Publisher Health

5 days agoShareSaveAlison HoltSocial affairs editorJames MelleySenior social affairs producerShareSaveBBC”A victory for common sense” or “devastating” –  the contrasting reactions to the statement by five Supreme Court judges that legally the term “woman” means a biological woman.Behind the different responses lie many of the often bitter and vitriolic arguments that set the country on a long, tricky road towards Wednesday’s unambiguous judgement.When the highest court in the land ruled that sex is binary – meaning legally it should be interpreted as referring to either a biological man or a biological woman – it was providing clarity that had been missing from such conversations for years.Words like “woman” and “sex” had become loaded with different meanings depending on your viewpoint. Language that for centuries had been uncomplicated and accepted, became a battleground.The judgement is intended to draw a line under that.It argues that for the Equality Act to be consistent, the term woman has to mean a biological woman. That does not include biological males, even if they have certificates to say they have changed gender.This means that where there are, for instance, women-only spaces, then a biological man who identifies as a woman cannot use them. That includes changing rooms, toilets, women’s refuges, single-sex hospital wards and anywhere designated as for one sex only.How much change that will mean in practice will be set out in detailed guidance. Until then, there remain lots of questions and some confusion – and that is challenging in an area where views are so polarised.From jubilance to devastationIt was Baroness Falkner, the woman who heads the watchdog that regulates equality laws, who described the judgement as a victory for common sense.She added it was only such a victory if you recognised trans people, “that they exist, they have rights, and their rights must be respected”.She also told the BBC about the abuse she had faced since taking over as chair of the Equalities and Human Rights Commission (EHRC) in 2020.She had previously told the Times that women had the right to question gender identity, and that had led to some very personal abuse from those who disagreed with her.”I had not realised how difficult the job would be,” she said. “It has taken a toll, but if you are in public life you have to take that.”Getty ImagesThe second response to the judgement was from the trans rights campaign group TransActual, which described the Supreme Court judgement as devastating.One of its activists, Jane Fae, told the BBC the judgement felt like a physical body blow, and that it was as if trans people were being excluded from society.”Today we’re feeling very alone” she said. “What does this mean – can I use this loo, can I do that, can I do the other?”In contrast, the women’s groups who fought the case feel vindicated and jubilant.Helen Joyce, the director of advocacy at the campaign group Sex Matters, says the ruling is “incredibly important for the half of humanity who need single-sex spaces”.Women’s groups argue that the ruling is important for reasons of privacy, safety, dignity and discrimination.The Supreme Court case was brought by a group called For Women Scotland. It wanted to overturn Scottish legislation which said 50% of members on public boards should be women – and trans women were included in their definition.Getty ImagesThe group lost its case in Scotland’s highest court but appealed to the UK Supreme Court. The case was heard towards the end of last year.”What we wanted was clarity in the law – when something is described as a single-sex service, a single-sex space, that this relates to biology,” Susan Smith from For Women Scotland told the BBC.Beginnings of the culture warsOver time the arguments over how a woman is defined had become increasingly angry, bitter and divided, because the stakes were high for all involved.For transgender people, who say they often face victimisation and harassment, the battles were rooted in attempts to win better legal protection.”Legal gender recognition is essential for trans people to enjoy the full spectrum of rights each of us is entitled to, including safety, health and family life,” according to Sacha Deshmukh, the chief executive of Amnesty International UK.  The charity opposed For Women Scotland’s case in the Supreme Court.The question of how to achieve legal recognition rose to prominence in 2002 when two judgements at the European Court of Human Rights found the UK was breaching human rights by failing to legally recognise transgender people in their acquired gender.This eventually led to the 2004 Gender Recognition Act, which allowed a trans person to apply for a Gender Recognition Certificate (GRC). This recognised their preferred gender rather than their biological sex, allowing official documents like birth certificates to be changed to reflect that.Getty ImagesBut it was a long-winded process requiring two doctors to sign it off and for the person to “live in their acquired gender” for at least two years. Only about 8,000 people have applied for a GRC since they came into being, according to government figures.Campaigners began calling for the process to be simplified. In a response to a 2020 government consultation on amending the GRA, Stonewall, the LGBTQ+ rights organisation, called for a “move to a de-medicalised and straightforward legal gender recognition process”.Gradually these calls gained momentum.In 2022, the Scottish government introduced a law that would allow people to “self-identify” in their desired gender. This was later blocked by the UK government and eventually dropped as a Scottish policy.As the rights of trans people were being debated, women’s groups started pushing back about what that meant for biological women.The meaning of words like “woman” and “sex” took on new significance, if someone who was biologically male had a certificate that identified them as a woman for legal purposes.Under the 2010 Equality Act, sex was a protected characteristic, and so was gender reassignment. With the very meaning of those categories in dispute, legal experts said it set the protections of one group against the protections of another.The complexities mean courts and tribunals have frequently been called on to arbitrate.And social media has often provided a starting point for angry disputes, connecting and amplifying voices, and in many cases, leading to more entrenched viewpoints. It had become a culture war.How the debate began to changeIn 2019, tax expert Maya Forstater lost her job because she tweeted that she did not believe people could change their sex. She said biological sex was immutable and not the same as gender identity.  As a result, her work contract was not renewed. Her employer said it wanted to build an inclusive workplace.She lost her case at an employment tribunal case, but an Appeal Court judge later ruled that gender critical beliefs were protected by the Equalities Act. In 2023, she was awarded £100,000 compensation for unfair dismissal.It was a high-profile battle through tribunals and courts which put employers’ policies on inclusion under the spotlight and raised questions about whether by protecting the rights of one group, another was being discriminated against.PAMs Forstater went on to set up the campaign group Sex Matters, and was among those celebrating outside the Supreme Court on Wednesday.There have been other similar cases brought against employers since then. Sex Matters lists 11 settled or ongoing cases on its website.But other high-profile cases have also shaped the broader debate.In March 2020, 23-year-old Keira Bell took legal action against the only children’s NHS gender clinic, saying she should have been challenged more by medical staff over her decision to transition to a male whilst a teenager.Although she eventually lost her case, it started a chain reaction, which led to a shake-up of gender services for children and young people.And in 2021 the Sussex University professor, Kathleen Stock, quit her job after being accused of having transphobic views. She had published a book that questioned whether gender identity was more significant than biological sex.Getty ImagesShe denied being transphobic but was subjected to a student campaign to remove her from her post. The university was later fined for failing to uphold freedom of speech.These and other cases put an uncomfortable spotlight on a debate that many preferred to ignore or dismiss as mainly happening on social media, because it was too tricky and using the wrong language could lead to abuse.Yet fundamental questions were being raised about freedom of speech, how we treat each other and how you define a woman. The need for clarity had become overwhelming.In terms of equality law, the Supreme Court ruling provided that.For women’s groups there is sheer relief that biological facts will now drive decisions.But for many trans people there is distress. Even though they still have protections under the Equality Act, for many it does not feel like that. They worry that harassment will increase.Activist Charlie Craggs, who is a trans woman, told the BBC it was really sad that this tiny community of less than 1% of the population was being “thrown under the bus”.Supreme Court ruling in practiceCrucially, the ruling provides a clear framework for what equality laws mean. The EHRC says it is “working at pace” to update its guidance, and expects that to be ready by the summer.It has already made it clear that if a single-sex space, like a toilet or changing room, is women-only, that means biological males who identify as women should not use it.It says instead that trans people should use their “powers of advocacy” to campaign for third spaces, such as unisex toilets.And it has said it will pursue the NHS if it does not follow the latest ruling.Health service guidance on single-sex wards currently says that “trans people should be accommodated according to their presentation, the way they dress, and the name and pronouns they currently use”.Currently this allows trans women to be offered beds on women-only wards.The NHS says its policy is under review.Former Supreme Court judge Lord Sumption says that while the ruling means organisations can exclude trans women from women only facilities, they are not necessarily obliged to do so.He told Radio 4’s PM programme that in sport, for example, it would be down to individual governing bodies to decide who is allowed to compete in women’s sport.”They could decide to allow trans women to compete on the same basis as biological women, some sporting authorities do, although I think that in light of the latest judgement, they would be wise to say so expressly in their rules,” he said.British Transport Police has been the first body to actually change its policies. It says strip searches of people in custody will be carried out by officers of the same biological sexIt means a trans woman would be searched by a male officer, and a police officer who is a trans woman would not be able to search a biological woman.Getty ImagesThe domestic violence charity Refuge says the ruling will not change the way it operates.Its chief executive, Gemma Sherrington, says, “we remain firmly committed to supporting all survivors of domestic abuse, including trans women”.But for many businesses, sports clubs and other organisations it is too soon to know what this will mean in practice.They will need to see the detailed guidance from the Equality Commission first. Until then it is difficult to know how much change, if any, they will need to make or what new issues might arise.Some organisations will also have to decide whether they have the space and money to provide so-called third spaces or unisex facilitiesFor trans people there is also a lot of uncertainty. They will have been used to using spaces which correspond to their gender identity – changing that may be difficult and, for some, frightening.The Equality Commission expects to publish its new statutory code of conduct by the summer. Only then will these questions begin to be answered.More from InDepthTop picture credit: Reuters BBC InDepth is the home on the website and app for the best analysis, with fresh perspectives that challenge assumptions and deep reporting on the biggest issues of the day. And we showcase thought-provoking content from across BBC Sounds and iPlayer too. You can send us your feedback on the InDepth section by clicking on the button below.

An interim U.S. attorney is demanding information about the selection of research articles and the role of N.I.H. Experts worry this will have a chilling effect on publications.A federal prosecutor has sent letters to at least three medical journals accusing them of political bias and asking a series of probing questions suggesting that the journals mislead readers, suppress opposing viewpoints and are inappropriately swayed by their funders.The letters were signed by Edward Martin Jr., a Republican activist serving as interim U.S. attorney in Washington, D.C. He has been criticized for using his office to target opponents of President Trump.Some scientists and doctors said they viewed the letters as a threat from the Trump administration that could have a chilling effect on what journals publish. The health secretary, Robert F. Kennedy Jr., has said he wants to prosecute medical journals, accusing them of lying to the public and colluding with pharmaceutical companies.One of the letters was sent to the journal Chest, published by the American College of Chest Physicians. The New York Times obtained a copy of the letter.The Times confirmed that at least two other publishers had received nearly identically worded letters, but those publishers would not speak publicly because they feared retribution from the Trump administration.In the letter to Chest, dated Monday, Mr. Martin wrote, “It has been brought to my attention that more and more journals and publications like CHEST Journal are conceding that they are partisans in various scientific debates.”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.

Government websites that once provided basic information about the virus now redirect to a page citing a number of misleading or heavily contested claims.The Trump administration has replaced the government’s main portal for information about Covid with a website arguing that the virus leaked from a lab, throwing its weight behind a theory of the virus’s origins that is so far not backed by direct evidence and that many scientists consider less likely than the idea that it emerged at a wild-animal market.Covid.gov and Covidtests.gov, government websites that used to deliver information about Covid and allow people to order tests, now redirect to the lab leak web page. Carrying an image of President Trump flanked by the words “Lab Leak,” the new page is illustrated by a satellite image of Wuhan, China, the city where Covid began spreading, and says it will describe “the true origins of Covid-19.”The website notes that the city is home to the Wuhan Institute of Virology, a coronavirus lab that had been involved with research projects that some scientists considered dangerous. It also alludes to concerns that the lab had conducted its work under improper safety conditions. C.I.A. officials cited those same concerns when the agency recently shifted its position to favor a lab leak.But the page sidesteps holes in that theory — a number of large Chinese cities, for example, have labs that reported studying viruses like those the Wuhan institute worked on — and does not address the considerable evidence from early cases and viral genomes that the virus instead spilled from animals into humans at an illegal wild-animal market. It also cites a number of misleading or heavily contested claims.The purging of old Covid websites reflects a broader practice by the Trump administration of scrapping health websites that do not align with its views, including ones related to climate change and L.G.B.T.Q. people. (Some of those pages were later restored.)And it has turned what used to be the government’s main portals for disseminating reliable information about the virus into a vehicle for attacking the administration’s political enemies, including Dr. Anthony Fauci, who led a federal research institute that awarded funding to a virus-hunting nonprofit that worked with scientists in Wuhan.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.

People in the community called the remarks dehumanizing and warned they could perpetuate harmful stigma.Robert F. Kennedy Jr.’s remarks this week that autism “destroys” children have prompted outrage among many autistic people, who said they had done things Mr. Kennedy claimed were impossible, like hold a job, write a poem, play baseball and go on dates. They added that the lives of people who did need help performing daily activities were still worthy of respect.“Autism doesn’t destroy families. It’s the ableism that does,” said Tyla Grant, who was diagnosed with autism at 17. She called Mr. Kennedy’s comments “fear-mongering” and said his “rhetoric flattens our existence into this outdated stereotype.”Many parents of autistic children said they feared Mr. Kennedy’s remarks would set back efforts to destigmatize autism and connect families with support services.“How will our children survive if they are considered a tragedy?” said Kim Cristo, whose 17-year-old daughter is “essentially nonverbal” but has a fulfilling social life, loves music and does yoga and karate. “How can we make their lives meaningful if they are being dismissed as lost causes?”Mr. Kennedy made his remarks at a news conference on Wednesday discussing new data from the Centers for Disease Control and Prevention that showed autism diagnoses among children in the United States have continued to rise. Though the increase is largely thought to be driven by broadened criteria and increased awareness, Mr. Kennedy falsely declared that autism was preventable and called the situation an epidemic.“These are kids who will never pay taxes,” he said, adding, “Many of them will never use a toilet unassisted.”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.

Eli Lilly reported promising results from a study of its experimental oral drug that could rival popular injections to treat obesity and diabetes.Encouraging clinical trial results announced on Thursday stand to open up a huge market for a convenient daily pill to treat obesity and diabetes.The experimental drug, developed by Eli Lilly and known as orforglipron, is a type of medication known as a GLP-1. Drugs in this class like Wegovy have become hugely popular because they help people lose weight.But those drugs must be given as weekly injections, which has limited their use. If orforglipron can deliver similar results in an easy-to-take pill form, as the study suggested it could, it has the potential to reach many more patients and become a major blockbuster.Here’s what to know about Eli Lilly’s pill, which still must go through a review process by the Food and Drug Administration to be approved for sale.When will the pill become available?Eli Lilly said that it planned to seek regulatory approval to market the drug for weight loss later this year, and early next year for diabetes. The F.DA. could take months and possibly longer to review the company’s trial data before making a decision.Wall Street analysts said that if all went smoothly, orforglipron could become available in the United States sometime in the second half of next year.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.

An internal memo proposes carving out $40 billion from federal health agencies while eliminating dozens of programs. Congress has ultimate appropriation authority.The Trump administration is eyeing about $40 billion in cuts to the Department of Health and Human Services’s budget next year, according to a memo obtained by The New York Times, as the White House charges ahead with plans for drastic changes to the agencies that regulate food and drugs, protect Americans from disease and research new treatments.The proposed cuts laid out in the preliminary budget memo would reduce the department’s budget from about $121 billion to about $80.4 billion. The document also proposes eliminating dozens of programs focused on various public health challenges, such as autism, teen pregnancy, lead poisoning, opioid recovery and support for rural hospitals. The memo was first reported by The Washington Post.The cuts deal with discretionary H.H.S. funding, not what the federal government is obligated by law to spend annually on insurance programs like Medicare and Medicaid, which insure nearly half of Americans.While it is not yet clear if the Trump administration will pursue all of the cuts the document outlines, it is Congress that will decide whether to enact them, as the legislature appropriates the federal government’s funding.Still, the memo reveals how President Trump and Robert F. Kennedy Jr., the health secretary, might put into practice their plans to overhaul the department and refashion it as a crucible for Mr. Kennedy’s “Make America Healthy Again” movement.About a quarter of the funds that would survive the proposed cuts would be directed toward the Administration for a Healthy America, a new $20 billion effort that would oversee agencies focused on H.I.V. and AIDS, maternal and child health, environmental health, mental health and primary care.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.

Surges in Mennonite communities near the U.S. border may complicate containment efforts, experts say. As the United States struggles to contain a resurgence of measles that has swept through swaths of the Southwest, neighboring countries are responding to their own outbreaks.Canada has reported more than 730 cases this year, making this one of the worst measles outbreaks in the country since it declared the virus “eliminated” in 1998. Mexico has seen at least 360 measles cases and one death, most of them in the northern state of Chihuahua, according to Mexican health authorities.Many of the communities grappling with measles have large Mennonite populations that public health officials have linked to outbreaks. The multinational resurgence has concerned epidemiologists, who fear that simultaneous outbreaks near the U.S. border will make it more difficult to contain the virus.“It’s just a line on the map that separates them — we share air, we share space,” said Lisa Lee, an epidemiologist at Virginia Tech.Falling vaccination rates have left the United States more vulnerable to the highly contagious virus, she added. “If we don’t have a buffer or herd immunity to keep the virus out,” she said, “we will be at risk as long as any of our neighbors are at risk.”The outbreak in the Southwest shows no signs of slowing. Since late January, the virus has sickened more than 560 people in Texas, 63 people in neighboring New Mexico, and a dozen people in Oklahoma.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.

Clinical results of a GLP-1 in pill form showed safety and efficacy data similar to blockbuster injectable drugs.A daily pill may be as effective in lowering blood sugar and aiding weight loss in people with Type 2 diabetes as the popular injectable drugs Mounjaro and Ozempic, according to results of a clinical trial announced by Eli Lilly on Thursday morning.The drug, orforglipron, is a GLP-1, a class of drugs that have become blockbusters because of their weight-loss effects. But GLP-1s are expensive, must be kept refrigerated and must be injected. A pill that produces similar results has the potential to become far more widely used.“In the coming decades, 700 million people around the world will have Type 2 diabetes, and over a billion will have obesity,” said Dr. Daniel Skovronsky, Lilly’s chief scientific officer. “Injections cannot be the solution for billions of people around the world.”The results Lilly announced came from a clinical trial involving 559 people with Type 2 diabetes who took the new pill or a placebo for 40 weeks. In patients who took orforglipron, blood sugar levels fell by 1.3 to 1.6 percent, about the same amount in that time period experienced by patients taking Ozempic and Mounjaro in unrelated trials. For 65 percent of people taking the new pill, blood sugar levels dropped into the normal range.Patients on the new pill also lost weight — up to 16 pounds without reaching a plateau at the study’s end. Their weight loss was similar to that achieved in 40 weeks with Ozempic but slightly less than with Mounjaro in unrelated trials.Side effects were the same as those with the injectable obesity drugs — diarrhea, indigestion, constipation, nausea and vomiting.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.

A scheme to support GPs to provide care and advice to patients which avoids them joining long NHS hospital waiting lists is being expanded in England, the government says.GPs will work more closely with specialists to access expert advice quickly for patients with conditions such as irritable bowel syndrome, menopause symptoms and ear infections.Backed by £80m of funding, its ambition is to help two million people receive faster and more convenient care in their local community by the end of 2025/26.Health minister Karen Smyth said the scheme would “save time and stop masses of people having to head to hospital for unnecessary appointments”.The expanded scheme is part of the government’s plan to cut long NHS waiting lists and create extra appointments for patients.It has pledged that 92% of NHS patients will be waiting less than 18 weeks for treatment after referral to a consultant, by the end of this parliament.Between July and December 2024, the scheme diverted 660,000 treatments from hospitals and into the community, the government says.Called ‘Advice and Guidance’, the scheme links GPs and hospital specialists before patients are referred onto waiting lists, so that tests and treatments can be offered in the most convenient place.For example, patients with tinnitus and needing ear wax removal often end up being referred to specialists when they could be helped outside hospitals. And women needing advice on types of HRT could be treated in local hubs, rather than waiting to see a gynaecologist.GP practices are able to claim for each time they use the scheme to shift care from hospital to the community.Health Minister Karin Smyth said the government was “rewiring the NHS” and doing things differently.”This scheme is a perfect example of how we are saving patients time and reducing pressure on key NHS services in the process,” she said.”It will take time to reverse the damaging neglect the NHS has suffered in recent years, but our Plan for Change is starting to deliver benefits for patients, with waiting lists cut by 219,000 since July, and 1,500 new GPs in post.”National Voices, which represents health charities in England, said “real choice” must be offered to patients about what the best treatment routes are.”We must see strong communication about what the service is and what it means in practical terms for patient care,” director of policy Sharon Brennan said.The British Medical Association said in a statement: “We have seen decades of underinvestment in general practice, and this is an important small step in acknowledging the important role of the GP and supporting practices to deliver enhanced care to patients in the community.”The journey to bringing back the family doctor has only just begun. Now we must focus on the secretary of state’s promise to complete negotiation of a new GP contract within the term of this Parliament in order to safeguard family GP services for the future, and we look forward to working closely with the government to achieve that.”

The World Health Organization finally reached a compromise on a pandemic treaty after three years of talks. The United States withdrew from negotiations after President Trump took office.After three years of contentious negotiations, the member nations of the World Health Organization have agreed on a draft of a “pandemic treaty” designed to help the global community better prevent and respond to health crises.The agreement is aimed at averting the fractious, faltering response to the Covid-19 pandemic, which left many poor nations with limited access to vaccines and treatments. It would oblige wealthy nations to share key information on pathogens, and technology for interventions such as vaccines, with the rest of the world.The member states are expected to adopt the treaty, which will be legally binding, next month. The United States, which stopped participating in negotiations after President Trump announced plans to withdraw from the W.H.O., is not expected to ratify the treaty.The draft treaty is more limited in scope than the vision the W.H.O. first proposed during the throes of the Covid pandemic, but it is significant as the first major multilateral agreement in a world where the United States is no longer the unquestioned anchor.“It shows that with or without the U.S., the world can pull together for global health, and a recognition that pandemics require global solidarity,” said Nina Schwalbe, a global health consultant who has held leadership roles in U.S. and international organizations and who followed the negotiations closely. “They pushed past their red lines and they got to agreement. That’s no easy feat for 191 states. And there’s a lot in there. It’s maybe not as strong as we wanted on many issues, but there’s lots to build on.”In December 2021, the W.H.O. convened a group of negotiators to hammer out the terms of a new global agreement that it hoped would help countries respond more swiftly and effectively to future health threats.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.