Some current recipients of health and disability benefits are likely to lose out under a planned overhaul of the welfare system, which is expected to tighten eligibility criteria for the Personal Independence Payment (PIP).

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Veterans who wish to change their gender “can do so on their own dime,” the V.A. secretary said.The Department of Veterans Affairs is phasing out gender-affirming medical treatments for veterans, including hormone treatment for patients newly diagnosed with gender dysphoria, the V.A. announced on Monday.The V.A. will continue hormone treatment for veterans who currently receive it or were receiving it when they separated from the military. The rationale is that abrupt cessation can be harmful to patients’ health.The policy change was made to comply with an executive order by President Trump, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” the V.A. said in a news release.That order states that the United States recognizes only two sexes, male and female, which “are not changeable.”“I mean no disrespect to anyone, but V.A. should not be focused on helping veterans attempt to change their sex,” said Doug Collins, the V.A. secretary.Transgender veterans will continue to be welcome at the V.A., he added, “but if veterans want to attempt to change their sex, they can do so on their own dime.”The V.A. has been providing treatment for gender transition to veterans since 2011. It has never provided surgeries, but it has offered supportive services. In addition to hormone therapy, these have included mental health care, preoperative evaluations and letters supporting the need for procedures, as well as postoperative and long-term care.Fertility services, prosthetic devices like wigs, and voice coaching were also offered. Those services had been authorized under a V.A. directive on guiding health care for transgender and intersex veterans know as 1341(4), which has been rescinded.Many mental health providers at the V.A. have had concerns about their ability to continue providing adequate care to transgender patients after they were ordered to remove rainbow flags and lanyards, pamphlets describing services offered to L.G.B.T.Q.+ veterans, and wall posters that read “All are welcome here” and “We serve all who have served.”Mary Brinkmeyer, a psychologist who coordinated care for L.G.B.T.Q.+ veterans at the Hampton V.A. Medical Center in Virginia, refused to remove signs and fliers. She recently resigned, fearing that mental health care for transgender veterans would be compromised.“Our code of ethics is, ‘First do no harm,’ and if you’re caught between an institutional demand and your ethical code, you have to resolve it in favor of the ethics code,” Dr. Brinkmeyer said.The cessation of hormone treatment, along with the recent designation of V.A. bathrooms and inpatient rooms by biological sex, “will have a real chilling effect on veterans’ willingness to seek care for gender dysphoria,” she said.Studies indicate that gender dysphoria is much higher among veterans than among the general population and that the risk of suicide-related events is as much as 20 times higher among veterans with gender dysphoria than in the general Veterans Health Administration population.“If veterans don’t have other health insurance — and many transgender veterans are homeless or underemployed — will they not seek care if they’re suicidal rather than go to the V.A.?” Dr. Brinkmeyer asked.

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After the Dobbs decision, births rose in states with bans, but more for some women than others.Abortion bans successfully prevented some women from getting abortions in the immediate aftermath of the Supreme Court’s overturning of Roe v. Wade, according to a detailed new study of birth data from 2023. The effects were most pronounced among women in certain groups — Black and Hispanic women, women without a college degree, and women living farthest from a clinic.Abortion has continued to rise since the period the data covers, especially through pills shipped into states with bans. But the study identifies the groups of women who are most likely to be affected by bans.For the average woman in states that banned abortion, the distance to a clinic increased to 300 miles from 50 miles, resulting in a 2.8 percent increase in births relative to what would have been expected without a ban.

For Hispanic women living 300 miles from a clinic, births increased 3.8 percent. For Black women, it was 3.2 percent, and for white women 2 percent.“It really tracks, both that women who are poorer and younger and have less education are more likely to have an unintended pregnancy, and more likely to be unable to overcome the barriers to abortion care,” said Dr. Alison Norris, an epidemiology professor at Ohio State who helps lead a nationwide abortion counting effort and was not involved in the new study.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Chatbots should be built with enough resilience to deal with difficult emotional situations, researchers said.Even chatbots get the blues. According to a new study, OpenAI’s artificial intelligence tool ChatGPT shows signs of anxiety when its users share “traumatic narratives” about crime, war or car accidents. And when chatbots get stressed out, they are less likely to be useful in therapeutic settings with people.The bot’s anxiety levels can be brought down, however, with the same mindfulness exercises that have been shown to work on humans.Increasingly, people are trying chatbots for talk therapy. The researchers said the trend is bound to accelerate, with flesh-and-blood therapists in high demand but short supply. As the chatbots become more popular, they argued, they should be built with enough resilience to deal with difficult emotional situations.“I have patients who use these tools,” said Dr. Tobias Spiller, an author of the new study and a practicing psychiatrist at the University Hospital of Psychiatry Zurich. “We should have a conversation about the use of these models in mental health, especially when we are dealing with vulnerable people.”A.I. tools like ChatGPT are powered by “large language models” that are trained on enormous troves of online information to provide a close approximation of how humans speak. Sometimes, the chatbots can be extremely convincing: A 28-year-old woman fell in love with ChatGPT, and a 14-year-old boy took his own life after developing a close attachment to a chatbot.Ziv Ben-Zion, a clinical neuroscientist at Yale who led the new study, said he wanted to understand if a chatbot that lacked consciousness could, nevertheless, respond to complex emotional situations the way a human might.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

On a recent Friday morning, Daniel, a lawyer in his early 40s, was in a Zoom counseling session describing tapering off lithium. Earlier that week he had awakened with racing thoughts, so anxious that he could not read, and he counted the hours before sunrise.At those moments, Daniel doubted his decision to wean off the cocktail of psychiatric medications which had been part of his life since his senior year in high school, when he was diagnosed with bipolar disorder.Was this his body adjusting to the lower dosage? Was it a reaction to the taco seasoning he had eaten the night before? Or was it what his psychiatrist would have called it: a relapse?“It still does go to the place of — what if the doctors are right?” said Daniel.On his screen, Laura Delano nodded sympathetically.Ms. Delano is not a doctor; her main qualification, she likes to say, is having been “a professional psychiatric patient between the ages of 13 and 27.” During those years, when she attended Harvard and was a nationally ranked squash player, she was prescribed 19 psychiatric medications, often in combinations of three or four at a time.Then Ms. Delano decided to walk away from psychiatric care altogether, a journey she detailed in a new memoir, “Unshrunk: A Story of Psychiatric Treatment Resistance.” Fourteen years after taking her last psychotropic drug, Ms. Delano projects a radiant good health that also serves as her argument — living proof that, all along, her psychiatrists were wrong.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

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