariño or strangled our voices or tripped us as we ran. As I set up my altar year after year, I breathe in the musty smell of the newspapers I have carried from home to home. These crinkled papelitos wrap and unwrap memories and give space for those I loved and lost to whisper consejos in the stillness. I unbind my heart wounds and apply the salve gained from another year of living—that little bit more of perspective and wisdom nestled in my corazón that wraps around me like a soft, colorful rebozo. This essay appears by permission of the author, Linda Gonzáles. Excerpted from Endangered Species, Enduring Values: An Anthology of San Francisco Area Writers and Artists of Color, edited by Shizue Seigel, Pease Press, 2018.

Hello sweet one. I see how much you care about the world, about your communities, about all of us surviving plagues and capitalism and a world on fire.

That clench in your throat, the knot in your gut, the tightness in your breath — this is how our bodies try to hold the world’s anguish. We write the wrongness into our bodies, a beautiful and devastating lament.

Just because your body can hold all the tragedy, the panic, the tension, that it is holding right now, that doesn’t mean that you must go on holding it, all, forever. The loving grandmother in you knows this to be true.

Set it down. Somewhere nearby, so you can pick it up again when you need to, but just for a moment, relinquish your illusions of control. Allow yourself to See the many-headed Truth monster: it might not all be okay. It might end in flames and death and horror, no matter what you do. Take a moment to acknowledge how fucking awful and sad that Truth is. And how not even the worst possible scenario would take away from your inherent worthiness.

Simultaneously, it is True that human beings have always fought for one another, cared for one another fiercely, and carried the world’s anguish in our bodies. And there are small Truths, like that we cannot control the future, no matter how much we wish we could. (Don’t worry when the Truths contradict one another, real Truths often do.)

No matter what, whether it turns out okay in the end or not, you carry the Divine within you. You are Enough, not because of the things you do but because of who you are fundamentally. Intrinsically. Always and without exception. Take a breath or two to allow yourself to Know this.

And when we pick up the anxiety again, let us aim for flexibility. Movement space for breath to get in and out of your rib cage, gentleness for the things we can’t do, and Integrity giving us the strength and resolve to turn our sometimes-excruciating caring into solidarity, mutual aid, and direct action.

We are each one person, breathing this one breath, with common Divinity.

We can do this. Together.

Note: This poem was an email response from my therapist when she closed her office because of coronavirus. The author has given permission for YES! to publish it, but wishes to remain anonymous. —Ayu Sutriasa

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

Editor’s note: This story has been translated into Spanish by Kristina Fullerton Rico. You can read the story in Spanish here.
(Una nota de los redactores: Eso historia ha translado a español por . Puede leerla en español aqui.)

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

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

The Toll of Long-Distance Loss

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

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

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

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

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

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

Bridging the Distance

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

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

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

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

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

Systemic Solutions

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

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

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

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

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

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

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

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

You can read this story in Spanish here.

CORRECTION: This article was updated at 1:55 p.m. PT on May 1, 2024, to clarify Fullerton Rico’s recommendations for better supporting immigrants. Read our corrections policy here.

After years of isolation, Eagen joined a growing movement to make spaces safer by focusing on air purification. Air filters acknowledge the intimacy that comes with sharing air, and the inescapability of our interdependency. Eagen launched an organization called in San Diego in February 2024, drawing inspiration from , a grassroots group that provides free air-purification equipment to local and touring artists in Chicago.

Emily Dupree founded Clean Air Club in early 2023 after her partner got COVID despite wearing a mask at a concert. “There had to be a better way for us to navigate the continuing pandemic, where we would be able to enjoy the arts community, but also be safe while doing so,” she says. 

Thanks to the blueprint that Dupree established, the movement has grown to across the United States, four in Canada, and one in Australia, with a handful more preparing to launch. These groups provide essential mitigation resources and community building in a political climate where COVID-19 remains an ongoing public health threat without adequate institutional or social support. 

Numerous studies have shown that high-efficiency particulate air (HEPA) filters, as well as ultraviolet radiation (far-UVC light) lamps, can reduce the transmission of COVID-19. Yet most venues have not upgraded their air ventilation systems to meet the of five air changes per hour—the rate at which a space’s entire volume of air is completely replaced. And that is only the minimum. 

“Clean Air Club exists as a DIY stopgap measure in the midst of ongoing institutional failure,” Dupree says. “What we’ve seen is a widespread suppression of the realities of how COVID can harm us so that capital and the interests of private businesses can continue unimpeded.”

When Katie Drackert developed long COVID, they say “it hurt” to be left out of performance spaces they had participated in for nearly 10 years. Witnessing the ongoing public health failures motivated them to found in Austin, Texas, and study communications. “Whether we want to or not, we’ve all agreed to be public health communicators—and in such a grassroots way, where we’re fighting such an intense media machine and social stigma.”

Before fundraising for air purifiers in San Diego, Eagen built a social media following by posting memes about the connections between COVID, disability justice, and decolonization. As an Indigenous Californian of the Acjáchemem Nation, an Irish American, and a descendant of the San Juan Capistrano Mission Indians, their ancestors have a long history of being inflicted with—and resisting—disease, from smallpox and tuberculosis to HIV and AIDS. The resulting loss of life, connection, and language (and the role the government played in each) formed the foundation of Eagen’s worldview. So while they have been harassed for wearing a mask, Eagen sees their work as pivotal for public health and social justice. 

“Isolation is not fun,” they say. “We can’t have a movement without joy.” Without play and recreation, “we can’t feed our soul and our spirit, to have energy and to have integrity for the fight.” 

This grassroots effort to purify air in social spaces is clearly meeting an urgent need: Clean Air Club has provided air-purification equipment at more than 600 Chicago and Midwest events, more than 30 national tours, and seven EU/U.K. tours. The group also supports eight official artist partners who commit to having air purifiers at most of their shows, and hundreds of local artists who want to make shows safer. 

In January 2024, Clean Air Club also launched the platform for COVID-cautious artists of all disciplines to find each other. Within a month, 450 artists had signed up around the world.

Clean Air Club prioritizes events that require and provide masks, and in many cities, organizations partner with a to distribute masks. 

“Venues worry that it’s going to drive away their customers or it’s going to interfere in some way with their customers’ enjoyment of the evening,” Dupree says of mandatory-masking events. “But in our experience, all of the Clean Air Club mask-required events sell out. They are packed with people who are happily masked and happy to participate in a form of care of one another.”

Many of these groups consider the clean air movement as harm reduction: People are going to gather anyway, and any level of mitigation helps reduce the chain of transmission. 

It’s no coincidence that this grassroots movement is being led by artists—many of them queer. 

“Historically, queer nightlife has been such a safe space for when the rest of the world isn’t accepting of us,” Drackert says. “Disabled queer people should be able to partake in celebration and pure joy as well.”

While most groups focus on providing cleaner air for music, arts, and leftist organizing spaces, some have a broader focus. Thanks to a crowdfunding campaign and material donations, Fan Favorite has provided some combination of rapid tests, masks, and air filtration at events including a Palestine solidarity event, a punk show, a fast-food workers organizing panel, an erotic art night, a social drawing night, and an open mic. They have also distributed masks and tests to workers crossing the Mexico–U.S. border.

founder Ashley Hayward is a burlesque performer and her partner is a comedian, so she hopes to make those shows safer. in Los Angeles focuses on air purification for the drag scene, which relies on lip-synching, making mask-wearing impractical. in Charlottesville, Virginia, has installed permanent air filters in three local nonprofits, and makes filters available for any community event. Even car dealerships have requested the purifiers; the group might start renting them to businesses to help subsidize the cost. 

Groups like INHALE Nashville and Clear the Air ATX also provide lists of local COVID-safer businesses to help incentivize these practices. 

Rob Loll, founder of in Jamestown, New York, aims to provide air purifiers as well as masks, tests, and COVID information to his community. He’s provided one permanent air filter to a yoga studio, and provided air filters for a Christmas choir concert. A small business owner himself, he is trying to help other business owners realize that cleaner air directly supports the local economy. 

“This whole idea that we’re just going to keep working until we’re sick, and then disrupt everything,” is unrealistic, Loll says. “Even from a business, capitalist sense, I don’t understand how this is supposed to play out for them.”

Accepting that the pandemic isn’t over means acknowledging the need for long-term infrastructural change and updated air-filtration standards. Several organizers compared the clean air movement with the structural overhaul necessary to purify water to eliminate cholera. “I really hope that we’re just the very early adopters of something that makes a lot of sense to do on a broad scale,” says Jennifer Bowser of in Richmond, Virginia. Similarly, during a January 2024 Senate hearing on long COVID, epidemiologist pushed for updated air filtration to fight the virus, comparing it to how many building codes now require earthquake-proofing.��

“I have to remind myself when I get overwhelmed, I’m doing the job of the state,” Drackert says. “But I will do it, and I’ll continue to do it, because I feel really passionate about it.” 

Making spaces safer for disabled and immunocompromised people helps everyone—especially considering each COVID infection increases a person’s risk of becoming disabled and immunocompromised. Cleaner air also mitigates allergies, wildfire smoke, and industrial pollution; it also lowers the risk of other airborne diseases like influenza and RSV. And making spaces safer means more people can participate in crucial organizing efforts. 

This grassroots movement for clean air is poised to grow—and quickly. In early February, Dupree hosted a call with 14 clean air organizations to share strategies and build solidarity, and the number of groups has almost doubled since then. 

“All of the planet’s health is connected,” Eagen says. “Not only has it been true eternally, but on this global scale with so much air travel, the people who are breathing on me here probably breathed on someone in Chicago or got breathed on by somebody from Chicago. Our clean air in each of our cities impacts all of us.” 

CORRECTION: This article was updated at 9:38a.m. PT on May 24, 2024, to correct the name of the organization Clean Air Cville. Read our corrections policy here.

“I started fighting, people trying to kill me in prison,” says Rodriguez, who was incarcerated in New York state prisons for 27 years. “I get stabbed, I get cut up. I start cutting people. But I don’t like violence. I had to fight for my life.”

In 2007, he started going to church again, began playing music and rediscovered both his passion and spirituality. He also began attending every prison program he could, including , designed to bring healing and structure to men currently and formerly incarcerated.

“That’s when I met brother Zach, brother for life, the beautiful angel, the beautiful people,” Rodriguez says. “Thank God for having these people in the world.”

 In 2017, Zachariah Presutti, a Jesuit of the northeast province of the Society of Jesus, officially launched Thrive, whose volunteers provide support to men incarcerated in six New York jails and prisons and help them find stable housing, education, and employment once they leave. While those are often considered the pillars of rehabilitation and recidivism reduction, Thrive also adds another focus: healing.

“Really what we’re dealing with is trauma,” says Presutti, who is also a psychotherapist. “The … trauma of being a victim of abuse, neglect, poverty, sociological constructions growing up. The trauma of being incarcerated, the trauma of inflicting pain and hurt on other people. Those have real psychological effects.”

Thrive provides spiritual retreats at the correctional facilities it serves and estimates about 700 men have benefited from them. The retreats offer a space for vulnerability and reflection, something nearly impossible to find on the inside. Thrive has also helped more than two dozen of them transition after release. In addition to seeing virtually no recidivism, Thrive has helped them make peace with their pasts and reconnect with family. Rodriguez, for example, now has a stable job and housing, while also sharing what he’s gained from his experience with others.

“We’re kind of witnesses of miracles,” Presutti says.

Sometime this summer, Thrive will open , a residential center in the Bronx for 24 formerly incarcerated men, intended to address more directly the stress and uncertainty that can accompany those returning from prison.

The organization addresses the trauma of the prison experience using what it calls “Ignatian spirituality.” In the 1500s, Saint Ignatius of Loyola founded the Society of Jesus, a religious order of the Catholic Church. Recovering after a cannonball shattered his leg, Ignatius read the gospels and grew to believe that closeness to God could be achieved by self-reflection, meditation, and service to others—practices Thrive sees as essential to helping men survive in prison and after returning home.

“We’re not trying to fix people or save people,” says Joe Van Brussel, the group’s chief operating officer. “We’re trying to give people tools and a lens to understand their stories.”

Those stories are frequently troubling ones, reflecting larger societal problems. Many participants have dealt with substance abuse or mental health issues and, according to Presutti, most have themselves been victimized in some way.

“I think prison is how we handle all our sociological questions,” Presutti says. “We have a hard time dealing with poverty, so we lock it away. We have a hard time dealing with [different races] so we lock them away. We have a hard time dealing with mental health. Well, we don’t have services for them, so lock them away.”

There’s evidence to suggest he’s right. As many as half of all inmates in American jails and prisons suffer from some sort of psychiatric disorder, according to new book  The Bureau of Justice Statistics that 37 percent of prisoners and 44 percent of people in jail had been diagnosed at some point with a mental health disorder. Jails in New York, Los Angeles, and Chicago are now the three largest institutions providing psychiatric care in the U.S.

Van Brussel said the conditions of prison—chaotic, violent, and uncertain—further erode the psyche. The retreats give the men a chance to be vulnerable, uncommon inside prisons.

“They never get a chance to breathe or just talk in a safe environment,” he says. “People have told us, ‘It’s been months since someone listened or wanted to hear my story.’”

Tracy Tynan, who volunteers at Thrive retreats, says they begin with a guided meditation that encompasses anything from envisioning relaxing on a beach to a “conversation with God.” Then, participants share positive recent events in their lives, such as phone calls from loved ones or progress with an appeal. But they also talk about the hardships of prison life—fights, fear, and lockdowns. Retreats might include art or music.

The centerpiece of the retreats is the lectio divina—a reading from the Gospels coupled with “imaginative prayer” and introspection based on how the reading resonates individually. All this combines to create the rare space where incarcerated people can close their eyes, relax safely, and look deeply within themselves.

“It really, really helps them,” Tynan says. “It’s unusual to close your eyes in prison.”

Santiago Ramirez served 36 years in prisons throughout New York state for committing a deadly robbery while in the throes of substance abuse. He remembers those retreats as his only opportunity to trust inside.

“Sometimes in prison, you can develop friendships and relationships,” Ramirez says, “but you’re not really comfortable disclosing everything about yourself. Then you worry: Is that person going to betray your trust? But Thrive is so welcoming, so encouraging, so supportive, so loving.”

Presutti says because love is such a rare commodity among formerly and currently incarcerated men, extending it is an important part of Thrive’s mission. “They need to experience love, to be loved, and I think that’s when healing begins,” Presutti says. “Healing begins when we realize just how much we’re loved. A lot of people have bad experiences of being loved. Someone told them they were loved one time and abused them. Someone told them they loved them one time and kicked them out onto the street or gave them a needle.”

Outside prison, Thrive provides emotional support and a sense of community some participants have never experienced—employing everything from monthly group dinners to counseling and transportation.

Convicted as an accomplice to a murder he said he witnessed but wasn’t involved in, Rodriguez wanted to live in Buffalo after his release where another organization was offering re-entry help. As a condition of his release, however, he had to return to New York City, the site of his arrest. Presutti and Thrive’s volunteers stepped in, picking him up from the prison, helped him get clothes, and gave him a place to stay.

“They told me, ‘You gotta follow the rules. Step by step, little by little, poquito, suavacito, you’re gonna be OK,’” recalls Rodriguez. “’But you got to take it easy because you been locked up for too many years, and life is not like it used to be when you were there.’”

At Ignacio House, which Thrive hopes to open by the end of summer, men with whom it connected on the inside will be given priority in housing. They will receive workforce training and gain access to scholarships from Manhattan College. Thrive wants to use open space inside the house for Alcoholics Anonymous meetings and local events, all designed to create a foundation of support for these men as they work to build their lives on the outside and develop a sense of community.

“It’s not building agencies,” says Presutti, who openly resists joining what he calls the nonprofit industrial complex. “It’s about being there as a community. Community brings connection and intimacy ultimately, which leads to the experience of love.”

Volunteers and participants hope that Thrive’s approach will take hold around the country, presenting it as an antidote to both the causes and effects of mass incarceration.

“I think it’s a way that we’ve been dealing with the issues we just don’t know how to deal with,” Presutti says. “If we can just put [incarcerated people] out on an island, nobody will know how to get to them and hopefully people will forget about them. The grace in the whole thing is if people haven’t forgotten about them.”

But in the words of Mark Charles and Soong-Chan Rah in their 2019 book “White America could not perpetrate five hundred years of dehumanizing injustice without traumatizing itself.” 

On the night of December 31, 2015, I learned about my ancestors’ long-standing history on this land. The next day, January 1, 2016, the process of unraveling our family’s amnesia began. As I began sharing my ancestral discoveries with my white friends and family, I encountered blank stares and shrugging shoulders, accompanied by a quick change of subject to something more timely, relevant, or entertaining. I was often told reassuringly, “Well, that was a long time ago. Everyone thought differently then. You shouldn’t feel guilty about that.” Far from being placated, I wanted to scream. People literally could not hear what I was saying. I felt isolated in a process that was rewiring my core identity.

What I had discovered in my own family history posed a threat to the person I thought I was, and to the person I was taught to be. Looking back now, it felt like I was receiving an ancestral push toward truth and healing after many generations of silence. The process went far beyond a tidy phrase like “white guilt.” Over time, I began distinguishing guilt from accountability. Staying stuck in guilt is not helpful. Moving into accountability catalyzes necessary change. I was rapidly becoming someone I did not recognize. 

What was now glaringly obvious and “in my face” all the time was being actively ignored by well-meaning white people all around me. Overwhelmingly, I felt pressured to calm down, behave, and just stop talking about it. Why? Talking about the shadows of colonialism and enslavement contradicts the heroic American mythology that we learned as children. Within the Euro-American diaspora, our capacity to deal with our ancestral legacies is compromised. We are part of a culture that is more invested in maintaining a narrative of innocence and denial than in embracing truth and healing.

I imagine this work to confront our collective amnesia will continue for the rest of my life. I hope it will persist into future generations as well. Over the years, I came to see our amnesia as .

When our European ancestors carried to Turtle Island their diseases, poverty, disrupted communities and families, severed cultures, and violence, it did not expunge their own historical trauma. Establishing dominance over the unique civilizations that were already thriving on this continent did not make us whole again. Kidnapping African leaders, healers, holy people, Elders, mothers, fathers, and children to build us a wealth-accumulating economy did not bring us peace. 

In her book , Euro-descended Elder Louise Dunlap shares how she perceives the suffering of our settler ancestors: “…a nightmarish, button-your-lips suffering that warped the mind, closing it to compassion for other humans and encouraging brutality against perceived enemies and the Earth itself. These ancestors struggled with a punishing legacy that still afflicts us.”

Our ancestors’ punishing legacy went into the underbelly of our society. Today, it hides out behind a polite mask of denial. Almost everything in Eurocentric culture conspires to keep us asleep. Amnesia is the path of least resistance. 

I am grateful that the ancestors have shown me the unpopular truth: Unleashing their tears and reviving their memory might just be the messy, raw, healing balm for the wounds our people sustained and perpetrated so long ago. If we muster the courage to traverse these shadows, who might we become on the other side of all that pain? Who are we underneath the denial, amnesia, grief, guilt, and shame? 

Let’s find out.

This essay is excerpted with permission from by Hilary Giovale (Green Writers Press, 2024).

“Over [two] months ago, I decided to permanently stop treatment for my autoimmune illnesses,” Alexandria wrote. “The side effects were absolutely horrendous and the treatments only provided a temporary fix that has to be administered again and again for the rest of my life to stall the illness, which isn’t a cure.” She ended the post by naming her dual diagnosis, which she had been largely private about aside from .

For people with rare diseases—estimated to be between —finding the right doctors and treatments can feel like a Herculean feat, a reality Alexandria knew all too well. “There is no long-term cure,” she wrote. “I’m very very very sick, things are progressing fast. I’m wheelchair or bed bound most of the time. I had 16 seizures yesterday and over 30 stiff person attacks.”

In the United States, rare-disease patients often go into significant medical debt to pursue treatment, even traveling to different states to see specialists with months-long waiting lists. In addition to the monetary burden, those seeking treatment for rare diseases also face a mental, emotional, and spiritual toll. 

“I wake up with excruciating pain,” says , a disabled adaptive fashion influencer and one of just a few hundred people in human history to have been diagnosed with , a cancer disorder that causes bone tumors and vascular lesions most often in the hands and feet. “There’s not a moment that I don’t have excruciating pain, which is awful for a variety of reasons. It obviously takes a toll on your mental health and your social and interpersonal and professional life. The first thing I have to do in the morning is wake up, take my opioids, and then wait an hour just to be able to get out of bed and do anything at any capacity.”

In the face of these obstacles, rare-disease patients like Durán must relentlessly call insurance companies and medical offices, create and share resources, and form care networks to lift some of the burden—and help keep them alive.

Routine Misdiagnosis

As a baby, Durán was misdiagnosed with , which similarly causes bone tumors in different parts of the body. When her father sought a second opinion, she was again misdiagnosed, this time with , which occurs when scar-like tissue replaces healthy bones.

“They ran with that diagnosis until I was 18,” Durán says. “The treatment is similar in that I still got leg lengthening, but I was also supposed to get annual cancer screenings with full-body MRIs or full-body CT scans with radiation, and they �ɱ�����’t doing that.” The Cleveland Clinic notes that Maffucci syndrome patients , with up to 50% of Maffucci patients developing chondrosarcoma, a bone cancer that begins in cartilage cells. (Durán estimates her odds of getting cancer at 55%.)

Just before Durán graduated high school, her doctor misdiagnosed her with cancer and referred her to orthopedic oncology. However, when she showed up for her appointment, she learned she’d been kicked off her when she turned 18. To continue treatment, she had to apply for adult benefits or find other insurance, which would severely delay care.

In 2017, Durán was officially diagnosed with Maffucci syndrome. “[Maffucci syndrome] is so rare that when I was diagnosed, they didn’t even know what gene caused it,” Durán says. Unfortunately, Durán isn’t the only rare-disease patient who’s been misdiagnosed more than once.

Miranda Edwards, a.k.a. , was dismissed by multiple doctors for “anxiety” when she had a malignant tumor in her adrenal gland. Due to the delay in care, her tumor became untreatable. She has been “” since 2014, sharing each step of her journey online as well as resources she’s created herself—like a —so others can advocate for their health.

In 2023, Edwards asked for help raising thousands of dollars to pay for life-saving molecular testing of her thyroid after she was outright denied surgery to remove a Grade 5 tumor because of her existing condition. Edwards, who is based in Canada, said her health care would have paid for the testing if the tumor had been Grade 4 or lower; essentially, she was once again put at extraordinary risk because of doctors dragging their feet with the “watch and wait” approach.

Tools for Progress

In many cases, rare-disease patients are forced to become the foremost experts on their conditions, putting them in the position of educating the medical professionals who are supposed to be treating them. “I think a lot of health care professionals give up on finding answers beyond our rare diseases,” Durán explains. “I was at a Maffucci syndrome and Ollier disease patients summit at Johns Hopkins last year, and my researchers told us that when doctors see a rare-disease patient, they often focus on the rare disease and forget [the patient] can have common diseases too.”

Durán describes seeing multiple doctors, independently researching her test results, and persistently asking questions of her care team, particularly when they didn’t have an immediate answer for symptoms that didn’t line up with her Maffucci diagnosis. Eventually, she was diagnosed with both hypermobile Ehlers-Danlos syndrome and Hashimoto’s disease. “We already deal with a lot of health issues,” Durán says. “Stress is a notoriously bad thing—for lack of a better word—for pain, for chronic pain and energy levels and mental health. I think having an advocacy group to help patients navigate the system would definitely improve the quality of our lives.”

Since 2008, the last day of February has been celebrated as , a patient-led effort coordinated with more than 65 global organizations, including the European Organisation for Rare Diseases (EURORDIS), to raise awareness for lesser-known diagnoses and the people living with them. Stanislav Ostapenko, who’s been director of communications at EURORDIS since 2021, says rare-disease patients must have strong support networks, including online, to effectively navigate their illnesses.

“We know that patient populations are very scarce,” he explains. “We know that for certain diseases there are just a handful [of] patients across the globe. So it is very important to know that you belong to a community and you can be accepted, you can be understood, and you can also speak to people who have the same condition as you do and that you can find support.”

A major component of Rare Disease Day is translating and adapting tool kits for multiple languages and impairments so anyone can use them, even if they lack expertise. EURORDIS uses this tool to encourage us all—those with rare diseases and those without—to be good patient advocates.

The Significance of Burnout

A from the physician network MDVIP and online random-probability panel Ipsos KnowledgePanel indicates that 61% of polled patients see the U.S. health care system as a hassle and that one in three are “burned out.” One-third of patients reported deferring care in the last five years because they couldn’t get a timely enough appointment to address their concerns or they had a bad experience with a provider. The survey also states that at least one in four Americans who did seek care suffered a negative impact on their mental health, had worsening symptoms, or were misdiagnosed.

All of these factors lead to patient burnout, with chronically ill, disabled, and rare-disease patients facing these issues on a more frequent basis because of how often they are forced to seek care for symptom management, procedures, and medications.

In her 2022 book , Leah Lakshmi Piepzna-Samarasinha writes about the importance of learning both one’s own and their loved ones’ “care languages” to create inter-abled care webs in which everyone can get what they need without harming others and getting caretaker burnout: “When I think of the care webs I am a part of that mostly work, they are a complex moment-by-moment dance of figuring out what we need that is a lot like consent negotiations in sex,” Piepzna-Samarasinha writes. “Raw embarrassment, messiness, confusion, working through shame at needing something (or anything), figuring out what I might need to even begin to ask for.”

Piepzna-Samarasinha also writes about the necessity of employing “a diversity of care tactics” so people can, for example, seek help chasing a referral from a doctor to another doctor to the insurance company and back again, or assistance applying for financial aid from organizations such as the National Organization for Rare Disorders (NORD) to help offset the costs of medication, diagnostic testing, travel assistance, and caregiver respite.

When the COVID-19 pandemic began in 2020, mutual aid and collective care became even more important for people with disabilities, including people with rare diseases. Whether it’s nondisabled people offering rides, helping call doctors or email insurance companies, or assisting with documentation and organization, advocacy networks—no matter how small—have become essential for rare disease patients.

In 2022, disability-justice activist Alice Wong wrote about that ended with her family expending great financial and personal resources to prevent her from having to move to an inpatient facility: “The safety net is not a net!” Wong wrote. “It’s a big fucking hole.” Without Wong’s family advocating for her, she would have had few choices for continued care: “The system drives people toward institutions,” she wrote. “It is designed to segregate expendable and ‘non-productive’ disabled and older people like me. Out of sight, out of mind.”

Advocacy networks can help patients fight for their needs with insurance companies, which are often quick to dismiss medications that are “too expensive” or treatments that are “not medically necessary.” They can work with NORD to launch local registries, promote or host funding drives for patient-focused drug development, and work directly with existing disability-rights organizations to streamline processes and/or build out their volunteer base.

Durán, like Wong, relies heavily on her nondisabled family members for help with daily tasks, which can include bringing her food and water or cleaning her room (the latter which she pays them to do). “As disabled people, we’re already grappling with our health and it already bleeds into every aspect of our lives,” says Durán. ���� we had nondisabled allies caring about accessibility or ableism at any capacity and advocating on our behalf, or just calling out ableism or inaccessibility even when we’re not in the room, I think it would make a world of a difference, especially because I think a lot of disabled people already face a lot of burnout because of our health or lack thereof.”

Highly visible advocates like Durán and Edwards use their platforms to educate their followers, but ultimately they shouldn’t be tasked with radicalizing nondisabled people into confronting and seeking to improve the medical system. “No one is immune to becoming disabled,” Durán points out. “It can happen to quite literally anyone.” If that doesn’t radicalize nondisabled people, perhaps nothing will.

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

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

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

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

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

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

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

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

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

Perhaps there is no moral universe. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

We are in a period of history where it is difficult to speak and sense the truth. In our 24-hour news cycle, the truth is spun and remixed and dramatized and tweeted. It can be confusing to determine what stories are real, what stories actually impact our lives, what is worth our attention, and what, once heard, we are accountable for acting upon. Many of us now find our attention directed by the trends and algorithms of social media. As I write this piece, there is an incredible unfolding, as scientists around the world lock themselves to the doors of their institutions, begging us to attend to the acute climate catastrophe unfolding. But I am watching that storyline be swallowed by celebrity news and other dramas. 

Distraction and redirection have become a field of specialization. There are professionals in every field and political distinction constantly calculating new ways to manipulate us into making decisions that serve their clients, their values, their politics, or their pockets. This focus-grouped messaging doesn’t come with a label, even though it’s the GMO of communications. 

There is also so much complexity of perspective in how human life unfolds—the reality is that there is no single truth. Context is everything. Power dynamics, cultural experiences, class norms, and age can all have a radical impact on what we understand to be the truth.

And then there’s the emotionality of language. I have been guilty of using hyperbolic language when caught up in a moment of anger or despair, language which oversimplifies or outsizes the truth in ways that can either reduce or oversell the narrative of what is actually happening. 

So how, in these times, do we “speak truth to power,” as our civil rights ancestor ? How do we speak honestly about where and how we are right now, and what we actually need to center in our organizing? How do we learn to “be impeccable with our words,” as Toltec wisdom through Don Miguel Ruiz advises in his outstanding text ?

I want to offer some of what I am learning—as a human, as a facilitator and mediator, and as a writer.

Fact-check everything.

Every source of information isn’t equal, especially in the realm of social media. Before passing information along, consider the source. Do they have expertise in a relevant field? Is the information well-researched? Does it include the voices of organizers actively working on the issue? What about communities directly impacted by the issue? Is the source a journalistic outlet committed to fact-checking? 

Speak as precisely as possible.

Especially when sharing information others really need to hear. I remember a poetry teacher telling me to “write it, now cut it in half. Now cut in half again.” As a verbose writer in love with words, I struggle with precision of communication. But in both intimate and collective moments of accountability and negotiation, I find it helps to take a deep breath before I speak, and think about what precisely needs to be communicated. 

Discern.

Is this the right time for this communication? Is it urgent, or is there time to ask questions and fact-check? If it is urgent—why? Who says so? And who benefits from the information being spread? Do you want to benefit them? Could someone be harmed by that information spreading? Do you want to harm or punish them? Are there other perspectives to consider? What are the potential impacts of this communication? Are those impacts you want to be accountable for? 

Speak when we are afraid.

I used to think that if I could not speak without my feelings showing—for instance, speak without a tremor in my voice when I was afraid, or without tears when I felt sad—that I should be quiet, and wait until the emotion passed. But I have been learning that my most powerful words are often accompanied by the release of tears, or the quaking of my gut as fear moves words out of my mouth. When I take the risk of speaking not through or over my emotions, but rather in alignment with, or even from, my emotions, I am speaking my truth. 

Speak truth that allows other truths. Hold strong boundaries against mistruths, lies, assumptions.

Not every perspective is equal, nor does every viewpoint deserve to be equally held or considered. None of us holds a definitive truth, and we need to speak with each other in ways that make room for a multitude of experiences. But we must set a standard of not indulging lies and willful mistruths. For instance, any indulgence of denial of the current climate catastrophe is dangerous for us as a species. We need to be clear and consistent in our standards for truth, and stop uplifting perspectives which cannot survive a fact-check. 

Speak from our own experiences.

We are each responsible for bringing our piece into the great story of our species, which is a long and complex story. Just because something feels true for you doesn’t mean it resonates for everyone. Relinquish control of the collective narrative—we are not meant to dictate and control each other. Live into your truth, and allow others to live into theirs. 

Speak as a body.

One thing that is helping me in my unlearning of dishonesty culture and cultivating the muscles for honest, accountable speech is to really listen to my body as I listen to others, and as I communicate. The body is often aware of the gap in integrity, whether it is in another or in us, the space between what’s being said and the truth. Start to pay more attention to how your body lets you know that what you are hearing or reading might not be true. I feel it in my belly. I have a good friend whose palms get a little sweaty, and another who feels a twinge in her spine. 

Speak what is kind, necessary, and true.

I learned this from Buddhism, and it is one of the simplest and most effective tools for accountable speech that I have ever come across. It only works as a balance. Truth without kindness can veer into cruelty. Truth that is unnecessary can cause harm. Kind speech that is unnecessary or untrue is infantilizing, patronizing, and diminishing the person you speak to. Necessary truth spoken without kindness can land as a blow that produces a defensive response, rather than an opening for connection and action. 

This is just some of what I have learned—and I am still learning. Like many of you, I suspect, I am not just navigating our current culture of communication confusion, but also recovering from cultures of politeness, passive-aggressive speech, repressed truths, and the webs of deceit and distrust that are woven into so many of our cultures. 

Commit to using language in ways that shed light. This is a time when we cannot afford to live in the fog of dishonesty. Our future depends on being able to turn and face what is, and to be honest about what we are going to do to survive.

The internet is filled with lists of which —the assumption seems to be that, otherwise, we singles would be festering alone in our living rooms, drinking vodka and singing “All By Myself” . I enjoy the genre, but as a feminist I have some qualms.

“I never liked his movies anyway. They don’t speak to me, first of all, as a woman, and second of all, as an African-American woman,” she says. “I know all the film critics and film students that I have been in contact with say that Woody Allen is a master at doing this and that. But I don’t align with anything that he does or is. And that’s how I go about it. If what the person does doesn’t align with my core values, then I just can’t do it.”

There are funnier, more romantic movies than Annie Hall, anyway.

3. Opt for rom-coms with fewer or zero problems

I know the classics are, well, classics, but why not watch a movie that takes a healthier approach to romance? “There are always movies that are smaller productions, and they might not have the big box-office dollars, but they’re still well-crafted, well-made movies,” Jones says.

Here’s a ��of five from Thought Catalog��to get you started: Warm Bodies, She’s Out of My League, Celeste and Jesse Forever, My Best Friend’s Wedding, and Kate and Leopold (sarcasm).

So, my fellow feminist rom-comphiles, don’t be discouraged.

There are still a lot of things people can enjoy about romantic comedies, Jones says. “With as much choice as there is out there, a person doesn’t have to give up their romantic comedy love altogether.”

This article was edited at 3:35 p.m. on February 12, 2021, to replace broken gif links with functional images. Read our corrections policy here.

What I don’t like is seeing ableism—that is, prejudice against adults and children with disabilities—rolled into discussions about abortion, as has happened often since the U.S. Supreme Court overturned Roe v. Wade. So many of the stories about the abortion bans that states are enacting describe abortions as necessary for pregnancies in which there has been a diagnosis of a fetal health problem. This suggests that avoidance of future disability for the child is the correct and rational decision. But the issue is more complicated than that. We can discuss abortion rights while also advocating for disability rights by centering bodily autonomy.

The intersection of disability rights and abortion rights is complex, but much of the discourse around the topic has centered on the perspective of parents of potentially disabled babies over the lived experience of disabled people. Ongoing access to safe and legal abortion is a critical issue, but reproductive health equity requires that we look beyond this single issue and toward the need for a system of care that values and supports the lives of children and youth, including those with special health care needs.

The care that pregnant people receive needs to honor their bodily autonomy.

Unborn children are a convenient group of people to advocate for, since they are inherently unable to advocate for themselves. That holds especially true for unborn children diagnosed with a serious disability. With timely prenatal diagnosis, modern medicine can save the lives of children who previously would have died at birth or shortly after. But access to this level of care is still marked by major disparities. Across the board, the states that have moved to impose severe restrictions on abortion access are the same states where children with major health care needs can’t get the care they require.

I learned that my son would have serious and medically intensive disabilities at a routine 18-week ultrasound. As I learned more about his medical conditions and the interventions that would be required to make sure he could breathe after birth, I had to read between the lines of what my husband and I were being told by our local doctors. The level of care that my son needed to survive was available—it just wasn’t available where we lived. My local obstetrician was upfront that she didn’t perform abortions unless the situation fit into her moral framework (she didn’t ask about mine). But, at the same time, my doctor could not provide the kind of care my son needed to survive after birth and declined to even refer me to another provider. Her beliefs about justified and unjustified abortions provided her with moral comfort but didn’t actually provide me with the kind of care that would make it possible for my son to live.

We live in California’s Central San Joaquin Valley, a region with a persistent lack of access to specialty medical care, including the kind of care that is necessary to support infants with major medical needs. I was on my own to get second opinions based on the limited information we got from our local doctors. I was on my own to figure out how to get to one of the big children’s hospitals in the Bay Area. I based my decision on whether to continue or terminate the pregnancy based on whether my son was going to have a fighting chance at life—and the sad truth of that was that chance depended on our family having the financial ability to uproot everything and travel 200 miles from home for all of his care. We knew that he might be able to live if we could get to a better-equipped hospital, and we knew that he would die if he was born in our hometown.

A nurse at my obstetrician’s office put her hand on my pregnant belly and prayed out loud that I would find the strength to fight against forces that would tell me to get an abortion. I didn’t give her permission to do that, and I certainly didn’t ask her to. Her intervention—which made her feel good in the moment—permanently damaged my willingness to talk about my health or decision-making process with that office.

In contrast, at the university hospital where my son still receives his specialty care, abortion was presented without judgment as an option alongside a comprehensive plan of what they could do to keep him alive after birth. When I was presented with abortion as part of comprehensive reproductive health, I felt like I was being respected as a person. But earlier, when my hometown medical care team let their bias take the lead, as a patient, I felt trapped.

My son is now 11, but instead of his ventilator being a scary thing in the intensive care unit, it’s just a normal part of his bedtime routine. He brushes his teeth, puts on his pajamas, and hooks up his ventilator while he reads comic books in bed. At the time I was making decisions about my pregnancy, I had internalized ableism. Because of institutional bias and lack of community living support for disabled adults, I had never seen anyone with disabilities like my son’s out in the community. I thought about his life as being a linear path from sickness to health. I was wrong about that—children with disabilities grow up into adults with disabilities, and it’s our job to build a world that works for them.

The care that pregnant people receive needs to honor their bodily autonomy. At the same time, the availability of abortion doesn’t diminish the lives of children who have special health care needs or of adults with disabilities. California can continue providing safe and legal access to abortion while building a wraparound system of care that values the lives and rights of people with disabilities.

This commentary was produced in partnership with the .

self-portrait as the ocean or Fofie’s wisdom��

study the tides of
the ocean shored by your skin 
each ripple each wave

know not all water 
is meant to quench dry throats or
to be waded through

know not everything 
that is left in the waters 
is an offering

reminders for my (impatient) selves��

don’t force what won’t come
what is for you is either
coming or waiting

closed mouths (and full ones)��don’t get fed

ask for what you need
ready yourself to receive
as well as release

a lesson learned from June��

i been wrong…and still
wrong ain’t never been my name
pronounce me correct

pronounce me (w)hol(l)y
won’t answer to all i’m called
act accordingly

train your timid tongues
sound out all my syllables
i been a mouthful

you are your own��

because you were both 
the cost and the one who paid
a terrible price

It was a hot summer day in 2007 when I wrapped filming for a documentary about women and children’s organizing and leadership in a refugee camp in Ghana. As I was saying my goodbyes, a woman approached me and said, “You know, Sis, the same AK-47s in child soldiers’ hands in Liberia’s civil war are in your children’s hands [in the United States]. You need to do something about that.”

The comment stuck with me, and ultimately shaped the subsequent decades of my life, when I volunteered to teach sociology courses inside prisons in Washington state, then spent 12 years filming inside those same prisons—and in the neighborhoods, homes, and communities from which those incarcerated people came. I became deeply concerned with how the culture of punishment impacts the lives of children.

Our 2020 documentary, , is a love letter to those children. 

Our film invites viewers to take an in-depth look at incarceration in order to better understand the processes that led a person to prison, their resilience, and prisoners’ ultimate role as models for all of us. Set in Tacoma, Washington, the film bears witness to an “everytown” urban neighborhood’s fight to stay alive in the face of racial profiling by police, gangs, drugs, and gun violence.

The film brings to life statistics of racial and gender disparity in , education, employment, and , and shows viewers the through stories from community members impacted by it. Viewers get a window into the ways that incarcerated people are organizing to bring education, healing, and compassion to one another and those who have been harmed—both in and outside prison walls. 

In 1993, Washington state voters were ostensibly designed to discourage “repeat offenders” by implementing increasingly severe sentences for each conviction, including for specific offenses. Washington is also one of (including for life sentences) and is among the few states that . It was also in poor and Black communities. 

This combination of policies, influenced by the frenzy of the war on drugs and perceptions of escalating crime and gang activity in the fear-mongering political climate of the late 1980s and early 1990s, led Tacoma voters to sacrifice their most vulnerable children, discarded as .” This culture of punishment, combined with the city’s lack of social services, disinvestments in early education, and increasing inequality in housing and employment, stained the Tacoma landscape and destined these children to live their lives out behind bars.

Yet even when thrown into prison for punitive removal from society, these children, now adults, could not be silenced. Together they built a prisoners’ community of healing, anchored in restorative and transformative justice that extended beyond prison walls. 

The film chronicles the impact of two prisoner-led groups that have been critical to growing efforts to dismantle the culture of oppression that permeates Tacoma and countless other cities nationwide.

The Black Prisoners’ Caucus (BPC), established in Washington state prisons in 1972, and BPC TEACH (Taking Education and Creating History) in 2013, offer blueprints for repair within the communities they once harmed. Two members of TEACH describe the organization as “a communal learning environment that’s not physical but mental, spiritual, and emotional.” The experiences of BPC and BPC TEACH members illuminate the essential roles of activism, compassion, love, and self-forgiveness in personal and community transformation.

The culture of punishment that groups like BPC are working to dismantle is unfortunately a pervasive element of our shared reality in America today. Especially in these times of and fear of difference, who better to show us the triumph of the human spirit than those caught behind bars for life?

The film introduces us to Kimonti Carter, who grew up in Tacoma. He was convicted in 1998 at age 18 of aggravated murder connected to a drive-by shooting. He was sentenced to 777 years, without the possibility of parole. Carter became not only our protagonist but the spine of our film. His story embodies the triumph of the human spirit—even when faced with social forces that attempt to define the margins as a place of deprivation, never of possibility.

In 2021, the that mandatory minimum sentences are unconstitutional for 18-, 19-, and 20-year-olds, pointing to “a rethinking of the culpability and punishment for young people, as science has revealed more about their developing brains,” according to . This ruling opened the door for Carter’s July 2022 resentencing, when a judge determined that Carter, having served 25 years in prison, must be released. 

He now serves as a community outreach specialist with the Washington State Office of Public Defense and continues to work with BPC Community Group and other formerly incarcerated peers and youth in schools, education, health care, prisons, and juvenile facilities. Carter’s goals are reflected in the film, as we see him—then and now—deeply committed to policy change, youth activism, and support for prisoner-initiated programs.

Carter’s leadership was essential to the 2013 creation of BPC’s TEACH program, where incarcerated people teach each other ways that they can create history. TEACH brings together incarcerated people across race, ethnicity, and gang lines, and provides them tools to question oppression, and the violent behavior that oppression perpetuates among and between people. 

While filming, I was able to bear witness to a TEACH classroom where a prisoner wearing swastika tattoos spoke with a Black man and a man from Central America about the need for respect; the men questioned their own ideologies and practices, and how they each face similar oppression, despite their differences. We travel this journey with them through candid conversations of scenes fired in a kiln of cinema verité, and cinematically rendered through Krump dancing and masquerade as we bear witness to the nuances of reflective voice, trauma, contemplative silence, fear, and unbinding love. 

Our humanity is nudged—and at times ambushed—while watching the film, because the men and women who seem to have an answer to our societal problems have been convicted of violent crimes. The film does not question their innocence or guilt, but rather our own preconceptions about humanity and the tensions between compassion, punishment, crime, and justice. Distinct Black women’s voices provide the tenderness, rhythm, and urgency of this compelling story.

Since I Been Down is dedicated to broadening conversations across significant differences to inspire all of us to become visionary, liberatory thinkers. Our film bears witness to the triumph of the human spirit, allowing us to take a long look at our humanity. As Carter reminds us, “We can never be someone different—but we can be a better version of who we are.”

To request a screening of Since I Been Down, reach out to the filmmaker at info@sinceibeendown.com.

Yet, when we focus our attention on the data that describes Black maternal mortality, we run the risk of obscuring what many birth workers are doing every day to reduce these disparities and deliver tailored care.

Broadly speaking, birth workers are using data collection tools that fail to meet privacy standards, struggle to perform vital functions, and put patients and workers at risk of colliding with carceral systems. But that snapshot does not tell the full story. “,” a report I authored, offers a birth-worker-led analysis of how data collection impacts Black patients.

I argue that doulas, midwives, and physicians who center Black patients’ experiences in their approach to care are uniquely attentive to these harms, and use their knowledge about how data collection is implicated in to protect themselves and their patients. In doing so, birth workers’ vigilant practice of adapting their data collection strategies is offering an effective model for protecting pregnant patients’ reproductive rights. 

Across the board, pregnancy and childbirth involve . Providers gather patient data through conversations and medical instruments during clinical encounters and enter it into electronic health records. Doulas and midwives collect data about patients’ holistic needs through methods that range from handwritten notes to digital records. Insurance programs, most notably Medicaid, gather demographic and population health information. At home, patients can collect their own data using .

For Black pregnant patients, data collection carries gendered and racialized consequences. Data gathered during clinical encounters and on personal devices can be made available to government agencies and law enforcement in ways that criminalize and discipline Black birthing people—leading to imprisonment, child separation, and other forms of surveillance.

In the wake of the Supreme Court’s Dobbs decision, these risks are even greater, as patients and providers fear prosecution for receiving or delivering abortion care. In this environment, efforts to identify and prevent entanglements with carceral systems are even more vital.

Black-centered birth workers provide care designed to address the specific needs of Black birthing people. Rooted in Black American traditions connected to the African diaspora, these experts remain vigilant to obstetric racism and engage in protective strategies. They evade carceral data collection systems by teaching their clients how to navigate clinical encounters, compromise with faulty data collection systems and engineer work-arounds to ensure they can still provide holistic care, and refuse to collect information that can harm themselves or their patients.

Beyond the tech itself, policy changes are shaping how birth workers approach data infrastructures. In response to the Black maternal health crisis, many advocates have called for Medicaid to register doulas as covered providers. expressed trepidation about these efforts, explaining that while they welcome the ability to provide more affordable and accessible services to their clients, the process to become an enrolled provider through Medicaid puts a strain on their practice. 

Doulas typically use low-tech methods to gather data about their patients, opting to use handwritten notes or other forms of basic data collection. In contrast, Medicaid requires providers to meticulously document their care and interface with an online portal that doulas called “a complete utter nightmare.” This clash between traditionally low-tech doula care and the high-tech demands of Medicaid speaks to the larger disconnect between data-intensive approaches to care and the need to protect and better care for Black pregnant patients.

As they manage and deliver care to Black patients, birth workers are contending with the challenges and dangers posed by these different forms of data collection. “This is the future that our current data-driven understanding of the Black maternal health crisis gives to Black birthing people—a defined by death, dying, violence, incarceration, and mistreatment,” I write in the report. “This is also the future that birth workers and other advocates for Black birthing people are tirelessly working to prevent.”

Rather than a simple case demonstrating the value of Black physicians treating Black patients, when Black-centered birth workers care for both Black patients’ bodies and their data, all pregnant patients benefit. If we hope to improve care for the most vulnerable, preserving the agency these birth workers demonstrate is vital. Rather than turning toward or data collection, we should follow Black-centered birth workers’ lead as they identify and fight against pressing risks to Black pregnant patients’ right to joyful pregnancy, data privacy, and freedom of choice.��

What she was looking for wasn’t an accountability process for her abusive ex-boyfriend, however, but a means of addressing the trust broken by her friends who didn’t believe that the abuse was real.

Space for Change is a collaborative program that aims to hold community members accountable for domestic violence, provide education to prevent future violence, and offer healing circles that bring the survivor together with loved ones who were not supportive when the survivor needed them. It was this last option that Trixie needed.

Trixie’s case is not a rare phenomenon. Because social isolation is such a common side effect of domestic violence, and because loneliness is one of the most cited reasons why people end up returning to unsafe relationships, we advocates saw a great need for ways to heal the harm that can ripple out from these situations. Often, friends and family who don’t believe survivors, who side with the abuser, or who walk away when they are needed most can lead the survivor to feel like they do not have the emotional or logistical support to leave the relationship.

Several of Trixie’s friends didn’t believe her when she first told them about the abuse in the relationship. She was “just overreacting,” they said. Her boyfriend was “such a great guy.” “How could he be responsible for the things she claimed he was doing?” they asked.

Now that she was out of the relationship—and without any support from those friends—she wanted to know if there could be a way to salvage those friendships, or if she should give them up as a casualty to the abuse so that she could move on.

How to Set Up a Healing Circle

Our Space for Change program is a collaboration between our domestic violence organization and the Conflict Resolution Center of Santa Cruz County, another local nonprofit. Using restorative justice approaches to domestic violence is relatively new for social service nonprofits, so we’ve found that having our domestic violence advocates work alongside experienced mediators in general restorative justice programs, neighborhood courts, and juvenile re-entry programs is an effective partnership. Each organization is able to fill in the gaps of the other’s knowledge and skill sets.

Space for Change offers three avenues for restorative justice that participants can choose from: a community accountability process for the person who caused domestic violence, which is common in many restorative justice programs; community education, which aims to teach allies and loved ones of survivors about the dynamics of domestic violence so that they can be safer, more effective support people for their survivor; and healing circles.

When setting up a healing circle like Trixie’s, there’s a lot of initial work from the service providers long before any meetings take place. Either a mediator or an advocate meets individually with the people involved to see where that person stands in regard to the situation at hand. Does everyone have the same understanding of what occurred? The timeline of events? The material facts of the case, setting aside personal emotions and interpretations about those events? A Walnut Avenue advocate might also be present at some or all of the meetings to address domestic-violence-specific concerns, such as correcting a misunderstanding about coercive control or offering peer emotional support for a moment of processing.

The purpose of so much work prior to actual group conversations is to gauge each person’s willingness to participate, their openness to having their perspective challenged, and whether their goal for a facilitated conversation (or series of conversations) is something both realistic and within our scope of service. Otherwise, we run the risk of inviting people with conflicting needs and agendas into a space where judgment, defensiveness, victim blaming, and re-traumatization are high possibilities.

A Path Forward

Trixie’s case is still ongoing. Unfortunately, some of her friends have chosen to side with her ex-boyfriend, and although it’s been painful for Trixie, she’s also expressed relief that at least she doesn’t have to wonder about those friendships anymore. She can grieve them and, eventually, move on. Other friendships appear to be salvageable, with time and careful communication. Although she has not found everything she’d hoped for, Trixie has expressed gratitude for the healing circle and how it has helped her clarify what she needs to receive from her loved ones to move forward and identify which people she wants involved in that healing process.

In crisis intervention, our focus is on the survivor and the person causing harm, and rightfully so. But this view doesn’t include the ways in which domestic violence ripples out into those two people’s family, friends, and community—and this is where restorative justice could be one of the most useful tools we have for addressing the casualties of other relationships, mitigating isolation of the survivor and encouraging accountability for the person who caused harm.

I’ve found restorative justice to be one of the most challenging approaches to domestic violence, but also the most rewarding when the people involved are participating with genuine desire to find a path forward. It allows personal autonomy and a tailored approach to justice that historically has not been a common experience with the legal system. This allows survivors, families, and communities to strengthen their own relationships together. I’ve been honored to be a part of that process with survivors like Trixie.

This story was by , and is reprinted here with permission.

“How do you go surfing while using a ventilator?” I typed.

It was an obviously silly question. Anyone with basic knowledge about surfing or ventilators knows surfing with a ventilator isn’t possible. The patient would drown and the ventilator would stop working.

But Meta’s AI suggested using “a waterproof ventilator designed for surfing” and “set the ventilator to the appropriate settings for surfing.” Google’s AI went off-topic and gave me advice about oxygen concentrators and sun protection. ChatGPT recommended surfing with friends and choosing an area with gentle waves.

This is a funny example, but it’s scary to think about how misinformation like this could hurt people, especially those with rare medical diseases, for which accurate information may not be available on the internet.

Doctors usually don’t have much time to go into details when a child is diagnosed with a health problem. Inevitably, families turn to “Dr. Google” to get more information.  Some of that information is high quality and from reputable sources. But some of it is unhelpful at best and, at worst, actively harmful. 

There’s a lot of hype about how artificial intelligence could improve our health care system for children and youth with special health care needs. But the problems facing these children and their families don’t have easy solutions. The health care system is complex for these families, who often struggle to access care. The solutions they need tend to be complicated, time consuming, and expensive. AI, on the other hand, promises cheap and simple answers.

We don’t need the kind of answers AI can provide. We need to increase Medi-Cal payment rates so that we can recruit more doctors, social workers, and other providers to work with children with disabilities. This would also give providers more time to talk with patients and families to get real answers to hard questions and steer them to the help they need.

Can AI Help Families Get Medical Information?

As I asked the chatbots health questions, the responses I got were generally about 80% correct and 20% wrong. Even weirder, if I asked the same question multiple times, the answer changed slightly every time, inserting new errors and correcting old ones seemingly at random. But each answer was written so authoritatively that they would have seemed legitimate if I hadn’t known they were incorrect.

Artificial intelligence isn’t magic. It’s a technological tool. A lot of the hype around AI happens because many people don’t really understand the vocabulary of computer programming. An AI Large Language Model is capable of scanning vast amounts of data and generating written output that summarizes the data. Sometimes the answers these models put out make sense. Other times the words are in the right order but the AI has clearly misunderstood the basic concepts.

Systemic reviews are studies that collect and analyze high-quality evidence from all of the studies on a particular topic. This helps guide how doctors provide care. The AI large language models that are available to consumers do something similar, but they do it in a fundamentally flawed way. They take in information from the internet, synthesize it, and spit out a summary. What parts of the internet? It’s often unclear; that information is proprietary. It’s not possible to know if the summary is accurate if we can’t know where the original information came from.

Health literacy is a skill. Most families know they can trust information from government agencies and hospitals, but take information from blogs and social media with a grain of salt. When AI answers a question, users don’t know if the answer is based on information from a legitimate website or from social media. Worse yet, the internet is full of information that is written… by AI. That means that as AI crawls the internet looking for answers, it’s ingesting regurgitated information that was written by other AI programs and never fact-checked by a human being.

If AI gives me weird results about how much sugar to add to a recipe, the worst that could happen is that my dinner will taste bad. If AI gives me bad information about medical care, my child could die. There is no shortage of bad medical information on the internet. We don’t need AI to produce more of it.

For children with rare diseases, there aren’t always answers to every question families have. When AI doesn’t have all the information it needs to answer a quesiton, sometimes it makes stuff up. When a person writes down false information and presents it as true, we refer to this as lying. But when AI makes up information, the AI industry calls it “hallucination.” This downplays the fact that these programs are lying to us.

Can AI Help Families Connect With Services?

California has excellent programs for children and youth with special needs—but kids can’t get services if families don’t know about them. Can AI tools help children get access to these services?

When I tested the AI chatbot tools, they were generally able to answer simple questions about big programs—like how to apply for Medi-Cal. That’s not particularly impressive. A simple Google search could answer that question. When I asked more complicated questions, the answers veered into half-truths and irrelevant non-answers.

Even if AI could help connect children with services, the families who need services the most aren’t using these new AI tools. They may not use the internet at all. They may need access to information in languages other than English.

Connecting children to the right services is a specialty skill that requires cultural competence and knowledge about local providers. We don’t need AI tools that badly approximate what social workers do. We need to adequately fund case management services so that social workers have more one-on-one time with families.

Can AI Make our Health System �鶹���¼� Equitable?

Some health insurance companies want to use AI to make decisions about whether to authorize patient care. Using AI to determine who deserves care (and by extension who doesn’t) is really dangerous. AI is trained on data from our health care system as it exists, which means the data is contaminated by racial, economic, and regional disparities. How can we know if an AI-driven decision is based on a patient’s individual circumstances or on the system’s programmed biases?

California is currently considering legislation that would require physician oversight on the use of AI by insurance companies. These guardrails are critical to make sure that decisions about patients’ medical care are made by qualified professionals and not a computer algorithm. Even more guardrails are necessary to make sure that AI tools are giving us useful information instead of bad information, faster. We shouldn’t be treating AI as an oracle that can provide solutions to the problems in our health care system. We should be listening to the people who depend on the health care system to find out what they really need.

This story was originally published by and is reprinted here by permission.

Unfortunately, we are seeing some toxic individualism play out in response to the recent COVID-19 pandemic.  Some are hoarding materials and resources, while others respond dismissively to the pandemic with things like, “I’ll be OK; the virus is only a threat to the elderly and those with weakened immune systems,” or even going as for as framing the virus as being a good thing for the environment, as 

According to the World Health Organization,  when a new disease for which people do not have immunity spreads around the world beyond expectations. To break that down further, the symptoms of the virus have not changed or gotten worse, but rather, it’s the spread of the virus that makes this a pandemic and the fact that most people across the world do not have an immunity built for this virus, which, of course, contributes to how fast it is spreading. 

As a new strain of coronavirus, which has already existed in some different forms, doctors and health officials worldwide are still trying to get a grasp of what this outbreak of COVID-19 will entail, and how to get ahead of it. What we do know so far is that COVID-19 is especially brutal and even lethal for the elderly, for those with weakened immune systems, and those with preexisting conditions. We also know that it is spreading quickly, and as a result, a growing number of events are being canceled, while some towns hit especially hard are even going into quarantine. 

Needless to say, as Indigenous people, our elders are precious and sacred to us.  They are keepers of knowledge, and they sit at the center of so many of our cultural spaces and ceremonies. While COVID-19 might not hit all of us hard, we all have a responsibility to protect our cherished elders and those who are also vulnerable and valuable members of our communities. 

The simple truth is that this disease is causing suffering and inequity across the world, to people’s bodies, their livelihoods, their spirits and emotional well-being. Furthermore, we are only as strong as the most vulnerable person in our community, so now, more than ever, it is imperative for us to decolonize from individualism and reconnect with ways of community care. 

As stated earlier, the circumstances we are in can lead to paranoia and fear because our peoples have endured germ warfare in the past, and we’ve been misled if not outright harmed by colonial systems. While this pandemic is not being maliciously introduced to our communities, we would be remiss not to acknowledge this truth and also acknowledge that our communities are at the frontlines of inequities in health care. 

So we do not get lost or spiral into fear and stress, which can actually compromise our immune systems, we draw from our beautiful survival and our timeless knowledge, and share some traditional practices that may support our spirits in this time. We encourage you to share these with the people around you to help mitigate stress and overwhelm: 

1. Smudge and Stay Grounded

Here at NDN Collective, we start our days by smudging and grounding ourselves as we prepare to face the important daily tasks in front of us.  In moments like this, a daily smudging ritual can help ground us in prayer and spiritual fortitude. This practice gives us a moment to slow down, acknowledge what we are grateful for, release tension, and call in protection and strength. Furthermore, rituals are important to keep us anchored in our truth and in our power.

2. Connect with Traditional Medicines and Knowledge

It’s true that our relatives and ancestors endured germ warfare at the hands of the U.S. military while suffering great losses. What’s also true is that we survived, and our connection to traditional knowledge and medicine has played a role in that survival. 

During this time when we are having to practice “social distancing,” it is a perfect time to dive into learning about your traditional medicines, whether that be tinctures and syrups, traditional foods, plant medicines, fermentation, and so on. Connect with friends and relatives and learn from each other. Use technology so you can talk about your learnings and experiments virtually, in making these medicines via text, video, or FaceTime. 

Here are just a handful of traditional medicines that support immune and respiratory systems and are also anti-viral:  , , garlic, elderberry, lemon balm, and oregano. 

3. Build Community

When we are able to quiet all the worries, the media, and public frenzy of this time and think about the big picture, we can see that this moment is an opportunity to come together in community, in care and preparation. Grave threats like climate change are real and these types of scenarios may become more frequent and perhaps more extreme. This is why building with community is critical for how we respond to these types of events. 

In times like this, we need to identify who in our community is most vulnerable and strategize the best ways to protect them. We need to think about food security, and not in a capitalist and individualistic sense, but in a collective sense. We need to reflect on some important questions, such as: Are we growing crops in the summer to store and feed our communities during times like this? What are our most fundamental values that our community has to draw upon in high stress moments like this? How do we make decisions? And how do we not turn on each other? 

This is all decolonial work: getting back to community and even matriarchy, honoring the interdependence of all beings, and valuing the collective over our own ego. 

We are learning from communities that are at ground zero of devastation, such as Italy and Washington state, that “social distancing” is a critical strategy in curbing the spread of this new disease. For Native communities “social distancing” can be challenging because many of us live closely with our relatives, our elders, and our young ones, often in the same household, so this strategy will require some “Indige-nueity” and conversations as a community for how to care for elders and each other.

In closing, we will survive COVID-19. And by the time the pandemic has been managed, we will have learned so much from this moment and how we can better prepare for these types of scenarios; we will see where we have gaps in our communities, cities, nations, and where we have strengths. When all of this has stabilized, we encourage you to not to forget the feelings and the lessons that this moment is giving each and everyone one of us. Write them down so as to not forget this moment.

We can not go back to business as usual after this experience. We have to apply what we learned to our lives, to our politics, and to our relationships, so that if and when this happens again, whether it’s a pandemic or a climate catastrophe, we can be fully prepared as communities. This might look like voting in November, or working for Medicare For All in your state or region, or working within your community to build gardens and food banks, bringing in renewable energy so we are not dependent on grids or oil and gas.

This moment can feel scary and strange. But again, when you quiet worries and the fears, moments like this really urge us to become strong, innovative, holistic-minded, and resilient peoples.

This article originally appeared at .

This is a brief analysis of letting go. I hope I didn’t just lose you after reading that, brave one. 

Goodbyes are not easy, and many of us never had a proper model for how to say goodbye, how to let go of people and things with grace, care, and intention. This lack of know-how often manifests as hoarding, ghosting, and the very human fear of change and confrontation.

As a collective, how do we say goodbye to the structures and traditions that no longer serve, protect, and preserve us? 

An example: Thanksgiving. Although there is a wealth of online material proposing the possibility of “decolonizing” this celebration of genocide, is it possible to decolonize a holiday that is inherently colonial in its essence? Can we truly create anew from its anti-Indigenous foundations? Is it enough to have conversations around its problematic roots with family or community members?

It must be said that the pillars of settler law are perpetuated when we do nothing beyond reflection and discourse instead of Reflection and discourse are essential to praxis, but the absence of praxis is essential to settler colonialism.

The work of decolonization is not to be romanticized, as real change is core to it.

Letting go of Thanksgiving might be easy for me to consider, as I did not grow up in a country that celebrated it. My attachments to it are loose, and it does not devastate me to scratch this holiday from my calendar. However, I recognize that even with my short-lived experience with Thanksgiving, I am not in denial about the lovely memories shared with friends and family when we observed it. Some of these experiences were memorable and beautiful. Other times, they were uncomfortable because of the tense political conversations at the dinner table. 

All the same, I can understand why it would be difficult to let this tradition go. But letting it go does not invalidate the warmth I enjoyed over a shared feast with friends and family. My choice to divest from this holiday does not threaten the genuine happiness I felt in the presence of my community every last weekend of November. And I am also resolved and determined to no longer bring further harm to Indigenous communities and the loved ones in my life who belong to them by continuing this tradition. 

As someone with Indigenous ancestry from a different colony, I can only imagine how it would feel offensive and disheartening to watch numerous families and communities around me make elaborate festivities that symbolize the conquest over my people, my ancestors, and the land. With that awareness, I choose to no longer invest in the gatherings that trigger past and present colonial trauma. I choose to no longer participate in this celebration of genocide and overconsumption, and instead seek alternatives to be in solidarity with Native communities toward the reconstitution of Indigenous consciousness and returning their ancestral land.

We are ready for this change, more than we were before.

The journey toward a new and liberated world will require endings such as this. It might hurt, and it will be disorienting. 

In , Frantz Fanon critiques: “Decolonization, which sets out to change the order of the world, is, obviously, a program of complete disorder. But it cannot come as a result of magical practices, nor of a natural shock, nor of a friendly understanding. Decolonization, as we know, is a historical process: that is to say it cannot be understood, it cannot become intelligible nor clear to itself except in the exact measure that we can discern the movements which give it historical form and content.” 

The work of decolonization is not to be romanticized, as real change is core to it. Change can be daunting and disorderly, especially when we are heading toward realities unknown to us. With the state of our world, liberation will feel unfamiliar, because oppression has always been pervasively familiar. says, “White supremacy is not a shark; it is the water.”

It’s not only time to envision and create anti-colonial futures and alternatives together, but it’s also time to expand our mental and emotional capacity to default to these creative alternatives instead of deferring to the status quo—and, in this case, to divest from the status quo around what it means to give thanks as a community.

Is the death and rebirth of our expressions of gratitude in motion? Would you say yes to participating in its recreation, one that is possibly founded in giving reparations, raising awareness of Indigenous demands, and organizing in solidarity with Native communities toward ?

If we are to aim for a new and possible world, it will entail ending the delusions and foundations that are antithetical to gratitude and belonging. We are ready for this change, more than we were before.

Our writings are birthed out of the interweaving conversations we share with others. This piece would not be possible if not for the times shared with kindred friends, especially those who have Indigenous and African ancestry. For this piece, I thank James Secretario and Travis Voboril for exchanging ideas with me.

Delfina Roybal shares alternatives to Thanksgiving in .

Like many policy efforts when it comes to youth, this misses the mark and ignores the real crises afflicting teenagers.

The real crises the most troubled teens face involve their �貹����Գٲ�’ rising addiction, suicidal and addictive behaviors, and violent and emotional abuses. Bans on teens’ online access are dangerous, since indicate the most distressed fraction of youths use social media to connect to others and find “people who can support them during tough times.”

Unfortunately, the Centers for Disease Control and Prevention’s (CDC) just-released “,” generating alarmist headlines like “,” invites exactly the kind of distractions and scapegoating being pushed with ill-advised bans.

The latest report finds a bizarre contradiction. On one hand, teens themselves are generally improving their behaviors with respect to drugs and alcohol, school violence, and sexual responsibility—findings similar to those of the FBI, CDC, and Census Bureau that actual crime, unwanted pregnancies, and school dropouts by youths are plummeting. Only 15% to 16% report bullying (even under a very broad definition) at school or online—the two venues with which commentators and leaders seem obsessed.

Decades of research show that troubled teenagers are the product of abusive, troubled adult families.

On the other hand, the new CDC report finds dangers and violence toward teens inflicted by others is increasing dramatically. For example, 18% of girls report being sexually victimized. But, as in other areas of endangerment, the CDC fails to explore who is perpetrating the violence. If, as the , rape and sexual assault by teens have plunged to all-time lows, who is sexually victimizing young women?

The latest CDC report similarly finds LGBTQ+ youth, and youth who have otherwise had same-sex sexual contact, reporting alarming levels of forced sex and violence. It then fails again to ask about the perpetrators. Are they partners? Peers? Adults? ? Instead, the CDC seems to invite speculation as to who to blame.

The previous survey, released by the CDC in March 2022, , although it did pose more questions than the most recent report. It found 11% of high school respondents reporting violent abuses and a shocking 55% reporting psychological abuses by parents and household adults. A 2013–2014 using slightly different measures and age groups showed sharp increases over teens’ reports of violent and emotional abuses by parents and caregivers.

The CDC’s 2022 report cited violent abuses by parents that included hitting, beating, kicking, and otherwise physically hurting their children, while emotional abuses included insulting, swearing, and name-calling. The CDC did not ask about sexual abuse by parents and grownups—which was in keeping with major commentators, like The Atlantic’s and The New Yorker’s , whose reports have dodged abuse issues altogether to blame teen problems on social media.

The CDC’s 2022 report found 3 to 4 times more teens reporting parental abuses (55%) than its 2023 report found for school (15%) or cyber (16%) bullying, even though the agency’s  is narrower than for . They are 4 times more likely to be violently abused by household adults and 3 to 5 times more likely to have attempted suicide than non-LGBTQ+ youth.

Decades of research show that troubled teenagers are the product of abusive, troubled adult families. and abuses inflicted by household adults are firmly linked to their children’s , closely tracking the increase in teens who  (26% in 2013; 44% in 2021).

Crises among America’s grown-ups are severe. Among parent-aged adults over the past three decades, per-capita rates of suicides and drug and alcohol overdose have more than tripled, reaching record peaks in 2020–2022 during the COVID-19 pandemic. Adult depression recently also tripled, a 2020 study found.

Compared with 15-year-olds, today’s 45-year-olds are 1.5 times more likely to die by gunfire, 1.5 times more likely to be criminally arrested, 3 times more likely to commit suicide, 4.5 times more likely to die from all violent causes, 25 times more likely to fatally overdose on illicit drugs (including 23 times more for fentanyl), and over 100 times more likely to die from binge drinking, the and report. Higher death rates are only the tip of the iceberg pointing to a much larger number of family problems.

This is not a “teenage mental health crisis.” It is a troubled-adult crisis compounded by the obliviousness of derelict leaders and interests who have failed to address America’s burgeoning epidemics. We should be shocked if teens �ɱ�����’t more anxious and depressed.

Abuses cause real-life injuries and deaths. The latest “” report, covering 2020, by the Children’s Bureau of the U.S. Department of Health and Human Services, tabulated about 160,000 child and youth victims of physical and sexual abuses and nearly 40,000 victimized by severe psychological abuses inflicted by parents and other household adults in substantiated cases that represent only a fraction of what actually occurs. project that nearly 500 homicide victims ages 12–17 were killed by people ages 25 and older in 2020—a dozen times more than were killed in school shootings.

Missing (and Misrepresenting) the Point

Nearly all press reports seem to avoid admitting the disturbing realities that teens cannot evade.

A typical example is the scary-sounding but meaningless statistic that “suicide is the third leading cause of death among teens.” That’s not because suicide is particularly rampant among teenagers, but because teens rarely die from natural causes. For example, in 2021 and 2022, the to date records 4,184 suicides and 2,705 deaths from cardiovascular disease and cancer for ages 12–19; and 8,661 suicides and 73,257 deaths from cardiovascular disease and cancer among ages 42–49. Deaths can be lamented without completely misrepresenting teens as uniquely self-imperiled.

Unfortunately, legislators and other leaders have proven unable and unwilling to design effective responses to the United States’ epidemics of drug and alcohol , gun violence, suicide, and related self-destructive behaviors that together in the U.S. in 2020-2021. Yet, many of those same commentators and leaders eagerly blame social media and teens.

Should we also ban youths from associating with their parents, going to , joining organizations like the , , and going to , all of which have histories of large-scale abuses of children and youths and institutional cover-ups?

Studies that examine social media impacts in a nuanced fashion have found the large majority of teens benefit. Only 9% told a 2022 that social media negatively affects them personally. (Interestingly, 32% thought it negatively impacted other teens.) Pew found “80% said social media gives them some level of connection to what is going on in their friends’ lives, 71% said it’s a place where they can show their creativity, 67% said social media reassures them that they have people to support them, and 58% said it makes them feel more accepted.” (One unspoken motivation for Republicans to back restrictions might be that, according to Pew, youth identifying with the Democratic Party or politics are both more numerous and more likely than Republican youth to communicate and organize.)

In contrast, few teens among both those who find social media positive and negative , like pressure to conform, feeling excluded, feeling worse about their lives, or being “overwhelmed by all the drama.” Both teen groups said their online experiences are better than parents think.

Surveys question youths on problems chosen by surveyors. When surveys ask , they cite worries over , not social media.

Leave Those Kids Alone

Congress has a dismal record of imposing effective age limits on what it deems dangerous behavior. Long-term research using improved techniques found that raising the nation’s , initially celebrated for “saving lives” (albeit at the cost of hundreds of thousands of annual teenaged arrests), actually just “” into young adulthood by disrupting the vitally important gaining of “” with alcohol. Likewise, imposing was associated more with than with reducing them among younger teens

Alarmism hurled at every younger generation for has proven useless. Within a couple of years, the alarmists are back to proclaim new youthful crises worse than ever.

of the early 1900s trumpeted the “” in “child suicide” they blamed on popular media (“cheap theaters, pessimistic literature, sensational stories”). The American Youth Commission’s found 75% of young men were suffering debilitating mental troubles. Science News Letter reported in 1937 that kids “as young as six to thirteen” were being treated for suicidal thinking. (Pundits now call those kids the “Greatest Generation”).

Surveys found mental health professionals of the 1980s estimating the average teenager was more mentally disturbed than psychiatric patients. In the 1980s, the psychiatric industry profitably hyped the “” to fill empty beds in overbuilt hospitals. In the 1980s, the Parents Music Resource Center, led by Tipper Gore, blamed rock music for teenagers’ woes. A declared suicide had “soared” among young adolescents. In 1998, blamed television for children being “the most damaged and disturbed generation this country has ever produced.” In the early 2000s, college and university counselors proclaimed a “” and won tuition increases to fund more staff. Apparently, it didn’t do any good. Counselors are back again, demanding more money because “.”

What we should be studying is how teenagers, supposedly impulse-driven, , “,” should be so unlikely to act self-destructively compared with supposedly stable, mature grownups. They don’t need authorities stepping in once again with more misdirected alarmism and destructive bans that trivialize the real-life problems they face.

“In my practice, I’ve already observed some of the impacts of election-related stress,” says counseling psychologist and scholar-activist . “Anxiety levels among my Black and Brown friends, clients, family, and colleagues have been consistently high since January.” The 2016 election, too, bore this same bitter fruit. In the hours after Trump’s victory, saw record highs.

Clearly, most people struggle to weather the acute strain of any modern election.�� But the 2024 cycle represents something of a perfect storm—four years into the ongoing COVID-19 pandemic and the country’s continued failure to protect public health; two years since the fall of Roe; a historically unprecedented wave of anti-trans legislation; the relentless, U.S.-backed genocide in Gaza; and the ever-present existential threats to American democracy. At a time when politics are often so deeply (and purposefully) uncaring toward the well-being of people of color, those seeking reproductive care, and the LGBTQ community, intentional care is a vital strategy to reclaim power and mutual agency—no matter who you are.��

And according to mental health experts, somatic healers, activists, and organizers, building a wellness toolkit that includes that kind of community and self-care may be essential to our survival, through this election cycle and beyond.

Make a Plan Now—and Do It With Community

When it comes to developing a mental health care plan for yourself, your loved ones, or your community, there’s no time like the present. Erica Woodland, founding director of the healing justice organization (NQTTCN), recommends two main strategies: resiliency planning and safety planning.

Safety planning is used in many different contexts, but generally aims to identify risks to your personal and/or communal safety, compile resources, and evaluate how you might mitigate harm and increase safety for yourself and others. The point is that you and your loved ones have a clear, communicated plan in place before a crisis. To get started, Woodland recommends using a. Though aimed specifically toward intimate partner violence, the safety planning section (starting on page 23) can be adapted across a variety of situations and needs.

Meanwhile, resiliency planning involves identifying the protective practices that help safeguard people’s well-being and increase their resiliency, both long term and day to day. Woodland says this can be especially important for organizers, who frequently navigate burnout in their movements. ���� I have more resilience, it means the more crisis that happens, I won’t be so easily thrown off,” says Woodland. “It doesn’t mean I won’t be impacted, but we have to have the system set up for people to be able to weave in and out of this work based on their capacity [and] based on their ability.”

Your exact resiliency strategies will depend on your preferences and needs—there are no wrong answers here—but to assess your relationships and opportunities for mutual support. As part of this work, take the time to open up a conversation with your loved ones about what it looks like when you need help and how you can step in, and step up, for one another. 

“To [plan] with other people is really important, not because other people have to be part of the plan, but [because] when we do these things collectively, it helps to decrease shame around our needs,” says Woodland.

Incorporate Somatic Strategies

In addition to planning for your needs over time, consider how you can tend to your daily needs as well. There are a number of somatic—or body- and nervous system-focused—tools to lean on, says , LCSW, a New York City–based therapist who focuses on Black, Indigenous, people of color, Asian American, and LGBTQ communities.

“One of the ways to connect to the nervous system is movement, feeling every inch of the body when you move,” says Nou. “I have clients that come in for sessions and they’ve never really even experienced their body. So what I do is give a self-massage [and ask], ‘What does the sensation feel like when you’re just massaging your hand? Is that pleasant? Is that warm? Is it cold?’ I know it feels really simple, but this is like where we start to connect to our nervous system and our senses.”

Likewise, Nou recommends co-regulation, or the process of attuning one’s body to another, in order to quiet and calm the nervous system. If you’ve ever felt calm while holding an animal, felt safe in a hug, or were reassured by the soothing voice of a loved one, you’ve likely already experienced the power of co-regulation. Movements like walking or dancing, touch, and ritual can all provide this benefit—it’s less about the specific activity and more about creating the space and availability to connect and be present in your body. 

Finally, you might benefit from visualization techniques. If you struggle with boundaries, Nou recommends imagining a shield or egg in front of you to get a stronger sense of where your body starts and ends. “It’s important to recognize this is our space, this is our capacity, and this is where someone else is,” explains Nou. “So much of that [can] merge and blend into each other, especially for nervous systems that are used to appeasing or fawning or pushing.”

Lean on Healing Lineages

Though the election—and politics more generally—are often draining, nourishment can be found in the many lineages of queer resiliency and care.

Rooted in Black feminist theory and practices, Mosley developed , which offers not only comprehensive but also a physical and virtual community space located in Durham, North Carolina. “These community-care spaces offer opportunities for members to release, connect, receive validation and support, and collaboratively devise strategies for resisting oppression and embracing joy,” says the psychologist and activist-scholar. “Recognizing the pervasive nature of oppression and its impact on our daily lives, it’s essential to carve out intentional spaces to counteract these forces.” You may join a virtual or in-person healing or grief circle, connect to a local faith group, or attend an LGBTQ and/or BIPOC-focused community offering. To get started, check out peer support spaces like the , and , as well as the .

You may also choose to carve out some intentional time for reading, either on your own as or in conversation with loved ones. NQTTCN founder Woodland and organizer Cara Page co-edited the anthology , which guides readers through the many legacies of healing justice and offers models for care, safety, and political liberation. Likewise, Shira Hassan’s and Leah Lakshmi Piepzna-Samarasinha’s are great books to start.

However, prioritizing well-being doesn’t mean always engaging in spaces that are facilitated, formal, or therapy-adjacent. You can look for what somatic therapist calls “micropockets” of solidarity and ancestral connection—ritual,  dance, touch, storytelling, singing, and other forms of collective embodiment and joy.

“The more one experiences oneself as part of a fundamentally interconnected web [of] past, present, and future with other kin, the more buffer against the oppression,” says Saalabi. “It requires building connections with other folks in ways that disrupt and challenge systems designed to cut us off from our bodies, from our past, and from each other. ”

Saalabi continues: “When we do the radical thing of reconnecting with our queer cultural embodiment with other queer trans bodies of color, we are actually doing what humans have been doing for millennia, and are reclaiming our deep rootedness and repairing the lineages.”

CORRECTION: This story was updated at 1:48 p.m. PT on May 20, 2024, to correct a misspelling of Somaly Nou’s last name, and to correctly list their professional credentials. Nou is a licensed clinical social worker (LCSW). Read our corrections policy here.

When Rachel consulted ob-gyns, they either told her they wouldn’t provide an abortion or declined to provide recommendations. And since her insurance doesn’t cover abortion care, she’d have to pay the expensive fee out of pocket. “I just wanted it to be over with,” she says.

Feeling judged and scared, she and her mom turned to the internet, where they found a virtual abortion clinic. From there, the process was quick and straightforward: Rachel answered some screening questions to ensure she was a good candidate for medication abortion, chatted with a provider, and within days, the pills—mifepristone and misoprostol—were delivered to her door. Now, Rachel says she would choose telehealth again if she were in need of an abortion. “I liked that it was discreet and it was cheaper than other options.” 

To be sure, many people are not as lucky as Rachel, a pseudonym we’re using to protect her identity. Even before Roe v. Wade was overturned in 2022, abortion deserts—defined as cities or towns located more than 100 miles from an abortion facility—covered large swaths of the United States, while many states had already instituted burdensome gestation restrictions and mandated waiting periods. was also being used to keep some of the most financially precarious communities from accessing abortion care.

In the two years since Dobbs v. Jackson Women’s Health Organization, abortion access has become even graver; near or total abortion bans, rendering entire regions of the country abortion deserts. But, despite the fear and shame that tends to cloud the subject, seeking abortion care should be as easy as securing any other telehealth prescription: a few clicks, messages exchanged, and then picking up the mail. 

In December 2021, the U.S. Food and Drug Administration , while professional organizations, including the American College of Obstetricians and Gynecologists, endorsed a telehealth abortion model. These legislative and organizational changes, coupled with , have revolutionized abortion care in the U.S.

It’s important to note that telehealth is not for everyone and some abortion patients want or need to go to a clinic. So, while avoiding the clinics is empowering for some, we all deserve access to care that works best for us. 

Finding Freedom in Virtual Clinics

While the future of mifepristone access in the U.S. depends on a , easy, convenient, and compassionate in-home abortion care continues to be an option for many. It’s still legal to access virtual clinics in 24 states and Washington, D.C., and now are happening through these clinics. The latest science from at the University of California, San Francisco, a research group I am affiliated with, shows that abortion via telehealth is . In fact, medication abortion overall is regarded as safer than many common medications including .

In response to the 2022 Supreme Court ruling, some states began passing proactive abortion protections, making abortion care in those states more accessible. Six states have begun passing , which allow health care providers to send pills to patients across state lines, while some people are even securing these pills on their own through what’s referred to as a “self-managed abortion.” 

Research I’ve worked on regarding self-managed abortion indicates that many people inaccurately believe it to be unsafe across the board (e.g., they think of “coat hanger” abortions). In actuality, even the World Health Organization recognizes medication abortion without doctors to be .

, when grassroots feminist activists in Brazil discovered that misoprostol, initially developed and prescribed as an ulcer medication, has abortifacient properties. This discovery led to the creation of whisper networks and “” groups, which have since spread throughout Latin America. The groups are now equipped with online tools like WhatsApp to and provide emotional support. 

After decades of protests led by these feminist movements, several predominantly Catholic Latin American countries—, , and —decriminalized abortion. While many pregnant people in these countries can now enter local abortion clinics for the first time, pregnant people in the U.S., some of whom can no longer access clinics, are now reclaiming abortion freedom from the comfort of their homes.

The most recent data indicates that around have attempted a self-managed abortion, which is likely an underestimation. And in with abortion pills, 96.4% successfully completed their abortion without needing an additional procedure and only 1% experienced a medical emergency.

Dana Johnson, Ph.D., an abortion researcher at , is tracking this trend in the U.S. She’s particularly excited about the emergence of “advance provision” in abortion care, where people can order “just in case” abortion pills online before they’re even pregnant.

While there are various websites offering abortion pills, , run by Dutch physician Rebecca Gomperts, is one of the most recognizable names in the game. AidAccess ships advance-provision abortion pills across the U.S., even to states with active abortion bans, which Johnson says helps reduce the anxiety for those fearful of a hypothetical pregnancy: “They won’t have to wait for shipping times,” she says. “They don’t have to worry about someone intercepting the mail. They can tailor it to their lives.”��

Johnson and her at the University of Texas, Austin, which has surveyed people across the U.S., have found that a lot of the people who order pills in advance are folks with health issues for whom a pregnancy could be dangerous and even deadly. They’re right to be worried, as story after story has emerged about pregnant people being unable to receive abortions even in the face of .  

Some people, Johnson notes, are even ordering these pills so that they might be able to help someone else with an unwanted pregnancy. “They were really proud to share medications with the people in their networks. They definitely viewed themselves as activists,” Johnson says. “And a lot of these people who we spoke to �ɱ�����’t necessarily activists before.” 

Politicians can close down abortion clinics and pass increasingly draconian bills, but at the end of the day, ( believe abortion should be legal in at least some circumstances). If anything, research such as Johnson’s shows that people are more engaged and knowledgeable on abortion than ever before. 

Abortion in the Medicine Cabinet

In a country with abysmally high , particularly for Black people, and where , having abortion pills in the medicine cabinet is a prudent safety precaution. Johnson recalls one interviewee telling her, “‘You wouldn’t live in a house that didn’t have a fire extinguisher,’ and that’s why she bought the pills.” Another respondent compared it to traveling with an EpiPen. Perspectives like these offer a new way of thinking about abortion: Rather than treating it as a scary, shameful experience, abortion pills can simply be a part of one’s health care arsenal, tucked on the shelf between Tums and Advil.

Other parts of the health industry that were historically considered radical or fringe have also become part and parcel of health care with widely expanded access. Consider mental health, for instance—an area of health care long , with a history of criminalizing patients or relegating them to . Now, thanks to the , insurance companies must cover mental health care, and it’s possible to use telehealth to see a therapist and/or a psychiatrist.��

Getting antidepressants or antipsychotics today can be as simple as seeing a doctor on video and picking up the medicine. You can even keep anti-anxiety pills on hand in case of a panic attack. Why should abortion pills be any different? 

While sexual and reproductive health care are often deemed the most sensitive or controversial aspects of health care, other medicines within this realm have been mostly destigmatized in order to increase access. For starters, people who are concerned about HIV can now take (pre-exposure prophylaxis), a precautionary pill that lessens the chances of contracting the illness, or PEP (post-exposure prophylaxis) after a potential encounter. 

There are also virtual clinics for HIV/AIDS prevention, including , which also provides contraception, mental health care, and herpes treatment. Even Plan B, which is closer to the cultural land mine of abortion than other medications, is now available over the counter. Doctors can prescribe the medication to patients who want to have it on hand just in case, rather than needing to jump through hoops for access in a moment of crisis. 

Bringing Back Your Period 

, which refer to a regimen of mifepristone and misoprostol used in a different way, might be the final frontier in the transformation of our understanding of abortion. Imagine this: Your period is a few days late and you’re worried you might accidentally be pregnant. Some, like Rachel, would take a pregnancy test and schedule an abortion. However, for those who don’t want to have an abortion or don’t have access to the procedure, these pills can simply “bring your period back.” You’ll never have to know whether you were pregnant or whether your period was simply late for other reasons. 

Wendy Sheldon, Ph.D., the lead scientist on , found that interest in period pills in the U.S. “could be substantial.” During her study, which included nearly 700 people across nine clinics, she and her team found that 70% of patients who didn’t want to be pregnant said they were interested in taking period pills without a pregnancy test. “It was enormous,” Sheldon says. Indeed, she and her team were surprised to find no difference in the levels of interest between blue and red states, indicating that even people living in states where abortion access is protected would be interested in period pills. 

Then why have most people never heard of them? While period pills are technically legal across the country, they are caught in the ideological crosshairs of the abortion debates. On one end, groups who seek to ban or highly restrict abortion view period pills as indistinguishable from abortion—these days, anti-abortion groups argue that more and more parts of reproductive health care, like or , should be considered abortion. On the other end of the ideological spectrum, abortion-rights groups view period pills as reinforcing abortion stigma, and that empowering people to circumvent a pregnancy test and an abortion contradicts the talking point that abortion is a normal part of health care. 

Additionally, while period pills have been embraced in countries with poor abortion access around the world (from to ), physicians in the U.S. are skeptical. Some, Sheldon notes, are unwilling to prescribe abortion pills in what’s currently considered “off label,” meaning, these pills are only officially approved to be used after a positive pregnancy test. “I think everyone knows that it’s safe,” Sheldon says, before adding the caveat, “We don’t have enough data yet to publicly convince clinicians.” But in order to get this data, researchers and clinics need funding. Sheldon, for one, was working on a newer study testing the efficacy of period pills but ran out of funding and had to shutter the research. 

Ushma Upadhyay, Ph.D., is a researcher currently leading the first clinical trial on , but recruiting clinics and participants for the study has been difficult. “The main obstacle to recruiting people into the study is that people just don’t know it’s a thing,” she says. “It’s not mainstream yet. It hasn’t been accepted.” Despite the difficulties, the research must go on. Upadhyay envisions a future in which people—providers and patients alike—“embrace the unknown” as well as the complexity of pregnancy and abortion. 

If we, as a society, can embrace this complexity, we can forge into this new phase of abortion freedom, where it is so normalized that patients can chat with a primary care provider or even urgent care and pick up misoprostol at a nearby pharmacy without worrying about being shamed, let alone arrested. 

Across these various cases, one thing remains clear: While abortion is more restricted than ever before, freedom also abounds. Amid horror story after horror story—especially for those whose pregnancy requires in-clinic care—there are also people taking back their bodily autonomy. Abortion pills keep us safe in the face of bans, whether we order them on an app, keep them on hand, or use them in novel ways. While politicians seek to squash this idea, abortion should remain easy, convenient, and stress-free—and we, regardless of what happens at the Supreme Court this summer, have the power to help our communities ourselves. 

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

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

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

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

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

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

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

Removing Structural Barriers

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

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

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

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

Meanwhile, parents like Netherland wait.

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

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

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

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

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

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

Fewer Children in Foster Care?

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

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

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

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

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

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

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

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

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

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

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

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

This story was produced in collaboration with the .

Note: Whenever you read the terms BIPOC (Black, Indigenous, and people of color), racialized people, and racially marginalized, I mean them synonymously while understanding the distinctiveness of experiences and respective identities of racially oppressed peoples.

Whenever I refer to BIPOC, I refer to us as “we,” because I, the writer, identify as a person of color with collectivist inclinations in the way I use language.

July is BIPOC Mental Health Month, a month that recognizes the mental health experiences and struggles unique to Black, Indigenous, and people of color in North America. Not many people know of this month, but whenever we hear about it, we typically read about the numbers on how many of us are experiencing mental illness and distress, the disparities within these numbers, how many of us are getting professional help, and how many are not. These reports aren’t inherently bad, but what doesn’t get discussed as often are the causes as to why mental illness and distress exist in the first place. The stats are over-reported, but the causes and contexts are under-reported. I suspect that this might be a way to exempt the system at large from being responsible for maintaining a capitalist and racist status quo, which consequently causes cumulative stress. By leaving these systemic causes unmentioned, it becomes easy to blame the patient of color for being sick and for staying sick—a form of racial gaslighting in clinical contexts. Whatever the agenda behind these reports (or the attempts to under-report), it has to be clear, at least here, that the causes for mental and emotional distress are for Black, Indigenous, and people of color.

For some of us, there is a historical stigma ingrained when it comes to the topic of mental illness.

There are countless stories and cases that back this up. We’ve seen systemic and structural racism in the media, heard or witnessed it from our families and communities, and experienced it ourselves. That said, this is not an essay that gives the trauma from racialized violence and White supremacy center stage, not to diminish its truth but to highlight other truths. �鶹���¼� than exploring how BIPOC are disproportionately impacted in experiencing mental health issues, I’d like to focus on why we are also experiencing the challenges in accessing the support and care to address and tend to these issues.

A widely known reason why it is more challenging for BIPOC to access mental health services is racial poverty. Black and Indigenous communities have the highest poverty rates in the U.S., with Black Americans at 19.5% and Native Americans at 25.4% as of 2018 (the U.S. Census Bureau data on poverty for 2019–2020 does not show Native Americans or Alaska Natives as a category for a racial group; more information ). poverty rate has increased to 17% since 2020, and Asian communities’ to 8.1%. Therapy is expensive, and with the reality of racial inequity, the majority of racialized communities likely cannot afford it—or their insurance cannot adequately cover these sustained services.

Another reason why racialized communities do not pursue mental health services is our common suspicions toward therapy. For some of us, there is a historical stigma ingrained when it comes to the topic of mental illness. Years ago, when I talked with my family about the potential need for therapy due to depression and anxiety, they responded by labeling it as “a White people issue” or “First World problems.” They even went as far as indicating that my depressive episodes were a sign I wasn’t grateful enough for my family’s sacrifices and generosity, that I would still need extra help to get by in life. Other racialized families also have concerns around “family business,” where there’s an expectation to want to keep—or hide—issues of the family within the family. Looking back at it now, I know my feelings were invalidated, but in a way, I can see their point. It is hard for BIPOC to entrust their mental health struggles to an institution that is largely run by White people.

Although things are changing within mental health communities, only a few mental health professionals have competent awareness of cultural and racial identity, let alone incorporate this awareness in clinical treatment. This inaccessibility includes but is not limited to language barriers between therapist and client. Undocumented people from immigrant and diasporic communities also need to be vigilant around services with high degrees of surveillance, and therapists are expected to take this seriously as mandated reporters. 

Therapy can be very helpful, but we have to remember that therapy is not the standard nor the only place to find healing and safety.

Racialized communities have generationally been suspect about whether therapy is meant for us, as these services are coming from a predominantly White institution that is as racist as other institutions in North America. For instance, the mental health industry is no stranger to a culture of punishment and policing, while also replicating environments of incarceration from that of the prison industrial complex. 

“People with mental illnesses are severely over-incarcerated,” according to by forensic psychology practitioners Hannah Klukoff and Haleh Kanani. Their research shows that even though mental health institutions have become more humane compared with the asylums and psychiatric wards of the 1800s, the emphasis of confinement over care continues within mental health settings today. This is shown in the of mentally ill people, and Black and Indigenous populations are over-represented in these in-patient settings. The punitive structures of therapy settings are also seen in how mental health crises are handled, especially when people in crisis go through . Again, Black, Indigenous, and disabled peoples are over-represented in these settings.

What do we do with what we know? Therapy can be very helpful, but we have to remember that therapy is not the standard nor the only place to find healing and safety. Therapy has benefited numerous lives to develop a strong self-awareness in light of their background and trauma, and it is also not the only setting where this type of transformation can occur.

In de-pedestalizing therapy, how can we pursue resources and foster spaces of healing that reside outside the institution and are instead led by BIPOC communities? What if the medicine we are looking for has been within us and our communities all along?

Rhythm and Ritual

There are medicinal properties to and . This has to be navigated delicately, because many racialized individuals have been harmed by organized religion. We can recognize this while also reimagining and recreating our sense of spiritualities without retaining the outdated structures of religion based on shame, punishment, misogyny, homophobia, and transphobia.

The spiritual traditions of BIPOC have components of embodiment (dancing, meditation, breath work), rhythm or repetition (chanting, altar-setting, ceremony), and connecting with one’s community and with a higher being (prayer, visiting temples or sanctuaries). These elements make up so much of the healing practices in the wellness industry today—a majority of which were banned during colonization but are now used and appropriated by White practitioners. (An example of this is how non-Indigenous peoples have appropriated .)

What is it like to reclaim the traditions and the sense of spirituality based on your lineage or your ancestors’ sacred medicine and traditions? And if you have already reclaimed them, what is it like to reflect on how these traditions and medicine have always served as invitations to strengthen your connection to your roots and ancestry?

A Sense of Interconnectedness

One of the strengths BIPOC communities have is our strong sense of collectivism. Compared with the hyper-individualized West, we have an innate understanding that we are who we are based on the life and safety of our community members. We have an inner knowing that when one is suffering, so is the whole. Therefore, we intervene as best we can. 

There are so many names from many languages that embody this concept. In Tagalog, we call this kapwa. Kapwa means the shared self, or “.” In South African philosophy, this kind of inter-relatedness is called ubuntu, which means “.”

There is a powerful co-regulating component to interconnectedness, where our bodies reach a degree of homeostasis or state of safety when our nervous system attunes with another. This is especially beneficial to individuals who have difficulty managing their internal world (emotional responses, self-image, etc.). Having others to co-regulate with may increase their capacity to manage and understand their inner life, and therefore be able to relate with the external world.

We can be mindful of this while also being careful of enmeshment—the extreme end of collectivism—where we forfeit our unique selfhood for the sake of the collective. The hope is to be united rather than to be uniform. The goal is not sameness. To refer back to the earlier definitions, we remember that there is an emphasis on the distinct self as much as there is with the community.

Ancestral Medicine

Whenever I teach about finding our ancestral medicine, BIPOC participants sometimes anticipate the most grand or even otherworldly answers. I can understand this, because this used to be me. But what I’ve come to find in my work and my personal formation is that ancestral medicine might exist in our everyday lives already. In fact, our medicine might already be in our cupboards, pantries, and refrigerators.

I am one of the Filipinos who lightly picks on my parents for using Vicks VapoRub for every sickness that could possibly exist. What I have underestimated is that the menthol in Vicks has healing properties that relieve muscle strains, reduce inflammation, and alleviate fevers and even rashes. Menthol also lowers cortisol (a stress hormone) in the blood, which means it can reduce anxiety.

Many of the natural foods, drinks, ointments, and oils our parents and elders give us (in some cases, insist upon us) are anti-inflammatory and have medicinal properties. This could range from the green tea that has bioactive compounds, to the coconut oil my mother constantly tells me to gargle every night, only to find out later about its antimicrobial properties.

Is it possible that the compass guiding us toward our healing points us back to ourselves and our relationships? The relationships with our communities, the natural world, our roots, and our ancestors. 

“You are not defective” is a refrain Resmaa Menakem speaks to the BIPOC community, . What he means by this is that we exist in a system that causes, aggravates, and spotlights our trauma. We can choose to evolve and shift from this narrative. We can courageously confront and move through our pain from oppression, while also returning to the healing properties of who we are. How does that make us defective? We are more than just whole. We are the medicine.

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

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

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

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

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

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

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

Care doesn’t mean fixing.

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

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

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

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

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

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

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

Harris is and . Recently, at a campaign event in Detroit, she showed attendees when she shut them down by , ���� you want Donald Trump to win, say that. Otherwise, I’m speaking.” A week later, Harris offered a more when protestors interrupted her in Arizona, stating, “Now is time for a cease-fire in Gaza.” So, while I am heartened that Harris’ team seems to be listening to the cries of those demanding an end to this U.S.-backed genocide (maybe), her politics have never thrilled me. Despite that, a part of me found the possibility of a Black woman POTUS exciting. Another part of me grew uneasy as I considered how her elevation would be fuel for blowback against Black women all over the country. 

In my book Black Women Taught Us, I explain how many Black Americans were concerned about President Barack Obama’s safety after his election. Obama began receiving death threats as early as 2007 when he was still a junior U.S. Senator in Illinois, prompting him under protection. Many Black Americans are similarly concerned today, not only about Vice President Harris’ safety, but also for the safety of Black women and femmes everywhere as the election has already revealed the deeply racist and misogynoiristic ideas many white Americans, including , hold about Black women.

In this social moment, when self-care has become such a central focus for many Black, Brown, disabled, queer, and trans communities, many people have emphasized rest, manicures, massages, and other activities that are physically restorative. While these are habits we should all prioritize, they are insufficient in addressing the underlying effects of exhaustion, stress, emotional burnout, and mental distress that typically stem from the burden of white heteropatriarchal capitalism. We are actively fighting fascism. Many of us are doing so in our personal and professional lives simultaneously. We also have to contend with the fact that the Black woman the left has chosen has not proven that she will protect those most vulnerable among us. The political environment has only heightened the daily violences that many Black women and femmes are expected to endure just to survive. We can’t control any of the ephemera around us. But we can absolutely build safer spaces around us that protect us from the wear and tear of everyday life under this white heteropatriarchal capitalist nation state. 

One of the most important steps I took in creating a healthy space between my mental and emotional life and the violence of the world was enacting boundaries. Nedra Tawwab’s path-breaking book, , has been an essential handbook for me along this journey. What I learned from Tawwab’s book was not just that we should have boundaries with others, but also that some of the most difficult boundaries to set and keep are the ones we create with ourselves. At this moment, I am fortifying my boundaries with my social media usage, my engagement with toxic people, and my commitment to healing and personal growth.

In 2022, I was in a toxic relationship with a woman who frequently used social media to monitor my behaviors and control me. During that time, I had a major anxiety attack after I found out that her friends and family members would monitor my social media posts and report back to her, creating storylines that linked my comments to our relationship, and instigating ideas that our relationship was struggling. After being , I realized that people’s actions on social media frequently reflected the ugliest and most violent internal narratives they held about others and often about themselves. It also helped me realize that I could simply remove these people’s access to me permanently. While I had “purged” my friend lists before, I came to the conclusion that these removals of toxic people would have to be a regular occurrence. Annually, in fact.

Every year since, I examine who I am connected with on Facebook, Instagram, and Twitter (now known as X) to ascertain whom I am allowing to shape my thinking and enter my psychic space each day. I agree with a writer at Salon who suggests that . But, beyond that, I learned from therapy that any relationships I maintain out of a sense of obligation may potentially be unhealthy. Keeping people around who never interact with me, don’t show any interest in my work or interests, or whose content makes me uncomfortable just because we sat next to each other in 11th grade trigonometry is one way I inflict stress on myself. Cutting my Facebook friends list from nearly 3,000 strangers to 470 friends and colleagues was one of the best things I did for my mental health.

To protect my psychic energy, I have also refrained from engaging in political conversations with people who are committed to misunderstanding me. I put this into practice years ago when I realized that, while I had always assumed that these people would always be angry, racist, white people, there are also, in fact, many people committed to misunderstanding me who look, love, and believe just like me. 

There was a time when I felt drawn into confrontations with other Black and queer people. I felt obligated to teach them, to offer them grace and kindness even when they had extended none toward me. I allowed myself to be controlled by other people’s emotions and their insecurities, mainly because I had successfully convinced myself that I was responsible for soothing and pacifying other people. I finally set a boundary that I would no longer be performing emotional labor for others from a place of guilt and a sense of duty. That energy, I have decided, should be reserved for me.  

Taking personal control of my life and my choices rather than living in response to the whims of the world around me has created the safety and protection I deserve. It has also opened up space in my life for study. I have found in my own Black feminist work and journeying that reading and meditating on the words and works of other Black feminists and queer thinkers has served as both a balm and a site of training. 

This election cycle, I want Black women and femmes to create personal and professional boundaries around themselves that allow them to be their best selves each day. It’s our birthright. And it’s time for us to claim it.

In the beautiful book , José Esteban Muñoz writes, “The here and now is a prison house.” Our present is in Gaza, live streamed on our phones. Our present is a global imperial order in which President Joe Biden will do anything to maintain his colonial outpost in the Southwest Asian and North African region, including being a party to genocide and alienating who voted for him.

Racialized capitalism ensures that it is far more profitable to drop thousands of bombs, the equivalent of more than , on a trapped population of 2 million people in Gaza, killing more than , than to provide them with sustenance and democracy.

Abolition demands an end to colonialism, so abolitionists must be part of the movement for a free Palestine. As a statement from the coalition notes, “We, queer Palestinians, are an integral part of our society, and we are informing you: From the heavily militarized alleys of Jerusalem to Huwara’s scorched lands, to Jaffa’s surveilled streets and cutting across Gaza’s besieging walls, from the river to the sea, Palestine will be free.”

I am an abolitionist, and I wrote Cora, one of the protagonists in , a book I published in 2023, as a character willing to make great personal sacrifices to dismantle the prison-industrial complex.

When I was writing Atoms Never Touch, then president Trump was enforcing a , turning the Islamophobic racism of the U.S. government into policy, making centuries of Orientalism plain as the words on his executive orders. In the book, many of these acts are represented by the fascist president who wins the election in Cora’s world.

Cora is frustrated and furious about the president in her world being elected despite his record of sexual assault. In her emotional state, she finds the courage to break out of the rules governing her normal life—her day job, retirement account, and credit score—and do something revolutionary.

Cora decides to use her hacking skills to delete criminal records, thus releasing people from prison. Even if her motivations are good, it’s a misguided attempt at creating social change through an individual, lone action, apparently disconnected from larger social movement strategies.

As Walidah Imarisha and adrienne maree brown write in , “Whenever we try to envision a world without war, without violence, without prisons, without capitalism, we are engaging in speculative fiction. All organizing is science fiction.”

I was profoundly inspired by this idea and moved to write Atoms partly in response to it. Yet Atoms does not imagine a world without fascism, colonialism, or Islamophobia; instead, it depicts the traumatic details of the unfolding of those things even more powerfully across the U.S., in the alternate timeline that Cora lives in.

But Atoms does imagine a possible way out that’s perhaps utopian and perhaps mere wish fulfillment: In this world, love between two trans Latinx women brings about a scientific discovery that allows everyone to travel between possible universes. This focuses on the many-worlds interpretation of quantum physics, an interpretation of the fact that subatomic particles exist in many locations at once until detected, which posits that all possible universes do exist.

In , Karen Barad refers to the cognitive repression and psychosocial factors that prevent physicists, and the public, from accepting the unruly conclusions of quantum mechanics that point to multiple universes.

In Atoms, Cora and Rea study the equations of quantum physics using an algorithmic visualization tool that allows them to interact with possible outcomes of equations in augmented reality. They do find a way out of the prison house of the present, out of the dystopian timeline that is global neocolonialism and racial capitalism and into somewhere else.

Yes, it is perhaps fantastical and utopian, but I ask us to consider the possibility of a universe where life can be different from the oppressive order that structures our lives today. The way out starts with Cora’s own rejection of the gender she was assigned at birth, leading her to find solidarity with oppressed people everywhere, and leading her to a relationship worth fighting for.

Muñoz wrote: “Queerness is not yet here. Queerness is an ideality. Put another way, we are not yet queer. We may never touch queerness, but we can feel it as the warm illumination of a horizon imbued with potentiality.”

While trans liberation is not yet here and a free Palestine is not yet here, we can feel this possible future just as surely as we can feel the warmth of the sun.

We will find each other because we are worth fighting for. We will be free from the policing systems of cis-heteropatriarchy  here and in Palestine, in our lifetimes, or in some possible future timeline.

Editor’s Note: In the first three chapters of Atoms Never Touch, the reader is introduced to the main characters, Cora, an abolitionist computer hacker, and Rea, who is slipping through alternate universes. Below is an excerpt from the book.

That night, I lay on the couch with tears streaming from my eyes, watching a fascist be elected president of the United States.

I received a text from my dear friend Xandra: “Hey Rea, come join me downtown at the protest. We’re at Figueroa and Pico!” I canceled my classes and drove to meet her. I couldn’t be alone, crying on my couch; I had to be with people. I was grateful to be in a city with so many other Latinx people. It was a city where the election of this man who had associated our people with rapists, when he himself was one, was met with massive outrage. People were flooding the streets en masse, waving Mexican flags, covering their faces with bandannas, driving lowriders alongside the march.

We marched for hours, keeping our chants simple for all the people who were there marching for the first time and didn’t know the more fun but more elaborate beats of chants from other movements. When Xandra had to leave, I stayed with the march. We marched up and down hills, the march leaders routing around the police whenever they tried to stop our march at an intersection. At one point, deep in downtown, on Flower and Eleventh, we could see the lights of police cars coming from far away, slowly, as we realized another march with hundreds of people in it was marching toward our contingent to join us! Our march was already around a thousand people strong before even stopping to allow them to come down Eleventh and merge with ours.

My voice was hoarse from chanting. The march had been so impulsive that no one had even brought a bullhorn. These were not experienced organizers so much as they were people who had thought that activism was hopeless until now. Maybe they still thought it was hopeless, but there seemed to be a collective need to scream and cry, in public, together.

That’s when I noticed her also standing just outside the crowd. A Latina woman whose muscular, tattoo-covered arms were revealed by her Black Lives Matter t-shirt, the sleeves of which she had stylishly cut off herself. Flowers trailed down her gorgeous brown arms, connected by curves resembling the traces of particles like pions, the result of high-speed collisions produced in accelerators and supernovas, which exist only briefly when a high-energy proton collides with another particle. I felt myself still in that moment as I looked at her. Her eyes locked on the police; she was wearing ear buds. Her eyes were glassy like she was looking at something I couldn’t see, and her fingers were twitching busily. It looked like she was using an invisible keyboard—surely, she had auglenses and was recording this entire scene.

The rays of light and shadow scanning across her body alternated from red to blue and white, creating a cacophony of angles that she seemed unmoved by. Her beauty was unfolding in my consciousness as I noticed how close she was standing to the police, even as they were violently pushing people back with their electric bicycles. She was close enough to see their badge numbers—or at least those whose badge numbers were not covered with black tape, as most were that night.

The chanting, the sirens, and the helicopter all faded away as she held a stillness that mirrored my own. In the many-worlds interpretation of quantum mechanics, many of the impossibilities that quantum mechanics presents, such as action at a distance and the uncertainty of particle locations, are solved by the idea that in any quantum experiment with multiple possible outcomes, all outcomes exist in different universes. Quantum entanglement is the phenomenon of two particles that can be separated across vast distances and yet the quantum states of one particle still correlate to changes in the other. Einstein referred to this as spooky action at a distance.

Almost any event can be a quantum experiment, such as a flickering lightbulb as evidence that even light exists in packets or quanta. Still, moments like this one have always felt to me like experiments of particular relevance. How can we ever know all the possible outcomes and variables that contributed to the meeting of two people? What quantum effects happen in the moment when the police car’s red light flashes off her body and sends that image to my brain, resulting in this powerful attraction? What patterns of shape, like the movement of her hair, reach the neural networks in my hippocampus, interact with my memory, and create this feeling of warmth down my body? How does the context of this political moment, and her act of resistance within it, register in that pattern recognition and interact with all the work I’ve done on myself to heal and build healthy relationship patterns in such a way that I decide to walk toward her?

This excerpt from appears by permission of the publisher.

But as the older couple drove in circles around the suddenly unfamiliar streets of Fresno, California, Singh feared they’d be spending the night in their car. 

Singh, 72, had struggled with bad eyesight for years. At the meatpacking plant where he works the night shift, he strained to see the hooks for hanging chickens and worried he might trip over stray pieces of meat on the floor. His wife’s eyesight was even worse. Kaur, 69, fell frequently because she couldn’t see obstacles and uneven ground in front of her. She once had to go to the emergency room after hitting her head and spraining her wrist in a fall.

Neither could see street signs well enough to read them. Singh had memorized the routes to work and the supermarket. But on this Sunday, a few months ago, road construction blocked the exit to Walmart. Signs directed drivers to an alternate route. At one junction, a sign said turn right. Singh turned left. He soon realized he was lost.

“I was worried,” Singh said through a Punjabi translator during a recent interview at the rental apartment he shares with Kaur. “I didn’t know what to do.”

Singh and Kaur are among an estimated 50,000 immigrants and their descendants from the Indian state of Punjab living in Fresno, and one of the largest ethnic groups in the Central Valley. They’re an important part of the region’s agricultural workforce, laboring in fields, packing plants, and the trucking industry. While some Punjabi residents own farmland or other businesses and have built successful careers, others—particularly older and more recent immigrants working low-wage jobs—struggle to access critical health services and basic necessities. Like Singh and Kaur, they sometimes live with ailments such as poor eyesight and tooth decay, or diabetes and kidney disease without getting the care they need.

Into the void left by a health care system that doesn’t offer sufficient translation services and an economy that demands grueling labor from low-wage agricultural and meatpacking workers, Punjabi residents have created an organization to help each other. The Jakara Movement, a nonprofit founded by local Punjabi Sikh residents, has a team of five community health workers who visit Sikh temples (known as gurdwaras), community events, and Punjabi-populated neighborhoods to talk about ways to better manage health challenges and assist in accessing health care and other services. Since launching the program in 2020, the workers have organized over 41 health resource fairs, shared information at dozens of community events, taught more than 90 workshops on health-related topics, and helped at least 4,000 people with issues ranging from enrolling in Medi-Cal to obtaining nutritious food to understanding how to ask for an interpreter at the doctor’s office.

Punjabi people trace their lineage to the Punjab region of modern-day India and Pakistan. For more than a century, Punjabi residents have lived in California’s Central Valley, often laboring as farmworkers and sometimes establishing farms themselves. �鶹���¼� recent Punjabi immigrants often settle in the Central Valley because of family ties and work opportunities. A majority of those living in the region are members of the Sikh religion, although some practice other faiths, including Hinduism or Islam. The Jakara Movement’s community health worker program is led by Punjabi Sikh residents but assists people of other faiths and ethnicities too.

Like other immigrant communities in California, Punjabi residents face numerous barriers to achieving and maintaining good health. Those in low-wage jobs often struggle to afford healthy food and adequate housing. They may not have money to pay for medical care or transportation to get to doctor’s appointments. Some don’t have health insurance, or the coverage they get through their employer is inadequate. Stress from working long hours or multiple jobs can also take a toll on their physical and mental health.

Language is another obstacle. About half of Punjabi speakers in California don’t speak English well, according to Naindeep Singh, Jakara Movement’s executive director. (Naindeep Singh uses the same last name as Nirmal Singh but is not related. Members of the Sikh faith often use the last name Singh if they are male and Kaur if they are female, as a rejection of the Indian caste system and a symbol of unity and equality.) Information on state and federal programs such as Medi-Cal, Covered California, and USDA farm worker relief grants isn’t offered in Punjabi or is poorly translated, Naindeep Singh said. Health insurance letters and bills are often sent in English, requiring the recipient to call a helpline if they need translation. Even when writing is in Punjabi, which uses a different writing script than English, some community members can’t make sense of it because they do not know how to read or the language is too formal.

Finding Punjabi-speaking medical providers is also difficult. Community members often don’t realize they have the right under state law to request interpretation for medical appointments or ask for translations of health documents, said Mandip Kaur, Jakara Movement’s health program manager. Even calling to ask for interpretation can seem daunting.

Some rely on English-speaking family members to help them navigate medical care. But not all community members have access to this kind of help. Many also feel ashamed to ask for assistance from people outside of their community or fear they might be scammed or face discrimination, Mandip Kaur said.

“When you talk about overall health and knowledge, the biggest, biggest [barrier] is language access,” she said. “It’s one of the reasons we have a lot of community members come to us to make phone calls for them, dispute billing for them.”

For Nirmal Singh and Daljit Kaur, not speaking English makes many aspects of life difficult. On the day they got lost on their way to Walmart, they drove around for two hours trying to find a Punjabi person to ask for directions because they didn’t know how to communicate their predicament to an English speaker.

It was one of the reasons they hadn’t sought help in Fresno for their vision problems either. How would they find an optometrist, they asked, let alone communicate with an English-speaking provider? The other problem was financial. Nirmal Singh’s employer-sponsored health insurance doesn’t cover dental or vision care. He couldn’t afford to pay for an optometry visit out of pocket.

That Sunday in the car, the couple did eventually stop an English-speaking passerby because it was getting dark and they couldn’t find a Punjabi resident. Nirmal Singh pointed to his address, which he keeps written on a piece of paper in his car, for just such a situation, and the passerby drew them a map. Ten minutes later, the couple pulled up to their apartment. Their vision problems, however, remained unresolved.

By and for the Community

The Jakara Movement’s community health worker program began during the pandemic. Before that, the organization, founded in 2000, focused mainly on youth leadership and development at high schools and colleges throughout the state.

But the pandemic pushed the organization to expand its focus. Fresno County hired the Jakara Movement to help with contact tracing of Punjabi residents exposed to COVID-19 and to educate people about the virus and how to protect themselves. Later, the Jakara Movement helped organize and translate at vaccine clinics. With support from the city of Fresno, the nonprofit also assisted community members in signing up for rental assistance and government aid for people working in the food industry. At the height of these efforts, the organization had about 20 community health workers.

But there were community members still waiting for help. People began coming to Jakara staff members with questions about non-COVID health concerns, how to access medical care in Punjabi, submit medical bills and paperwork, and resolve labor issues. Many didn’t understand their health care rights or were misinformed because there was so little reliable information available in their language.

“COVID brought up this whole other world of ‘How do we help our youth if we don’t help their families as well?’” Mandip Kaur said.

With a grant from the city, the Jakara Movement launched a health literacy program. Community health workers set up tables at local gurdwaras where they offered information in Punjabi about managing ailments such as diabetes and hypertension, translated health documents, signed people up for Medi-Cal and other government programs, and answered questions about finding medical care, dealing with wage theft, and resolving immigration issues. They held workshops in Punjabi on navigating the health care system, healthy eating, asthma, heat illness, and mental health.

Word of the assistance soon spread. Inderjeet Singh Brar, 55, got help signing up for rental assistance and Medi-Cal, allowing him to stay housed after he lost his job and get treatment after a heart attack. Soon he began bringing his neighbors to meet with the health workers too.

“Jakara helped me when I really needed help, so that’s why I trust Jakara for other community members,” he said through a translator. “When I was drowning, they threw me a lifesaver.”

The community health workers also began organizing health resource fairs for Punjabi residents and provided translation and information at events held by other organizations. The fairs bring in medical providers to offer free health screenings and local agencies such as the Department of Social Services and Area Agency on Aging to sign people up for Medi-Cal, Medicare, and other social safety-net programs. Community health workers also regularly go door-to-door in Punjabi neighborhoods to offer their services and tell people about upcoming events.

“We’ve learned we have to go to people. We have to go to where they’re at; they’re not going to come to us,” Mandip Kaur said. “When someone has so much on their brain and so much on their shoulders, it’s a task” to seek out health resources.

On one recent visit to an apartment complex, Mandip Kaur helped a man understand a letter he’d received in English from the local Medi-Cal plan, CalViva Health, telling him he’d lost his benefits. She promised to help him resolve the matter the next day. She also pulled out her phone to show a visiting neighbor how to get to a local food bank and information about an upcoming job fair.

Also at the apartment complex, resident Manjit Kaur, 58, expressed thanks for the Jakara Movement community health worker who helped her quickly get an appointment with a Punjabi-speaking dentist after she became bedridden with tooth pain. Her friend, Kulwant Kaur, 62, said the Jakara Movement had helped her obtain rental and food assistance after her husband died. 

“Thank God they’re there to help us,” said Kulwant Kaur, whose adult children live in India. “They’re like our daughters and kids that we have here.”

A Trip to the Optometrist

One regular event the Jakara Movement organizes is a monthly farmers market at a park on the west side of Fresno, where many community members live. Named after a Sikh human rights activist, Jaswant Singh Khalra Park is within walking distance of several housing complexes where many Punjabi residents live. On a given day you might see older men in turbans playing cards, women in saris pushing strollers, and young people playing cricket on the baseball field. The farmers market caters to the community with fresh produce such as mustard plant that can be used to cook traditional dishes like saag. And it provides another opportunity for Jakara Movement workers to connect with community members.

It was at the May farmers market that Jakara Movement community health worker Harjit Kaur spotted Nirmal Singh and Daljit Kaur, who live nearby. She’d met them at one of the Jakara Movement’s health fairs earlier in the year, where they’d mentioned their need for eye exams. There was no optometrist at that health fair. But Harjit Kaur had just heard about a free, mobile vision clinic run by a nonprofit organization in another part of town. Would Nirmal Singh and Daljit Kaur like to go?

Harjit Kaur spent the rest of the day with the couple. Because Nirmal Singh’s vision made him hesitant to drive and his wife doesn’t drive at all, Harjit Kaur drove them to the clinic herself, stopping by their apartment to pick up an old pair of Nirmal Singh’s glasses. She interpreted during the eye exams, which took several hours. The next day, she picked up the couple’s new prescription glasses and dropped them off at their apartment.

This ability to spend time with the people they’re serving and understand their needs is what makes community health workers so valuable, said Andrea Mackey, who oversees a community health worker coalition on behalf of the California Pan-Ethnic Health Network. These workers are from the communities they work with. They understand the lives, culture, and language of the people they help and are passionate about the work they do. This allows them to build trust and serve as a bridge between underserved communities and mainstream systems. In fact, community health workers have been shown to , lower health care costs, and reduce health disparities.

“It’s an anti-racist strategy, shifting power to the people who experience health care inequities,” Mackey said, although she acknowledged “bigger structural problems” such as the cost and complexity of America’s health care system, particularly for people of color who don’t speak English or are low income.

For Harjit Kaur and other Jakara Movement health workers, helping the community is just as much a calling as it is a job. Selfless service to others, or seva, is a key tenet of Sikhism. The workers do everything they can to assist people, whether that’s driving them to doctor’s appointments, accompanying them to the DMV, or translating during a medical visit. Harjit Kaur and Mandip Kaur said they also donate a portion of each paycheck back to the Jakara Movement, their temple, or people in need. 

“When I came to Jakara, I found the purpose of my life,” said Harjit Kaur, who became a community health worker after raising three children and leaving a difficult marriage. “Helping my own community, speaking my own language, and getting paid—it’s a blessing.”

The work is also an extension of what some of the workers were already doing for family members and neighbors. Mandip Kaur, for example, grew up translating and making phone calls for her parents, who arrived in the U.S. when she was 3.  Community Health Worker Gurpreet Singh, 25, who lives in nearby Madera, is the go-to translator for his parents and their Punjabi-speaking friends. He’s seen firsthand how language, information, and transportation barriers prevent people from getting help.

“I think the role that community health workers play is super important,” he said. “Sometimes it’s as important as a doctor. A doctor’s visit is scheduled for 15 minutes, 30 minutes max. But what we do as community health workers is really listen to the community members, take our time, and build that trust.”

California has around 8,700 community health workers, according to the , although Mackey says that’s likely an undercount because not all people doing the work classify themselves as such. Like the Jakara Movement, many organizations pay for these workers with grants and donations. But in July 2022, California began paying for community health worker services for Medi-Cal enrollees. The rollout of this benefit has been bumpy, due to and . A pay increase next year for workers providing services to Medi-Cal enrollees is expected to provide some relief.

The state needs more community health worker programs like the Jakara Movement’s, particularly for Punjabi residents, said Simranjit Mann, a graduate student in public health from California State University, Fresno. Mann did her on barriers Punjabi residents in Fresno face in accessing diabetes care. She said she was surprised at the scarcity of research on the health care needs of Punjabi people living in the U.S. and culturally effective interventions. Expanding these types of programs will require more research to understand what works best so it can be replicated, she added.

The Jakara Movement is currently preparing to do its own research on how to best help Punjabi families achieve and maintain good health, Naindeep Singh said. Later this year the organization plans to launch a three-year program that will serve 500 Punjabi-speaking families in Fresno and hire additional community health workers to visit them regularly, conduct basic health screenings, and survey them about their health needs and challenges. The goal is to help these families access the resources they need and, by analyzing the results, build a better understanding of how to best serve them.

“At the most basic level, I hope the families have an immediate benefit in terms of what they thought was possible,” Naindeep Singh said. “And I hope there’s a larger story to tell about how we should be doing health in Fresno and California … reaching out to people where they live, appreciating and recognizing them and their autonomy to make choices, and just helping them reach the goals they set.”

Meanwhile, Nirmal Singh and Daljit Kaur are already benefiting from the existing community health worker program. They both have up-to-date prescription glasses. Nirmal Singh can see clearly at work, and he’s no longer afraid to drive. Daljit Kaur isn’t falling as much as she used to. But the optometrist said she will need cataract surgery to fully restore her eyesight. Mandip Kaur and Harjit are looking into low-cost options for her.

“I’m very, very thankful,” Nirmal Singh said.

This story was produced in collaboration with the California Health Report. Aallyah Wright with Capital B, Emily Schabacker with Cardinal News, Claudia Rivera Cotto with Enlace Latino NC, and Jenny Stratton with CatchLight contributed to this report. This story is part of a collaborative reporting effort led by the Institute for Nonprofit News’ Rural News Network. Support from the Walton Family Foundation made the project possible.

I often reflect on how small things, like my children playing loudly in our backyard, would be impossible in a different time or place. My heart aches knowing I experience a level of freedom and agency the mothers in my lineage couldn’t visualize, let alone exercise. Still, the artifacts of injustice don’t feel distant. I see the afterimage of “whites only” signs every time I blink. I lose my breath calculating how I’d explain such an explicit color line to my children, though today’s covert line is equally overwhelming. And while so many things are better, so much feels the same. 

I found the thread that helped me make sense of this feeling during graduate school. The exact moment I learned of , an English legal doctrine passed in 1662 that loosely translates to “the status of the child follows the mother,” escapes me now. But I remember feeling something shift. I felt like I had learned the answer to a question I hadn’t known to ask. I recognized this revelation as a through line, equally past and present, and sensed I’d encountered the most crucial mothering lesson of my life.

Enslavers created the principle to enshrine the relationship between race and slavery. It solidified enslaved women as capable of giving birth but never truly mothers and created a binary between white and Black wombs: The former held an unborn human; the latter was a queue for chattel. 

I wanted to parent in resistance. But I found mothering in anticipation of harm made me tired.

Partus sequitur ventrem explained why the Black mothering experience felt inseparable from narratives of hypervigilance and trauma. The doctrine captivated and taunted me with reminders of why I wasn’t carefree like the white moms I found community with. But it also offered direction in my mothering: I could fight wholeheartedly to free my children. But if I was unfree, my efforts would be futile. Partus sequitur ventrem revealed that my foremothers and I share the goal of raising free Black children despite contextual differences. 

, a licensed clinical social worker certified in perinatal mental health, says that historical circumstances limited Black mothers’ agency in parenting in every area—from conception to caring for our children. Often, that involved hard choices. Williams says this history can leave Black mothers with a feeling of powerlessness and the pressure of knowing: I have to keep my children safe, especially when I know the systems are not keeping my children safe. 

“And still, today, we have so many different reminders and events that the system is not supporting our care and well-being,” says Williams. “That pressure on us as Black mothers to wonder: If I don’t choose my kids, am I also dismissing them like the system is?”

Black infants and birthing people today face death-rate disparities comparable to . Black families are trying to make ends meet as layoffs disproportionately impact Black employees. We are grateful they’re not the identical stressors our ancestors experienced. But painful headlines like those describing the Texas Child Protective Services removing newborn from her �貹����Գٲ�’ care and 16-year-old being shot after going to the wrong house reveal that family separation and the dehumanization of Black youth hasn’t ended. “A lot of us are carrying things that our ancestors and grandmothers didn’t get to resolve,” says Williams.

It hurts to read the heritability of nonfreedom. Enslavement has ended, but this doesn’t feel like freedom. Generations of Black women have tried to pass an inheritance we never held. I wanted to parent in resistance. But I found mothering in anticipation of harm made me tired. It impacted my relationship with myself and my children; I was anxious, irritable, and often depressed. 

, a licensed clinical psychologist, says putting your mothering identity first is natural. But the pressure to be a “good mother” can lead to negative emotions, including exhaustion and social isolation. Similarly, parents can experience guilt and shame when they don’t meet their own parenting goals and expectations: “This can lead to depression, anxiety, or even obsessive-compulsive tendencies, because even though we know perfection does not exist, we continue to hold ourselves to impossibly high standards and judge ourselves harshly when we are unable to meet them.”

I know I’m the best mother when I start from the inside out.��

I found this especially true for marginalized parents. I felt guilty that I wasn’t more grateful to mother with new stressors instead of those my grandmother had. Shame told me it was my job to give my children the world because I had unprecedented access. I went through the motions of gentle parenting—and the guilt, rage, and shame when I “failed.” I grew resentful that I wasn’t giving my children the soft landing they deserved. But with reflection, I realized that gentle parenting wasn’t the problem: I had to start with myself. I needed something that met me where I was. So I built it.

I created a framework called #FreeBlackMotherhood to actively challenge the lineage of partus sequitur ventrem. But I realized perspectives on motherhood disparage all caretakers, albeit to varying degrees. “” is the expectation that mothers sacrifice themselves at the altar of motherhood and be judged by their capacity to mother based on race, class, and other parts of identity. This version of mothering weaponizes old harm in new ways. Like the dehumanizing English law of partus sequitur ventrem, intensive mothering reinforces a binary of valid and invalid mothers based on standardized expectations, when, in reality, mothering is subjective.

Williams notes a myriad of personal and familial factors—including whether a parenting journey was planned—impact how we show up as caretakers. She says we need “individualized mothering plans” in the same way we have individualized education plans for our children. Intensive mothering affirms motherhood, especially Black motherhood, as a site of suffering. It creates a racist, heteronormative, class-based definition of mothering where mothers carry a disproportionate share of the burden. The model also upholds individualized solutions to systemic issues and emphasizes responsibility over joy.  

Black motherhood is often seen as a , leaving little room for freedom, authenticity, and joy. Once I abandoned binaries, I realized my views didn’t conflict with gentle parenting: They conflict with standardized mothering that is rooted in white supremacy and patriarchy. But I know I’m the best mother when I start from the inside out. 

Montfort affirms that child-centric models, like gentle parenting, are a wonderful way to build secure attachments with our children. But they can’t be done at the cost of supporting the self. Placing my needs at the center reminded me it’s OK to pause and have days I don’t feel like mothering. Montfort says scheduling time alone, communicating with your child-rearing support team, and having a therapist can help during rough times.

Like Williams, Montfort supports abandoning a standardized image of mothering. She encourages caretakers to define—or redefine—their values for themselves instead of basing them on prescribed models. This starts by asking who you want to be and what qualities you want to embody as a parent and taking small steps to get there. 

My journey is still unfolding. But I’m grateful I’ve created a personal mothering practice that resonates with caretakers of diverse identities. 

My framework helps me break the binary that racism and intensive mothering created and helps me hold my love for myself and my children simultaneously. It encourages me to abandon the weight of mothering perfectly to reduce systemic harm. But it also reminds all of us that we deserve motherhood rooted in shared responsibility and joy.

The best way to transmit freedom to my children is to hold it myself.  

This is one of my deepest truths: If we are in relationship, no matter how scared or unskilled I may be, I want to repair with you. Part political commitment, part survival strategy, part just essence of who I am, holding out hope for repair is at my core.

Rupture is a given. We will disagree. We will hurt each other. We will sometimes find ourselves facing the irreconcilable. And we will need ways to make ourselves—and each other—whole in the aftermath of rupture.

I have grappled with the dynamics of repair throughout more than 20 years of practice with transformative and restorative justice. In this age of deepening cultural and political divides, facing the election of our lifetimes and whatever comes after, it is more critical than ever that we learn how to be in principled conflict and repair with each other. Three things stand out to me in this high-stakes historical moment: We have much to learn about the possibilities of genuine repair, our unrepaired places are where we are most vulnerable to ongoing harm and domination, and the human capacity for repair is vast and stunning—when we are given the support to move toward it.��

The Possibilities of Repair

This seems to be a principle of dominant society, often internalized and acted out by our communities and families: You will live wounded, unrepaired, and you better not expect anything more. Yet this grim promise is juxtaposed with an evolutionary drive toward relational healing. I believe each of us comes from a lineage—no matter how buried—that knew how to heal, how to repair with each other. Throughout history, we have survived by bringing our harms to the circle of community and quite literally humming and drumming through them together. It is by design that most of us have no living memory of these possibilities. And still, they are there. We can find them. 

We don’t have to repair in every possible direction in order to have a meaningful experience of repair. The criminal legal system, especially in the United States, has limited our imagination to a zero-sum game: There’s a victim and a monster, and punishment is the only healing anyone gets. While this system may not have room for the possibilities of repair, our communities do. Sometimes we can’t repair with the person who hurt us most, but repair is possible within ourselves, with our close people, and with our larger community, which can offer us the medicine we need.

The Unrepaired

Those organizing systems of supremacy exploit our unrepaired wounds for their gain. They use them to split us, to co-opt us, to draw us to their ranks. They understand that without repair, the trauma they unleash will create cycles of violence in which our survival strategies will never get us to freedom. And despite our critique of these systems and strategies, many of us have internalized the carceral logic that tells us our best shot at healing requires separation from and disposal of those who have hurt us. How many projects have you seen fall apart, how many coalitions are under strain, because when conflict happens, we quickly choose sides, close ranks, and tell each other the story of how impossible and unworthy repair is?

It is time for us to tell each other new stories. People change differently than systems do. The strategies we use to push back on systems, to force them to change through shame and blame, do not produce life-giving change in people. The work of repair requires us to risk beyond our righteousness and bridge across narrow notions of identity, allegiance, and whose pain “counts.” When we can hold the pain of multiple, divergent truths and lived experiences, we can remember our wholeness, our shared humanity, and let it guide us towards the mass-based people power we need to win.

Our Stunning Capacity

I will never forget sitting in a basement courtroom as Jonathan read his survivor impact statement, for the first time seeing the face of his shooter. He told in excruciating detail how the , had paralyzed him for the rest of his life, putting him in daily unrelenting pain, taking his career as a carpenter, his love of movement in sports and outdoors, and leaving him to answer his newborn daughter’s questions when she someday soon asks, “Why can’t Papa walk?” In the midst of all this, Jonathan told the court, “A longer sentence will not help me heal, and I don’t believe that more time will help my shooter. My shooter can’t undo what he did on June 6th, and locking him away for longer will not enable him to heal. I believe he deserves a chance to do better.” 

I’ve found that the degree to which people can be open to the humanity of those who have hurt them is directly related to the degree to which they have been held well in their own wounding. Facing and feeling the immensity of our losses, the dignity of our rage, the depth of our sorrow, grows our capacity for connection beyond what we can imagine. I’ve seen it while with Jonathan and so many other survivors of profound violence, with everything they’ve lost, still reaching across the chasm of excruciating pain for repair. 

The Irreconcilable

And then, there is that which is irreconcilable. This word has often felt like the truest thing in the aftermath of Oct. 7, 2023. I was sitting in a grief ritual, surrounded by safe, imperfect humans, looking at an altar full of things we love and have lost, and I could not reconcile the images in my head of what was happening in Gaza at that exact same moment. I looked out the window at the trees blowing in the breeze, my child playing, warm food in my belly, and I couldn’t make sense of it. Why are we here and not in the midst of a genocide? How can life be like this and like that? Marching and organizing and and still, this terrible ache, this desperate feeling of complicity and helplessness. And so I fell down and wept, screamed and flailed with all that is unreconciled, irreconcilable. 

Facing the irreconcilable is part of repair. It is the part where we get really honest about the things and the people that we cannot change—at least in this lifetime. It requires the vulnerability to surrender into the limits of our agency, to know that we tried as hard as we could and still did not get what we wanted, what we needed, what we deserved. When we cannot face the irreconcilable, we often try to destroy each other instead. Our grief and rage get directed at each other, as we cannot tolerate the contradictions we live within—and which live within us. 

Rather than annihilating those with whom we can’t repair, we can draw close to our trusted people and grieve what we do not know how to resolve. In this way, we can repair with ourselves and each other, even when accountability and justice are not possible. Repair is to make whole, not to make perfect. Not even to make right. Some things will never be made right. In accepting this and finding ways to live together with it, we expand our capacity to repair in the places where the openings are.

And so, I want to learn to repair with you. I want to sit in the circle with you, tell you in the rawest detail about how I’ve been hurt, even by you, and hear in the rawest detail, how you’ve been hurt, even by me. I want to hold it all, together. Witness the carnage, grieve it in the loudest and quietest of ways. Face the irreconcilable. Agree not to annihilate each other, even when we are heartbroken. I want to try and try again. It’s the place I’ve found the most palpable hope, in the face of all that we are up against. I believe you can find it there too. We can find it together.

De La Cruz, a health educator with Planned Parenthood of Orange and San Bernardino Counties, is here to lead a workshop for between 10 and 20 incarcerated youths, a majority of whom are of color. De La Cruz will guide them in lessons about anatomy and pregnancy, birth control and sexually transmitted infections. He also explores healthy relationships and the pitfalls of toxic masculinity.

But the fun really begins when De La Cruz pulls the condom out of his pocket. As to be expected, all eyes are on him.

“They’re like, ‘Wow, are you going to open it?’” he says. The answer is yes … after he asks a few questions.

“I start off with asking them what the first step is,” De La Cruz says.

To which they might answer: Get the girl or Buy the condom.

Wrong. The first step, he tells them, is consent.

“Consent is ongoing,” he says. ���� at any point a person doesn’t want to have sex, consent is not given and they will stop. That’s step number one.”

It’s common in the ensuing discussion for one of the workshop participants to protest that he is too well-endowed for a condom. De La Cruz is ready for this, stretching the condom a couple feet lengthwise or even inserting his hand up to his wrist to assure the youth that, yes, he most likely can wear a condom.

De La Cruz also encourages them not to rip condoms open with their teeth because they might break them, always check the expiration date, avoid putting it on backward (aim for a sombrero, not a beanie), and of course, make sure that once in place, the condom has some air pockets, like a bag of chips.

These conversations, coupled with the condom demonstration, break barriers and help De La Cruz earn trust. As he sees it, participants are thinking, “This isn’t just an old man trying to teach me about math or life choices and how to be responsible. But I am teaching them about life and how to be responsible—but in their sexual and reproductive health—and in a fun way.”

Respecting participants and inviting them to share their thoughts is key, says De La Cruz: “That’s what makes them eager to have us back.”

From Birth Control to the “Man Box”

Planned Parenthood’s Orange and San Bernardino chapter, which is the second largest Planned Parenthood affiliate in the nation, began these workshops in 2013. They’re now taught at not only Juvenile Hall but at Theo Lacey Facility, a nearby maximum security jail complex.

Workshops cover healthy relationships, gender and sexuality, and sex trafficking. One session is reserved for what Planned Parenthood calls the Male Involvement Program, which explores “the man box,” or limitations on behaviors not considered masculine. Other topics include youth rights and resources, such as a program that provides birth control and STI testing to low-income Californians.

The lessons align with the sex-ed curriculum used in California’s middle and high schools. But many incarcerated young men missed those classroom lessons due to truancy or incarceration. Their lack of knowledge about sexual health puts them at a lifelong disadvantage. It’s just one more factor contributing to the poorer health outcomes associated with disadvantaged communities.

The chapter expects to reach about 300 incarcerated male teens and young men by the end of June, with plans to expand to facilities in San Bernardino County. 

How did Planned Parenthood, which is normally associated with women’s health, find its way into the lives of incarcerated young males?

The idea is that by improving the sexual and reproductive health of young men, the workshops also benefit their female partners, explains Faviola Mercado, community education manager at the Orange and San Bernardino chapter of Planned Parenthood.

“We’re increasing the likelihood of men being more open to seeking resources and testing for STIs,” Faviola says. “It helps their own sexual reproductive health, and we also know that toxic masculinity traits can be harmful to themselves and to women and children.”

By anecdotal measures, the workshops can lead to changes in thinking, such as when participants conclude that an activity they earlier said was strictly feminine—say, cooking—is fine for men to partake in. The workshop’s interactive format accounts for these mini-breakthroughs.��

“Our presentation is less of a teacher telling students what to do [and] more of a conversation, with respect between each other,” health educator Neil Reyes explains. “We’re breaking down ideas of masculinity, learning about reproductive health, and helping partners.”

The Challenge of Changing Mindsets

But the effort certainly comes with obstacles. De La Cruz and Reyes are quick to note that a jail, which operates on traditional notions of masculine power, is not the ideal setting to foster emotional expression.

“The participants are not in a place where empathy is rewarded,” Reyes says. “So it’s not clear how much the message of men being OK to cry or to show emotions is being put to use where they are.”

Some lessons are also met with resistance. For example, participants often push back on less restrictive definitions of gender and sexuality, though De La Cruz and Reyes hope that by answering questions on these subjects, providing explanations, hearing viewpoints, and calling for respect for all, they can build more tolerance.

“At the end of the day, I say, ‘I’m not trying to say what is right or wrong,’” De La Cruz says. “But let’s talk about it. Let’s be respectful and have this conversation.”

It’s difficult to gauge the success of prison programs in changing behavior in the long term. Sometimes the only metric is the rate of re-offending—a “crude measure,” says Lois Davis, a senior policy researcher at RAND Corporation with expertise in correctional education.

But the Planned Parenthood workshops at Theo Lacey, the adult facility, will be subject to far more nuanced evaluation since the Lacey participants are enrolled in a special initiative called the Transitional-Age Youth, or TAY sector, for short. TAY sector houses men between the ages of 18 and 25 together and provides classes in areas such as securing employment, navigating addiction and mental health, and preparing for re-entry.

TAY administrators will continue to interview participants up to three years after release—to ascertain, in part, whether participants adhere to sexual health practices—and compare findings to a control group. And while it’s too early for results, the program’s co-developer and clinical director, Marie Gillespie, is optimistic about the educators’ rapport with the young men.

De La Cruz and Reyes “are incredibly approachable,” she says. “They’re able to connect with these young men perhaps at a level other people haven’t attempted to connect with them on. It’s not a peer relation but someone you can see in your shoes saying, ‘These are essential skills.’ That’s going to resonate more with young adult populations.”

For now, Planned Parenthood’s health educators are continually refining the workshops based on feedback from participants.

One such moment happened during a workshop that Reyes was conducting. A participant said that while he was raised not to talk about his emotions, he would support his son’s choice to be more expressive.

“I absolutely remember that moment and thought it was pretty cool,” Reyes says. “Now I know that this person got something from the workshops that he could show the next generation if he has his own son.”

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

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

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

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

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

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

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

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

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

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

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

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

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

With his hand over his head, Sandberg ducked between rows of cars and barreled into the safety of his vehicle. He has since tried to block out most of the gay slurs his harassers yelled at him that night.

Sandberg is a senior at Bethel University, a Christian college in Arden Hills, Minnesota, where being gay is a reportable offense. Along with eating disorders, suicidal behavior, and alcohol use, resident assistants must immediately report homosexuality to their hall directors and possibly Student Life deans.

While the university has chosen to engage with other social issues, hosting a #BlackLivesMatter panel discussion and establishing a gender studies minor, conversation about homosexuality and homophobia has been comparably quieter at the institutional level.

“There’s no discussion,” Sandberg said. “It’s either ‘you’re a sinner’ … or ‘let’s get close so we can fix you.’ It’s a really toxic environment.”

In its Covenant for Life Together, a lifestyle agreement that all faculty, staff, and students must sign, Bethel identifies homosexual behavior—along with adultery, idolatry, and dishonesty, among others—as a character quality inconsistent with the Christian lifestyle. However, according to Executive Vice President and Provost Deb Harless, that doesn’t mean Bethel shouldn’t be a safe and welcoming place for LGBT students.

“Bethel University needs to be a place where all people, regardless of sexual orientation, are treated with love and respect,” Harless said.  

Reference to sexual orientation is, however, missing from the Covenant’s anti-discrimination clause. According to Harless, the university does not discriminate based on race, gender, age, or disability, but it does reserve the right to discriminate based on sexual orientation in its hiring practices.

“As a religious institution, we are exempt from the provision of the Minnesota Human Rights Statute regarding employment,” Harless said.

For some LGBT students, Bethel’s stance on homosexuality doesn’t mean they are isolated or unsupported. But for Sandberg, all the policy communicates is that he’s not part of the in-crowd.

“The biggest thing for me is feeling like I’m not allowed to be a Christian because I’m gay,” Sandberg said. “Who are you to tell someone what they are allowed to do or be? That’s between them and God.”

Campus pastor Laurel Bunker heaved a sigh as she sat at the polished wooden table in her office, searching for the right words to describe her opinion on homosexuality at Bethel. She’s faced with a challenging balancing act—trying to uphold the traditional interpretation of Scripture while still showing love to gay students.

“We need to somehow create a level of honesty in talking about it, but that does not mean broad-range understanding or acceptance,” Bunker said. “What it should mean for us is trying to create an atmosphere where young people can wrestle well and with integrity around the things that matter most to them.”

While the university has approved subculture-based organizations like United Cultures of Bethel and Disability Awareness Group, Bethel is the only Minnesota Intercollegiate Athletic Conference school without an official support group for LGBT students.

For gay students like Jonah Venegas, that’s OK. Although he said an on-campus support group would be “an incredible thing to have,” his relationships with students and faculty have been enough to make him feel safe and accepted.

“None of my friends are awkward about it. They’re not trying to skirt around things,” Venegas said. “No one has treated me differently since they’ve found out … if I need to talk, they’ve been super willing to listen.”

According to psychology professor and alumnus Joel Frederickson, animosity toward LGBT students has abated over the last few decades. He pointed to numbers from a 2008 UCLA survey that revealed 10.3 percent of Bethel’s incoming first-year students believed same-sex couples should have the right to legal marital status. By the time those students were seniors, that number had risen to 48.6 percent. It was the largest perspective shift on the entire survey.

While more than half of students surveyed still opposed same-sex marriage, Bunker said far-flung approval isn’t necessary to feel secure in one’s identity. She’s faced plenty of criticism for her role as a female pastor, but she doesn’t doubt God’s purpose for her life.

“I don’t think that every person who wants to live their life as a gay person needs to have the affirmation of the entire church if they feel that somehow this is the life they are called to live,” Bunker said. “I would question that and challenge that, but … we have to be really careful about what we’re presupposing is necessary for people to feel as though they can function.”

Curtiss DeYoung raised his eyebrows at the student sitting across from him, trying to decide how to answer the question that had just been posed by a Bethel sophomore. After a brief pause, he responded with another question.

“Do I think homosexuality is a sin?” DeYoung repeated. “Does that stay in this office?”

His response highlights a deep-seated fear among faculty members to speak publicly about homosexuality — a fear that DeYoung, a former reconciliation studies professor, said still exists on Bethel’s campus.

DeYoung cited the termination of sociology professor Ken Gowdy in 1991 as one of the reasons faculty and staff are reluctant, nearly 25 years later, to engage in conversation about homosexuality. A 1991 edition of The Clarion, Bethel’s student-run paper, reported Gowdy was released after telling a student he wasn’t sure homosexuality was a sin.

Harless said there isn’t a simple, yes-or-no answer to whether employees who express a view counter to the Covenant could be fired.

“Given that faculty sign the Covenant, which includes a statement about the university’s perspective on homosexual behavior, we would not expect a faculty member to advocate for a position that conflicts with the Covenant,” Harless said. “The response to a faculty member who seems to advocate for a position that contradicts the Covenant would be made carefully and thoughtfully.”

Almost a decade after Gowdy was released, an informal group of students called the Straight-Gay Reconcilers decided to offer faculty a small but significant way to support LGBT students by handing out “Safe Place” signs for professors to hang on their doors.

When English professor Joey Horstman posted one of the signs at the entrance of his third-floor Academic Center office, it was gone by the following Tuesday morning. He replaced the sign five or six times. Then he gave up.

As part of their “Safe Place” campaign, the Straight-Gay Reconcilers conducted a survey to gauge student attitudes toward both the signs and the group itself. According to results published in a 2010 edition of The Clarion, 59 percent of 697 students polled believed the signs were unnecessary because the entire campus should be a safe place. Forty-three percent said Straight-Gay Reconcilers should not be allowed club status.

A reported that Bethel did not charter the Straight-Gay Reconcilers or allow them to advertise on campus.

Now, five years later, social psychologist and reconciliation studies professor Christena Cleveland said faculty, staff, and even students are still waiting for administration to tell them it’s OK to openly talk about issues surrounding homosexuality and the church.  

“I think in this community right now there’s so much taboo around [the topic] that it really does take the green light from leadership,” Cleveland said. “From the top—the provost, the president—the people who have the most power here.”

For DeYoung, that green light never came. While he tried to support LGBT students behind closed doors, remaining silent ultimately felt like an act of betrayal.

“As a person working for reconciliation, the school’s inability to have open dialogue and discussion of homosexuality—and its inability to allow students to be who they are—certainly was a contributing factor as I thought about leaving Bethel,” DeYoung said.

He resigned from his position as co-chair of the anthropology, sociology, and reconciliation studies department in January 2014.

Music education major Elizabeth Ciesluk has the word “breathe” tattooed on her left wrist. The black, willowy letters are a constant reminder of her mother’s comfort during her darkest days: Breathe in the good. Breathe out the bad.

It’s Ciesluk’s second year at Bethel, and she almost didn’t come back. Ready to “get out” after her first two semesters, Ciesluk planned to transfer to Gustavus Adolphus—another MIAC college that has a strong music department and a gay-straight alliance group.

“I felt very trapped in a place where I couldn’t express who I was or what I was feeling,” she said. “I was ready to move on to somewhere where I knew that there was a lot more acceptance.”

One Friday afternoon last year, Ciesluk had just plopped into her favorite leather chair in the Clausen Center lounge when a student in the adjacent pod of chairs asked his friend whether sexual orientation was a choice. The second student responded with an unequivocal “Yes.”

Ciesluk’s fists clenched.

“If that were the case, I’d probably be the straightest person on the planet,” she said. “I loved being in the church growing up, I loved learning about Christ and I still had these feelings toward women that I could not control.”

Both Venegas and Sandberg agree that being gay isn’t a choice. Venegas said he almost had “to be slapped in the face” to come to terms with his identity, and Sandberg can’t imagine signing up for the pain he’s experienced.

Because he’s an openly gay student, Sandberg said people have picked up their things and left to avoid sitting next to him. Male students have ignored his greetings because they’re afraid he’s trying to make a pass at them. He feels unwanted.

“If this were a choice, do you think I would choose to be lonely, miserable, and rejected by my family and friends?” Sandberg said. “No. I would not choose to be that way.”

Venegas realized he was gay three years ago, when he was sitting in the basement of Bethlehem Baptist Church in Minneapolis on a Sunday morning. After listening to a friend’s youth group testimony about same-sex attraction, Venegas was finally able to put his feelings into words.

He believed he was called to celibacy until just this year, when he was engulfed by crippling feelings of depression. Hardly able to get out of bed or dress himself, Venegas was terrified by the thought of a lifetime alone.

He started praying for hours every day, writing letters to God, and asking Him to take away his longing for a male partner. When no relief came, Venegas finally began considering the possibility of a God-honoring homosexual relationship.

“I really don’t think the Bible is as clear in regards to this as a lot of people think it is,” Venegas said. “For me, I think it comes down to praying a lot and making relationships with people who identify as LGBT to figure out where God is calling me on this.”

According to DeYoung, who now serves as the executive director of a faith-based nonprofit organization in Chicago, there are theological inconsistencies in the university’s hiring practices. While Bethel hires divorced and remarried faculty and staff, it does not hire people who identify as gay.

Just as dancing and alcohol were once condemned in the Covenant, so too was remarriage considered adultery. But as perspectives have changed, DeYoung said, Bethel “chose grace on these matters.”

“I hope Bethel will also choose to extend its affirmation to LGBT folks,” DeYoung said. “There’s no better time than right now, given the changes happening in the broader society. Too often, the church is behind.”

But, for Bunker, an imminent change in policy is hard to foresee. While she said Bethel should continually strive to live in Christian community with LGBT students, there isn’t much wiggle room when it comes to the university’s stance on homosexual behavior.

“Bethel represents an evangelical community that has made its commitment to biblical fidelity clear in terms of its understanding of the Scriptures,” Bunker said. “Do I think Bethel will change its position on homosexuality? Not anytime soon.”

The moonlight glistened across Lake Valentine as Sandberg walked toward Seminary Hill with another gay student. At half past one in the morning, they had been talking for more than two hours.

“I don’t know what it means to be gay and Christian,” the student told him.

Sandberg nodded. He’s still trying to figure out the answer himself. For now, he draws peace from the indescribable rush of divine love and affirmation he feels every time he questions his identity in Christ.

While scenes like that are common in Sandberg’s life, many Bethel students struggle to reconcile the university’s stance against homosexual behavior with the presence of gay students on campus. In Bunker’s experience, students are often left with the same question.

“When you are a [gay student] and you read that Covenant, why do you still choose to come to a place where you know there might be limited access to … an open community that affirms your lifestyle?” Bunker asked. “What draws you to Bethel?”

For Ciesluk, it was Festival of Christmas. For Venegas, it was a positive postsecondary experience. And for Sandberg, it was absolutely nothing—his parents forced him to attend.

While they have experienced different comfort levels at Bethel, Ciesluk, Venegas, and Sandberg all chose to stay.

“My purpose in being here has been to help those who are gay realize it’s not about who you love, it’s about how you love,” Sandberg said. “People have come up to me and said that I’ve helped them by being myself, and that’s all I can ask for.”

Ciesluk, however, wants more than student-to-student support and quiet conversations with faculty. She wants institutional change, and she has two years left to make it happen. While she hopes to start an official support group for LGBT students next year, Ciesluk said her long-term goal is to help Bethel become more “knowledgeable and accepting of all.”

And Venegas? He just wants all Christians, both gay and straight, to remember to have the conversation about homosexuality in human terms.

“This isn’t an issue. This isn’t a debate. This is life for a lot of people,” he said. “People with real lives and real stories and, a lot of the time, real pain.”

Esther Jones and Sarah Nelson contributed to this report. Graphics by Mary Quint.

In the last 100 years, we got very confused about happiness. This is no small thing. The way we define happiness drives what we do, what we’re willing to sacrifice, and how we spend our money and our time.

This confusion didn’t just happen. Advertisers spend billions spreading the illusion that more stuff will bring us happiness. And policy wonks of all political stripes—but especially those connected to business interests—spread the message that economic growth leads to well-being. Both are false promises that have instead been undermining the very conditions that could lead to sustainable happiness.

Sustainable happiness is built on a healthy natural world and a vibrant and fair society. It is a form of happiness that endures, through good and bad times, because it starts with the fundamental requirements and aspirations of being human. You can’t obtain it with a quick fix; sustainable happiness cannot be achieved at the expense of others.

The good news is that sustainable happiness is achievable, it could be available to everyone, and it doesn’t have to cost the planet. It begins by assuring that everyone can obtain a basic level of material security. But beyond that, more stuff isn’t the key to happiness.

It turns out that we don’t need to use up and wear out the planet in a mad rush to produce the stuff that is supposed to make us happy. We don’t need people working in sweatshop conditions to produce cheap stuff to feed an endless appetite for possessions. We don’t even need economic growth, although some types of growth do help.

The research shows that sustainable happiness comes from other sources. We need loving relationships, thriving natural and human communities, opportunities for meaningful work, and a few simple practices, like gratitude. With that definition of sustainable happiness, we really can have it all.

A short history of American-style happiness

Consumption has not always been king in the United States. It became a national preoccupation beginning in the 1920s when business leaders began worrying that Americans were satiated, that they had all the appliances and consumer goods they wanted. Executives and pro-business politicians thought the economy would stall if people chose to spend time enjoying life rather than working more and buying more.

So the advertising industry joined forces with Freudian psychologists to channel our desires—to link the universal wish for status, love, and self-esteem with the new “Gospel of Consumerism.”

“Wants are almost insatiable,” claimed President Herbert Hoover’s report on the economy, published just months before the 1929 crash. “One want satisfied makes way for another…. We have a boundless field before us; there are new wants that will make way endlessly for newer wants, as fast as they are satisfied… by advertising and other promotional devices, by scientific fact finding, by a carefully predeveloped consumption, a measurable pull on production has been created… it would seem that we can go on with increasing activity.”

The modern advertising industry systematically set out to redefine our beliefs about happiness. Freudian psychoanalyst Ernest Dichter is one of those who joined forces with the advertising industry. “To some extent,” he said, “the needs and wants of people have to be continuously stirred up.”

Their strategy works. Today, an iPad, the right vacation, or the latest sneakers have become prerequisites for getting respect. Certain brands of beer are synonymous with friendship and a sense of community. An oversized house points to status and proof of your earnings and ability to provide for a family. These are all, of course, ideas created by advertisers whose clients profit when we buy more than we need.

Advertisers spend billions spreading the illusion that more stuff will bring us happiness.

But buying all this stuff has real consequences. Houses today are, on average, twice as large per person as they were 40 years ago. The burden of debt for those extra rooms and deluxe finishes lasts for decades. Some get addicted to the buyer’s high that follows a big purchase, but the initial exuberance spikes and disappears quickly. The debt, the extra work hours required to pay it off, and the resulting time away from friends and family go on and on.

Exhausted by long hours working and commuting, people begin to wonder what happened to real happiness. Advertisers are there with the answer: You just need to spend still more on plastic surgery, antidepressants, or a new car. The average child in the United States sees between 50 and 70 ads a day on television; the average adult sees 60 minutes of ads and promotions a day.

For the working poor, those on limited incomes, and the unemployed, much of the stuff that advertisers claim will bring happiness is out of reach, making the false promises a cruel joke. For all income levels, but especially for the poor, advertising becomes a relentless reminder that one is falling short of what others have—and of the good life.

“Who tells the stories of a culture really governs human behavior,” said media scholar George Gerbner. “It used to be the parent, the school, the church, the community. Now it’s a handful of global conglomerates that have nothing to tell, but a great deal to sell.”

The conversation about sources of fulfillment and joy has been colonized by the advertisers that manufacture the mindset of the consumer culture.

Paying the price for cheap stuff

The workers who make and distribute our stuff are among those who pay the price for our consumer lifestyle. When people lack money but are told that more stuff is essential to their happiness, low prices become paramount. Local businesses are driven into bankruptcy by big-box stores that can slash prices by paying rock-bottom wages.

Production workers find themselves unwilling participants in a race to the bottom for the lowest wage. Employers pick up and relocate if wages and safety standards are lower somewhere else or if workers begin organizing a union.

The nonhuman life of the planet suffers, too, from the colossal ecological burden of producing all our stuff. Human activity is causing species to go extinct at 1,000 times the rate that would otherwise occur in nature, according to a recent study published in Science. Industrial chemicals turn up in the bodies of sea mammals in the Arctic—and in our own bodies. A giant patch of plastic garbage circulates in the Pacific Ocean, poisoning wildlife up and down the food chain. Most troubling of all are the effects of burning massive quantities of fossil fuels and clear-cutting and burning forests. The carbon saturating the atmosphere is turning the ocean acidic and overheating the planet. The disruption of the climate threatens our coastlines, food supplies, and sources of fresh water, and supercharges wildfires and massive storms.

Growth no longer delivers happiness

�鶹���¼� consumption was supposed to bring happiness to us as individuals, and, likewise, economic growth was supposed to bring well-being to society as a whole.

The postwar period was considered an economic success story, and especially in the ’60s and ’70s, it was a time when many were lifted out of poverty and the gap between rich and poor was much smaller than it is today. The growth of the economy as measured by Gross Domestic Product (GDP) rose steadily.

We don’t need people working in sweatshop conditions to produce cheap stuff to feed an endless appetite for possessions.

But the GDP is an untrustworthy measure. It gauges economic activity, whether or not that activity means improvements. Dig a strip mine and sell the metals, minerals, or coal, and the GDP will thank you—even if you pollute the drinking water for thousands. Raise fresh food in your garden, share it with friends and with the local homeless shelter, and stay healthy and happy, and the GDP doesn’t budge.

The Genuine Progress Indicator (GPI), on the other hand, measures overall well-being; it subtracts out harmful things like crime, illness, farmland loss, and declining water quality, and adds in contributions to the economy that the GDP doesn’t count, like unpaid work in the home and volunteering in the community.

Until 1979, GDP and GPI both increased in the United States, more or less in tandem. But after 1979, something different happened. The GDP continued growing, while the GPI stalled. �鶹���¼� and more of our time and resources were invested in economic growth, but it was no longer delivering happiness, especially for those still stuck in poverty.

Why did the size of the economy continue to grow while well-being stagnated?

The culprits are “a rising of income inequality combined with environmental and social costs rising faster than consumption-related benefits,” says Ida Kubiszewski and colleagues in a paper published in Ecological Economics.

In other words, we’re not getting much happiness for all the time, money, and natural resources we’re using—and the benefits are going mostly to those at the top.

What changed? Among other things, free trade agreements and pro-corporate governments now make it possible for transnational corporations to outsource production to the lowest-wage regions of the world with the fewest regulations guarding worker and environmental safety. That strategy keeps prices down. But it makes it easy for corporations to slash good jobs and exploit workers here and internationally. The poverty wages and abuse of farmworkers in the United States, the numerous factory fires and the collapse of the Rana Plaza building in Bangladesh, the suicides at the Chinese factories that make Apple products, and the blood diamonds in the Congo are just some examples of the high price paid by those who produce our stuff.

Productivity has risen throughout the postwar era, especially with the deployment of computers and robotics. �鶹���¼� is now produced with an hour of worker time than ever. The increased income from that productivity could have been shared with workers in the form of higher pay or fewer hours for the same pay. Or the profits could have been taxed to fund higher education, infrastructure upgrades, a high-speed transportation system, a transition to a green economy, or any number of other things that would increase sustainable happiness. Instead, companies used the increased productivity to lay off workers, offer huge compensation packages to executives, purchase other companies, and pay out high returns to wealthy stockholders. And they spent billions on lobbyists and campaign contributions to win favorable laws, reduced taxes and regulations, and sweetheart trade deals. Organized labor no longer has enough clout to negotiate for a share of the increased income; wages have stagnated since the ’70s, while the income and assets of the top 1 percent—and especially the top 0.1 percent—have skyrocketed.

A diminished quality of life

The dominance of this profit-driven economy is undermining our quality of life.

To get by in an age of stagnant wages and government indifference, Americans work longer and longer hours. Those at the bottom of the income ladder, especially single parents, often work two or three jobs to bring in enough to get by, and many live in poverty even while working full time. With long hours (plus long commutes), who has time to be happy?

This form of corporate-driven consumerism increases inequality and undermines family life, and it’s gobbling up the natural resources of our planet. Mountaintops are blown off, forests converted to tar-sands open-pit mines, and farmland converted into fracking drill sites and strip malls. The planet has limits—a reality overlooked by those who preach unending economic growth. We now have industrial chemicals in our water supply, Dust Bowl-style droughts, acidifying oceans, dying bee colonies, melting polar ice, and extreme hurricanes and fire storms. There’s a saying: ���� mama ain’t happy, ain’t nobody happy.” Mother Earth is not happy.

Wages have stagnated since the ’70s, while the income and assets of the top 1 percent—and especially the top 0.1 percent—have skyrocketed.

Many people are concerned about these issues, of course. But ordinary people don’t have the resources to get the attention of elected officials, who must raise millions of dollars to run national campaigns. A recent study by two prominent academics, slated for publication in the Fall 2014 Perspectives in Politics, confirms that the United States has become an oligarchy. The views of ordinary people and their advocacy groups have virtually no effect on policy, the study found. Yet economic elites and organizations representing business interests have “substantial independent impacts” on government policy.

This is how inequality undermines sustainable happiness. The promise that more stuff brings happiness turns out to be a false promise. Likewise, the claim that the rising tide of economic growth “lifts all boats” is also false.

So where can we find sustainable happiness now?

If economic growth and consumerism aren’t a recipe for sustainable happiness, then how do we get it?

Sustainable happiness is a form of well-being that goes deep—it’s not a fleeting sensation of pleasure or a temporary ego boost. Instead, it is enduring because it taps into our most authentic aspirations and involves building relationships and practices that support us through good times and bad.

Sustainable happiness is built on a mutually supportive community. It grows out of the recognition that our well-being is linked to that of our neighbors. When we know that we can count on others in difficult times, that there is a place for everyone, and that we can make a meaningful contribution and be recognized for it, we have the foundations of sustainable happiness.

And sustainable happiness grows out of a healthy living Earth. At a very basic level, it comes from recognizing that each drink of water, each breath of air, the food that grows out of the soil or comes from the waters—all is possible because of the living ecosystems of the planet. Sustainable happiness goes deeper, though, to a celebration of the natural world even when it is not offering us a direct benefit.

The good news is that sustainable happiness is compatible with a healthy environment, an equitable world, and our own fulfillment. And it is contagious—the things that create well-being for one person tend to be good for others and for all life.

Sustainable happiness is possible—but much depends on the choices we make individually and as a society. Here are some places to start: 1) Stop the causes of trauma and support healing, 2) Build economic and social equity, 3) Value the gifts we each bring, 4) Protect the integrity of the natural world, and 5) Develop practices that support our own well-being.

1. Stop the trauma

Like the common sense rule contained in the Hippocratic Oath, we could start by doing no harm.

Life inevitably brings some kinds of hurt: A relationship breaks up, a loved one dies, or a job fails to materialize. With support from friends and family, we recover and go on.

Yet there are types of trauma that can be debilitating for a lifetime and even across generations. And many are preventable.

Veterans suffer high rates of post-traumatic stress disorder (PTSD). According to the Department of Veterans Affairs, 30 percent of those treated in VA hospitals after returning from deployment in Afghanistan or Iraq have PTSD. Their children also suffer and are more likely to be anxious or depressed.

Sustainable happiness goes deeper, though, to a celebration of the natural world even when it is not offering us a direct benefit.

Sexual violence is another way large numbers of people are traumatized. An estimated one in five women will be raped over the course of her lifetime, and a third of rape survivors will experience PTSD. Survivors are also three times as likely to have an episode of serious depression.

Nearly 700,000 children are subjected to sexual and physical abuse each year in the United States, according to the U.S. Department of Health and Human Services. Children suffer disproportionately from poverty, which also causes lasting trauma.

And there are the intersecting traumas caused by generations of exclusion, economic dislocation, and violence directed at people of color, who experience higher rates of PTSD as a result of ongoing racism, according to research cited by Dr. Monica Williams in Psychology Today.

Among the most important ways to create a happier world is to end the wars, abuse, and exclusion that are sources of continued trauma, and to support the healing of survivors.

2. Create equity

Stress can be healthy, if it’s the right kind. Short-term stress actually increases memory and mental function. But chronic stress—especially stress caused by events over which we have little control—increases the risk of heart disease and the likelihood of death. The Whitehall Studies—the famous 20th century investigations into the causes of death and disease among British civil servants—showed that low-status workers had a death rate three times higher than those in the upper reaches of the hierarchy, even when controlling for other class-based stress factors. �鶹���¼�over, the damage caused by inequality extends beyond the workplace. Epidemiologist Richard Wilkinson has demonstrated that those living in unequal societies have many times higher rates of mental illness, homicide, and teen pregnancy.

So if we want healthier and happier lives, we need a more equitable society—fairer in both an economic sense and in terms of the empowerment we all have to determine our own lives.

3. Value everyone’s gifts

It may be counterintuitive, but sustainable happiness comes from what we give, not what we take or even what we have. People who find their unique gifts and are able to offer them to others are often happiest.

Cameron Anderson, a professor at the Haas School of Business at the University of California, Berkeley, published a study in Psychology Science that shows winning the respect and admiration of our peers matters more than having stuff. “You don’t have to be rich to be happy, but instead be a valuable contributing member to your groups,” says Anderson. “What makes a person high in status in a group is being engaged, generous with others, and making self sacrifices for the greater good.”

Likewise, research cited in YES! Magazine by Stacey Kennelly shows that our happiness increases when we have the respect of our peers, but not necessarily when we have a higher income or more wealth.

College students who are politically engaged are happier, according to research by professor Tim Kasser. “Political activism scores were associated with feeling more pleasant emotions, reporting greater life satisfaction, and having more experiences of freedom, competence, and connection to others,” he says in a YES! Magazine article, “Making a Difference Makes You Happy.”

4. Protect the integrity of the natural world

The natural world doesn’t just bring us happiness; it is what makes life possible, and protecting its integrity contributes to sustainable happiness.

Getting out into nature improves our sense of well-being and is especially important for children. Benefits include reduced stress, improved health, more creativity, and better concentration, says Amy Novotney in the Monitor on Psychology.

The illusion that humans are separate and apart from the living Earth is finally giving way to an understanding that our fate is tied to the fate of the planet on which we all depend. Our work to protect and restore the planet’s ecosystems will mean clean water, healthy foods, a stable climate, and a better shot at sustainable happiness for generations to come.

5. Develop practices that support our own well-being

An egalitarian society that protects the natural world; minimizes war, racism, and abuse; and welcomes the expression of each person’s unique gift provides the foundation for sustainable happiness. But we don’t have to wait for the world to change. There are things we can do at home, too, that boost our own sustainable happiness.

We can exercise, a better cure than prescription drugs for much of what ails us. A sedentary life is as dangerous to health as smoking, according to studies cited by the American College of Sports Medicine. Regular moderate exercise not only reduces the risk of heart disease, diabetes, and stroke; it also makes us happier, often controlling depression as effectively as prescription antidepressants. It’s much cheaper, and all of the side effects are good.

Sustainable happiness goes deeper, though, to a celebration of the natural world even when it is not offering us a direct benefit.

We can also develop a practice of gratitude and learn to be mindful.

Some of the happiest people are those who have survived great illnesses or other major life challenges and have become conscious of the choices they make about their finite lives. There’s something about facing the possible end of life that brings into focus the precious choice we have about how to spend our remaining days.

“Everything can be taken from a man but one thing: the last of human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way,” Viktor E. Frankl wrote.

A global happiness reset

As endless growth and bottomless consumption lose their luster as aims for our lives, many people are seeking out better ways to achieve happiness. New approaches are beginning to take hold around the world.

Buen vivir

Out of the indigenous regions of South America comes the idea of buen vivir (the good life). In this way of thinking, well-being does not just come from the individual pursuit of happiness. It comes from being part of a vibrant world that includes both human and natural communities. Instead of serving the economy, the economy exists to serve us. We are here to live well with our families, and it is in relationships of respect and reciprocity with neighbors and with our ecological neighborhood that we will find happiness.

This, of course, is a radical reversal of the economic growth aims of society as promoted by both liberal and conservative political leaders. Instead of seeing nature and human labor as an input into a production machine we call the economy, this perspective aims to foster an ethic of stewardship, mindfulness of the interests of descendants seven generations on, gratitude for what we have—along with a sense of enoughness—and the acknowledgement of the rights of all life.

Buen vivir has now been embedded in the constitutions of Bolivia and Ecuador. This framework has inspired a grassroots approach to the climate crisis and has become the foundation of international discussions, especially in Latin America.

Bhutan’s gross national happiness

In 1972, soon after ascending to the position of the Fourth Dragon King of Bhutan, the young Jigme Singye Wangchuck declared that he was more interested in gross national happiness than in gross domestic product. This statement launched studies and assessment surveys, based on Bhutan’s unique culture and values, so that happiness could be used as a yardstick for policymaking in this small Asian nation. Gross national happiness as defined by Bhutan includes psychological well-being, health, education, time use, cultural diversity and resilience, good governance, community vitality, ecological diversity and resilience, and living standards.

Focusing on the well-being of the people guided Bhutan as it followed its own path, rather than adhering to the interests of global economic forces. Bhutan decided not to join the World Trade Organization, for example, when it concluded that such a move would undermine happiness and well-being.

���� we look at things holistically, based on health, community connection, arts and culture, the environment, we will govern the country differently.”

���� Bhutan joins the WTO, it surrenders, by very definition, the right to determine who participates in defining and achieving the happiness of the Bhutanese whole to external forces. In other words, Bhutan surrenders to market forces and to the powers that are dominant in the market its own sovereignty,” said Stanford history professor Mark Mancall.

Bhutan’s idea that happiness, not growth, should be the measure of progress is spreading. The United Nations General Assembly adopted a Bhutan-sponsored resolution in July 2011 that calls on other nations to make happiness and well-being a central feature of their development work, and to develop indicators to measure the well-being of their own people.

The happiness movement in the United States

In the United States, the states of Maryland and Vermont are using the Genuine Progress Indicator to measure happiness. They are factoring in the benefits of volunteer time, housework, educational achievements, and functional highways and streets while subtracting things like crime and the depletion of nonrenewable energy sources. By measuring these and other factors, a more complete picture emerges of real well-being.

���� we look at things holistically, based on health, community connection, arts and culture, the environment, we will govern the country differently,” John deGraaf, a co-founder of the Happiness Alliance, told me. “We will understand that success comes more in societies that are egalitarian, that have great time balance—short hours and shared work, strong social safety nets so people feel secure. We’ll have greater confidence in government and greater trust in each other.”

Maybe happiness sounds like a frivolous endeavor for us as individuals, and especially for governments and the United Nations, to pursue. But consider Thomas Jefferson’s insistence on including the “pursuit of happiness,” rather than “property,” along with life and liberty in the Declaration of Independence. Jefferson was deeply influenced by the Greek notion of eudaimonia, which refers not to a fleeting pleasure but to the essentials of what it means to be human—in other words, to human dignity.

In this sense, sustainable happiness is not frivolous at all. There aren’t enough resources in the world for all of us to live a consumer lifestyle. But by choosing wisely, we can have a world in which each of us can live in dignity.

Those who are affluent can gain happiness by eschewing excess consumption, de-cluttering, practicing gratitude, relishing good times with loved ones, and protecting the natural environment.

Much of the stuff that advertisers claim will bring happiness is out of reach, making the false promises a cruel joke.

For those lacking the means to provide for themselves and their families, an increase in access to resources can result in real improvements in well-being.

As a whole, we stand to gain a lot. A more equitable world fosters trust, increasing our capacity to work together to solve the big problems of our time. It means a world with less crime, less disease, less corruption, and less waste. And it’s a world in which we make the best possible use of the natural resources we extract from the Earth by making sure that—to loosely paraphrase Gandhi—our natural wealth goes to meet needs, not greed.

Ways of life that focus more on happiness and less on economic growth leave time for family, community, and the development of the many dimensions of our lives that we know bring real happiness.

One more thing: In a time of increasing disruptions related to a changing climate and economic dislocation, our challenge will be to create the conditions that encourage us to turn to each other in hard times, not turn on each other. We are far more likely to achieve that in a more equitable world, where we are mindful of the many blessings we have and skilled at discovering sources of happiness that don’t cost the planet, but are abundant and free.

According to a recent study, more than 70 percent of 18- to 34-year-old men visit porn sites in a typical month.

I didn’t know it then, but porn had become an addiction. And, like most addictions, I was ashamed to talk about it or even admit it was a problem.

“Everybody watches porn,” I remember hearing. It seemed so pervasive and culturally accepted that having an actual conversation about it was a total non-starter. So I kept it to myself.

I thought I had my habit under control. I thought I could quit porn whenever I felt like it. I even tried to quit a few times and then rationalized my eventual return to the addiction.

I didn’t realize how much watching porn had manipulated my mind, warping my sexuality, numbing my feelings, and affecting my relationships with women. And I was not alone.

It got to a point where I felt physically ill watching the videos, and yet I kept watching.

According to , more than 70 percent of 18- to 34-year-old men visit porn sites in a typical month. And it’s not just guys watching sex online. It is estimated that 1 in 3 porn users today are . Now, I want to be clear that porn use extends across all gender expressions, but for the purpose of this post I am sharing my experience with porn from the perspective of a heterosexual white man with more or less traditionally masculine ways of acting and speaking.

Let me also state clearly that I don’t think all porn is bad. I’ve seen some great videos of couples engaging in intimate and respectful sexual encounters—of course, these are usually found only on or in the category on mainstream porn sites called “female friendly” (It’s interesting to note what the category name “female friendly” implies about all the other categories). But I’m not here to judge anyone else for what they choose to watch. I’m simply sharing the impacts that porn has had on my life and what has changed for me since I’ve stopped using it.

To me, what is worrying about porn is not how many people use it, but how many people have found themselves addicted to it.

Impacts of porn

One of the best of the many conducted on the impacts of porn on men and women in society is a by psychotherapist Gary R. Brooks. It documents many effects of porn, including three that strongly resonated with my experience:

1. Violence against women

This includes an obsession with looking at women rather than interacting with them (voyeurism), an attitude in which women are viewed as objects of men’s sexual desire, and the trivialization of rape and widespread acceptance of rape culture—fueled by fake depictions of women in porn videos often pretending to desire violent and abusive sexual acts. (Numerous studies have documented links between porn viewership and increased instances of sexism and violence toward women. Here is one s.)

2. Numbness and disembodiment

This can include , inability to orgasm when not watching porn, detachment from your physical body, emotional unavailability and numbness, lack of focus and patience, poor memory, and general lack of interest in reality. Furthermore, to boredom with their sexual partners, higher levels of sexual promiscuity, adultery, divorce, sexism, rape, abuse, and suicide.

3. Fear of intimacy

Watching porn contributes to many men’s inability to relate to women in an honest and intimate way despite a longing to feel loved and connected. This is because pornography exalts our sexual needs over our need for sensuality and intimacy; some men develop a preoccupation with sexual fantasy that can powerfully impede their .

Why I quit watching

I always felt like a hypocrite watching porn. Here I was, a man who is striving to be an ally to women, perpetuating the very culture of violence and misogyny that I was ostensibly trying to fight. The reality was that most of the videos I found online had titles that included words like “bitch” or “slut” and showcased controlling behaviors that were rooted in a culture of subjugation and objectification, where women are nothing more than sexual bodies to be exploited and dominated by men.

My year without porn has helped me reconnect to my body and begin to develop healthy emotional expression.

When I am deeply honest, I have to admit I was both intrigued and disgusted by these images. By that time, my mind had been trained to find aggressive, misogynistic, and even non-consensual sex arousing. I found that this response was just one of many symptoms of a larger system of patriarchal oppression affecting my life. It is difficult for me to admit, but it got to a point where I felt physically ill watching the videos, and yet I kept watching. That’s when I realized I was dealing with an addiction.

What I’ve discovered is that there is a whole spectrum of addiction, from a feeling of compulsion on one end to an intense dependency on the other. My porn addiction seems to have been pretty mild, since I did not experience any serious withdrawal effects. For some people with more serious addictions, may be needed.

Last February, after a decade of use, I decided to quit watching porn for one year, both for the challenge of seeing if I could and for the chance to see how life might be different.

Today marks my one-year anniversary of life without porn. It hasn’t been easy, particularly as a single guy, but what I’ve learned about myself through this experience has transformed my life forever.

Life after porn

Here are some of the things I’ve gained during my year without porn:

1. Integrity and love

Since dropping porn, I have restored a sense of personal integrity that had been missing from my life. Regaining this integrity has allowed me to move through a lot of my shame and find myself in a new space of deepening love for myself and others. I’ve also noticed that I am often able to stay more present with women now, rather than projecting fantasies onto them. This was hard to do when my mind was cluttered with images from porn videos. This newfound presence has also allowed me to begin to dismantle some of the subconscious sexism within me, helping me work toward becoming a better ally to the women in my life.

2. Embodiment and emotional expression

My year without porn has helped me reconnect to my body and begin to develop healthy emotional expression. I’ve begun to expand my sense of self by learning how to move out of my head and into my heart. After many long years void of emotional expression, I’ve reconnected to my tears. This release of suppressed emotional tension has unlocked a lot of joy in my life. All of this has helped me begin to shift my sexuality from physical detachment to true intimacy, presence, and embodiment.

3. Creativity and passion

Over the past year, I’ve started feeling more comfortable in my own skin. I’ve become much more willing to let go of control, to improvise, and to accept people’s differences. I trust myself more than I ever have and, as a result, my sense of self-confidence has soared. I wake up every morning grateful to be alive, clear about my life’s purpose, and passionate about the work I am doing in the world. My life today has a depth of authenticity and power that I never felt before.

Stepping up

Last week, many folks in my community and around the world engaged in conversations about ending the sexual violence and abuse that directly affect over a billion women across the globe today. Of course, women and girls are not the only ones hurt by sexual violence. I’ve heard stories from a lot of guys who are also affected by cycles of violence and abuse that got passed on through generations. It is important, however, for me to recognize that .

It’s time we begin transforming our pain into love by opening our hearts and reconnecting with our bodies.

As the Franciscan priest and compassion advocate has written, “pain that is not transformed is transmitted.” And this pain is often transmitted in the form of violence. So how do we, as men, break this cycle? It’s clear to me that we will never transform our pain within a culture of silence. It is only by bringing our shadows to the light that we can diffuse the power they hold over us.

Over the past several years, I have heard a lot about inequality, sexism, and violence against women. I believe it is vital for porn to be a part of that conversation, particularly amongst men.

If we are serious about ending violence against women, then we must be willing to have open and honest conversations about how porn is affecting our lives.

I am committed to a world of love, respect, and safety for all people. I’m sick of all the shame, numbness, and secrecy surrounding porn and addiction. I’m saddened to hear about all the guilt people feel (from churches, parents, teachers, etc.) simply for wanting to express their sexuality in healthy and authentic ways. And I’m outraged by all of the violence, degradation, and exploitation of women. Enough is enough!

The only way we can transform the culture of violence is to make it transparent by speaking the truth about the ways that we consciously and subconsciously contribute to it. A culture of love and healing can only be built on a foundation of radical honesty and integrity, built from the ground up in our own lives.

Will you stand with me? It’s time we start talking about the things we’ve been afraid to talk about, knowing we’re not alone. It’s time we begin transforming our pain into love by opening our hearts and reconnecting with our bodies. It’s time we, as men, step into a more mature masculinity: one that recognizes the sacredness of the human body, one that creates intimacy and cultivates authentic connection and healing, one that is unafraid to love and be loved.

This article originally appeared on 

Additional Resources:

1. The Great Porn Experiment:

2. Why I Stopped Watching Porn:

3. Violence Against Women: It’s a Men’s Issue:

4. Make Love Not Porn:

5. Sexual Recovery:

6. The Good Men Project:

7. ManKind Project:

Traveling to the jungle, though sometimes difficult, is an important part of her self-care strategy. The hot and humid weather, the rough terrain, and the level of attention it requires help her to decompress from the abortion activism she’s doing in the northern state of Nuevo León.

“Last time I went, I was like, ‘I’m going to die, right?’ I asked myself, ‘What am I doing here?’ And one of the girls told me: ‘You have to listen to your heart and learn to return to its rhythm. You are going to breathe four times and release it as slowly as you can, as if you were blowing,’” says Jiménez, laughing while sitting on the couch at home in Monterrey.

Jiménez and her long-time partner, Sandra Cardona, are the founders of Necesito Abortar, a group of 20 “�����dz��貹ñ���Գٱ��” (companions) that provide support throughout the abortion process. Most of the companions receive no financial remuneration and carry out this work in addition to their paid jobs and daily commitments. While these volunteer collectives have brought Mexico to the forefront of abortion access, there is one struggle that goes largely unnoticed: the health and emotional well-being of these volunteers.

Perla Martínez, who’s a member of Las Borders, a collective based in Mexicali, Baja California, explains that sometimes the demand can be overwhelming, so it has been important to establish fixed hours of attention, create spaces that allow activists to decompress, and delegate cases to other members as needed.

“Take days off! We didn’t do it before, but we’ve already started doing it,” says Martínez. “We rotate activities so as not to wear out. Also, if suddenly we are very saturated, we share it between us.”

Keeping Activism Strong

Across Mexico, these networks provide counseling, in-person or online accompaniment, and follow-up care for people seeking at-home abortions. Despite the legislative advances in the country, many women and pregnant people are still choosing the �����dz��貹ñ��������Գٴ�.

Mexico’s Supreme Court on the federal level in 2023 and requires federal health facilities to offer and provide abortion care. However, medical workers can still refuse to carry out terminations, and 20 of Mexico’s 32 states still have .

Pending legal battles aside, reproductive justice activists along the U.S.–Mexico border agree that the social stigma surrounding abortion remains one of the biggest challenges facing the region. This can have a negative impact on both the people seeking abortions and those providing access to them. In some cases, this can even manifest itself in the form of fatigue, illnesses, sleep disorders, burnout, and more.

“Sometimes it can be emotional when there are complex accompaniments, or that they are crossed by various forms of violence,” says Martínez. “That’s also heavy … holding people every day. But I also think that there are people who support me every day.”

To combat these side effects, collectives are organizing recreational events that encourage relaxation. The Necesito Abortar network hosts two large annual meetings with all members, while Las Borders tries to schedule time to hang out or celebrate. Individually, members also try to create space for self-care. Just as Jiménez enjoys spending time in nature, Cardona’s chosen activity is binge-watching television with her cat. Martínez also enjoys spending time with her cat, Gati, and watching  “trash TV.”

“I go to screen-printing classes as an occupational therapy, which also helps me not only to get out of my bubble, but also to generate some things out from that rage, anger, or joy,” adds Martínez.

A Network That Keeps Growing

Some cases can trigger past experiences or have a strong emotional impact on the �����dz��貹ñ���Գٱ��. For Jiménez, cases that involve violence and sexual torture are the toughest. In these situations, she often finds it necessary to share how she feels with the rest of the network.

Samantha Montalvo, an independent acompañante trained by Necesito Abortar, explains that these cases reveal the complexity and responsibility of the support the acompañante provides. In 2005, Mexico passed the to establish procedures for the prevention and care of family violence. It states that health institutions are obligated to guarantee access to abortion services in cases of sexual assault. However, as Montalvo explains, there are health facilities that still refuse to follow it, complicating the �����dz��貹ñ��������Գٴ�.

“As a companion, you have to find the methods to make the NOM-046 valid,” she says. “It requires commitment, knowledge, network, ethics, and self-care.”

Montalvo, a psychologist on the autism spectrum, mainly focuses her �����dz��貹ñ��������Գٴ� on people who are neurodivergent and/or have disabilities. “I asked myself the question too, right? OK, yes, we all have abortions. But what about the ‘locas’ [crazy ones]?” she says, adding that her use of the term “crazy” is a powerful tool against stigma and prejudice.

In their battle to expand disability services, Montalvo and her “community of locas,” as she calls it, have witnessed the stigmatization of community care. They are called manipulators, promoters of abortion, or even “intellectual authors of a crime.” They are often harassed on social media and at work.

“Being psychologists who accompany abortion processes, [other colleagues] see us as unethical,” Montalvo explains. “They also threaten to take away our professional license because they believe that we offer therapy in order to make them get an abortion, when one thing has nothing to do with the other.”

Organizations like Ipas, which seeks to increase access to safe abortions and contraception, and Mexico’s Red Nacional de Defensoras de Derechos Humanos, which responds to the violence faced by women defenders and journalists, offer self-care resources. However, with all the various violences that women face in Mexico, there is still a lack of more detailed information on how the �����dz��貹ñ���Գٱ�� are affected.

“We still need to make a detailed analysis of the psycho-emotional and psychosocial impact that defenders who defend the right to decide have specifically. …[We] need to carry it out to look in more detail at some aspects that may possibly help us generate more comprehensive attention to the issue of defense of colleagues,” says Cecilia Espinosa, co-director of the Red Nacional.

Despite the challenges, �����dz��貹ñ���Գٱ�� are committed to reducing abortion stigma,  increasing knowledge, and expanding access to sexual and reproductive health services in Mexico and beyond its borders. For instance, a cross-border network with U.S. activists in states where abortion is banned or severely restricted is supporting mainly undocumented immigrant women while sharing information on the creation of underground networks of community abortion providers. 

“Now we have to focus on other groups or on how to socialize it more every time and make it more accessible, beyond the groups that have access to social networks,” says Jiménez. “It is a daily job: to sell the �����dz��貹ñ��������Գٴ�.”

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

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

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

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

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

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

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

The Intersection of Spiritual Healing and Sexual Healing

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

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

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

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

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

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

Inch by Inch

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

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

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

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

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

Get to Know Your Politicized Body

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

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

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

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

Hope for Sexual and Spiritual Healing in Our Time

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

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

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

Birth narratives might also contain clues about how the adjustment to parenthood will go.

 to understand difficult experiences. Stories may be particularly valuable as a source of “meaning-making,” the process of finding order in chaos by making sense of unexpected events, identifying silver linings, and discovering the patterns and connections that thread seemingly random events together into a coherent narrative.

In a new study led by , a former graduate student in , we found that the levels of meaning-making in the stories new parents told about their baby’s birth  in the child’s first months.

Constructing Meaning in Your Own Life

Finding meaningful themes and patterns in life’s seeming randomness is a fundamentally human activity. As writer Joan Didion put it, “.”

Meaning-making can buffer despair in the wake of tragedy. Holocaust survivor Viktor Frankl’s memoir, , argues that meaning and purpose can prevent the bitterness and disillusionment that can otherwise fester after great loss. Research on what psychologists call “” has found that the level of meaning-making in people’s narratives about a difficult event predicts their mental health over time.

For example, studies have found  in cancer patients, bereaved parents, and caregivers. Cancer survivors might discover that their chemo ordeal brought them closer to friends and family, or helped them step back from the hustle of everyday life and embrace a slower pace.

Although childbirth is typically experienced as a joyful rather than a tragic event, it can still be unpredictable, frightening, and even life-threatening. Indeed, psychologists have begun to recognize that particularly difficult labors , not just in mothers but in their partners as well. Even normal, nontraumatic births require parents to cope with hours, sometimes days, of pain and discomfort. Therefore, we hypothesized that meaning-making might be an important part of couples’ birth narratives, potentially promoting resilience in new parents.

To test these hypotheses, we collected birth stories from 77 couples who were participating in our lab’s . We visited couples at the hospital within a day or two of their infant’s birth, and audio-recorded them sharing their stories together. We told couples, “We’d like to hear you tell the story of your birth experience. Start from the beginning and tell us as much as you remember.”

Listening for Meaning-Making in Birth Stories

A team of coders listened to each story and recorded examples of meaning-making, using three categories established in the research literature:

• Sense-making: Identifying reasons that an event might have unfolded the way it did or making connections that show why an event was meaningful. For example, one mother in our sample found meaning in her long labor, describing her baby as “very brave and tough” because she survived hours of pushing.
• Benefit-finding: Pointing out silver linings or unexpected positive effects of a difficult experience. For example, after a difficult birth, one parent in our sample stated, “It was scary, but the nurses and the doctors were so nice to us.”
• Change in identity: Describing how an event has transformed one’s sense of self. As a parent in our sample said, “I feel like my life has changed completely with the baby now here.”

Although couples told their story together, we tracked meaning-making separately for each partner. We also rated how much each partner participated in telling their story so we could adjust for their levels of engagement in sharing their birth narrative.

The : Almost all the participants made at least some meaning-making statements in their birth stories. Of the three categories of meaning-making, change-in-identity language surfaced least often, appearing in about 37% of the birth stories. Mothers tended to use more sense-making and benefit-finding language than fathers. And both members of a couple tended to use similar amounts of meaning-making language.

Becoming Mom or Dad

After we had coded all of the narratives, we next looked to see whether meaning-making predicted relationship satisfaction and parenting stress in our couples. The transition to parenthood can be a  and is often linked with .

But when mothers used more sense-making and benefit-finding language, they showed a smaller drop in their relationship satisfaction than moms who used less. Fathers who used more sense-making and benefit-finding language reported lower parenting stress at six months postpartum than dads who used less.

And partners of fathers who used more change-in-identity language also reported lower parenting stress later on, suggesting that dads who experience the transition to parenthood as transformative may be able to help mothers cope better with new parenthood. On the flip side, though, when mothers showed more meaning-making, their partners actually reported more parenting stress at six months postpartum. It may be that when mothers find the birth experience to be more personally meaningful, partners feel left out or pressured to step up their own parenting.

Overall, these results supported our initial hunch that meaning-making might be detectable in birth narratives and forecast �貹����Գٲ�’ psychological adjustment after birth. Greater meaning-making language seemed to benefit the couple relationship and largely buffer parenting stress.

This study was limited by a fairly small sample of cohabiting heterosexual parents. Nevertheless, it highlights the value of stories in shaping family transitions. For therapists working with new parents in the wake of a difficult birth, encouraging couples to seek meaning in their birth story may help ease their transition to parenthood. Journaling and storytelling exercises may help couples process their feelings about their childbirth experiences. After all, the birth of a baby is also the birth of a story—and that story is well worth telling.

This story was originally published by . It has been published here under a Creative Commons license.

I have a unique perspective on the subject: I was 6 when Islamic fundamentalists and started a war on joy. I learned quickly that oppression often manifests through the policing of the arts. The morality police cracked down on most types of music, dancing, and even playing. Our teen neighbor’s birthday party was who pointed AK-47s at us. Half of my sister’s high school senior class was imprisoned. Without warning, one of her friends was executed.

At the same time, we found ourselves embroiled in a bloody war with Iraq, and daily funerals became routine. There was little to be joyful about, but my family and friends still took dangerous risks to nourish our souls. We intuitively knew playing , singing, and dancing served as powerful coping mechanisms to get us through the devastation of war and theocratic oppression. We broke the law even though we knew we could lose our freedom or even our lives.

�鶹���¼� than four decades later, Iranians are still engaging in collective joy as an act of , often with dire consequences. Now as a (MAP) in the United States, I bring music and dance to refugees as a form of communal healing. When I started dancing with refugees in Tijuana, Mexico, in 2018, some activists dismissed the program as frivolous and even wasteful. They argued that refugees needed legal and medical help and permanent housing, not art.

While those are real needs that must be addressed, the shelter directors asked us to continue the program even if we couldn’t provide a monetary donation. The directors told us that the of our sessions, including increased collaboration, lasted several days. Participants reported feeling more at ease and less anxious or depressed, with even headaches disappearing.

During the pandemic lockdown, asylum seekers stranded in Mexico insisted on continuing the program, leading us to transfer our dancing to Zoom sessions.

Around the same time, essential workers and activists dealing with began reaching out to us to organize similar programs. Having witnessed countless instances of transformation in these sessions, I’ve grown increasingly curious about the link between joy and , an interdisciplinary field of research that explores how aesthetic experiences and the arts affect the body, brain, and behavior.

Susan Magsamen, the founder of the International Arts + Mind Lab at Johns Hopkins University and the co-author of , confirms that there is an inherent human need for joy “through neuroaesthetic experiences.” Activities that bring us joy stimulate the release of dopamine in the brain, which contributes to mood regulation, learning, and memory enhancement. “Researchers are confirming that the body naturally leans toward health and it is in play, music, dance, and visual arts that our bodies respond, find nourishment and healing,” she says.

Given that the nervous system acts as a homing device for neuroaesthetic experiences that stabilize, nourish, and fortify us, it is unsurprising that even in the most dangerous parts of the world, people engage in communal arts. Here are a few examples of such resilience and resistance in the most perilous conditions.

Art With Asylum-Seekers in Tijuana

Currently, the U.S. has more than with unprecedented waiting periods of up to seven years. The trauma of experiencing violence, fleeing an unsafe home, undergoing a grueling journey, and then facing the uncertainty of the asylum process takes a heavy toll on , many of whom are children. 

Ada, the director of a migrant shelter in Tijuana, who is using a pseudonym to protect her identity, believes that collective joy expressed through the arts provides a sanctuary for healing. Migrants themselves view this as an act of resistance in the face of unjust and often draconian policies that prevent them from seeking refuge. “That’s why we adopted the concept of joyful resistance or in Spanish, ,” Ada says. The practice allows migrants, whose bodies are constantly policed, to reclaim some of their .

Ada and her group also noticed early on that the media doesn’t include migrant voices. “Most of the time when there is talk of immigration, you only hear experts, authorities, and organizations,” Ada adds. By engaging in music, art, and mural making, migrants can raise their own voices without compromising their identity. In this way, resiste gozando has become a powerful vehicle for amplifying migrant voices.

Dancing With Freed Congolese Child Soldiers in Uganda

In , where Congolese Tutsi have been systematically massacred and driven from their ancestral lands for nearly 30 years, my MAP colleague, , dances with traumatized kids in three settlements catering to hundreds of thousands of refugees in western Uganda.

When he was 18 months old, Conrad’s entire family was murdered during the Rwandan genocide; he was the only survivor. His adoptive mother found him hidden in a sorghum garden and brought him to Uganda. “I joined MAP because I saw the impact music and dance had on my own healing journey,” he says.

The age range of the child soldiers, the majority being girls, spans from 7 to 14 years old. Most children were kidnapped by various factions of Congolese rebels and endured horrifying experiences, including being trained to become killers themselves. The children were ultimately rescued by joint forces beginning in 2018 and brought to refugee settlements, where Conrad’s team is providing activities for trauma healing. 

“We play music, move our bodies, and create together,” Conrad adds. He finds that the traditional popular in central Africa connects the children to their roots and makes healing war wounds more accessible. “It’s amazing to see the smiles and laughter return to their faces as they begin to heal.”

Singing and Dancing With Kids in Gaza

Even before Oct. 7, 2023, many Palestinians experienced . Instead of , where the mind is trapped in a loop of a traumatic experience, there is no end to the trauma they are experiencing every single day. The situation is far worse now, especially for the more than 600,000 children who are enduring starvation, , constant displacement, and loss of loved ones.

My MAP colleague, , recognized the urgent need to tend to children’s mental health and was set to resume the singing program a few weeks after October 7. Before he could begin, he was in an Israeli airstrike.

During months of incessant bombing and slaughter, another one of my colleagues, , sang indigenous Palestinian songs with displaced children in different parts of Gaza. Those children told Shamaly they were afraid of being bombed and becoming martyrs. Singing together allowed them to experience grounding, joy, and respite from the constant horror. 

With the help of donors, MAP evacuated Shamaly in April, but her entire family is still suffering in Gaza. “It’s really a genocide,” she says. “The Israeli army bombed everything. Gaza is destroyed. Our life [is] destroyed,” she adds. After leaving Palestine, Shamaly immediately returned to music to help her with the trauma she experienced and to use her voice to bring attention to the plight of Palestinians. Her music was live streamed at this past April.

At the time of this writing Bashar Al-Bilbisi, a 23-year-old pharmacist and the director of the Al-Fursan Arts Ensemble still teaches , an Indigenous Palestinian dance, to children in Gaza. He, and the children he dances with, were displaced multiple times and are still on the move to evade Israeli airstrikes. “We dance together to preserve our heritage and also to be a means of discharging negative energy in all areas of Gaza, despite all the difficulties we are exposed to due to the war,” he says.

Communal Culture for Collective Healing

Joy and art are transcendent and essential to human . “We often say that the arts create culture, culture creates community, and community creates humanity,” says Magsamen.

Refugees, the oppressed, and the dispossessed carry their community, culture, and humanity in their blood through generations-old songs, poetry, and dances that no assailant can take away from them. “These aspects of their culture are ingrained in them, and they need nothing more than their voices and their bodies to access the foundational aspects of their communities,” adds Magsamen.

Many populations have and are currently experiencing . Communal art, then, fosters joy, serving as a primer to connect to one’s self to one’s roots, and to others. It also provides a supportive environment to invite and process more difficult emotions. While addressing the root causes of individual suffering from various angles is essential, now is the perfect time to embark on the journey of through cultivating joyful communal practices, nurturing healthier individuals, and fostering a more robust society.

The little girl approached her mother, who told her that she was menstruating. She said menstrual blood was dirty, and that menstruation was a curse from God. Paudel was so traumatized by witnessing these restrictive monthly practices that she begged God to turn her into a boy. When that didn’t happen, at 9 years old, she attempted suicide, and survived.

When Paudel’s first menstruation arrived at age 14, rather than be forced to follow the restrictions surrounding the idea of menstruation being unclean, she ran away from home.

It was only when she started attending nursing college the next year that Paudel learned that menstrual blood is a natural part of the body. She realized that the menstrual discrimination that she, her mother, and her three sisters experienced was widespread in Nepal. It affected both rural and urban menstruators, rich or poor.

As Paudel later learned in her career as a nurse, activist, and writer, many of her educated friends and colleagues who lived in the capital, Kathmandu, still practiced menstrual restrictions because of the fear of elders, religion, culture, traditions, or societal pressures.

“Menstrual discrimination plays a huge role in constructing and reinforcing unequal power relations and patriarchy,” says Paudel, who has since pioneered the movement for dignified menstruation and founded the Global South Coalition for Dignified Menstruation.

Seclusion and Secrecy

Menstrual discrimination takes many different forms. In , women are told they shouldn’t cook, visit sacred temples, or touch or go near plants. In Democratic Republic of Congo, menstruating women are told that if they work in the field the whole harvest will be destroyed. In some communities in Pakistan, women are told not to consume cold beverages, ice cream, fish, meat, milk, eggs, or pickles. 

In addition to these restrictions, there are also widespread myths about menstruation that are harmful for the physical and mental health of those who menstruate.

When Pacifique Doriane-Sognonvi started bleeding for the first time at 14 years old, she saw the drops of blood slowly trickling down her thighs and thought that she must have hurt herself somehow. She had never heard the word “period” before and didn’t know what to do. Doriane-Sognonvi went to her older sister for advice, who informed their father, and together they cut up pieces of clothes and stuffed them in her underwear.

Then her father turned to her with a stern look on his face and proclaimed: ���� you come close to a boy and touch him or if he touches you while you are bleeding, you will become pregnant.”

Puzzled and still feeling uncomfortable from the itching fabric, she accepted her father’s words as truth. It was only at 21 years old, when Doriane-Sognonvi left home and started university, that she learned that her father’s warning was untrue. 

“When I found out that it was a lie, I was horrified and super angry,” says Doriane-Sognonvi, who now works as a peer educator for the nonprofit . She organizes workshops about menstrual hygiene and sexual and reproductive health for the LGBTQ community in Ivory Coast.

Without proper and accurate information, menstruators cannot make informed decisions about their bodies and lives, and they become susceptible to misinformation.

The problem often comes down to one simple fact: The period is considered dirty, and menstruating women are either forced to stay secluded or keep it a secret. This builds fear, stigma, and silence about menstruation—at home, at school, at work, and in public.

“In Ivory Coast, menstruation is viewed as a handicap or an illness,” Doriane-Sognonvi says.

The stigmatization and lack of awareness feeds into an ignorance of menstruation as an issue of public health importance. Globally, to menstrual products and adequate facilities for menstrual hygiene management.

“Many girls in rural areas have never seen a pad in their whole life,” says Crispine Ngena, a reproductive and climate justice activist from Democratic Republic of Congo, who is helping communities displaced after volcanic eruptions and military interventions in eastern Congo. “Access to period products just doesn’t exist here.”

Recognizing Discrimination

For a long time, Paudel didn’t think there was hope for menstruating people. All she could see was pain, trauma, and suffering. Despite isolation and even death threats, she has dedicated her life to changing the way societies see menstruation.  

Paudel spearheaded a global movement for dignified menstruation, which she defines as “a state where menstruators of all identities are free from any forms of menstrual discrimination, including taboos, shyness, stigma, abuse, violence, restrictions, and deprivation from services and resources associated with menstruation throughout the life cycle of menstruators.”����

The main goal of the Global South Coalition for Dignified Menstruation is to ensure that international organizations and countries recognize that menstrual discrimination plays a key role in constructing and shaping unequal power relations and patriarchy, starting in childhood.  

“�鶹���¼� than half of the population of this planet experiences menstrual discrimination in one way or another, but the United Nations has never recognized that,” Paudel says.  

That’s why she has been pushing the United Nations to acknowledge menstrual discrimination as a barrier to gender equality and as a form of sexual and gender-based violence. She has presented her work to the Commission on the Status of Women four times and submitted a petition to the UN in 2019.����

Menstrual discrimination violates individuals’ rights to dignity, freedom, and equality. It also denies (or severely complicates) their access to food and water, and can dramatically increase health risks due to the delay or denial of care.

Paudel has been consulting with governments to include dignified menstruation in national policies. Nepal has had a dignified menstruation policy since 2017. If anyone reports any form of menstrual discrimination, it is considered a social crime. By law, the perpetrator can be punished with up to three months in jail and/or a $30 bail. Paudel has been providing technical input to menstrual equity policies and research for other countries in the Global South.   

Paudel has also been teaching about menstruation at universities and high schools worldwide, mentoring Ph.D. fellows internationally, and writing fiction and nonfiction books on dignified menstruation. For her, menstruation dignity is the way to achieve equality, dismantle patriarchy, achieve sustainable development goals, and reimagine feminism.  

Paudel is often met with hostility, abuse, and blame from Nepalese and international organizations who accuse her of being anti-Hindu, negativist, and anti-tradition.  

“I don’t mind,” Paudel says. “I will never give up. I will do this whether people support me or not, till my last breath.”

Conversations As a Gateway

But even without a war or a climate disaster, getting a pad or tampon can be an insurmountable task. In the United States, . This so-called period poverty—in which low-income menstruators cannot afford menstrual products—can be a one-time experience or a permanent state.

After reading by Nadya Okamoto, Aydan Garland-Miner realized that period poverty intersected with multiple issues of injustice that she was already passionate about. She launched a chapter of the menstrual equity nonprofit PERIOD at her university and distributed period products, advocated for menstrual equity legislation in Washington state, and hosted educational workshops for students. 

Now she works as the global community engagement coordinator at PERIOD, which annually distributes millions of menstrual products to grassroots organizations who are serving their communities. PERIOD has 180 chapters in the United States and 34 internationally. 

Talking about menstruation is not celebrated or popular, but Garland-Miner strongly believes it has to be done. “You don’t have to be giving a formal talk about menstruation, but you can talk to anyone and everyone about the fact that period poverty exists. The uncomfortable conversations are the ones that we should be having the most,” she says.

. In 2023, there were more than 130 menstrual equity-related pieces of legislation introduced across the nation. 

In 2021,, which expanded period health education in the school curriculum and provides free menstrual products for all menstruating students in public schools. Oregon is one of 10 states that both require and fund period supplies. Eleven states require period products in schools but don’t provide the funding for them. And seven states provide funding but don’t require period products in schools. 

Advocates are also working on which deems menstrual products to be luxury items. This tax is on the books in 21 U.S. states, making period products even more expensive and less accessible to low-income people. 

“By removing the sales tax on menstrual products, we are recognizing that these items are essential items for health,” says Garland-Miner. “Eliminating the tax won’t end period poverty, but it does help identify the products as the medical necessities they are.”

Making Periods Safer

In the Democratic Republic of Congo, menstrual health doesn’t only mean period products but also access to water, which is a huge challenge in communities where Crispine Ngena works.

In the North Kivu province, access to water sources is limited. People mainly rely on rainwater, which, due to climate change, has become irregular. People have to buy 20-liter (5-gallon) jugs of water that cost U.S. $0.17—a major expense when . With water being scarce and underwear a luxury item, menstruation is hard to manage and many bleeding people suffer from infections and rashes.

That is why Ngena’s nonprofit, Actions for the Conservation of Nature and Community Development (ACNDC), has been distributing reusable pads, water buckets, soaps, and underwear to different communities. They have been working with groups of girls who were displaced after the volcanic eruption of Mount Nyiragongo in 2021 and also with girls who had to move to camps due to the ongoing military conflict in Congo since 2023. For most of these girls in rural areas, it was the first time that they have seen a pad or worn underwear.

Ngena is a firm believer that access to period products should be easy and free for everyone. Without them, girls stay at home, do not go to school, and cannot work or go to religious ceremonies. She says introducing comprehensive sexual education courses at school would help break the stigma around menstruation.

“With proper education, girls would learn how to manage their menstruation safely,” says Ngena.

Gender-Responsive Disaster Relief

Educating people about menstrual health is also a priority for Ayesha Amin, a Pakistani women’s and climate justice activist. Amin’s nonprofit, Baithak: Challenging Taboos, has been conducting sessions to educate both women and men about different aspects of menstrual health. 

Amin says the most common myth in Pakistan is that women should not bathe during their period because it will lead to infertility. To counter this and other misinformation, Amin and her peer educators speak about physiological, hormonal, physical, and emotional changes, as well as premenstrual syndrome, premenstrual dysphoric disorder, nutrition, managing stress and pain, hygiene, and sanitation. Over the past five years, they have reached 300,000 girls and women with sessions on menstrual health as well as family planning and gender-based violence across Pakistan.

. The floods affected 33 million people, of which 8 million were girls and women of reproductive age.

“We saw young girls and women having urinary infections because they didn’t have any menstrual products. They used leaves, ragged clothes, and were not able to change menstrual cloth for an entire day,” Amin says.

During this climate disaster, Baithak set up a flood response to provide menstrual kits to women and girls who were worst affected by the floods. Soon, they received requests from other parts of the country, so they expanded their program. 

Together with the Pakistani government, the nonprofit is building the capacity of grassroots organizations so they can work with their local governments to ensure that climate crisis responses are gender responsive. They are also building the capacity of disaster management authorities in Pakistan to ensure that the needs of menstruating people are prioritized in case of climate emergencies.

While fundraising for menstrual products, Amin has received both positive and negative reactions. “There was a whole Twitter campaign saying that ‘If you are giving pads to women, also send shaving kits to men.’ This really struck me. Women don’t choose to menstruate during a climate disaster,” Amin says.  

Making Menstruation Positive

Menstruation is a taboo in so many societies. But it doesn’t have to be. With the right education—at home, at school, and in the halls of government—menstruation can be seen as the natural part of life it is. 

���� we want the menstrual cycle to have a place in all discussions—from being listed in the Declaration of Human Rights to pharmaceutical testing, from employment law and work practice to educational approach and exams—we need to ask the question, ‘How does this situation disadvantage cyclic women?’” says Miranda Gray, a British author of books on menstrual wisdom for modern women. 

“For society to have a positive image of the menstrual cycle, and for it to be part of discussions, women themselves first need to have a positive view of their own cycle.”

There are just over 1 million Druze people worldwide. They mainly live in Syria, Lebanon, Israel, Jordan, and Palestine, with communities also present in the United States, Canada, Europe, and Latin America.����

“We are very much a community where if I hear someone’s last name, I will be able to place them: what country they’re from, who their family is, who their relatives are,” says Deena Naime, a Druze born and raised in the U.S. “And I think that’s very important, because when you come from a community like that, it also really impacts things like sexuality, sexual identity, and sexual education.”

Being part of a community where everyone knows each other makes these discussions difficult. Naime says, “Anything that you want to know or need to know or need to express and share, most of the time, you cannot do that without the luxury of anonymity,” says Naime. “Anonymity is very important. There must be a great amount of trust to have those conversations without anonymity. That trust usually happens between women when they start to have certain conversations. But in our community, it’s not always possible because a family member is often present.”

The Druze are a small religious and ethnic group with a rich history and cultural heritage. Originating in Egypt, their faith can be traced back to the 11th century and was influenced by many religious sources, including the Quran, Christian and Jewish scriptures, and Greek philosophy. They have since evolved into a unique group rooted in traditions and a strong sense of community. Most of their beliefs and practices are concealed from outsiders to preserve their religious heritage.

“The Druze community is very tight-knit. You’re born into the community. If someone wanted to convert, they couldn’t. That’s partially why we are such a small group. It also comes from a background of persecution. And because of that, we have a kind of secretive identity,” Naime explains.��

“Sexual Education Is Not Spoken About”

Although the Druze community holds an egalitarian regard for men and women in things like marriage, divorce, and inheritance, their views on women’s bodies and sexuality are conservative and characterized by a traditional way of life. However, it varies by generation and the country in which they live.

“We are very much an honor-based community. And one aspect of how we experience honor is through what I’ll call female ‘purity’ or ‘innocence’: In theory, girls in our community are expected to be virgins until they’re married,” Naime says. “But that’s an antiquated belief. It does not hold true to younger generations or across the board. It’s similar again to other religious communities in that respect: It’s an idea, but it’s not legitimized. People don’t go along with that.”

“Sexual education is not really spoken about. It’s expected that girls figure that out along the way. My experience is different because I was raised and educated in the United States. Like most Druze girls in the diaspora, my sexual wellness and health education came from school.”

For Noor Jaber, it was different. She is a Druze public health expert living in Lebanon, where it is deemed inappropriate to have sex education at schools. Although there was an attempt to introduce a comprehensive program for youth 12-to-14 years old in 1995, it was removed after criticism from several political and religious groups.

“There are several programs that run haphazardly, but nothing is done by the state. My parents know the importance of sexual health education, and my mother educated me on sex and menstruation,” she says. “But I find that a lot of young girls in my community, when they reach puberty, are unaware about this basic physiological phenomenon that they pass through every month—they have no clue about it.”

The Impact on Women’s Health

“There are a lot of challenges associated with a woman’s sexual and reproductive health, especially if it is not related to marriage and reproduction,” Jaber explains. “It’s a taboo. Topics like endometriosis, for example. If you’re a single woman, seeking information and getting care is very difficult. Without a safe space to be able to discuss and ask questions, women are worried they might be shamed or blamed for talking about sexual health.”

Jaber shares her personal experience to highlight how hard this can be. “As a health expert, I know that even if I’m not married or engaging in sexual activity, I should get a yearly checkup by a gynecologist. I used to freak out. The doctor’s assistant’s first question would be: ‘Are you married?’ Then I would feel like, what should I tell her? Regardless of what I tell her, she shouldn’t be asking this question as the gateway for me being eligible or not to access this service. And the fact that the assistant is from the community, you feel that extra pressure—if I open up, she would go and talk. You don’t trust them, there is no confidentiality. And that is coming from someone who’s educated. Other women wouldn’t even try to access the service.”

“The lack of a comprehensive sex education can create a lot of mental health problems. It impacts your body image and the way you govern specific body decisions,” she explains. “When they get married, many women suffer from vaginismus because they’re so scared of their first sexual experience. Their bodies start having those involuntary responses of it being this traumatic experience and that they don’t have a right to actually enjoy it, because it’s ‘haram’ or shameful.”

“Women are also unaware of dangerous signs and don’t seek support or care that would prevent a lot of problems, like breast or ovarian cancer. The fact that we don’t talk about it means they might get diagnosed at a very late stage, when it becomes too late to intervene.”

Breaking the Silence Around Sexuality and Health

The internet has played a significant role in the sexual education of young Druze people. For Jaber, it is an opportunity to create a safe space for young girls and women.

Wishing to make a change and break the stigma around sexual health, Jaber created NAWAT to support young girls and women in her community to access information and make informed decisions about their bodies, sexuality, and relationships. It’s a digital platform in both English and Arabic that offers educational courses on sexual and reproductive health and connects women with experts anonymously and confidentially.��

“I want to shift the discourse around sex education and make it pleasure-positive,” says Jaber. “Pleasure is the most important motivation to have sex. But many of us have learned about sex and our sexuality through negative messages that focus on fear and shame. So while prevention remains vital, managing risks associated with unsafe sexual behaviors is not the only way to talk about sex. The enjoyment of sex and ensuring women’s health and rights are important.”

“We also want to include a holistic aspect, bringing in both traditional and alternative medical approaches,” Jaber adds. “For example, if a woman has endometriosis, she needs to understand how her body works and what is causing that clinically. But how do we bring in the mental health aspects to support her through that journey? How do we bring in the physical aspects like exercise or nutrition? So rather than looking at her sexual and reproductive health like a disease and a cure, it’s more about looking at the overall quality of how a woman deals with it as part of her everyday life.”��

“Women Are Creating Their Own Care Network”

Naime, who is working on a Ph.D. dissertation on how women cultivate spaces of intimacy and care in Druze communities, explains how access to safe online spaces impacts younger generations.��

“It is something that is drastically changing in our community. Women are very interested in making a change in terms of sexual education,” says Naime. They are starting these conversations not just with their own children but with their peers and their friends. There are also a lot of conversations happening right now, even between women and men, in terms of women advocating for more sexual education and more awareness around sexual health and wellness.”

“It’s significantly increasing over the generations,” Naime continues. “I see, for example, the difference between how older generations of women educated their daughters on things like menstruation versus how women are now educating their children about having their periods and what that cycle looks like.”

“That’s also partly because information is now more accessible—that’s very important,” she adds. “We are at a point in time right now when we understand women’s sexual health in a different way than we ever understood it before. People realize that the female body is different, and that is also reflected in our community.”

“Druze education, both in terms of Druze studies and education within the Druze community, is actually skyrocketing,” Naime concludes. “It is really a crucial time right now in the Druze community, where a lot of these things are coming up to the surface, and people are doing this work. It’s an exciting time because a lot of this change is happening, and it’s beautiful.”

This story was (UAE) and is republished within the program, supported by the ICFJ, .

Since grief can be isolating, disorientating, and even polarizing, we often try to ignore or bury it. We don’t want it taking up too much space or attracting too much attention. It can be a burden, and one that fills us with unnecessary feelings of shame.��

But there’s evidence that supports that sharing the burden of grief in public invites others to aid in the healing process. It can also allow a stronger social resilience to discuss topics of grief and mourning. And it connects us to community in ways that may be able to enact change. In short, externalization and communal care of grief can be transformative.

The American Psychiatric Association (APA) defines grief as Jamie Eaddy, thanatologist, activist, and founder of has a different definition for grief. She says, “Grief is our human response to loss, change, and transition.” As a thanatologist—someone who studies death, dying, grief, and bereavement—she believes the experience of grief extends beyond being able to name whom we are grieving. “Beyond people, it is ideas and safety and all of those things that are not necessarily directed toward us but are felt as losses emotionally for us when they’re no longer here.”

No matter whom or what we are grieving, Eaddy stresses the importance of recognizing and processing our grief. “We know that grief is felt or experienced in the body like stress. And what does stress do to the body? It impacts your, your immune system, your heart.”

Research supports that beyond physiological distress, unattended grief can also negatively impact mental health, including, which according to the, can make sufferers incapable of performing normal activities because of deep, overwhelming feelings of sadness.

The Emotional and Psychological Benefits of Acknowledging Grief

Christiana Awosan, a licensed therapist and founder of in New York, says when the emotions of grief remain trapped in the body and aren’t processed, “we physically, emotionally, and psychologically become paralyzed.”

“It’s important to acknowledge not only the loss that we experience but also the process of letting ourselves know that someone and/or something significant has shifted in our lives,” she says.

Melissa Burkhead of Massachusetts says that when she was overwhelmed with grief, her first instinct was to isolate. “When I lost two sister friends and an aunt in a 12-month period, I felt overwhelmed and didn’t want to talk about it or even get out of bed,” she says. “But when I started going back to church, and people started asking why I hadn’t been attending, a friend suggested the grief group being held once a week. I attended for six weeks, cried lots of tears, made lots of new friends, and slowly began to feel happy again.”

In contrast, Julia Mallory of Pennsylvania says after her son was killed seven years ago, she felt she had to “grieve publicly and talk candidly about her loss, and the many layers of loss, even if it conflicted with what people felt grief was supposed to look like.” She says, “I felt and heard in my spirit that I needed to speak openly and publicly about it.”

Awosan says acknowledging grief “allows you to be patient with yourself and give yourself grace to feel, express, and accept the waves of grief. And in turn, you’ll also have the capacity to provide others with the room to do the same.”

This was true for Mallory. After she began her very personal healing journey, she recognized the need for more compassionate spaces for others to process their grief. She is currently the owner and operator of a community creative space called where she hosts events and “healing hours” for her community to talk about their grief. 

“We need connection and community in order to process our grief fully,” she says.

Awosan and Eaddy agree that grieving in public can provide validation of our humanity.

“Sharing grief gives people the opportunity to allow themselves to be cared for and to care for others. It allows people to witness how they and others experience and express grief while being human,” Awosan says.

“At the end of the day, I don’t need validation that I’m human,” Eaddy says, “but there is a part of all of us as humans that longs for connection and validation.” She adds, “In isolation we don’t avail ourselves of the healing power that can come from somebody saying, ‘I see you.’ Your person or thing, the experience, whatever the loss is, it matters.” 

Public Grief Can Lead to Mobilization

We know we can experience grief due to and traumatic stress, but we have also seen how collective grief can lead to mobilization. We’ve seen environmental activism as the result of the grief over environmental degradation. We’ve seen the women’s rights movement come as a result of the grief over gender inequality, and global movements for justice following the grief over political or racial injustice.

Research shows that particularly in the Black community, and calls for systemic change. We saw this in the form of protest and sit-ins during the civil rights movement, and more recently from 2016 to 2020 through the work of movement in response to the murders of Travyon Martin, Breonna Taylor, George Floyd, and many others.

Eaddy says, “For me, Black Lives Matter publicly said, ‘We are grieving. We are hurting. We are sad, and we’re not going to hurt in the closet.’” She explains that hiding grief has social consequences as well. ���� I have to hurt in the closet, it gets to remain hidden from everybody, including those who are causing the pain.”

She adds, “Just by putting it in the world’s face, there was a percentage of humans who decided they would no longer be ignorant to what was happening to fellow humans.”

Currently, we are seeing public grief and grievance play out with protests in response to the innocent lives lost in Palestine and the Congo.

Collective Healing Through Grieving in Public

Just as there is collective grief, there can also be collective healing. Whether it’s through church groups, or sharing stories and experiences to create empathy and unity, or forming support networks and communities, we can find ways to heal together.

Eaddy says, “You need to grieve in public because when we grieve in isolation, it pulls us away from people, and the truth is we are not designed or created to operate in isolation. We are created to be in community.”

If we don’t share our grief, we contribute to the lack of empathy and understanding in society, the perpetuation of systemic injustices and inequalities, and divisions and conflicts within communities. For the sake of personal and collective well-being and empowerment, individuals and society must choose to acknowledge and process grief.  

The power of public grieving is its ability to connect us and drive healing and change.

Soon I’m in the center of the lake, alone with the water striders, which scoot away from me on their long and spindly legs as my hands cut through the surface of the water.

My breathing settles and my thoughts fall away as I focus on the movement of my legs and arms, propelling me forward. The sun strains to break through the marshmallow clouds, its weak rays reflecting off the surface of the water.

If there is anything as peaceful as this, I have yet to discover it.

Dr. Melissa Lem, a Vancouver family physician and longtime advocate of the health benefits of nature, remembers feeling that same quieting effect while spending time outdoors. (Lem and I went to high school together.)

“I grew up feeling that connection to nature and not necessarily feeling as connected to my community as I should have been,” she tells me. She experienced racism and bullying on the playground and at school. “I found when I spent time at the park or when our family would go camping in Bruce Peninsula National Park . . . I felt so comfortable. I didn’t feel like anyone was going to come and yell something at me or exclude me.”

Lem tells me about facing other stressors in her early career as a doctor, and the way nature improved her mental health. In her first role, as a rural family physician in Northern British Columbia, she faced intensive work running an emergency room and performing acute care during long overnight shifts. Despite the challenges, she loved the work and credits easy access to nature as part of what helped her cope.

“My commute was walking to work past the hospital garden and looking at the mist rising over the mountains—I think that went a long way,” she says. Then she moved to the busy metropolis of Toronto, which she describes as “streetcar town, skyscrapers, and concrete.”

Suddenly she found herself much more stressed, even though her work was easier than in B.C. After she realized that her problem was a lack of access to the great outdoors, she decided to do a literature review to collect evidence that would support her intuitive sense that nature was a missing piece of the well-being puzzle.

“It had to be backed up by evidence, because I’m a doctor trained in evidence-based medicine,” she says. What Lem found was a large body of literature on the health benefits of nature, which she says none of her colleagues were talking about at the time.

A systematic review from 2018 included 143 studies on the topic from the previous decade, illustrating a recent and rapid growth in the study of nature and health. A quick search on PubMed for citations since 2018 gave me more than 2,000 results for “greenspace and health,” with that number growing year over year.

It’s not just the wilds of the forest that have been studied. The systematic review I reference above included studies of 11 different types of greenspace, such as urban trees and street greenery, larger parks, forests, and even the effect of viewing trees from a hospital room window.

The review found statistically significant benefits for a heap of objective (and some self-reported) health measures, including all-cause mortality, type 2 diabetes, measures of cardiovascular health, blood pressure, stress hormone levels, and preterm birth.

There are also many studies showing that nature can be therapeutic for those with mental health challenges, including reviews on horticulture therapy and wilderness adventure therapy for young people. What we don’t yet fully understand are the underlying reasons why greenspace might benefit our mental well-being, which means we don’t know enough about how to replicate these interventions for different populations.

Would gardening be something teens would want to do? Could wilderness adventure therapy work for older people with physical limitations?

“A doctor prescribing nature time in Regent Park is different from a doctor prescribing nature in Kitsilano, so we have to definitely be aware of our patient’s strengths and abilities, and also the communities we live in,” says Lem, comparing a low-income housing community in Toronto with a trendy neighborhood in Vancouver surrounded by beautiful biodiversity.

Lack of access to nature is a problem, with many people living in urban gray areas where scraggly trees barely survive in a concrete desert. “We’re coming up with a plan for programs where people can get free or discounted transit to greenspaces to reduce that barrier,” she says, adding that it’s also important to change people’s perceptions of what nature can be. “You don’t have to be in the middle of a forest

by yourself or on the side of a mountain; it can be in your garden or your neighborhood park.”

It was a naturopathic doctor (ND) who handed me my first PaRx—a park prescription, sometimes called a ParkRx or NatureRx. I had exhausted all the treatment options with my family doctor and had turned to alternative medicine for answers.

In addition to several nutritional supplements and dietary changes, my ND suggested I leave my claustrophobic cubicle each day at lunchtime, head over to a small butterfly garden adjacent to our office building, and take off my shoes. I was to stand in the grass for 10 minutes, feeling the cool blades tickling my toes. This was written down on an actual prescription pad, and I carried the slip home with me in my bag.

The prescription felt silly at first, but I dutifully followed it every day throughout that summer. I would burst out of the air-conditioned building at lunchtime into a wave of oppressive heat, my eyes adjusting from fake fluorescent lighting to the stunning white glare of the sun. I’d shuffle around in the grass while other employees lounged near the garden eating their lunch.

And I was surprised to find that it helped—my lunchtime communion with this small greenspace seemed to set the tone for a better mood in the afternoon and post-work evening. I began to look for other ways to incorporate the outdoors into my everyday life, like biking to work instead of taking the bus. I went for daily walks in the ravine behind my house.

Nature prescriptions, or “nature pills,” are a growing area of interest for researchers and medical practitioners. Lem is one of the leaders in the movement in Canada and has launched the Park Prescriptions (PaRx) initiative with the BC Parks Foundation, a program offering health care professionals nature prescription files and codes, with instructions for how to prescribe and log their nature prescriptions.

“There are just under 100,000 physicians in Canada, and over 5,000 registered for our program, so that’s over 5 percent of doctors,” she says. “I think it’s important for nature to become routine advice during a health care visit—diet, exercise, sleep, and nature time.” Lem calls these the four central pillars of health, and she’s excited to see the movement growing among physicians.

I connect my own time in nature to similar benefits I get from practicing mindfulness. I believe that it’s not just about the trees that I’m seeing or the cold water that’s lapping around me. The setting becomes the doorway to a deeper connection with my body, which gives me the space I need to mindfully observe all the things happening within and around me—something I wouldn’t be able to tap into if I were distracted by my phone or hurrying through a park to get to a destination.

The science agrees with me: the mindful component of time in the outdoors could be one of the key reasons we experience such significant changes in our psychological and physiological health.

Other research suggests that it’s not only the positive health outcome that we get from nature that is the interesting part—it’s what predicts those positive changes. In the example of my cold lake swim, being in the presence of something awe-inspiring could be what’s causing real physical changes in my body.

Adapted with permission of the publisher from the book All in Her Head, written by Misty Pratt and published by Greystone Books in May 2024. Available wherever books are sold.

CORRECTION: This article was updated at 11:27 a.m. PT on July 8, 2024, to correct a misstated number of Canadian physicians participating in the Park Prescriptions program. The correct participation is more 5,000 doctors, or 5% of the less than 100,000 physicians in Canada. Read our corrections policy here.

I was a little girl in the north
at the far edge of a zone
where summer darkness began
long after bedtime 

Where children played outside 
in hours of blue twilight
bare feet and Batman pajamas

I’ve learned

that a moon-sized core spins 
in earth’s belly
where days are born

that lightning
creates waves
of global heartbeat

that every sunset
every horizon
depends on where we stand 

that every day 
we tell a story 
of light

Yo era una niña pequeña en el norte 
en el extremo más alejado de una zona 
donde la oscuridad del verano comenzaba 
mucho después de la hora de acostarse 

Donde los niños jugaban 
afuera con el atardecer azul 
los pies descalzos y las pijamas de Batman 

Yo he aprendido 

Que una luna de sustancia
gira en el vientre de nuestra tierra 
donde nacen los días 

Que el relámpago 
crea olas 
de latidos globales 

Que cada puesta de sol 
Cada horizonte 
depende de dónde estemos parados 

Que cada día 
contamos un cuento 
de luz

By Tamela Gordon

“I’m telling you right now, Tamela! Make me take another step, and I’ma punch you in your fuckin’ gut!” 

Shevone Torres and I were on her second day at Casa de Tami. It had been going great—at first. But the moment we hit the sand, she started getting weird. 

“I’m not gettin’ in that water,” she kept repeating as we searched for the ideal spot to spread out our blankets and beach bags. Her hair, jet black and super curly, was pushed back with a headband, and she was rocking a really cute blue-and-pink bathing suit. 

“Relax. You’re going to love it,” I assured her. Looking back, I probably should have taken her declaration more seriously. However, she checked the “Yes, I’d like to add beach and swimming to my wellness itinerary” box on her assessment form. She was also from Jersey, so I assumed she’d spent a weekend or two at the Jersey Shore. 

I couldn’t have been more wrong. It took 15 minutes just to convince her to get knee-deep in the water. 

“Let’s just take a breath and a step at a time,” I kept encouraging. I lightly held onto her fingertips, slowly taking baby steps so tiny I was sure she wouldn’t notice. She noticed. 

“Nigga, you can breathe all you want! I, Shevone, am not gettin’ deeper in this water! Hoe.” 

It would have been hard to tell at this moment, but Shevone and I were, and still are, very good friends. We met on social media, but our friendship evolved into an in-person dynamic soon after. If I wasn’t going to Jersey to check in with her, she was coming to New York to see me. She even helped moderate several online spaces I facilitated, helping me navigate the nuances of holding equitable and safe spaces for people. 

Through her, I learned the importance of being self-aware of the privileges and energy I bring into a room. Despite being a person who navigates a marginalized intersection, I embody a unique combination of privileges, such as two supportive parents who have always provided shelter and resources when I lacked, as well as the societal perk of assimilating, moving through mainstream and white spaces that are more abundant with access to valuable resources. Understanding these privileges doesn’t invalidate my life experience or make me less. 

For as long as I’d known her, Shevone’s life was centered around two things: her two sons and activism. And not the keyboard activism that takes place in the comment section. The real frontline shit—the dangerous part of the movement that leads to direct interaction with the pigs, getting doxxed, and incarceration. 

When she wasn’t flying around the country for random protests or injustices that any given Black person faced, she was collaborating with a local Black organization that regularly held protests against their county’s police force as well as state officials. She’d been arrested in the four years that I’d known her.

I have been a staunch believer that Black people should stay as far away from anybody’s “front lines” as humanly possible—most especially Black marginalized genders. I believe that the dangers we face on a regular basis, the perpetual fear of murder and incarceration, has put too much strain on our already compromised well-beings. 

This couldn’t be truer for Shevone, who lives with sickle cell anemia and idiopathic chronic pancreatitis. When she wasn’t fighting for justice in the streets, she was fighting for her life in the emergency room.

In February 2019, after a series of complications and medical neglect, Shevone was hospitalized and in need of expensive medication along with financial assistance to help cover her bills, as she was immobile to hustle as she normally did. I, along with a collective of other Black marginalized genders, fundraised the money through social media. It was a small action as far as we were concerned, but it was also the kind that helped people like Shevone get the medical treatment and resources she needed, as well as people like me maintain housing.

I’ve never been the kind of person who references the acts of kindness I’ve done for someone else. However, when scrolling through my Facebook feed and seeing a video of Shevone screaming through a bullhorn while marching down the street less than one week after getting discharged from the hospital, I felt some kind of way.

“Was that a throwback video of you protesting in the street?” I intentionally Facetimed instead of our normal text message mode, knowing it would throw her off.

“Yeah.” She sighed. She went on to explain the situation that led to the protest.

“Do you feel like being there for those people, for that situation that’s going to exist whether you’re dead or alive was more important than your health?” 

As I look back, a small flash of guilt comes over me for being so harsh with my friend. But, also, the memories of praying for her life at my altar touch me too.

Years later, the two of us stood in the water, face-to-face with a fear Shevone didn’t even know she had.

“We could just … stand here and let the water splash on our legs!” I suggested. 

When somebody forewarns that they’ll resort to bodily harm, I believe them. I was still determined for Shevone to experience a proper dip in the Atlantic, but I knew not to push too hard.

We stood there in silence. I figured Shevone was still contemplating if she was going to punch me. But then, her vibe shifted from raw fear. Her chin quivered, and the puddles in her eyes grew. The gentle splashes of warm water against her bare skin sent her over the edge.

“You know what? Let’s not even focus on the step part!” I encouraged. “Let’s just breathe, girl!”

A gasp of air passed through her mouth, and her shoulders collapsed. I considered walking her back to our beach blanket and calling it a day. Water therapy does wonders for a stressed body, but nothing is therapeutic about being scared to death. I was still debating, and Shevone was still quivering, when two small brown children splashed their way between us. They couldn’t have been older than 6 or 7. The same waves that splashed against our knees delighted the kids as it practically swallowed them.

“See.” I grinned, pointing at the children. “Fun! Swimming is fun. I promise!” 

It would take another 10 minutes of “a breath and a step,” but eventually, Shevone was waist-deep in the water. And then, breast-deep. Each time she got a little deeper, it was as if she had amazed herself.

“I feel like I could float if I wanted to,” she said, bobbing up and down, taking huge gasps of breath before plunging her body to the ocean floor. Soon enough, she was wading around, her head barely poking above the water. 

For hours, we jumped. Swayed. Floated. Splashed. Exhaled. We laughed at nothing at all. We surrendered to the current, allowing us to do the one thing that was too dangerous to do on dry land: Let go. 

Hours later, over mojitos and Cuban food, we reflected on how necessary it was to exist in moments not reliant on our sacrifice. We didn’t have to campaign to have a good time; we could go and have one. Like me, Shevone had been programmed to believe that joy, rest, and adventure had to be “earned.” 

Societal and cultural standards expect us to appear as Mammies, mules, and fixers. These tropes have such a significant impact on the lives we live that we inhabit their characteristics without even realizing it. By enjoying nature, air, and life, we’re resisting in the most radical way possible.

As the mojitos kicked in and our coils bounced back, Shevone opened up about the stress she’d been carrying from intense community organizing. The never-ending conflicts from a male-led organization constantly challenged her boundaries, skills, and needs.

I told her there was more than one way to pursue liberation and that it should never involve us showing up as a sacrifice. I also reminded her about how many Black marginalized genders have died giving to movements that have yet to protect or even respect them. Marsha Johnson. Erica Garner. Venida Browder. Sandra Bland. Korryn Gaines. Oluwatoyin Salau. To their last breath, each one of them sacrificed all they had for a movement that cost them their life. 

I didn’t want that for Shevone or anyone. I don’t need bloodshed to be free.

“The thing is that I don’t have a lot of time left,” Shevone responded. “It’s important that I do as much work toward my mission as possible to continue to create change, even when I’m not here.”

“What is your mission?” I asked.

“I want to open up a space called Imperfect Village that provides resources and aids in building community by collecting its fractured parts.” She started perking up, and her eyes widened as she spoke. She had so many ideas for Imperfect Village, so many resources she was ready to organize and provide for her community.

For the remainder of Shevone’s stay, we had a really good time. I showed her around Miami, specifically Little Havana. We did some light shopping and sightseeing, but most of our time was spent at the one place where she wanted to be: the beach.

Part 2: I Made a Way

by Shevone Torres

I’m not one who got into activism because it was cool. I fight for my rights. Literally, it’s something I’ve had to do my entire life as a Black woman, so there’s nothing new or strange about doing it now regularly.

Activism is essential to me because there are so many racist, ableist, queer-hating systems of oppression that need to be dismantled, and we don’t all have the capacity to stand up against them. I’m one of the people with the capacity, so I rarely stay seated.

Before I got to Casa de Tami, I knew the problems I had with leadership at the organization I was a member of were severe, but I didn’t want to admit how bad it was. A lot of infighting, patriarchal bullshit, and toxic dynamics made it hard to focus on the work and center liberation. How can we get liberated if we’re constantly coming at each other?

I know how serious Tami is about self-care and mindfulness, so I was ready for meditation and hydration. I needed it, so it was welcome. But I wasn’t expecting to have my comfort level pushed the way it was at the beach. I said I was interested in the ocean but didn’t realize how uninterested I thought I was until the plane started flying over Florida and I saw all that blue water. No thank you was my first thought. It looked pretty, but that’s because you can’t see the sharks and undercurrent.

Looking at that body of water reminded me of when I was a kid and went swimming with friends and family. At one point, I almost drowned. Thankfully, there was someone around who could swim, and they saved me. I must have buried that memory deep in the back of my mind because I didn’t remember it until I was on that plane.

By the time we reached the beach, I was in full PTSD mode from that near-drowning. I love Tam to death, but I was serious when I said I wasn’t taking another step. It wasn’t until those kids started splashing around and Tam said, “Come on, let’s live!” that I realized something. 

I get emotional admitting this, but I’d been so consumed with death that living was just happening before death for most of my life. When you’ve got a severe and life-threatening illness, you are not thinking about where you’re going to be when you’re 80; you get to work on what you want from life right now. 

When I finally let go and went into the deep part of the ocean, I let go of all those fears and thoughts of death. I was alive, and I was well. The high I got from being in that water was unlike anything I had ever hit off a blunt. My body felt healthy too!

I’ve always had someone push me into leading something, taking over something. I never really had anyone push me to do something fun for me. It was such a thrill. 

When I returned to Jersey, I could only think about the beach. I started Googling all these different cities and countries with amazing beaches—the Caribbean, Mexico, Central America. I wanted more of that experience. The thought of going somewhere exotic and tropical excited me for a while, but life got in the way. I went back to protesting and organizing and the same old routine. 

But then, about three months after I returned home, something changed. There was a conflict in the organization I was a part of. It wasn’t even a big deal, but it was something that proved to me that their objective and mine had become totally different. So when somebody asked me to do something, I said, “Nah, I’m out.” 

Just like that! I didn’t even feel sorry about it. I felt like, seeing as I don’t know how much time I have left, I can’t be playing around in spaces that take up time but don’t offer any real change. I need to be a part of communities serious about caring for each other. I realize now that my time and my spirit are best served in spaces where I am offering direct care and support to my people. 

I will always be Shevone, an activist. But I will also be Shevone, the human. I understand now that my activism can change and expand over the years and shouldn’t come at the expense of my happiness or livelihood.

That’s what inspired me to get Imperfect Village Org finally started. I finally did it—I am the proud founder and president of a nonprofit that provides for the community everything from holiday meals to book bags and school supplies. 

I also work as a drug outreach volunteer helping people who struggle with substance abuse. It’s not easy, and even when I can help someone off the brink of death, I still worry about them and hope they’ll be OK. But, at least in that moment, I’m there for them, and it’s help that I know they need, whether they want to take it or not.

Since I’ve taken a big step back from frontline activism, my health has stabilized. I haven’t been in the hospital in almost a year, and for the most part, I feel healthy. Of course, my illnesses aren’t curable, but at least, at this point, they’re managed, which is the most I can ask.

Life still isn’t easy, but at least I’m not afraid to live anymore.

This excerpt from  (Simon & Schuster, 2024) appears by permission of the publisher.

“These are all typical signs there might be a bullying problem,” says Bettina Dénervaud, co-founder of the Swiss initiative Hilfe bei Mobbing, which translates as “Help With Bullying.” She and her two colleagues use a 30-point checklist to evaluate whether there is an underlying issue of mental, emotional, and physical bullying or something else—maybe a conflict, which might require conflict resolution. “A conflict is usually resolved in a matter of days or weeks, but bullying can go on for months or even years,” Dénervaud says.

What happens next sounds counterintuitive. Instead of being punished, the bullies are invited to help the bullied student. In a 2008 that looked at 220 bullying cases, the No-Blame Approach, as this method is known, was successful in 192, or 87%, of the cases. In most evaluated schools, it only took two or three weeks for the bullying to stop.

This stunning success rate prompted Bettina Dénervaud to sign up for training with German mediator Detlef Beck in 2016 and to start a consulting office for bullying in 2019.

With Ben, Dénervaud began by encouraging a personal talk between him and the teacher he trusts most. (Dénervaud or one of her colleagues is sometimes present in person or via Zoom if the teacher has not been trained in bullying intervention.) The goal is for Ben to talk openly and confidentially about everything that happened, his emotions, and his thoughts about the bullies. 

“This is an opportunity for them to get everything off their chest that bears down on them and to make sure we have their consent for the next steps,” Dénervaud explains. “Nothing happens against the victim’s wishes, and even the parents aren’t told details about what the child revealed in the confidential talk.” 

In Ben’s case, this was the first time anybody learned that the bullying had been much worse than his parents and teachers assumed. It included other children tripping and shoving Ben, name-calling, and excluding him from games. He was also voted “ugliest” in his class in an online “poll.” The bullying had started much earlier and gone on for much longer than the parents feared. The teacher also asked what would help him feel safe.

The second step is the core of the No-Blame Approach. It includes calling six to eight children whom the teacher chooses into a meeting set up as a social get-together: in Ben’s case, three of the bullies, three students Ben felt he could count on, and two “neutral” tagalongs. The children are not told the meeting is about Ben. “I have a problem,” the teacher might start the discussion after some small talk. “I noticed some students don’t feel supported in class. What can we do to help them, for instance, Ben?” 

The teacher carefully avoids calling out the bullies and instead says: “I notice the other students are looking up to you. What you say counts.” In Dénervaud’s experience, “That immediately makes the bully feel seen. They feel they matter.”

The teacher then asks for suggestions: “What do you think you could do to help?”

One boy volunteered, “We could include him in our afternoon soccer group.” Another suggested, “I could talk to him in the breaks.” 

The group writes these suggestions on a whiteboard.

The third step includes follow-ups with all students, including Ben, within the next few weeks. If necessary, the intervention might be repeated or tweaked.

“The goal is to change the social dynamic,” Dénervaud says, “and to lay open what has been happening.” Younger children often start crying in these meetings, Dénervaud has observed, “because they realize for the first time what has been happening and how unhappy the bullying victim has been. We talk about empathy, tolerance, and respect. How do I want to be treated, and how do I treat others?”

The No-Blame Approach was developed in the U.K. in the early 1990s by psychologist Barbara Maines and educator George Robinson. Even in severe bullying cases, this approach encourages educators and psychologists not to blame and punish the perpetrators, except for criminal offenses. Two , Heike Blume, and Detlef Beck, simplified the approach further and have trained more than 20,000 educators in Germany, Austria, and Switzerland since 2003.

Switzerland is number one in bullying, according to the global 2018 (Programme for International Student Assessment) study by the OECD (Organisation for Economic Co-operation and Development). The survey shows a rise in school bullying since the previous PISA survey in 2015, with the rate of physical bullying in Switzerland. 

Bettina Dénervaud can only speculate about the reasons: “Maybe the pressure to perform?”

Experts agree that bullying can cause , including depression and anxiety, self-harm, health complaints, and decreased academic achievement. ���� this issue is not dealt with, the harm can persist for many years, even into adulthood,” Dénervaud observed. A Washington Post analysis found nearly in the U.S. in recent years when a bullied student took his or her own life. 

Almost every fifth student in the and Europe says they have experienced bullying. Nearly half of teens say they have been the victim of cyberbullying, according to . In the U.S., most states have enacted , but how they are implemented on the ground varies greatly, not only from state to state but also from school to school.

Dénervaud has been a language teacher for more than two decades, mostly for adults but also for teenagers and children. Because parents, students, and teachers frequently asked her for advice on bullying, she grasped the enormity of the need. She decided to focus on that issue: “I realized there were not a lot of specialized offerings. In the standard teacher training, the topic is addressed in a two-hour lecture, which simply isn’t sufficient.” Concerned parents or teenagers are often told to call the mental health hotline, Dénervaud says, “but it usually offers general psychological advice, not specifically how to proceed and what the next steps should be regarding bullying.” 

Hers is the only office in Switzerland solely dedicated to the issue of bullying, though the magnitude of the problem is rising worldwide.

She and her two colleagues get about 10 calls a week, she says, “mostly from parents or from schools who request training for their staff.” She is frustrated by what she sees as a failure of schools to take the issue seriously. “We often hear, ‘Oh, the kids will sort it out.’ We sometimes see glaring inaction by the schools who try to dodge responsibility,” Dénervaud says. “Too often, we learn that the schools do nothing, or even worse, they put the victim and the perpetrator at one table and expect them to sort it out. That’s almost always counterproductive.” 

In Dénervaud’s experience, punishing the perpetrators tends to worsen the bullying for the victim. “Usually, the bullies will make the victim ‘pay.’ Or the victim gets sent into therapy, enforcing the feeling there must be something wrong with him or her, because they are singled out and need to get help, while no intervention happens with the bullies.”

Somewhat surprisingly, Dénervaud says in her experience, bullying is not tied to specific victim characteristics, such as weight, looks, or social status. However, LGBTQ students are at a significantly greater risk of bullying than their peers.��

“Contrary to what most people believe and what I, too, believed at the beginning, there is no ‘typical’ bullying victim. Anybody can be singled out to become the victim of bullying,” she says. “That’s why focusing on what is perceived as being ‘wrong’ with the target, such as losing weight or changing their looks, does not work.”

She sees the underlying causes of bullying in the social dynamics at a school. The nerd with glasses bullied in one school might be envied in another community for his smarts.

This is part of why Dénervaud is convinced parents and bullying victims must not be left alone to solve the issue. “These parents are often desperate and sometimes even sell their home and leave the community they were a part of, uprooting the siblings too, to send their kid to a different school,” she explains. In Switzerland, parents have to send their kids to the public school closest to their zip code unless they can afford the tuition for private schools. 

Because she tried in vain to get public funding and make her service free, Dénervaud and her two colleagues have to charge either the parents or the schools for the consultations and training. “I wish we could offer it for free,” she says.

She sees limits to the No-Blame Approach “when bullying has gone on for too long, sometimes for years. Then the patterns are so ingrained that removing the victim from the situation might be the best solution.” And sometimes, she admits, the approach is poorly implemented. “Then we intervene or try the approach again with a different group of students.”

When bullying turns into criminal behavior, she recommends involving the authorities. One of the worst cases in her practice was that of a student who was made drunk and severely sexually abused. “He ended up leaving that school because the abuse had also been documented on video and circulated at school, and there was no way for him to go back there,” she says. “But the school then still needs to work with the students who stay there.”

Other approaches that have shown success include the , which involves the entire school; , a method developed at the University of Turku, Finland, with funding from the Ministry of Education and Culture, that claims to have helped ; and .

Virtually all experts agree that it is best to act preventatively or intervene at the first signs of bullying rather than hoping the issue will resolve itself.

In Ben’s case, the intervention was successful. After a month, his stomach pains stopped, and he looked forward to attending school again. 

About the author: , is a contributing editor at l. An award-winning author and solutions reporter, her recent books include Bouncing Forward: The Art and Science of Cultivating Resilience (Atria).

This story was (U.S.), which shared this story to be republished within the program, supported by the ICFJ, .

Jennifer Liang, The Action Northeast Trust Co-Founder

After severe ethnic violence disrupted life in the Chirang district of Assam, India, in 2014, Jennifer Liang, co-founder of rural development nonprofit the Action Northeast Trust (referred to as ), sought a means to guide children and youth toward peace building between once-feuding communities. She discovered the U.S. sport of Ultimate, which was novel in the region, easy to learn, required only a disc, and encouraged inclusivity through mixed-gender play. Furthermore, the sport has no referees, which means that players self-officiate and talk through any fouls or conflicts. “I felt the sport had a huge potential as a peace sport and to be transformative,” Liang says. “I really liked its values.”

In 2015, the ANT trialed a simple version of the game in a conflict-prone area called Deosiri. The community responded so positively that the Manoranjan (meaning “entertainment”) League continues to this day, aimed at children between the ages of 11 and 14. A more advanced form of the game for older youth is practiced in the Rainbow League. In an effort to build social cohesion, the ANT requires every team in the Rainbow League to include players from at least three different villages, three different ethnicities, and three different mother tongues.

In 2023, nearly 3,500 children from about 100 villages participated in the ANT’s Ultimate program. “Families have now accepted the fact that their children go out to play with children from other communities,” Liang says. “That’s a nice thing to happen.”

Participating in the program has been transformational for many. In 2019, eight girls were invited to try out for India’s national team, traveling to the 2020 World Junior Ultimate Championships in Sweden; two girls were selected for the national team. The tournament was eventually canceled due to COVID-19, but the opportunity was still hugely motivational for these girls and others around them.

According to Liang, the success of these eight girls has encouraged parents to become more open to sending their daughters out to play. She relates one story of a father from a conservative background taking his daughter to buy sports shoes for a tournament.

“The fact that [girls] are now able to play in public, which they never had a chance to do before … alongside boys, gives them a lot of confidence.”

Aminath Zoona, Salted Ventures Swimmers Founder/CEO, Ocean Women Program Co-Leader��

As an island nation, the Maldives is more than 99% water. Most travel between the islands happens by sea, making swimming a much-needed life skill. But many girls and women are never taught how. “Parents here feel more comfortable sending their daughter to a female instructor to learn swimming,” says Aminath Zoona, who is a mother of three, including a 7-year-old daughter. But the dearth of female instructors means many girls and women miss out on the recreational benefits of the ocean, as well as job opportunities in the tourism and marine conservation sectors. 

Zoona’s father, a diving expert, taught her to swim at a young age. This gave her a rare skill among her peer group. Zoona grew up to become the first female Maldivian trainer for swim and snorkel instructors in the country.

In 2019, she started her own swim school, , in the nation’s capital, Malé. The school quickly became a success, with a long waitlist of children and adults wanting to learn how to swim. “By ensuring that my students have a positive experience while learning swimming, I instill a love for the ocean in them,” Zoona says.

Then in 2022, the United Kingdom–based marine conservation charity announced its program that sought to train local women to become swimming and snorkeling instructors. Zoona immediately stepped up. She now co-leads Ocean Women with Flossy Barraud from the British nonprofit.

During the nine-day Ocean Women pilot held in November 2023, Zoona trained five women from Rasdhoo Island (and two men from other islands) to become certified swim and snorkel instructors. The following month, the Ocean Women graduates organized their first swim teaching session: 19 children and five adults participated.

After the successful pilot, Zoona and Barraud are now planning for the next phase of the program. They intend to create new teaching opportunities for the recently graduated instructors and hope to expand the program to other islands in the Maldives. 

“It’s all about empowering women,” Zoona says. By expanding the pool of female swim and snorkel instructors, she hopes to create many more ocean champions for the Maldives. “It will have a domino effect,” she says.  

Meredith Harper Houston, The Swan Within Founder and Executive Director��

Professional ballet dancer Meredith Harper Houston knows firsthand about the healing power of dance for abuse survivors. She had always wanted to share these transformative benefits—a dream she realized in 2016 by founding . The nonprofit brings dance to incarcerated girls in Los Angeles County. 

“My own experiences as a professional athlete, dancer, and trauma survivor drove me to create a program that helps these girls reclaim agency over their bodies,” Harper Houston says. “It provides them with the tools to reclaim their lives through the principles and practice of ballet.”

Early on, Harper Houston did all the teaching herself. Eight years later, the program now has 12 dance instructors.

Nearly 700 girls between the ages of 14 and 18, many of whom are from communities of color, have participated in the program to date. They have all experienced some form of trauma, such as physical, emotional, or sexual abuse, or have been victims of sex trafficking. “Witnessing the resilience and strength of these young individuals reaffirms the importance of our mission,” Harper Houston says.

The program typically runs for 12 weeks, with multiple sessions each week. At the end of the program, the girls present a performance to their families and the facility staff. “It is a celebration of the indomitable human spirit,” Harper Houston says.

She says she sees measurable improvements in self-awareness, emotional expression, and interpersonal relationships among the girls in the program. In the short term, the program has been found to reduce fights, suicide attempts, self-harm, and harm to others. In the long term, it has helped these youths reintegrate into society. Harper Houston is now expanding the program to help participants prepare for the job market, with mentoring sessions that cover goal setting, etiquette, and financial literacy.

In 2019, Harper Houston received a Pioneer Woman of the Year award from the office of then Mayor Eric Garcetti and the Los Angeles City Council in recognition of her contribution to incarcerated youth. “The program has become a powerful journey of healing and empowerment for both the girls and myself,” Harper Houston says.��

When I tweeted about this article, people were shocked that a young disabled person had lived in a hospital for five years. But it didn’t surprise me at all, even decades after the passage of the Americans With Disabilities Act in 1990 and , a 1999 Supreme Court ruling that found it’s tantamount to segregation to force disabled people, who could otherwise live in the broader community, to live in institutions. The Olmstead ruling also insisted that public entities must provide community-based services for those who wish to use them. This is a struggle I understand intimately.

Born with a neuromuscular disability, I am a wheelchair user and have a tracheostomy, a hole in my throat connected to a ventilator that allows me to breathe. I have a team of caregivers who work for me around the clock. Medicaid covers some of the cost, but I also have to crowdfund out-of-pocket costs that total $840 per day. This is not sustainable, yet here I am, treading water until a medical or financial crisis forces me to abandon the family I’ve built with my cats, .

Some disabled people must live in a nursing home or hospital due to their complex medical needs and the lack of and . Medicaid, , is structured in a way that forces disabled people into impossible situations. States are required to provide care in institutions, but community-based services are optional, often with long waitlists. found that nearly 700,000 people with disabilities are on lists for these services, with an average waiting period of three years. Ratcliff is one of many people who have their entire lives on hold because of institutional bias. 

Two years ago, I was in the ICU, which left me unable to speak or eat by mouth. I was determined to return home, but we could not find the additional help I needed. When my sisters relayed this to the discharge planner, he matter-of-factly said we had two choices: Family members would have to indefinitely fill in the gaps, or I could be transferred to a facility outside of the county. I burst into tears. I raged silently, but my face expressed my terror at this prospect. I felt so powerless and fragile, tethered to structural ableism designed to warehouse people like me purely because of our bodies. I have always been vulnerable and dependent on others, but in that moment, I, like so many disabled people, was seen as nothing but a burden, a drain on society, a collection of diagnoses and expenditures. 

My sisters consoled me, saying, “We’re going home, and we will make this work,” pulling me out of the depths of shame, guilt, and fear. Without their support I could easily have been persuaded into thinking that living in a facility was the only option. So many people are in this system designed to disappear us. This haunts me daily.

In January 2024, I was reminded again of in a nondisabled world: My feeding tube ruptured, and I couldn’t get it replaced until the following week. Meanwhile, the tube began coming out and my abdomen became distended, tender, and rigid. When I could not tolerate the pain anymore, I went to the emergency room. 

I arrived to discover many patients, staff, and health care providers unmasked. When I lay on the exam table to have my tube replaced, I could not communicate the excruciating pain I was in throughout the procedure because they would not allow my smartphone or caregiver in the room. I tried mouthing words, but no one could understand me. My body shivered, every nerve ending tingling as I tried to hold on. 

Two days in the hospital felt like two years. Laws like the ADA require only the bare minimum of care, and there is no enforcement. Compliance cannot be forced, even on people who do not see you as fully human or deserving of the right to access the same space.��

Disabled people constantly navigate hostile environments, especially health care settings. Here people in positions of power can say whatever they want while patients have to give citations, articulate clearly and effectively, and have the presence of mind to push back during acute, potentially fast-moving situations. I have been advocating for my health with doctors since I was a child, but this latest experience shook me. They gaslit me about my valid concerns of mistreatment. Even with all my social capital and resources, I was reduced to nothing. I thought of all the patients on the same floor who were alone, scared, and suffering.

When will disabled people be free to just be and to fully participate in society with autonomy and dignity? Liberating disabled people is a constant collective effort that at times feels like a distant mirage. Alexis Ratcliff had no choice except to live in a hospital for many years and now is being forced to leave even that semblance of a home. I only recently created a home of my own, which took decades of planning, scheming, and manifesting. The constant labor of ensuring my freedom weighs on me heavily. It should not be so hard to survive—and survival is not enough. 

wrote that “creating access is a critical way of showing up in solidarity.” If we lived in a world that placed access above all, creating access would be a collective responsibility. In this world, cultures of care would ensure that carceral institutions like nursing homes are abolished; people, not profits, would be the priority; care would flow generously without restrictions from the state; and people like me would be secure knowing we are valued and wanted not for what we can produce but for who we are. This world—an accessible one centered on justice—would be ruled by a simple phrase always put into practice: “None of us are free until we all are free.” 

She isn’t alone: A number of disabled workers given the opportunity to work remotely want to retain that privilege. After all, for some disabled people, this accommodation made it possible to advance their careers, improve the quality of their work, and become more active participants in workplace culture. For others, remote work had a more mixed effect. 

Abby Schindler, an autistic researcher in the Chicago suburbs, found that remote work came with positives, such as being able to manage sensory issues, as well as negatives: “As someone who struggles to build social relationships, working from home gets very, very lonely and hard.” 

, the unemployment rate in the United States hit 14.8% in April 2020, the highest since 1948—the first year in which this data was collected. By July of 2021, the unemployment rate had bounced back to 5.4%, still higher than February 2020, but an astounding recovery after being gripped in a pandemic-fueled economic crisis. A surprising population of workers had even more explosive employment growth: disabled people, who achieved a labor force participation rate . Given that the pandemic has due to long COVID, which affects as many as , exploring the reasons why is critically important.  

The popular explanation for was that the rapid transition to remote work across the country for disabled workers. But the truth is more complicated: Remote work is not a solution for everyone, for a variety of reasons. Furthermore, the availability of remote work should not be used to force disabled people out of the physical workplace. 

During the height of the pandemic, society briefly chose collective practice to protect each other. One standout example was remote work, which acted as a form of mass accommodation that benefited all employees, without forcing individuals to ask for it workplace by workplace. However, the ongoing conversation about how the nature of work has changed for everyone, including disabled people, may be putting too much emphasis on working from home. The conversation also tends to focus on one group of workers: those in professions that allow for remote work, while closing the discussion to much larger structural reforms. 

“Employers may have become more open to hiring people with disabilities because … there was the Great Resignation that accompanied the pandemic and lots of people dropped out of the labor market,” says , Ph.D., director of the Center for Employment and Disability Research. O’Neill is hesitant to attribute the rise in disability employment to a singular factor and points to improvements in hiring practices, as well as more flexible working conditions, such as , a practice that allows several workers to share a single full-time role. 

Remote work certainly was transformative for some disabled workers, such as Fiona Kennedy, an operations manager for a construction consulting firm, who says “remote work saved my life.” However, the truth is relatively few disabled people benefited from remote work.

There are two important reasons for this. One is flexible scheduling and better leave options: In a examining the rapid shift to remote work, researcher Jennifer Bennett Shinall found that “disabled workers report far less access to these pandemic-relevant accommodations than do nondisabled workers.” The other is , in which participation in certain careers and sectors of the economy is heavily mediated by race and/or disability status. For instance, the and executives are white is rooted in reality—and while executives can work from home, janitors cannot. 

What the pandemic highlighted wasn’t just the benefits of remote work, but the need to move away from an individual, rights-based model of disability in the workplace to a larger cultural, social model, a conversation that will benefit a much larger swath of workers as well as society as a whole.

Equitable Not Equal

Under the Americans with Disabilities Act of 1990 (ADA), which built on earlier legislation and policy, including the , , including at work. The ADA reflected a larger societal shift away from the charity model, in which disabled people were viewed as objects of pity, to one of broader social inclusion in which they were entitled to access to society.

���� there’s an event that affects everyone and there’s a solution that might address it in a way that preserves health and well-being, why not provide a mass accommodation relying on the infrastructure and process usually created on an individual basis and allow everyone to do what they do from home to the extent it’s possible?” says , an assistant professor of law at Brooklyn Law School. “For teaching, that turned out to be absolutely possible, particularly teaching adults in a legal education setting.”

Lin’s work focuses on DisCrit, work that lies at the intersection of disability studies and critical race theory, and she’s very interested in how the pandemic illustrated that it was possible to move away from a “liberal individualized model where you are responsible for your own safety and security by showing up to work” to a more collective, social one. In Lin’s view, this “mass accommodation” allowed a huge percentage of the workforce to pivot overnight, accessing a tool disabled workers had been . “The experience of having isolation and needing to innovate quickly to preserve health and well-being through policies that acknowledge interdependence to me was a huge potential cultural shift,” she says.

In ordinary conditions, workplace accommodations take place through an individual “” that is supposed to include bargaining in good faith and negotiation on both sides, but ultimately leaves workers on their own. Prior to the pandemic, disabled workers who needed hybrid or remote work struggled to access that accommodation. And when emergency declarations expired, those mass accommodations ended as well. 

“After a tooth-and-nail accommodations/disability discrimination fight with my employer that resulted in union, news, and federal civil rights agency intervention, I won the right to keep my remote work accommodations,” says Heather Ringo, a graduate student and teacher. Unfortunately, the same is not true for many other disabled people, who were forced back into the workplace as shelter-in-place orders expired. 

But those employment protections aren’t available to , freelancers, and . An Uber driver with kidney disease who needs dependable restroom access is expected to manage it for themselves, for example, just as a freelance journalist who to write needs to purchase their own equipment. 

Meanwhile, accommodations ranging from a safe, clean space to take injectable insulin to seating in retail spaces can be a struggle for low-wage workers, many of whom must work in person. During the pandemic, these workers had to fight for even the most basic personal protective equipment, even as companies patted themselves on the back for offering various forms of hazard pay ().

The Pandemic Work Rebellion

Workers and bosses alike learned an important lesson during the pandemic: Workers have the power to shape their environments. The as the country opened back up highlighted the fact that more workers were willing to walk away from their jobs in a growing “” movement. The aftereffect of this is also apparent in a slew of opinions grousing about how Generation Z simply .

White-collar workers overall—who are predominantly white, with —found that shifted dramatically when they were able to do it from home, and once they had a taste of freedom, they were reluctant to let it go. The call to return to the office triggered a revolt. In workplaces across the country, workers argued passionately for remote and hybrid options, insisting that the flexible hours of remote work were beneficial for the quality of their work, overall productivity, and happiness. 

Across industries, furious snowstorms of internal memos circulated, with workers drawing upon a growing body of research to make the case for remote and hybrid options. Some were also that remote work represented a revolutionary accommodation that must be protected now that society recognizes that it’s possible. The , often viewed by executives and upper management as an authority on innovations in business, crowed over how remote work .

For some disabled people, such as Casey Doherty, this was absolutely true. Doherty, who has illnesses that limit her energy, graduated into the pandemic, and is now struggling to find work. She expresses frustration with alienating job ads (“must be able to lift 10 pounds”), refusals to consider remote work, and the sense that “this is the way things were done,” so it’s the way things should be done forever.

“Why can’t we expand our understanding of what work can be?” she asks, when talking about the career progress enabled by remote and hybrid options. But the question could and should be applied to a larger conversation. 

Who Really Benefits From Remote Work?

Researchers in fall 2020 estimated that only can be performed wholly remotely. However, conversations about the early months of the COVID-19 pandemic tend to erase the presence of the other 63% of jobs, particularly those of  “essential workers,” who were ordered to report to in-person jobs: the meat-packers, nurses, transit engineers, grocery store employees, power plant workers, and others who kept critical systems running. At times, it seemed that society at large felt entitled to the labor of these workers.

For those who must perform on-site work, the conversation about remote work can feel frustrating, a scene of privileged workers celebrating much-needed changes while ignoring the army of workers who made those changes possible.

“The fact that in in which there was the highest level of COVID deaths were industries in which Black workers are predominant is incredibly telling, because it rests on this history of racial capitalism in which hard labor, manual labor, labor that is associated often with nonwhite communities …could not be outsourced,” explains Lin. “When essential workers who continued to show up to work during the pandemic physically were celebrated, they actually had their exposure to severe harm and death become the very reason they were deemed essential.” 

Lin explains that the explosion in labor organizing during the pandemic highlighted the collective fight of workers, such as those at Amazon fulfillment centers. “Activists are in a position to point to the ways in which life is made better, but for whom,” she says. “There were multiple, basically mass-structural accommodations during COVID that still broke along lines of privilege versus inequality,” where workers with preexisting social and cultural power received more support than historically marginalized ones. 

Remote work, or a traditional accommodations process, can’t fix occupational segregation and related disparities. True progress in disability employment requires a societal shift from the way that the law, and our larger culture, currently view disabled workers, toward a world in which society is “not entitled to our deaths,” as disability activist Mia Mingus wrote on her popular blog, , in 2022. This necessitates solidarity across cultural and social identities, and across workers. As Lin notes in a forthcoming paper, “Rather than letting vulnerable professional staff with [less] access to resources fall through the cracks,” bargaining by unionized Albuquerque teachers benefited students and staff collectively.

The conversation about disability employment needs to track not just jobs, : Are disabled people in roles with fair pay, benefits, and opportunities for advancement, or are they pushed into low-status roles? When the distribution across different kinds of jobs is weighted, does remote work really explain the rise in disability employment? And when this conversation excludes the racialized nature of disability and low-wage jobs, is it really representative of the employment landscape as a whole?

The mass accommodations offered during the pandemic provided a glimpse of a world in which disability inclusion is, as Lin notes, folded into the idea of universal design of workplaces. Access to remote work has indisputably changed individual lives, but meaningful solutions lie in shifting the conversation away from one very specific accommodation issue that affects a particular class of workers to disabled workers as a whole, and the deliberate social choices that perpetuate economic and social inequality across race and disability status. Expanding that conversation opens the way to bold solutions, such as ensuring that all jobs are good jobs, dismantling occupational segregation, and promoting collective freedom rather than individual struggle. 

After the 1960s and the Black Power movement in the United States, wearing Afro hair became a political act of resistance, a symbol of reclaiming Black self-determination and “Blackness as identity.”

In Cuba, at least in the last decade, the wave of vindication has also been driven by various ventures seeking female empowerment and fighting against racial discrimination against Black women and men.

Rizo Libre (“Free Curl”), a community hair salon where Afro hair care is discussed through workshops and activities, is one of the initiatives aiming to rescue Afro-descendant roots on the island. Its creator, Yadira Rachel Vargas, is working to break stereotypes and achieve freedom so all people can be proudly Afro.

In her venture, Yadira uses the maxim “combing with philosophy” to promote a self-recognition process that allows Black people to engage in a broader conversation about racism, identity, self-esteem, beauty, and inclusion through their hair. While a large part of her community comprises women, she also conducts workshops for girls and boys and has received inquiries from many men.

Yadira, 31, is the mother of two young girls and an irredeemable lover of the arts and wood. She also says she found an essential piece of her life in Rizo Libre, delving into the world of styling Afro curly hair.

When asked how the idea came about, she returns to her childhood. At just 10 years old, she learned to braid her hair because she didn’t like the hairstyles her mother did for her. Then, in high school, she began styling her mother’s, aunts’, and cousins’ hair. Her aunt Nancy was a hairdresser, and with her, she acquired many techniques for hair care.

“My mother is an extremely authentic and natural woman in every sense. She never gave up on her hair, but thanks to my encouragement, she stopped straightening it, embraced her Afro identity, and started wearing it natural,” she says.

“My mom felt happy when I styled her hair and saw the results in the mirror, and that happiness was my fuel. There was the energy I had to enhance, and that was my drive to create Rizo Libre. It was like a prophecy longing to be fulfilled, and without realizing it, the dream materialized based on the care I learned to give to my hair and my mother’s hair.”

Yadira has proudly worn her natural hair since 2016. Three years later, she began studying everything related to its characteristics—what stylists call “hair diagnostic elements.”

“I followed the Colombian stylist and influencer Cirle Tatisy and various Brazilian stylists. In Cuba, I followed content on hair care, defining techniques, and cosmetic products for styling Afro curly hair from Beyond Roots and the brand Qué Negra,” she says.

Just 10 days after becoming a mother for the second time, Yadira decided to start styling professionally. As one of those strange coincidences of fate, her Aunt Nancy, from whom she learned a lot about hair care, passed away last year, so Yadira started the new business. Rizo Libre became her third child.

Defining Afro Hairstyles: Rizo Libre’s Growth

Yadira’s thermometer for measuring results and customer happiness is her before-and-after photographs. “I have had the joy of creating a wide spectrum of clients, from 5-year-old girls, teenagers, adults, elderly ladies, to young men and children. When it comes time for the final photo, I marvel at the poses, the expression on their faces, the carefree smile … then I know they are satisfied.”

She feels very fortunate and adds, “Because despite being a new venture, I am constantly amazed by all the requests to come to Rizo Libre.”

Although it is a business primarily focused on female customers, she has also had male clients. “My husband was the first male model for Rizo Libre’s publications, and you wouldn’t believe the acceptance he had. They also want their crowns to shine. I love using the term ‘crown’ when referring to hair because it’s a powerful word, and I like my clients to feel like kings and queens when we finish styling.”

Even many white women also long to have well-cared-for curly hair. With a smile, she shares a personal anecdote. “Once, I wrote on my WhatsApp status about the beauty of curly and Afro hair of Black women in Cuba, and the doctor from my clinic responded by [asking] where did I leave curly white women like her. I agreed with her; I understood that curly white women observe what I do. For them, and for those who want to express themselves through their hair, Rizo Libre’s services are also available,” she said proudly.

“Every day, Rizo Libre gains new meanings. I am a historian, and I recently earned a master’s degree in Cultural Heritage Conservation. For many years, my passion for rescuing valuable, authentic, essential aspects and identity was reflected in my undergraduate thesis. But with Rizo Libre, I found the space to communicate those learnings that nourished and continue to nourish me as a woman, Black, Afro descendant, Cuban, practitioner of the Yoruba religion.”

For Yadira, each client is a fascinating world. “Listening to them speak while waiting for their crown to shine is an opportunity to understand Afro identity’s place in their lives. That’s why, in addition to posting hairstyles, I write texts to reflect on beauty paradigms; the vindication of type-four hair textures, which are full-fledged Afro hair; and other topics related to motherhood, which is my other driving force.”

Mother and Entrepreneur: Shared Identities

“My daughters are my teachers; each has taught me the most difficult lessons: patience and calmness. I have always considered myself determined and focused on my ideas and projects, but I only achieved the lucidity to materialize the idea of Rizo Libre after becoming a mother. Something changed inside me; I decided not to sabotage my happiness and started styling my hair even when the girls were little. They deserve an example of a mother happy with what she does and who strives to grow without them ceasing to be my priority.”

The entrepreneur has a strong support network built by her husband; her mother, despite the distance; her mother-in-law; and her daughters, who are the strongest support. “Meli, at 2 years old, stands in front of the mirror and touches her hair with her fingers and styles it. And Lucía, like clockwork, when I’m about to finish styling, starts demanding that I breastfeed her. In a few years when I look back on my life, I will think I was crazy to venture into entrepreneurship with two little kids, but it was worth it in the end,” she confesses.

Motherhood and entrepreneurship practically came together in her life. Therefore, she is in a phase of assimilating both. “I must achieve a balance between them because each one has its dynamics, but we cannot lose sight of the fact that time passes, and the business can prosper, but children grow, and that time does not come back. I am what is known as self-employed; I still do not have a team, but I know that the time will come, and I must be prepared.”

So far, the experience has been challenging because her husband also has his time occupied with work dynamics, and they must balance the loads so that both enjoy quality time with the girls. “I think we deserve the respect of our family and support to pursue our purposes without feeling guilty.”

Just a few days ago, Yadira participated in an event called “Vibrating Among Bosses” that was aimed at personal development for women, mostly entrepreneurs, and designed by Adriana Heredia (leader of Beyond Roots) and Mario Ferrer (a digital marketing specialist).

“Connecting with empowered, resilient women, but at the same time being sensitive, was very inspiring for me. I went to the space with my youngest baby, just four months old, and we both received all the understanding and support to participate. Sometimes we need so much to feel listened to, and at the same time hear that we deserve care and respect, starting from ourselves. There were laughter, tears, and a lot of good vibes.”

�鶹���¼� and more dialogue spaces are emerging on the island for the tribe of mother women. However, this type of initiative must continue to be encouraged and managed to incorporate all those who still feel lonely in their context.

Rizo Libre in the Future

Yadira has many dreams for her venture, but the immediate one is to grow and connect with the community of entrepreneurs for feedback on their businesses. “The intention will always be the happiness of our clients from the freedom to see themselves naturally and love themselves as such.”

As part of that support among ventures, Rizo Libre employs among its main products the cream and gel from the national cosmetics brand Qué Negra, developed by Erlys Pennycook Ramos from Ciego de Ávila, to provide new ways of treating hair in Afro-descendant men and women who choose to wear it naturally.

Yadira’s third child is her way of bringing new perspectives to the Cuban Afro-descendant community from the freedom of authentic and history-filled hair. “Rizo Libre is just a baby building its own identity as more people interact and leave their mark and experience while receiving hairdressing services.”

As a tribute to all the Black women who have trusted her hands to highlight the beauty that has been stigmatized for centuries, the entrepreneur and incomplete poet, as she calls herself, wrote “Monument to the Black Woman”:

Black woman who rises, awakening the dream of clay, my hands have not finished your feet, and your head has already thought of walking. I have had to open your mouth; there is no way you will remain silent. Your eyes discover me and question me, it is impossible not to attend to your impetus, your emphasis for me to put all the ancestral force into you.

You are not an easy idea to materialize! Give me light, my Black one; give me the ������é and the secret of your fierceness to fund and create life. Where do I put your children? In your hands, your chest, your back, tied to your waist, or lying at your feet? Some far away and others close? Happy and sad children? Victorious or successful children? It doesn’t matter, if in those breasts I made for you, it already seems like you’re going to breastfeed as if your cub had never grown up.

What are those hands doing, crazy one! Let me straighten your fist, let me refine your fingers more so you can finish squeezing, washing, writing, sowing, combing, and healing. Oh, your power to heal, holy Black, witch Black, and learned. Science and herbs, you carry them in equal measure. Let me smooth your calluses, and I’ll let you fly once and for all.

Back and pelvis, they are ready! There will be no man who can resist the charm of your walk. You are already upright, my Black one, ready to conquer spaces that by right you have known how to earn. Everyone will have to make way, everyone will have to greet, strong men, fat men, green men, those who earn less and those who earn more.

I’m going to your feet, my Black one. Your footprint in the clay is there, with a step overcome and a shackle to loosen. You’re standing on the world map, ready to unveil.

This story was (Cuba) and was republished within the program, supported by ICFJ, .

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Impact on Families

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

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

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

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

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

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

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

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

Solutions

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

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

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

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

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

And sometimes, the calendar stays blank.

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

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

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

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

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

If you can’t get a timely appointment:

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

 This story was produced in collaboration with the .

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Mothers Who Are Missing, Martyrs, and Murderers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A Radical Reimagining of Motherhood

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

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

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

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

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

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

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

Twenty-two hours later, he was assassinated.

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

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

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

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

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

We, Not Me

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

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

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

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

The Myth of Time

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

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

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

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

Forged in Adversity

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Practice 1: Courageous Presence

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

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

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

Practice 2: Visioning the Arc  

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

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

Practice 3: Embodied Adaptation

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

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

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

Stewards of the Future 

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

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

Join us in discovering a revolution of being!

MOTH

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

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

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

Do you remember 
your simultaneous
origin and conclusion?

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

Care Coordination

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

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

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

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

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

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

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

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

Closed Referral Loops

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

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

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

Remove Limits on HCBA Waiver

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

Automatic Medi-Cal Reimbursement, Better Coordination With Other Plans

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

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

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

Enforce Existing Regulations

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

Enroll All Children in Medi-Cal

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

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

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

This story was produced in collaboration with the .

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

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

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

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

“I Can See Where People Would Give Up”

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

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

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

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

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

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

But that’s just part of her responsibilities.

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

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

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

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

The Impact of Delays

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

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

She also needed more health insurance.

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

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

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

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

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

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

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

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

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

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

“A Cloud Above My Head”

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

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

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

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

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

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

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

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

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

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

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

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

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

This story was produced in collaboration with the .

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

It takes a village to create a film. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Embrace Equal Entitlement to Orgasm

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

�鶹���¼� Clitercourse With the Intercourse

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

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

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

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

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

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

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

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

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

Black Classical Canada

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

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

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

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

Absence of Colleagues, Mentors

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

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

Negative experiences can start early.

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

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

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

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

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

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

The Power of Many

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

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

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

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

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

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

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

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

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

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

Change Is Constant, and Needed

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Guilt in the NICU

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

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

A Tube-Feeding Odyssey

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

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

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

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

Learning to Eat

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

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

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

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

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

Breakthroughs

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

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

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

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

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

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

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

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

This story was produced in collaboration with the .

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

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

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

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

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

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

There Will Be Living After All

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

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

there will be living, after all.

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

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

there will be living, after all

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

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

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

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

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

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

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

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

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

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

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

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

kuruman

this is what happened
from a wish to become
nothing

i became everything
i became pull

i became the only thing
we did not choose

i became gravity

*

this is what happened
in the dream where
i was everything

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

i became what peace
you could imagine

*

this is what happened

i became star
i became morning

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

*

this is the wish

a desert of salt
wide

and that you cross it

this is the wish

a sky 
black 

and that it holds you

this is the lesson

earth
was never still

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

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

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

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

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

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

Reclaiming Kinship and Connection 

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

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

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

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

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

Challenging Perfection and Achievement 

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

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

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

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

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

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

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

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

Challenging Anti-Blackness and Punitive Discipline

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I’m 63, and I love sex.

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

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

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

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

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

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

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

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

Communication is key

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

Embrace sexual values

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

What makes you hot is you

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

Pleasure is adaptable 

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

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

As are we all. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

There Is No Ethical Ambiguity About Bombing Hospitals

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This column was produced in collaboration with the .

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

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

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

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

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

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

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

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

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

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

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

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

Tips for managing stress:

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

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

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

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

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

Resources

You can find parent resource organizations using these directories:

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

This story was produced in collaboration with the .

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

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

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

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

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

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

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

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

Bad news first—and it is bad.

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

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

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

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

Who’s Murdering and Abusing Girls?

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

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

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

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

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

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

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

What Does “Depression” Mean?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

We have to keep us safe. 

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

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

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

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

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

between the breath’s 

peak and trough

an infinitesimal point

of stillness

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

between a pendulum’s swings

at the edges of its repeating arc

gravity grapples with inertia

and wins eventually

always

given air friction

drag force

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

at the top of each swing

before the pendulum turns

to return

a pause

in that stillness
we can slide

out

away from the war

declare a ceasefire

a truce in this tug of war��

between the inescapable pull��

downward��

the constant push to move

this face-off

between what we can’t outrun

and all that keeps us running

the weighty dilemmas of history
at war with life’s

bottomless desire for more��

life

trapped in clock

and calendar forced march

we lose circular time

the seasons’ reminders in feeling

that the planet

rotates on its own axis

revolves, inexorable,

closer to and further from its star

we lose the joy of that wheeling

the peace of fulcrums 

of light and darkness balanced

while we��

wild freedom

slip

out

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

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

Eros and the Revolution

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

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

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

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

“Guilty Pleasures”

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

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

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

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

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

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

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

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

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

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

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

The Erotic Fortifies Our Commitment in the Revolution

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Accessiblity of Care

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

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

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

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

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

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

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

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

How Abuse and Stigmatization Are Leading to Unsafe Abortions

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

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

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

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

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

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

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

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

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

Solving Problems Before They Happen

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“No Space for Caring for Yourself”

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

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

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

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

�鶹���¼� than a third of Californians are insured under the state’s Medicaid program, known as Medi-Cal, and they often struggle to find therapists willing to take that insurance due to low reimbursement rates compared to private insurance or out-of-pocket pay. About 3 million Californians, many of them undocumented immigrants, have no health insurance, and most of them cannot afford to pay for mental health care in cash. For survivors who speak languages other than English, finding therapists who speak their language and understand their cultural background can be especially hard.

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

“Afraid to Call the Police”

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

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

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

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

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

A Lifeline for Mental Health Support

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

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

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

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

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

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

Forced to Limit Patients to Pay Bills

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

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

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

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

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

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

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

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

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

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

Mental Health Care Seen as Secondary 

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

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

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

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

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

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

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

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

Domestic Violence support:

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

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

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

Mental Health support:

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

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

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

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

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

Disrupting Power Imbalances

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

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

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

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

Teaching Consent and Boundaries

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

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

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

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

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

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

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

Tips for Talking to Your Child About Consent:

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