21 May 23
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A playbook for autocracy
They have become globally recognized symbols of excellence. They have served as incubators of thought, engines of economic growth, and laboratories for transforming human knowledge about the mysteries of life and the wonders of the universe.
They have not been perfect, beset by the same biases, struggles, and systemic injustices that hamper and churn the rest of our society. But they have also been agents of positive change, pushing and prodding the nation to think differently.
Whereas once they were the exclusive domain of the most privileged (originally a majority were explicitly open to white males only), they have come to more closely reflect the diversity of our society and the planet as well, drawing students and faculty from around the world.
These same attributes render colleges and universities dangerous to autocrats like Florida Governor Ron DeSantis and the pitchfork-wielding wave of like-minded Republican officials in other states who are targeting academic freedom, free speech, and the very need to reckon with reality. The health, vitality, and future of our nation are at risk.
It is common for despots to attack intellectuals and universities. Free thought is anathema to the slavish obedience that authoritarians demand. So it should come as no surprise that DeSantis has put Florida’s schools in his sights as he wages a cynical and destructive culture war that he believes will one day deliver him the presidency of the United States.
At Steady, we have written before about DeSantis, race, and education — how he has blown “the ‘Anti-Woke’ Dog Whistle” and “delighted in division.” Well, he’s at it again, and it is vital that America realizes what this man intends to do — and indeed is actually putting into place.
A few days ago, DeSantis signed a bill that bans the study of diversity in public higher education. The Washington Post described the effects of the new law:
Under the new law, Florida’s public colleges are prohibited from spending state or federal money on DEI efforts. These programs often assist colleges in increasing student and faculty diversity, which can apply to race and ethnicity, as well as sexual orientation, religion and socioeconomic status. The bill does not prohibit colleges from spending money on such programs if they are required by federal law.
The law also forbids public colleges from offering general education courses — which are part of the required curriculum for all college students — that “distort significant historical events,” teach “identity politics,” or are “based on theories that systemic racism, sexism, oppression, or privilege are inherent in the institutions of the United States and were created to maintain social, political, or economic inequities.”
Understandably, this action has met a fierce backlash both within Florida and beyond. The chilling effects of this bill are likely to be considerable as professors look over their shoulders at the coercive power of the state, wondering whether teaching about the true, complicated history of this nation and our modern society will run afoul of the law. DeSantis’s intent is clear: He wants to reverse the progress by which institutions of higher learning represent and serve the needs of a changing America.
The role of diversity, equity, and inclusion programs at universities and in the culture more generally have been controversial. After all, their aim is to right some of the wrongs of centuries of injustice by challenging entrenched privilege. They are agents of change, and change can be scary, especially if you are part of a group that fears losing power. As we reckon with the more unsavory chapters of our history and culture, many will see narratives they had learned as children contradicted by new currents of thought.
We can have a debate about how we find balances between the old and new. We can recognize that certain efforts may go too far or become too dogmatic in their own right. But that is not what DeSantis and his ilk are trying to do. They want to stifle any reckoning, preserve whitewashed narratives, and protect their interests over the needs of those who think or look different.
We are seeing similar efforts in other red and purple states, including, sadly, Texas. And here we must contend with other damaging implications of these crusades of intolerance. What will happen to the wonderful public colleges and universities in these places? Will they be able to recruit top faculty? Will students who have the means to go elsewhere, including leaving the state, choose to do so? Will there be a brain drain?
“If you want to do things like gender ideology, go to Berkeley,” DeSantis snarled in signing the law. Demeaning one of the most illustrious public universities in the history of the United States as a basis of comparison? We’ll see how that turns out. But DeSantis wasn’t finished. “For us, with our tax dollars, we want to focus on the classical mission of what a university is supposed to be.” Well, Governor, that “classical mission” would be free thought and new ideas, not the dogmatic fantasies of small-minded intolerance.
Perhaps most tragically, we are left to wonder what this will mean for the students for whom local public universities are ladders of social and economic mobility. Many don’t have the resources to go to private schools or out of state. Many of these are students of color, the ones who have been traditionally excluded and marginalized. They will now have to attend institutions that diminish or even banish their narratives … under state law.
The crowd that countenances racism, denigrates science, and undermines democratic values is eager to remake higher education to serve their craven interests. They are weakening their states and our nation in the process. But one has a feeling — perhaps hope is the more apt word — that they will ultimately lose.
Younger generations are rejecting intolerance and those who would push us back into the darker realities of our past. Also, the truth eventually has a way of prevailing. Unfortunately, even if it does, a lot of unnecessary damage and loss will occur along the way. How much damage and loss is now in the process of being decided in extreme-right political strongholds such as Florida and Texas.
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Georgia Secretary of State Brad Raffensperger on Capitol Hill last year. (photo: Kenny Holston/NYT)
Among the 500 people singled out for travel and financial restrictions were Americans seen as adversaries by former President Donald J. Trump.
Among the 500 people singled out for travel and financial restrictions on Friday were Americans seen as adversaries by Mr. Trump, including Letitia James, the state attorney general of New York who has investigated and sued him. Brad Raffensperger, the secretary of state of Georgia who rebuffed Mr. Trump’s pressure to reverse the outcome of the 2020 election, also made the list. And Lt. Michael Byrd, the Capitol Police officer who shot the pro-Trump rioter Ashli Babbitt on Jan. 6, 2021, was another notable name.
None of those three has anything to do with Russia policy and the only reason they would have come to Moscow’s attention is because Mr. Trump has publicly assailed them. The Russian Foreign Ministry offered no specific explanation for why they would be included on the list but did say that among its targets were “those in government and law enforcement agencies who are directly involved in the persecution of dissidents in the wake of the so-called storming of the Capitol.”
As recently as this month, Mr. Trump has tried to rewrite the history of that day and has dangled pardons for convicted rioters if he is elected to a second term. He also refused to commit to supporting Ukraine in its war against Russia if he is elected president again, saying instead he would seek to mediate between Kyiv and Moscow.
Presumably, the Russian sanctions will have little actual effect on Ms. James, Mr. Raffensperger and Lieutenant Byrd since none of them is known to have assets in Russia or plans to travel there. Mr. Raffensperger reposted a tweet from Gabriel Sterling, his chief operating officer, who wrote: “A great honor for @GaSecofState Raffensperger. He is one of the hundreds of Americans banned from Russia by Vladimir Putin. That means Brad is doing it right.”
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Nebraska state Sen. Merv Riepe chats with fellow Sen. Jane Raybould on the floor of the legislature at the Nebraska Capitol in Lincoln, Neb., on May 4. Sen. Riepe, a longtime Republican, would have been the decisive vote to advance a 'heartbeat'abortion bill to a final round of voting but he abstained over his concern that it might not give women enough time to know they are pregnant. (photo: Rebecca S. Gratz/WP)
GOP lawmakers in North Carolina and Nebraska are casting new 12-week bans as “mainstream,” while Democrats say they are “cruel and extreme”
Instead, on Friday, Nebraska’s conservative legislature voted to ban abortions at 12 weeks of pregnancy — a threshold that significantly narrows the window for legal abortions but still allows the vast majority to occur.
A few days earlier, North Carolina Republicans used their legislative supermajority to enact a similar 12-week ban, calling it a “mainstream” approach that would be more broadly accepted than the stricter bans many conservatives had sought to pass. And in neighboring South Carolina, state Sen. Katrina Shealy (R) told The Washington Post that she and the other female GOP senators who blocked a near-total ban are planning to push for a 12-week ban on most abortions when the state Senate takes up a bill next week restricting abortion after roughly six weeks of pregnancy.
“We can’t live at the extremes,” North Carolina Sen. Amy Galey (R) said in an interview. “As a country, we can find a way to take a difficult issue and resolve it without a huge amount of acrimony and viciousness.”
Immediately after the Supreme Court overturned Roe v. Wade, Republican lawmakers were quick to embrace so-called “trigger” bans designed to take effect as soon as the decision was released, while others rushed to pass additional restrictions that would halt the procedure in their states, sometimes backing proposals that did not include exceptions for rape or incest.
Now, almost a year later, lawmakers in some Republican-led states have started coalescing behind bans that allow most abortions to continue — a reaction, some Republicans say, to the sustained political backlash to abortion restrictions that has been mounting since the landmark decision in June.
While the 12-week bans have so far only passed in two states — North Carolina and Nebraska — the proposal has also gained traction with some national antiabortion groups who say they’re supportive of restricting abortions as far as a state can, including Susan B. Anthony Pro-Life America, which has also been pushing for, at minimum, national limits on abortion at 15 weeks.
But the approach has drawn sharp criticism from others in the antiabortion movement, who argue the 12 or 15 week bans don’t do enough to stop what they see as widespread murder, allowing more than 90 percent of abortions to continue. Some Republican lawmakers and antiabortion advocates remain adamant that the only path forward is to aim to eradicate abortion completely nationwide.
How voters respond to these new bans could impact how abortion plays out as an issue in the 2024 presidential election. With little polling on the 12 week proposals, it’s unclear whether voters will buy Republican arguments that these kinds of bans are a “mainstream” compromise.
Abortion rights advocates are adamant that these measures are potentially just as harmful as their stricter counterparts, maintaining that voters will reject any attack on abortion rights.
“At Planned Parenthood our position is that any ban on abortion is going to harm people that could become pregnant,” said Olivia Cappello, state communications manager for Planned Parenthood Action Fund. “Whether it’s six weeks or 12 weeks, an abortion ban stops people from getting the care they need when they need it and interferes with their freedom to decide what is best for their bodies and their lives and futures.”
Public opinion
A majority of Americans want to keep abortion legal in all or most cases, several polls have shown in recent months.
Yet support for abortion limits increases as pregnancy progresses through the second trimester, which starts at 13 weeks. An April Fox News poll found 54 percent of registered voters nationally favored a law banning most abortions after 15 weeks of pregnancy in their state with an exception for medical emergencies. In an AP-NORC poll, 57 percent of adults said abortion should be illegal in most or all cases in the second trimester, while a small majority — 53 percent — supported abortion rights up to 15 weeks. Many countries around the world — including most European nations — limit abortions around the beginning of the second trimester.
The debate over abortion has morphed in other ways since the justices fundamentally altered the landscape across the United States. Last summer, public backlash swiftly ensued over abortion bans that don’t include rape or incest exceptions — terrain least favorable to the GOP. Of the 13 “trigger” bans, only four included exceptions for both rape and incest, according to the Guttmacher Institute, a research group that supports abortion rights.
But that’s not the case for many of the bills passed this year restricting abortions. Measures in North Carolina, Nebraska, Florida, Wyoming and North Dakota all included exceptions for rape and incest in some form, though some are limited by gestational age. Abortion rights groups have expressed concerns that such policies don’t work well in practice.
This dynamic is in part because, before Roe was overturned, the laws were designed with the antiabortion movement and Republican primary voter in mind, said Mary Ziegler, a professor of law at the University of California at Davis.
“There are Republicans who are looking at this and saying we can’t just cater to the antiabortion and the primary voter because there’s a lot of voters now who care about abortion,” she said. “It may actually backfire on us.”
In the months since Roe was overturned, voters have repeatedly demonstrated support for abortion rights, striking down antiabortion amendments even in conservative states such as Kentucky and Kansas. The 2022 midterms, in which a number of Democrats won competitive races after making abortion rights a central issue, were widely viewed as a danger sign for Republicans.
North Carolina
Concerns about political backlash on abortion shaped the campaigns of a small group of moderate Republicans running for the legislature in North Carolina, a state where abortions are legal up until 20 weeks of pregnancy and that saw one of the largest spikes in abortions in the months after Roe fell.
Abortion had become a defining issue across the state ahead of the midterms, with North Carolina Gov. Roy Cooper (D) inserting himself into several key races. He filmed ads that cast Republicans as “cruel and extreme” on the issue and warned they would vote to severely restrict abortion access in North Carolina.
While a plurality of Republicans in the North Carolina legislature supported a “heartbeat ban” on abortion after roughly six weeks of pregnancy, some moderates realized they would struggle to win their races if they took a hard line stance on abortion, according to a person familiar with internal discussions who spoke on the condition of anonymity to recall private conversations.
To counter the governor’s ads, one of the most heavily targeted Republicans, state Sen. Michael Lee, wrote an op-ed in the Wilmington Star News before the election voicing his support for abortion bans in the second and third trimesters, but not before.
“We must find common ground on this issue,” Lee wrote, adding that a consensus “can be found between the extremes while respecting the sanctity of life and allowing for common-sense restrictions and exemptions.”
When the legislature convened in January — before Rep. Tricia Cotham would switch her party affiliation to Republican and hand the GOP a veto-proof majority in both chambers — working groups assembled to find what Republicans in the state called a “middle way” on abortion.
At the beginning of the conversations, Galey said, some Republicans voiced support for a ban at conception while others preferred no additional restrictions at all. While everyone disliked the 12-week option “to a certain degree,” Galey said, eventually a critical number of Republicans came to accept it.
Many Republican hard-liners, as well as antiabortion groups in the state, initially were angry and frustrated, said Jason Williams, the executive director of the North Carolina Faith & Freedom Coalition, a statewide antiabortion organization. The 12-week option seemed like a cop-out, he said, allowing the vast majority of abortions to continue.
“Many of those who wanted a heartbeat bill were open to a compromise of 8 or 10 weeks,” said Williams. “Unfortunately, there wasn’t any movement from those who were firm on 12 weeks.”
At one point during the discussions in Raleigh, several Republican members suggested that North Carolina put the question to voters in a referendum — an idea that was swiftly rejected by antiabortion advocates, according to the person familiar with internal discussions.
An advocate for the 12-week ban pointed out their hypocrisy, recalled the person.
“You admit you don’t want that, because it’s not popular,” the advocate for the 12-week ban said. “But you want our members to vote for something that’s not popular.”
Ultimately, the antiabortion groups got on board — starting with Susan B. Anthony Pro-Life America, according to a person in the state who was familiar with the discussions. The group had put out polling in North Carolina, as well as in Nebraska, and supplied information on the impacts of abortion to state lawmakers and local antiabortion leaders, said Stephen Billy, the vice president of state affairs at SBA.
“Our focus is on being as aggressive as we can in finding consensus to protect as many babies and serve as many moms as possible as quickly as we can,” he said. “In Nebraska and in North Carolina, with their bills, that’s exactly what’s happening.”
Democrats have fiercely rejected the idea that the North Carolina legislation is a mainstream compromise, pointing out that other restrictions embedded in the bill, including an additional mandatory in-person consultation at an abortion clinic 72 hours before the procedure, will limit abortion long before the 12-week mark.
“The fine print requirements and restrictions will shut down clinics and make abortion completely unavailable to many women at any time — and that’s going to cause desperation and death,” Gov. Cooper said in an interview.
Republicans in North Carolina kept the 12-week proposal a secret until the last possible moment, in part to prevent Republican hard-liners from amending the bill to make it more restrictive, according to the person familiar with the internal discussions. Instead of introducing the measure as a new bill, as is typical, Republicans gutted a different piece of legislation and inserted the 46-page abortion proposal, allowing them to move straight to an up-or-down vote and pass the bill less than 48 hours after it was introduced.
Nebraska
In Nebraska — where lawmakers are technically nonpartisan but generally have a party affiliation — Democrats and abortion rights groups blasted conservatives for attaching an amendment containing a 12-week abortion ban to a gender-affirming care bill.
They described a feeling of whiplash when the one-chamber legislature adopted the amendment Tuesday evening.
“It was very emotional, it was very challenging, … it was also just really disheartening,” Andi Curry Grubb, executive director of Planned Parenthood Advocates of Nebraska, said in an interview, her voice breaking.
Just weeks ago, they thought they’d secured a major victory with Riepe’s decision to abstain from voting on the “heartbeat bill,” allowing abortions to continue through 22 weeks of pregnancy.
But key Republicans in the state saw the bill’s failure differently.
“It became our job then to negotiate,” said Sen. Ben Hansen, the state’s health chair who was one of the leaders of the negotiations and introduced the amendment. He added: “If we can save 300 babies a year in the state of Nebraska by moving it to 12 weeks, that’s important to us.”
After the initial “heartbeat” ban failed, Hansen began assessing whether any abortion restrictions could be brought back this year. Local antiabortion groups described “difficult” and “emotional” conversations about how early in pregnancy the state could realistically ban abortion. And Riepe, the holdout on the ban earlier in pregnancy, spoke at least three times — and exchanged numerous texts — with Gov. Jim Pillen (R), who he said was insistent on getting stricter abortion laws passed.
The governor has said he’d sign the bill. His office didn’t respond to multiple requests for comment.
On Tuesday, the day of the amendment vote, Riepe said the protests inside and outside the chamber were tense, unlike anything he’d seen in the state capital. Afterward, security escorted the members out of the building.
The senator understands he disappointed a lot of people, especially on the left. But he believes that he’s been clear from the start about where he stood on the issue.
“There’s one thing I’m stuck on,” Riepe recalled telling the governor. “I think 12 weeks is a reasonable number.”
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Leonardo, 19, has received gender-affirming care from the adolescent medicine clinic at Dell Children's since he was 17. He said he worries about finding a new clinic, although it will remain legal for him to receive hormone treatments if Senate Bill 14 becomes law. (photo: Patricia LIm/KUT)
“I was like, ‘That can’t be right," she said. "That’s my clinic. That’s where our doctor is."
But a quick check of the client portal used to manage appointments seemed to confirm the news; the information page for her son's doctor was already gone.
Dell Children’s confirmed Saturday that the doctors staffing the clinic were “departing,” but said the clinic would remain open with support from other staff. Although hospital representatives did not offer a reason for the change, it followed a May 5 announcement from Attorney General Ken Paxton that he would investigate the hospital’s gender-affirming care practices.
Chantel, who requested KUT withhold her last name due to safety concerns, had already considered the possibility that her family might need to move in order to maintain access to her teenage son Juniper’s gender-affirming care. She had been rattled by Paxton’s move last year to investigate parents of trans children for child abuse and was watching the progression of Senate Bill 14, which would outlaw certain kinds of care, such as puberty blockers and surgery. The bill passed the Legislature on Wednesday and is headed to Gov. Greg Abbott's desk. The ACLU of Texas vowed to sue the state over the measure.
Chantel and her husband visited Colorado over spring break to scope out a possible move — but they had thought they had more time to consider their options.
Since losing access to care at Dell Children’s, their plans have accelerated. Chantel’s family is working on putting their house up for sale, and she is contacting clinics in Colorado to find a new provider for her son. They are considering whether Chantel’s husband and their younger child will stay behind in Texas at first while Chantel and Juniper find short-term housing.
The providers at the clinic had guided Chantel’s family through what she described as a “long, slow journey” to establish a course of care for Juniper, and losing long-built relationships with physicians felt destabilizing.
“To say the least, I’m shell-shocked,” Chantel said. “I don’t really know what to do. I’m scrambling.”
Processing the news
KUT spoke to eight patients and parents of patients who received some kind of hormone-related care at Dell Children’s adolescent medicine clinic. Like Chantel, most requested anonymity or for only their first names to be used due to safety and privacy concerns.
Among those patients, some received communication from the clinic directly about the doctors’ exit; others, like Chantel, heard the news secondhand. Rumors spread on social media in the week following Paxton’s announcement that the clinic had shut down entirely. Dell Children’s dispelled this, but confusion persists about whether doctors left voluntarily or were fired; physicians did not respond to requests for comment by KUT.
A mother named Elizabeth said she had been trying to get ahold of the clinic for days when she received an email from her 12-year-old’s doctor May 11. The doctor said she and the clinic's other doctors were “mutually parting ways” with Ascension, the organization that owns and operates Dell Children’s.
Elizabeth’s child, who uses the pronouns they and them, had been receiving period suppression medication to treat a hormonal imbalance that resulted in severe emotional challenges during their cycle. While the child was considering their gender, Elizabeth said that was not the primary reason for their treatment.
“We’ve had two suicide attempts because of hormonal imbalances,” Elizabeth said. “It’s like, I’m just trying to keep my kid alive, you know?”
The parent of a 12-year-old on puberty blockers and low-dose estrogen said she had talked with her doctor in previous weeks about the possibility that SB 14’s passage would halt gender-affirming care at the clinic.
“We had a discussion about that, and they said, ‘Yeah, this legislation is going to pass, and we’re assuming we’re going to have to close," the woman, who wished to remain anonymous, said.
Still, news of the clinic’s shake-up came as a surprise to the mother. So did Dell Children’s response to Paxton’s investigation. The hospital said it prohibited surgery and prescribing hormone therapy for children with gender dysphoria, and that its pediatric and adolescent medicine clinics “did not provide these interventions.”
This statement, the mother said, was at odds with her experience. She said she had dealt exclusively with “trans-accepting” staff at Dell Children’s and that the treatment her daughter received appeared to be typical for the clinic.
“It's inconsistent with what we received, which was gender-affirming care that was consistent with the law,” she said. “Nothing felt anything but above board.”
Seeking new care
The mother says she’s lined up a new doctor for her daughter in New Mexico and is deciding whether to travel for appointments or move.
Dell Children's offered some patients a list of clinics where they might seek care in the future, including spots in Texas and other states. Several patients also received a final prescription refill.
But many patients expressed concern about their ability to find new providers among limited offerings, even young adults who could legally continue to receive care in Texas if SB 14 becomes law. Nineteen-year-old Leonardo was notified by his social worker that his doctor was leaving Dell Children’s on the same day Paxton announced his investigation. While looking for a new provider, Leonardo discovered other clinics often had wait times of at least three months. He said he fears those clinics will be inundated by calls from young adults who are losing their doctors.
“We’re all trying to go to the Kind Clinic or trying to find these specific [doctors],” he said. “If we're all flooding in and it's already three months to six months, where are we going to get our care?”
Leonardo first began hormone therapy at Dell Children’s when he was 17. Now an adult, he says stress about the safety and ease of living in Texas as a transgender person has affected his mental health.
“I have attempted to be my authentic self, but in recent years it's been even harder to really flourish,” he said. “Even if they’re targeting children, it still affects all of us.”
Leaving Texas
Although SB 14 applies only to minors, several young adult patients and parents of young adult patients told KUT they plan to move, fearing they will face barriers to health care and safety in the coming months and years.
A 25-year-old transgender man who began receiving testosterone treatments from Dell Children’s when he was 20 has been able to make an appointment with a new provider in Texas and will legally be able to continue to receive hormone therapy as an adult. But he and his wife still plan to move to Washington state, which has passed recent laws aimed at protecting transgender people.
He said he feared Texas might pass a “bathroom bill,” like the one recently passed in Florida requiring people to use bathrooms that match their gender assigned at birth.
“Having to risk a year in prison every time you use the restroom would make that trip inherently unsafe,” he said. “It’s a long drive out of Texas.”
He is able to do his engineering job remotely, and he and his wife are considering having children, so he said it feels like the right time to move. As a born-and-raised Texan, the decision wasn’t an easy one.
“We’re going to miss Texas, our community, bluebonnets, H-E-B, good brisket, and most of all the opportunity to continue advocating for other trans Texans here,” he said. “But leaving still feels like a huge weight off.”
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US Military members. (photo: Bo Zaunders/Insider)
The United States remains the world’s largest military spender by far, with its $877 billion representing 39% of global military spending. That’s three times as much as the second largest spender, China, which spent $292 billion in 2022. And it’s about ten times as much as the next largest spender, Russia, which spent about $86 billion in the same year.
U.S. spending is more than the next ten countries combined, more than last year when it was larger than the next nine. Many of these next ten countries are geopolitically aligned with the U.S. — including Ukraine, which had the highest single-year increase in military spending SIPRI has ever recorded, rising 640% to $44 billion since Russia invaded.
U.S. military aid to Ukraine amounted to $19.9 billion in 2022, but this was only 2.3% of total U.S. military spending. Military spending by NATO members, including the U.S., totaled $1.232 trillion in 2022, up 0.9% since 2021. Many analysts have predicted a long-term war of attrition, with no victory in sight for either side – it remains unclear how continuously increasing militarization can end this war.
Meanwhile, basic needs continue to go unmet for hundreds of millions of people around the world. The climate crisis continues to wreak havoc, and the U.S. has barely begun to address its historical responsibility in contributing to global fossil fuel emissions. The nations of the world are dangerously unprepared to secure our collective planetary future.
The full U.S. military budget is much more than the $514 billion spent by the rest of the world’s 144 nations combined. That’s a difference of $363 billion, which would be enough to fund solar power for nearly every household in the U.S. for 10 years.
$363 billion would be enough to fund 43 million public housing units – more than the 38 million people displaced as refugees in the post-9/11 wars waged by the U.S. over the past two decades.
Just 10% of the U.S. military budget would go a long way toward meeting any number of societal needs.
It’s worth noting that it’s not inevitable for countries to keep perpetually increasing their military budgets – a number of large nations, like Nigeria and Turkey, have significantly decreased military spending in the past year.
Over-investment in the military is a major cause of the crises we face today. But it’s possible to reinvest in real solutions and begin to repair the harm caused by many decades of war.
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Timothy Leary, the Harvard psychologist turned 'high priest of LSD,' escorted by federal officers after his 1973 arrest. (photo: Bettmann Archive)
What we lose when psychedelics are medicalized.
Funding for research and legalization efforts on psychedelics are ramping up across the US. In January alone, seven states introduced new psychedelic legislation that ranges from decriminalization to supervised adult use to psychiatric treatment. Abroad, Australia became the first country to legalize psilocybin — psychedelic mushrooms — and MDMA as prescribable medicines by psychiatrists. The US looks poised to follow, with the FDA potentially set to approve MDMA for therapy later this year.
These tectonic changes in drug policy are taking place against the backdrop of a US mental health crisis, one where existing treatments have fallen short: The World Health Organization’s (WHO) largest mental health report this century has termed current interventions “insufficient and inadequate.” Turning to psychoactive fungi for treatment-resistant mental illness is a sharp pivot, a sign of both the impoverishment of current approaches and the excitement around a genuinely novel remedy.
But as important as anything that can turn the tide on mental health is, the frenzy over transforming psychedelics into new treatments for illness obscures — and may even interfere with — their further potential to expand our understanding of what healthy minds could be. The deep history of psychedelics shows they have far more to offer than simply the next generation of psychiatric treatment.
Conventional psychiatry looks at mental disorders: clinically significant disturbances in areas that are important for day-to-day functioning, like emotional regulation, behavior, and thinking. But psychedelics, when used carefully, can do more than heal disturbances. The WHO’s founding constitution defines health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” Psychedelics can help shift attention toward reconfiguring the baseline of ordinary, non-impaired experience in ways that enrich what we call “normal.”
But fully harnessing these drugs may require a very different set of research and regulatory approaches than current conventional efforts focused on turning psychedelics into the next generation of therapeutic medicines. To make the most of what psychedelics can offer to the more expansive project of human flourishing, medicalizing isn’t enough. Regulators should consider allowing access outside a doctor’s office.
“The problem with the current biomedical vision is that it’s very much based on an individualistic understanding of mental health and human flourishing,” said Claudia Schwarz-Plaschg, a social scientist and visiting scholar at the University of Edinburgh’s Usher Institute who spent three years studying attitudes toward psychedelics in the US. “Medical interventions are geared towards making the individual fit better into society through therapeutic and substance-based interventions, but other approaches are more open towards a broader vision of how mental health issues and societal structures are producing each other,” she said.
Leaving psychedelics in the hands of the biomedical industry and state-regulated facilities can undermine their potential by excluding more diverse “sets and settings” (a term describing how psychological, social, and cultural factors all profoundly shape the kinds of trips one might experience) while leaving inequalities across race, culture, and class unaddressed.
But there is little consensus among researchers and policymakers on questions of access — from who gets access to where and how — in ways that could make the most of psychedelics’ benefits while balancing the potential risks.
Given the extent of the mental health crisis, policymakers should embrace new treatments to help those who suffer from mental illness. But in that embrace, we shouldn’t lose sight of what psychedelics can offer beyond psychiatry. Used holistically, these drugs can help expand our understanding of what healthier, richer, more flourishing states of consciousness might be like. The smothered dream of those hippies and former Harvard psychology professors who called on Americans to expand their minds with psychedelics could be revived in more prudent, diverse, and informed ways — provided we don’t box them in.
Why the psychedelic renaissance is focused on mental illness
In 1943, the Swiss chemist Albert Hofmann first discovered the effects of LSD, which is part of the family known as “classical” psychedelics. These also include psilocybin (magic mushrooms), mescaline (from the peyote cactus), and DMT. Classical psychedelics are non-addictive and bind to the brain’s serotonin receptors. That makes them unlike “non-classical” psychedelics such as ketamine and MDMA, which have different mechanisms of action in the brain and higher risks of side effects and abuse. (For example, in warm environments coupled with dehydration, MDMA can cause death via heatstroke, while ketamine could exacerbate existing heart conditions).
Like the psychedelic experience itself, there is no single narrative that fits the midcentury American trips that followed LSD’s introduction. It was a blooming, buzzing, revelatory confusion. LSD psychotherapy leaped into the Hollywood elite, the CIA experimented with the drug for mind control, and Jimi Hendrix front-manned a culture of Black psychedelia. But that experimentation largely came to an end in 1971 when President Richard Nixon’s Controlled Substances Act banned psychedelics (among other drugs) and stifled psychedelic research.
While the legislation forced those interested in psychedelics underground, they didn’t stay there long. By the 1990s, a mostly new generation of researchers had begun revisiting studies from the 1950s, while attitudes toward psychedelics within the FDA and DEA were softening. Regulators no longer saw them as exotic substances with unknown long-term consequences, but increasingly, just another potentially dangerous drug. By 1991, a series of legal challenges, together with the perseverance of researchers who believed psychedelics were worth studying, led to the first approval for human psychedelic research since the 1970s.
Regulatory hurdles to obtaining approval remained steep, and young scientists still risked their reputations by working with psychedelics. But a landmark paper published in the journal Psychopharmacology in 2006 on mushrooms and mystical experiences — where recipients reported mystical experiences with high personal significance that endured for months afterward — signaled the above-ground renaissance in scientific research was professionally viable, institutionally acceptable, and already underway.
This time, however, the focus was not directed toward expanding the mind, Timothy Leary-style, but alleviating mental illness. In part, this shift was a strategic response to the 1960s moral panic and 1970s legal action against psychedelics. By reintroducing psychedelics through the most accepted and controlled channels — medical research — scientists aimed to minimize the risk of another backlash.
The shift toward psychiatry was also a response to a clear need. By 2019–2020, approximately a fifth of all adults — over 50 million Americans, up from 39.8 million in 2008 — were reporting some kind of mental illness. The growing body of psychedelic research suggested significant promise in treating precisely the illnesses that were most widespread: depression, anxiety, and addiction. That list may continue to expand as research fans out into new areas, like eating disorders.
No single group of chemicals can solve the complexities of mental health, which extend beyond the individual mind to include social and political elements. But if recent research holds course, psychedelics may well provide much-needed relief while inspiring entirely new approaches to psychiatry. That’s especially vital given the lack of innovation in mental health treatments since SSRI antidepressants like Prozac were approved in the 1980s.
Still, a singular focus on making psychedelics into pharmaceutical medicines carries its own drawbacks, in part by isolating the psychoactive molecules themselves from the wider cultural practices that have traditionally been inseparable from the experience.
“Mainstream culture hears about psychedelics primarily through a medicalized or therapeutic lens,” said Ariel Clark, an Odawa Anishinaabe regulatory attorney based in California and a founding board member of the Psychedelic Bar Association. “But the use of sacred medicines in Indigenous paradigms of access really eclipse the medical use by far.”
As the Harvard theologian Rachael Peterson put it: “Important wisdom is lost when technologies of transcendence are stripped from their spiritual and religious contexts and presented as psychological treatments.” Now, a new generation of researchers is seeking to return a wider spiritual lens to targeted questions of therapy and neuroscience.
How psychedelics can enrich your mind
Until recently, there was little funding for psychedelic research on volunteers without diagnosed mental illness, what researchers sometimes call “healthy normals.” That’s why Roland Griffiths, director of the Johns Hopkins Center for Psychedelic and Consciousness Research, recently launched the Griffiths Fund. The fund supports research and a professorship at Hopkins to study the effects of psychedelics on well-being and secular spirituality in healthy volunteers. Griffiths, whose research has been pivotal in advancing the field since his 2006 paper helped launch the psychedelic renaissance, has called this “the most consequential direction for future psychedelic research.”
The first recipient is David Yaden, an assistant professor at Johns Hopkins who works in the Center for Psychedelic and Consciousness Research. Prior to studying psychedelics at Hopkins, Yaden’s work focused on “self-transcendent experiences,” or altered states of consciousness achieved through drugs or other means, ranging from meditation and brain stimulation to simple walks in nature. While most research on psychedelics and spirituality has treated elements like mystical experiences as secondary to therapeutic outcomes, Yaden told me he plans to “confront the issue of spirituality” head-on, rather than as a side quest.
“I think it’s essential that the study of well-being is not lost in this emphasis on therapeutics,” Yaden told me. He calls this focus on whether and how psychedelics can improve well-being (even for those who aren’t mentally ill) the “positive program” of psychedelic research.
Although the Griffiths Fund is the first effort specifically dedicated to these questions in healthy volunteers, there already exists a small foundation of academic research on the subject. Most of it can be divided into two buckets: the observable effects of psychedelics on the brain and their subjective effects on the mind. This blurry relationship between the brain and the mind is one of the many mysteries psychedelics may help clarify.
We can record objective data on how LSD changes patterns of electrical activity in the brain with neuroimaging technologies like EEG and fMRI. But to capture the feeling of the psychedelic dissolution of the boundary between yourself and the world, we can only rely indirectly on people’s recollections. Mainstream psychedelic research leans toward what you can directly measure, but Yaden told me that the subjective experiences are a necessary part of any full explanation of the lasting benefits on well-being some psychedelic users report.
In the brain, psychedelics are associated with at least three groups of observable effects. They boost neuroplasticity, which supports the rewiring of existing neurons. They promote neurogenesis, which supports the creation of new brain cells. And they increase brain “entropy,” or the diversity, randomness, and unpredictability of electrical activity across brain regions.
Neuroplasticity likely plays a key role in addressing mental illness by enhancing the brain’s ability to rewire patterns of thought. Especially when paired with psychotherapy, psychedelic-induced neuroplasticity can help reshape harmful habits — from mental patterns of self-criticism to forms of addiction — into more beneficial ones.
While anyone can benefit from a little more neuroplasticity, which tends to decline with age, increasing brain entropy offers another explanation for the spectrum of benefits beyond treating illness. In 2014, Robin Carhart-Harris, a neuroscientist who was then the head of the Centre for Psychedelic Research at Imperial College London, published a landmark work on what he called “the entropic brain.” The basic idea is that what any state of consciousness feels like — and in particular, what he calls the “richness” of its feeling — depends on the amount of entropy in the associated brain activity. Brain entropy is low in reduced states of consciousness, like when you’re under general anesthesia. During altered states, from psychedelic trips to deep meditation, entropy is higher. In ordinary waking consciousness, it rests somewhere in the middle.
Carhart-Harris argues that the brain evolved an ability to strike a useful balance of entropy levels. In particular, he believes that the collection of regions known as the default-mode network (DMN) is primarily responsible for suppressing entropy in the ordinary brain. Doing so favors forms of cognition that help us make sense of our environments in ways that are useful for survival. “Equally however,” he writes in the paper, “it could be seen as exerting a limiting or narrowing influence on consciousness.”
Psychedelics reduce activity within the DMN, loosening its hold over entropy levels. The resulting high-entropy states may not have been the most beneficial for our ancestors on the savannah. (Predators would welcome blissed-out prey, marveling at their surroundings rather than scanning for threats). But for a species where basic survival can now mostly be taken for granted, these states may have much to offer. Beyond mere vacations into “richer” states of consciousness, entropic states can cast new light on the ordinary ones we return to when a trip subsides. Sometimes it’s tough to imagine how different something that’s grown so familiar can be — like the habitual ways we experience ourselves, those close to us, and the world — until we’ve had the direct experience of it being otherwise.
But Yaden emphasized that entropy, neuroplasticity, and all the other factors that we can observe with brain-imaging technologies are only part of the story. He calls these “lower-level neurobiological processes,” and adds that higher-level ones, like the subjective content of the experiences themselves, play a key role in explaining the benefits of psychedelics.
These fall into the hazier category of effects on the mind, where scientific tools awkwardly grasp for measurements that don’t come easy. To describe these parts of a trip, you must rely on imperfect language: mystical experience, ego death or dissolution, unselfing, oceanic boundlessness. They can run the spectrum from blissful to terrifying, and the quality and intensity of these experiences shape the long-term effects.
For example, one study found that higher scores of oceanic boundlessness during a trip (a term reaching all the way back to the 17th-century philosopher Baruch Spinoza, describing the sense of separation between self and world melting away, like a water droplet losing its separateness as it rejoins the ocean) were more predictive of long-term clinical benefits than basic hallucinatory effects (like seeing undulating geometric patterns). The interpretation was that when it comes to psychedelics, the ordinary and predictable relationship between dose and outcome isn’t as simple as with other drugs. Sometimes, the kind of experience someone has — and the set and setting in which that experience takes place — is more important than the dose of psychedelics they take.
While the majority of clinical psychedelic experiences are positive, this is likely because researchers have a great degree of control over risk factors. But the very measures of control that help ensure more positive experiences can also suppress the wider range of possibilities, just like the default-mode network’s regulation of entropy levels. The clinically controlled environments employed in research trials and regulated psychiatric contexts have their own set and setting that will tend to reproduce particular kinds of experiences while discouraging others. Many within the psychedelic community believe that greater freedoms in where, how, and in what company we take psychedelics are crucial for maximizing their benefits, especially in already healthy users.
States across the US are introducing varieties of psychedelic legislation that will lay the groundwork for what psychedelic access may come to look like domestically while also informing global strategies. “From a global perspective,” Schwarz-Plaschg writes in her ethnographic study, “the US can be understood as a test bed from which lessons might be drawn for how to best build a post-prohibitionist world for psychedelics.”
The debate over how to expand access to psychedelics
There’s an unavoidable tension in legislative efforts to shape this post-prohibitionist world. Supporting wider uses and benefits of psychedelics by making them easier to access means raising the risks for individuals, as well as the chances of another legal backlash. As states continue introducing new bills, there is no settled blueprint. Each approach explores different ways of balancing benefits and risks.
One approach gaining traction is the “adult-use” model pioneered in Oregon, which took effect at the start of 2023. Anyone over the age of 21 who can afford the cost (early estimates suggest as much as $1,000 per session, which would keep out all but the well-off) can sign up for a psychedelic service session. These can only take place at a service center approved by the Oregon Health Authority (OHA) under the supervision of facilitators who have completed one of the training programs vetted by the Oregon Psilocybin Services division of the OHA.
By eliminating the need for a medical diagnosis or referral, the adult-use model does expand access. But requiring the trip to occur inside a government-sanctioned room, under the supervision of a facilitator one may have very little relationship with, and without the company of others joining in the experience, can all run counter to the variety of social and nature-immersed ways Indigenous cultures have used psychedelics for generations.
Colorado recently went a step further, including a decriminalization component alongside adult-use legislation. This would allow citizens to possess, grow, and share psychedelics for personal use in whatever forms they see fit. But psychedelic researchers and practitioners disagree on permitting such unregulated access. Beyond concerns over the risks of psychedelic use in unregulated environments, there are further worries that decriminalization could undermine researchers’ ability to carry out rigorous clinical trials, or that an absence of restrictions on the quantity of psychedelics that can be grown for personal use will lead to a large black market supply for the drugs.
Beyond “where” and “how,” there is also the question of “when.” As Rick Doblin, director of the Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit specializing in psychedelic research and education, told GQ in 2021, “medicalization precedes legalization.” But for how long?
There are two broad camps here. One (including Doblin) sees medicalization as the necessary path toward broader acceptance, arguing that mounting evidence of medical benefits will gradually turn public opinion in favor of wider access to psychedelics. The other camp sees medicalization as a sort of waiting room that will slow legalization efforts.
Clark echoed the idea that careful regulatory policy is essential, but rejected that medicalization is the best approach in the meantime. As she pointed out to me, holding psychedelics in an exclusively medicalized waiting room could worsen the existing diversity problem. “You want to talk about the history of Black people or Native people with the medical establishment?” Clark said. “Who’s driving the conversation around the medical and therapeutic being the safest and only way?”
There is also the uncomfortable matter of psychedelic capitalism. The reservation of early access to psychedelics for pharmaceutical companies, medical researchers, and opportunistic investors is transforming the psychedelic industry — including the drugs themselves — before it even reaches the public. Broadly, the concern is that capitalism’s profit motive won’t necessarily support the prudent research, rollout, and harm reduction measures that can help ensure a smooth and equitable reintroduction.
Schwarz-Plaschg said that a complementary non-biomedical focus (like decriminalization) would help maximize the benefits. “The broader the spectrum of psychedelic services and legal uses in society, the more people will be reached who can benefit in their own flourishing, and that will enable society to flourish more in the long term.”
But the sometimes strained move from biomedical to recreational legalization in cannabis suggests the need for prudence. Businesses that deal with a substance legalized by the state but still outlawed by the federal government face a variety of elevated costs (for example, they can’t deduct business expenses from their federal taxes and struggle to find willing insurers). The odds of success in the industry are stacked toward large corporate entities with money to blow. “We have to go slow to go fast,” Clark told me. “That is a huge lesson from cannabis, and with psychedelics, there’s even more reason to go slow at the beginning. It’s the foundational stages that matter the most because of these huge, important, intersectional issues.”
The current moment presents an opportunity to engage deep representation and participation from all stakeholders of psychedelic drugs and sacred plant medicines alike. Colonial tensions are baked into the psychedelic renaissance, but movements to decolonize the industry can elevate a commitment to equity while helping to expand the conversation around different models of access.
These Indigenous approaches vary by culture and place, but generally share a few themes. First, as Clark explained, psychedelics are not seen as substances you “take,” like an aspirin or an antidepressant, but as entities that you enter into relationship with. “It’s a deep and sacred relationship, grounded in veneration and relationality.” Second, many Indigenous models could not be carried out on a solo trip inside a cozy doctor’s office, isolated from larger communities of practice.
Finally, many Indigenous models do not recognize a distinction between therapeutic and spiritual. Illness and one’s existential relationship to the self and the world go hand in hand. The idea that you could extract the therapeutic mechanism from the spiritual context is seen as a peculiarly Western conceit.
Next stop on the trip
President Biden’s administration expects the Food and Drug Administration to approve MDMA and psilocybin for treating PTSD and depression, respectively, within the next year or two. This would increase pressure on the DEA to reschedule the drugs, which are currently categorized as Schedule I substances “with no currently accepted medical use and a high potential for abuse.” This status — widely considered out of touch with current research — restricts access to the substances, creating a major barrier to further studies and to those who could benefit from their use.
With or without rescheduling, the flurry of state bills for psychedelic access is likely to continue. One study based on cannabis legalization trends predicts that a majority of states will legalize psychedelics in the next 14 years. Whether these legal models will open up access for a wider range of potential benefits (and risks) or reinforce the conditions to explore only a narrow, more manageable band of their potential is still up for grabs.
So what could legalization efforts that extend access beyond psychiatry look like? It would require a diversity of sets and settings, not just clinical trials or government-approved cozy rooms. It requires a diversity of participants, beyond privileged subgroups who can afford access to expensive services. And it needs an equal investment in harm reduction alongside benefit maximization.
Doblin has sketched one idea: licensed legalization. Think of it like getting your driver’s license but for buying psychedelics. Once you are a certain age, you would become eligible for a supervised psychedelic experience at a licensed facility — a sort of initiation ritual where you learn the ropes. Perhaps there’s a written portion to ensure basic knowledge. Afterward, you receive a license that allows you to purchase psychedelics for use however you see fit. The license could be revoked for any number of infractions, just as we do for drunk drivers.
Advocates for this sort of regulated legalization still lack answers for how to keep purchasing costs down — one reason that some support decriminalization, where personal cultivation could afford cheaper access. The cannabis legalization experience shows how dealing in Schedule I substances entails regulatory compliances and tax burdens that drive up the price.
Costs aside, there’s still a bumpy road to licensed legalization. There is no getting around the fact that lowering barriers to access can raise the risk of harm, and safety measures in clinical settings are better developed than those for communities new to the drugs. Nor are there established business models for psychedelics that ensure benefit sharing with Indigenous communities.
Experiments are underway, though, like Journey Colab’s “Reciprocity Trust,” where they designate 10 percent of their founding equity to cycle back into Indigenous communities and other stakeholders working on equitable access. Finally, rising demand from widespread access would deepen exploitative pressures on the ecosystems where psychedelics grow. Synthetic alternatives developed in the spirit of open science could help. But whether synthetic alternatives are as effective as their naturally occurring counterparts remains under-studied.
Whatever rationale — or concern — one leans toward, a broader approach to psychedelics offers something that’s otherwise hard to come by. Disturbances in ordinary experience are easy to spot, like measuring the brain’s electrical activity. But how much richer ordinary experience itself can be is a camouflaged question that seldom arises unprovoked.
Psychedelics are one way of bringing the construction of ordinary consciousness into view, wherever one falls on a diagnostic rating scale of mental disorders. But regulatory environments and models of access are part of the wider set and setting that shapes or constrains psychedelic experiences. Hopefully, the burgeoning post-prohibition world for psychedelics won’t remain boxed in by lab coats and psychiatry alone, and we won’t deprive ourselves of the strange, fascinating, sometimes risky, and meaningful views a wider approach to psychedelics can offer.
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Environmental activists are removed from the famous Trevi fountain by police officers. (photo: AP)
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Members of Ultima Generazione fossil fuel group climbed in and poured diluted charcoal into water
The protesters from the Ultima Generazione (Last Generation) group held up banners saying “We won’t pay for fossil [fuels]” and shouted “Our country is dying.”
Uniformed police waded into the water to take away the activists, with many tourists filming the stunt and a few of the onlookers shouting insults at the protesters, video footage showed.
In a statement, Ultima Generazione called for an end to public subsidies for fossil fuels and linked the protests to deadly floods in the northern Italian region of Emilia-Romagna in recent days. The group said one in four houses in Italy were at risk from flooding.
Rome’s mayor, Roberto Gualtieri, condemned the protest, the latest in a series of acts targeting works of art in Italy. “Enough of these absurd attacks on our artistic heritage,” he wrote on Twitter.
The tradition is for visitors to toss coins into the famous 18th-century fountain to ensure that they will return to Rome one day.
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