American capitalism is being remade by state power

Source: The Conversation – USA (2) – By H. Sami Karaca, Professor of Business Analytics, Questrom School of Business, Boston University

Is the Trump administration trying to reshape American capitalism? Recent moves by Washington, such as taking a 10% share of semiconductor maker Intel, point to a shift in that direction. For decades, Washington has supported free-market capitalism. Today, the government appears to be supporting a new direction – state-directed capitalism.

As a professor at the Questrom School of Business who studies different economic systems, I find this reversal striking. My research is supported by the Ravi K. Mehrotra Institute, which is trying to understand how business, markets and society interact. My previous research – finding, for example, that U.S. news coverage of capitalism was far more negative in the 1940s than it is now – suggests capitalism isn’t in retreat but is rather evolving.

In what direction is the Trump administration pushing it?

Types of capitalism

While many people bandy around the term “capitalism,” it actually comes in many different forms. The most basic definition of capitalism is when the means of production – such as factories, farms and offices – are owned by private individuals.

Capitalism is driven by profit. Some of the earliest descriptions of the profit motive that drives the whole system come from Adam Smith. As he wrote in 1776, “It is not from the benevolence of the butcher, the brewer or the baker that we expect our dinner, but from their regard to their own interest.”

Who gets the profits and who controls the means of production determine the specific forms of capitalism. While there are many types, I want to focus on three of the most important.

Free-market capitalism, also called laissez-faire capitalism, is when the government takes a hands-off approach to the economy. The U.S. after the Civil War is a good example of free-market capitalism. During the late 1800s, the federal government imposed few regulations on businesses.

State-guided capitalism is when the government chooses industries or companies to support. Favored sectors are given money and face looser regulations than nonfavored sectors. China today is an example of state-guided capitalism, where the state provides support for industries such as shipbuilding, steel and AI.

Oligarchic capitalism is when a very small part of the population owns key industries and controls the economy. Russia today is an example of this type of capitalism.

Each form of capitalism has its strengths and weaknesses. For example, free-market capitalism provides the most incentives to grow the economy, but the lack of rules often leads businesses to run roughshod over consumers. U.S. historians describe the late 1800s as the era of robber barons.

State-guided capitalism can dramatically boost the output of favored industries. However, if the government invests in the wrong industries, huge amounts of money can be wasted propping up dying firms.

Oligarchic capitalism can rapidly invest in new areas and shift resources, but the profits enrich only a tiny elite.

Recent changes

The U.S. currently appears to be operating under a hybrid model of capitalism, blending free-market principles with elements of state capitalism.

One of the most recent changes is the Trump administration’s decision to take a 10% stake in Intel. Congress passed the multibillion-dollar CHIPS and Science Act in 2022 to bolster U.S. computer chipmakers. Intel is slated to receive US$11.1 billion in grants from the program and other government funding. The current administration has converted that public support into a 10% ownership of the semiconductor maker.

Intel isn’t alone. The government has recently become a shareholder in other companies it views as strategically important – a trend that seems likely to continue and possibly result in the creation of a “sovereign wealth fund.” In July 2025, the Department of Defense agreed to buy $400 million of convertible preferred stock in MP Materials. MP Materials is the only U.S. rare-earth minerals mine with integrated production capacity. The company said the Department of Defense would be positioned to become its largest shareholder.

The government is also requiring a share of revenue from large computer chip manufacturers. Nvidia and AMD will have to remit 15% of revenue from certain chip sales to China as a condition for export licenses.

Why the US change is important

The CHIPS and Science Act has already funneled billions into U.S. semiconductor manufacturing via grants, tax credits and R&D support. MP Materials and Intel could serve as pilot models for further strategic intervention. However, the U.S. government spends trillions each year, and the amounts invested in American industries and companies represent only a small percentage of total spending.

While the CHIPS and Science Act was passed in 2022 under the Biden administration, the implementation relied on traditional tools of industrial policy such as grants, tax credits and milestone-based funding. In contrast, the Trump administration has converted these grants into equity arrangements, with officials stating the government should get a return on its investment.

This shift from an incentive-based approach to a direct ownership model represents one of the most fascinating experiments in modern American capitalism. The real question is what happens if – or when – this strategy expands. The government could become more involved in energy, biotech and AI, or any place where markets show signs of lagging or supply chains are geopolitically fragile.

The U.S. isn’t rejecting capitalism but recalibrating its boundaries. The next few years will show exactly how Washington’s interventions will reshape U.S. capitalism.

The Conversation

H. Sami Karaca receives funding from the Ravi K. Mehrotra Institute.

ref. American capitalism is being remade by state power – https://theconversation.com/american-capitalism-is-being-remade-by-state-power-263881

We’ve been tracking the number of Americans who identify as transgender – soon, there will be no reliable way to measure them

Source: The Conversation – USA (2) – By Jody L. Herman, Senior Scholar of Public Policy at the Williams Institute, University of California, Los Angeles

Researchers have traditionally had a difficult time tracking the number of Americans who identify as transgender.

But over the past decade, our work has become easier, largely thanks to federal data. In 2014, for the first time, the federal government included a question on transgender identity in the Centers for Disease Control and Prevention’s Behavior Risk Factor Surveillance System. It subsequently added gender identity questions to other surveys, like the National Crime Victimization Survey. Since 2016, we’ve been able to use federal datasets to estimate the number of people who identify as transgender at the national and state levels.

Our recently published analysis suggests that 2.1 million U.S. adults identify as transgender. In our prior study, published in 2022, we found that 1.3 million U.S. adults identified this way. In our new report, we also found that 724,000 youth age 13 to 17 identified as transgender.

To arrive at these estimates, we drew from the CDC’s Youth Risk Behavior Survey and Behavior Risk Factor Surveillance System, which provide the most comprehensive data on the gender identity of Americans. Though these datasets are the best available to make these estimates, we lack state-level data in certain cases. So we used a statistical technique called multilevel regression and poststratification to fill in those gaps.

This information is important. It allows policymakers, educators, judges, the media and others to understand the size and characteristics of this population, as well as who will be affected by public policies, such as nondiscrimination laws that aim to protect transgender people or bans on transgender people’s use of public bathrooms. The U.S. Supreme Court has even cited our estimates in decisions that impact transgender people.

But our work is about to become a lot harder, if not impossible.

At the directive of the Trump administration, federal surveys will no longer collect data about gender identity. Questions that aim to identify transgender respondents will be removed, while binary sex questions with only “male” or “female” response options will remain.

Though data sources are being erased, the transgender population will not be. And yet it will likely be at least a decade before we can publish updated figures on the estimated number of people living in the U.S. who identify as transgender.

Age group differences persist

But first, let’s highlight what the new report reveals.

One consistent pattern across our reports from 2017, 2022 and 2025 is that younger people are more likely to identify as transgender than older adults.

In our new report, however, we were able to see significant differences among different age groups of adults for the first time.

Those 18 to 34 are now significantly more likely to identify as transgender than those 65 and older, and those 18 to 24 are significantly more likely to identify as transgender than those 35 to 64.

When considering population changes over time, our estimates for the youngest age group – those 13 to 17 – have utilized different data sources and methodologies. Therefore, we can’t make direct comparisons across years. Among adults overall, we haven’t seen any significant changes over the past decade or so.

However, our estimate for the youngest adult age group – those 18 to 24 – is now significantly higher. Using 2014-15 data, we estimated that 0.7% of U.S. adults aged 18 to 24, or 205,850 people, identified as transgender. The data we analyzed from 2021-23 puts that figure at 2.7%, or 827,200 Americans.

This uptick doesn’t support the idea that there is a sudden, rapid growth in the transgender youth population, however. In fact, our findings are consistent with the idea that acceptance of gender and sexuality is generational and shaped by your social surroundings.

These generational differences likely impact whether someone will disclose their transgender identity on a survey. Our own analysis of CDC data found that young people are more likely than older adults to answer questions about their gender identity. This also means the real percentage of older adults who identify as transgender may be higher.

As younger transgender people grow older, we expect observed differences between age groups to diminish over time.

Disappearing data sources

More research is required to determine the reasons for this growth among young adults identifying as transgender. Yet future efforts to better identify and understand transgender population trends will likely be delayed for the foreseeable future.

Should gender identity data collection be reinstituted under a new presidential administration in 2029, federal surveys will need to be updated and administered. Once data collection resumes, three years of new data are required before we can update our estimates.

While we and other researchers will look to other data sources in the interim, there’s nothing that can fully replace federal data sources.

In the end, no amount of data suppression can erase the reality on the ground. Millions of transgender youth and adults will continue to live in communities across the U.S. – in cities and small towns, in red states and blue states. They’ll continue to enroll in schools, get hired for jobs and navigate health care systems.

This population will not vanish simply because some of those in power wish it would. But in order for us to continue to shed light on the characteristics and needs of the transgender population – whether it’s assessing impacts of gender-affirming care bans to changes in U.S. passport gender marker policies – we’ll need these questions to be added back on federal surveys.

The Conversation

Andrew Ryan Flores receives funding from The Williams Institute at the UCLA School of Law to conduct research that fulfills the Institute’s mission of independent research. He is affiliated with American University, the Public Religion Research Institute, and the World Bank.

Jody L. Herman does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. We’ve been tracking the number of Americans who identify as transgender – soon, there will be no reliable way to measure them – https://theconversation.com/weve-been-tracking-the-number-of-americans-who-identify-as-transgender-soon-there-will-be-no-reliable-way-to-measure-them-263599

Pregnant women face tough choices about medication use due to lack of safety data − here’s why medical research cuts will make it worse

Source: The Conversation – USA (3) – By Almut Winterstein, Distinguished Professor of Pharmaceutical Outcomes & Policy, University of Florida

More than 9 in 10 women take at least one medication during pregnancy, yet data on prescription drugs’ effects on the fetus are sparse. Adam Hester/Tetra images via Getty Images

A panel convened in July 2025 by the Food and Drug Administration sparked controversy by casting doubt about the safety of commonly used antidepressants during pregnancy. But it also raised the broader issue of how little is known about the safety of many medications used in pregnancy, considering the implications for both mother and child – and how understudied this topic is.

In the U.S., the average pregnant patient takes four prescription medications, and more than 9 in 10 patients take at least one. But most drugs lack conclusive evidence about their safety during pregnancy. About 1 in 5 women uses a medication during pregnancy that has some preliminary evidence that it could cause harm but for which conclusive studies are missing.

We are researchers in maternal and child health who evaluate the safety of medications during pregnancy. In our work, we identify medications that might raise the risk for birth defects or pregnancy loss and compare the safety of different treatments.

While progress has been slow, researchers and federal agencies have built monitoring systems, databases and tools to accelerate our understanding of medication safety. However, these efforts are now at risk due to ongoing cuts to medical research funding – and with them, so is the knowledge base for determining whether sticking with a therapy or discontinuing it offers the safest choice for both mother and child.

How pregnant women got sidelined

One big reason why so little is known about the effects of medications during pregnancy stretches back more than half a century. In the 1960s, a drug called thalidomide that was widely prescribed to treat morning sickness in pregnant women caused severe birth defects in over 10,000 children around the world. In response, in 1977 the FDA recommended excluding women of childbearing age from participating in early stage clinical trials testing new medications.

A pill bottle with a label carrying the drug's brand name, Kevadon, and its generic name, thalidomide.
Thalidomide, sold under several brand names including Kevadon, was used in many countries to treat morning sickness, though the Food and Drug Administration never approved it for that purpose in the United States.
U.S. Food and Drug Administration

Ethically, there is long-standing tension between concerns about fetal harm and maternal needs. Legal liability and added complexities when conducting studies in pregnant women serve as additional barriers for drug manufacturers.

When drugs are approved, studies about whether they might cause birth defects are typically done only in animals, and they often don’t translate well to humans. So when a new medication comes on the market, nothing is known about how it affects people during pregnancy. Even if animal studies or the medication’s mode of action raised concerns, the drug can still be approved, though companies may be required to conduct studies observing its effects when taken during pregnancy.

Cause and effect

Of 290 drugs approved by the FDA between 2010 and 2019, 90% contain no human data on the risks or benefits for pregnant patients. About 80% of some 1,800 medications in a national database called TERIS, which summarizes evidence on medications’ risks during pregnancy, lack or have limited evidence about the risks for birth defects. Researchers have estimated that it takes 27 years to pin down whether a medication is safe to use in pregnancy.

As a result, many pregnant women stop treating their chronic diseases. In a U.S. study published in 2023, over one-third of women stopped taking a medication during pregnancy, and 36.5% of those did so without advice from a health care provider. More than half cited concerns about birth or developmental defects as the reason.

Yet uncontrolled chronic disease comes with its own toll on both the mother’s and the baby’s health. For example, some medications used to treat seizures are known to cause birth defects, but stopping them may increase seizures, which themselves raise the risk of fetal death.

Women with severe or recurrent depression who abruptly stop their antidepressants risk their depression returning, which is in turn associated with increased risk of substance use, inadequate prenatal care and other negative effects on fetal development. Stopping the use of medications
for treating high blood pressure also causes adverse effects – specifically, a greater risk of pregnancy-related high blood pressure that can cause organ damage, called preeclampsia; a condition called placental abruption, when the placenta detaches from the wall of the uterus too early; preterm birth; and fetal growth restriction. An online resource called Mother to Baby, created by a network of experts on birth defects, provides an excellent summary of the available data on medication safety during pregnancy.

The FDA in some cases requires drug companies to establish registries to track the outcomes of pregnancies exposed to certain medications. These registries can be useful, but they have shortcomings. For example, recruiting pregnant patients into them takes time and considerable effort, resulting in small sample sizes that may not capture rare birth defects. Also, registries typically follow a single medication and rarely include comparisons to alternative treatment approaches – or to no treatment.

What’s more, following the 2022 Dobbs v. Jackson Supreme Court decision overturning the constitutional right to abortion, women might be reluctant to add their names to a pregnancy registry or to provide data on prenatal detection of birth defects due to concerns about privacy and legal risks.

Decades of underfunding

In 2019, a task force established by the 21st Century Cures Act identified a major gap in knowledge about drug safety and effectiveness in pregnant and lactating women and recommended a boost in funding to fill it.

However, little has changed. A 2025 review by the National Academies of Sciences, Engineering and Medicine pointed out that research funding for women’s health topics has remained flat over the past decade, while the overall budget of the National Institutes of Health has steadily increased. The review recommended doubling the NIH funding allocated for such research, but this seems unlikely in light of the recent proposals to cut the overall NIH budget by 40%.

The National Institute of Child Health and Human Development funds the bulk of research on the safety of medications during pregnancy across federal agencies, although the institute has an appreciably smaller budget than most of its sister institutes such as the National Cancer Institute. Grants awarded are typically broad and take four to five years to complete, but they allow the more comprehensive assessments that are needed to support informed decisions considering outcomes for mother and child. For example, NIH-funded researchers have established a clear link between autism and prenatal use of valproate, a potent teratogen used to treat epilepsy and several mental health disorders.

The Centers for Disease Control and Prevention as well as the FDA have also funded specific pregnancy-related research. For example, following the COVID-19 epidemic, the CDC renewed its funding for studies that help expedite pregnancy safety studies for treatments that might be used for newly emerging infections. In response to emerging concerns about a substance called gadolinium, which is often used during MRI procedures, the FDA funded our own work on a study of almost 6,000 pregnant women, which found no elevated risk.

For healthy pregnancies, more research is critical

These efforts have laid a crucial foundation for evaluating medication safety and effectiveness during pregnancy. But keeping pace with the release of new medications and new ways they are used, as well as addressing the backlog of missing evidence for medications that were approved in the past millennium, remain a challenge.

Recent terminations of NIH-funded studies have focused on topics presumably relating to diversity, equity and inclusion. But research on safe and healthy pregnancies and on maternal health – for example, on the safety of COVID-19 vaccines during breastfeeding – has been affected as well.

The NIH has scaled back new grant awards by nearly US$5 billion since the beginning of 2025, and the odds for receiving NIH funding have plummeted. Proposed sweeping budget cuts for the CDC and FDA leave their role in supporting research on healthy pregnancies similarly uncertain.

In our view, removing or reducing ongoing investments in healthy pregnancies poses a danger to much-needed efforts to reduce excessive rates of stillbirths as well as infant and maternal deaths.

The Conversation

Almut Winterstein consults on medication safety issues to Merck, Syneos, Lykos and Novo Nordisk. She receives funding for pregnancy-related research from NIH, CDC, FDA, and the Gates Foundation.

Sonja Rasmussen receives funding from Harmony Biosciences, Axsome Therapeutics, Biohaven (acquired by Pfizer), Lundbeck, Novo Nordisk, and Myovant Sciences to serve on pregnancy registry scientific advisory committees. She also receives or has received funding from NIH, CDC, and FDA.

ref. Pregnant women face tough choices about medication use due to lack of safety data − here’s why medical research cuts will make it worse – https://theconversation.com/pregnant-women-face-tough-choices-about-medication-use-due-to-lack-of-safety-data-heres-why-medical-research-cuts-will-make-it-worse-260783

FDA approves updated COVID-19 vaccines with new restrictions, potentially limiting access for healthy children

Source: The Conversation – USA (3) – By David Higgins, Assistant Professor of Pediatrics, University of Colorado Anschutz Medical Campus

The FDA’s move comes as, for the first time in decades, guidance from federal health authorities and pediatric experts diverge. PeopleImages/iStock via Getty Images Plus

Guidance around COVID-19 vaccines has once again shifted after the Food and Drug Administration on Aug. 27, 2025, approved updated shots for the fall season, but for a more limited group than in prior seasons.

These changes, announced on X by Secretary of Health and Human Services Robert F. Kennedy Jr., raise new questions about eligibility and availability of COVID-19 vaccines for children.

As a pediatrician and researcher who studies vaccine delivery and health policy, I foresee these changes adding to the confusion facing parents and providers, just as this summer’s COVID-19 wave continues to rise.

How does the new guidance differ from before?

The FDA revoked the emergency use authorizations for COVID‑19 vaccines, a status used during public health emergencies that made it possible to provisionally approve vaccines swiftly during the pandemic. The agency also limited their approval to only people at higher risk of serious illness from COVID-19 infection, such as those over 65 or with underlying health conditions. But for children it is even more complicated.

The FDA approved two updated mRNA-based vaccines – Moderna’s vaccine for children 6 months and older and Pfizer’s vaccine – both targeting a new variant called LP.8.1, for children 5 years and older. The agency also approved an updated version of the the protein-based Novavax vaccine targeting a strain of the virus called JN.1 for children 12 years and older. But all three approvals are limited to children at higher risk of serious illness from COVID-19 infection.

Previously, all children 6 months and older were able to receive either the Pfizer and Moderna vaccines, with the Novavax vaccine available for anyone 12 years and older. These changes mean it may be significantly more difficult for infants and young children to get vaccinated, even though they remain at higher risk for complications from COVID-19 compared with the general population.

The decision comes as, for the first time in decades, guidance from federal health authorities and pediatric experts diverge. The Centers for Disease Control and Prevention no longer routinely recommends COVID-19 vaccines for healthy children ages 6 months to 17 years. The decision to take this approach bypassed the CDC’s normal independent review panel, creating concerns about credibility.

In contrast, the American Academy of Pediatrics recently issued its own guidance based on its review of the evidence. The AAP recommends that all children 6 months to 23 months old and children 2 to 18 years old at higher risk receive vaccines. They also emphasize that COVID-19 vaccines should be available for all children whose parents want them.

The FDA’s new guidance on vaccines may make it difficult for families to obtain vaccines for healthy children.

The AAP’s review of the evidence showed COVID-19 remains a serious risk for young children and kids with certain high-risk conditions. It also found that children are still being hospitalized and dying at rates similar to those with other illnesses for which vaccines are routinely recommended, such as influenza. And an independent expert group called the Vaccine Integrity Project confirmed that no new safety concerns have emerged relating to COVID-19 vaccines and that the vaccines remain effective.

How might access to COVID-19 vaccines for kids change?

Despite young children remaining particularly vulnerable, changes to FDA approval and conflicting recommendations will mean access to vaccines could be challenging.

Children under 5 years of age can now only receive Moderna’s vaccine. Providers who had planned to use Pfizer’s vaccine need to quickly pivot, and Moderna will need to fill supply gaps. Also, providers may not be able to use any Pfizer vaccine stock they still hold now that the emergency use authorizations is no longer in effect. Families who already face barriers to vaccination, such as those who live in rural areas or who lack health insurance, may be especially affected by these new limitations.

If providers give healthy children a COVID-19 vaccine, they would be doing this “off-label,” meaning different than what the FDA label says. This practice is legal and common, with an estimated 1 in 5 medications prescribed off-label. However, while physicians can give vaccines off-label, in many states, pharmacists and other non-physicians may not be able to do so for any age.

Even if it is legal, some providers may be hesitant to give COVID-19 vaccines off-label. After the AAP released its own recommendations, Kennedy warned that vaccine recommendations that diverge from the CDC’s official list are not protected from liability, though legal experts argue that this is misleading.

The AAP published a list of high-risk health conditions or characteristics to guide parents and providers in deciding whether a child should receive the vaccine.

At the federal level, the only current list is on the CDC website and is not specifically related to COVID-19 vaccine recommendations. For example, it includes pregnancy, even though federal health leaders have previously stated the vaccines would no longer be recommended in pregnancy. In contrast, the American College of Obstetricians and Gynecologists strongly recommends updated COVID-19 vaccination during pregnancy, when planning pregnancy, in the postpartum period and while lactating, noting benefits for both patients and their newborns.

What might happen next?

Unfortunately, the confusion may deepen as the CDC’s recommendations, including who is at high risk, may be revised after an upcoming meeting of the Advisory Committee on Immunization Practices, a panel of independent experts that advises the agency.

In June 2025, in an unprecedented move, Kennedy disbanded the entire committee and hand-picked new members. The new committee has yet to weigh in on COVID-19 vaccines for children. The chair of the COVID-19 vaccine work group, which will make recommendations to all committee members, is led by an outspoken critic of COVID-19 vaccines who does not have a biomedical degree or medical experience. Also, on Aug. 27, 2025, federal officials attempted to oust the CDC’s director just a few weeks after she was confirmed, and multiple top officials resigned.

The bottom line is that with these FDA changes, fewer vulnerable children may end up vaccinated against COVID-19 because of supply constraints, parental confusion or provider uncertainty. The best thing a family can do is talk with their pediatrician about what options remain and what is best for their child.

The Conversation

David Higgins volunteers as Vice President of the Colorado Chapter of the American Academy of Pediatrics and as a board member of Immunize Colorado. He was not involved in the development or publication of the American Academy of Pediatrics’ immunization guidelines. The views and opinions expressed in this article are solely his own and do not represent those of the American Academy of Pediatrics.

ref. FDA approves updated COVID-19 vaccines with new restrictions, potentially limiting access for healthy children – https://theconversation.com/fda-approves-updated-covid-19-vaccines-with-new-restrictions-potentially-limiting-access-for-healthy-children-264098

Supporting religious diversity on campus is a surprising consensus among faculty across the red-blue divide

Source: The Conversation – USA – By Matthew J. Mayhew, Professor of Higher Education, The Ohio State University

University faculty are the most important people influencing student learning, development, persistence and degree attainment. Maskot/Getty Images

Universities, often perceived as bastions of progressive thought, are increasingly reflecting the broader political polarization gripping the nation.

Faculty members represent a university’s core identity and mission. They express the values of the institution in numerous ways, including teaching, mentoring, advising and researching.

In my research into the impact of college on student development and learning, I – and others – have found that faculty are the most important people influencing student learning, development, persistence and degree attainment.

However, no systematic efforts have ever been undertaken to find out how faculty’s work is influenced by their understanding of university life and religion – until now.

The Templeton Religion Trust, a charity focused on improving societal well-being through understanding individual well-being, funded a recent national survey my team and I administered to 1,000 faculty members. The survey asked faculty about their perceptions of university life, including free speech and diversity, equity and inclusion initiatives, often shortened to simply DEI.

The survey results reveal a striking divergence in perspectives on the often divisive issues of free speech and DEI among faculty. Those differences showed up particularly along the red state and blue state divide.

Yet, amid these deep disagreements, a surprising point of bipartisan consensus emerges: faculty members’ belief in the importance of religious, spiritual and secular inclusion in diversity efforts.

A student wears a graduation cap with a verse from Koran written on it.
Faculty agreed on the importance of religious, spiritual and secular inclusion in diversity efforts. Here, a student graduating from Columbia University in New York on May 21, 2025, wears a graduation cap with a verse from the Quran written on it.
Jeenah Moon/POOL/AFP via Getty Images, CC BY

State political leaning is key

Survey responses represented national trends across various factors, including region, institutional control, institutional type and academic discipline.

In part of the analysis, we uncovered that the political leanings of a state – how a state voted in the presidential election of 2024 – play a significant role in what faculty perceive about free speech and DEI programming.

Even more compelling, significant differences reported by faculty from red versus blue states showed up consistently across gender, race, religion, academic discipline, faculty rank and whether the faculty member was employed at a private or public institution.

In other words, political leanings of a state were strongly associated with faculty perceptions regardless of these other factors.

Measuring the right to free speech

We asked faculty four questions related to their First Amendment rights, which we presented as: “The First Amendment protects freedom of speech, freedom of religion, freedom of the press, freedom of assembly, and freedom to petition.”

Working closely with experts in legal epidemiology, we asked faculty the extent to which they agreed with the following statements: a) the First Amendment is relevant to my job as a faculty member; b) the First Amendment is relevant to my research engagement; c) my institution provides me with my constitutionally mandated First Amendment rights; and d) I am aware of my rights and responsibilities as they relate to the First Amendment of the U.S. Constitution.

While awareness of First Amendment rights appears consistent across the board, a notable difference arises in faculty members’ perception of institutional protection of those rights.

Faculty in blue states are significantly more likely than those in red states to report that their institutions uphold their constitutionally mandated First Amendment rights. This implies a potential disconnect in how freedoms are experienced and protected, depending on the political leanings of the state where an institution is located.

Measuring attitudes about DEI

The divide deepens when it comes to DEI, defined in the survey as “campus diversity programs” in some instances and “diversity, equity, and inclusion” in others.

When compared with faculty in blue states, those in red states are far more inclined to view DEI efforts as “overreach,” agreeing with the statements that “diversity programs generally do more harm than good on college and university campuses” and “the promotion of diversity, equity, and inclusion on college and university campuses has gone too far.”

Conversely, blue state faculty largely disagree with these assertions. When compared with faculty in red states, those in blue states were more likely to agree that “campus diversity programs support student success,” demonstrating a stark ideological chasm on the value and impact of DEI.

This partisan disagreement extends to the very concept of banning DEI programs.

Red state faculty show moderate support for banning DEI, suggesting a belief that current efforts to curtail campus diversity initiatives are, according to survey response options, “well justified.”

Blue state faculty overwhelmingly support the continuation of these programs. They gave strong endorsement to the idea that “colleges and universities should continue to offer identity-specific organizations and programming.”

This schism reflects the ongoing national debate about the role and scope of DEI in higher education. Faculty perspectives mirror the political sentiments of their respective regions.

Amid this significant polarization, a crucial area of common ground emerges: what we call religious, spiritual and secular inclusion.

That’s the idea that DEI efforts should include programming and activities designed to help students from all religious, spiritual and secular backgrounds belong and succeed.

Religious, secular and spiritual diversity

Despite their sharp disagreements on other aspects of DEI, both red state and blue state faculty overwhelmingly agree that “colleges and universities should provide support for students of all religious, secular, and spiritual identities and backgrounds.”

And both groups similarly reject the notion that “campuses should not concern themselves with religious, secular and spiritual diversity.”

The findings from this survey highlight the complex landscape of faculty opinion in higher education. While significant difficulties remain in reconciling differing views on free speech and DEI, the shared commitment to religious, spiritual and secular inclusion offers a potential path to agreement.

By focusing on areas of consensus, institutions can begin to foster more inclusive environments to serve the needs of all students, regardless of their background or beliefs. Understanding these nuanced perspectives is the first step toward building more cohesive, pluralistic and intellectually vibrant academic communities across the nation’s varied political terrain.

The Conversation

Matthew J. Mayhew receives funding from the Templeton Religions Trust, the Arthur Vining Davis Foundations, the Pew Charitable Trusts, the Educational Credit Management Corporation (ECMC) Foundation, the National Science Foundation, the Alfred P. Sloan Foundation, the Merrifield Family Trust, the Andrew W. Mellon Foundation, the Fetzer Institute, the Ewing Marion Kauffman Foundation, the Merrifield Family Trust, and the United States Department of Education.

ref. Supporting religious diversity on campus is a surprising consensus among faculty across the red-blue divide – https://theconversation.com/supporting-religious-diversity-on-campus-is-a-surprising-consensus-among-faculty-across-the-red-blue-divide-262589

Escaped slaves on St. Croix hid their settlements so well, they still haven’t been found – archaeologists using new mapping technology are on the hunt

Source: The Conversation – USA – By Justin Dunnavant, Assistant Professor of Anthropology, University of California, Los Angeles

The red square on this 1767 map of St. Croix marks where Danes believed the Maroon settlement was. Paul Kuffner/Royal Danish Library

“For a long time now, a large number of [escaped slaves] have established themselves on lofty Maroon Hill in the mountains toward the west end of the island [of St. Croix]. … They are there protected by the impenetrable bush and by their own wariness.”

Those are the words of Christian Oldendorp, a Danish missionary who visited the Caribbean island of St. Croix in 1767. His account is one of the few Danish historical records of Maronberg, a community of escaped slaves, known as Maroons, in the northwest mountain ranges of the island.

In 1733, the Danish West India-Guinea Company purchased St. Croix from France and quickly expanded the island’s sugar and cotton production. This also meant expanding the slave population to harvest lucrative plantations. But the Danes were never able to fully control the island – or the enslaved. By the end of the 1700s, nearly 1,400 people – more than 10% of the enslaved population – successfully escaped captivity. But where did they escape to? Only recently have researchers started to shed more light on this centuries-old mystery.

As an archaeologist specializing in slavery and resistance, I’ve excavated plantations in the Americas and used geographic information systems to model Maroon escape routes by sea. Recently, I turned my attention to Maroon settlements on land, working with a team of archaeologists to locate Maronberg.

Maroon Ridge on St. Croix is believed to have been home to hundreds of escaped enslaved people from 1733-1848.
Justin Dunnavant, CC BY

Honoring a legacy

I first learned about Maronberg on a nature tour of St. Croix given by local activist and University of the Virgin Islands professor Olasee Davis in 2016. At that time, I was on the island to excavate a sugar plantation, a project that gave my colleagues and me a unique perspective on the enslaved experience in the Danish-controlled Caribbean.

In August 2025, Davis’ decades-long campaign to create an official heritage sanctuary to protect Maronberg finally came to fruition. The local government purchased 2,386 acres of land to serve as the U.S. Virgin Islands Maroon Territorial Park.

But one problem remains: We have yet to find the physical remains of the settlement. Locating and preserving Maronberg’s historical artifacts and buildings could provide new insight into residents’ way of life and give greater meaning to the sanctuary.

Fortunately, advanced computer modeling and high-resolution maps are helping us get closer to pinpointing the settlement.

Finding what was meant to remain hidden

Many Maroon settlements in the Americas have proved difficult to locate. This makes sense when you consider that their inhabitants were trying to hide from colonial settlers. If the Danes had found Maronberg, they would have either killed its inhabitants or forced them back into slavery.

Runaways tended to settle in areas that were intentionally difficult to access, like remote swampy or mountainous terrain. Houses and other shelters often consisted of semipermanent structures so that Maroons could relocate as needed to avoid detection.

The boundaries of Maronberg and the size of the settlement along the northwestern mountain range remain unknown. Colonial militias attempted periodic raids, but historical records report that they were met with rugged terrain, booby traps and counterattacks.

The missionary Oldendorp wrote: “[The Maroons] keep every approach safe by attempting carefully to conceal small, pointed stakes of poisoned wood so that the unwary pursuer might wound his foot on them and therefore be prevented from continuing the chase as a result of the unbearable pain.”

All those precautions paid off: The Danes were never able to penetrate the Maroons’ encampment.

Using new tech to see 300 years into the past

Recent attempts by researchers to locate Maronberg began in 2007, with more extensive geographic information systems mapping conducted in 2008. These digital, computer-based geographic programs allow researchers to store a range of geological data and model spatial patterns across vast terrains.

Pairing a historical map with a low-resolution elevation map from the U.S. Geological Survey, archaeologist Bo Ejstrud created a predictive model to assess the probable location of the Maroon settlement. He considered elevation, slope and colonial infrastructure to identify the most remote areas of St. Croix with the least visibility from colonial lines of sight.

Back in the 1700s, urban centers accounted for only a small percentage of the overall landmass of the 83-square-mile (215-square-kilometer) island. Much of the land was either plantations or uninhabited forests and mountains. Ejstrud’s model reaffirmed the likelihood of a Maroon settlement in the northwest region. But it left us with a massive survey area. The map also didn’t account for the possibility that the settlement moved over time.

In 2020, I teamed up with archaeologists Steven Wernke, from Vanderbilt University’s Spatial Analysis Research Laboratory, and Lauren Kohut, from Winthrop University’s Geospatial Environmental Modeling Lab. Together, we developed and visualized a more dynamic model using advances in mapping since 2008.

We began by digitizing two of the most detailed colonial maps of St. Croix – one from 1750 and another from 1799. These maps, created by Danish military engineers and surveyors, detail the spread of plantations, roads and settlements over time.

Next, in order to build a digital elevation model of the island’s terrain, we incorporated high-resolution light detection and ranging, or lidar, data collected by the National Oceanic and Atmospheric Administration. Whereas traditional digital elevation models can be skewed by dense vegetation and trees, lidar uses laser pulses that penetrate through the forest canopy to map the Earth’s surface. This technology allows us to analyze some of the most secluded, inaccessible areas on the island. Prior to 2013, lidar was too costly for archaeological research purposes. But these days, it’s built into many cellphones.

By layering these datasets in geographic information systems software, we created a suitability model that estimated where Maroon settlements were most likely to have existed. In addition to isolation and visibility, we also incorporated accessibility to water sources and terrain ruggedness to model the degree of mobility through the landscape.

This approach allowed us to simulate how the opportunities and constraints the landscape offered to people seeking refuge shifted as colonial society grew over time.

side-by-side maps of where Maroon settlements were believed to be on St. Croix in 1750 and 1799
The red areas indicate where on St. Croix that Maroons may have settled. The area shrank between 1750 and 1799, as the Danish settlers spread out.
Lauren Kohut, Steven A. Wernke and Justin Dunnavant, CC BY

Mapping changes

In addition to providing more nuance to the picture of the areas where Maroons potentially settled, our research suggests that the Maroon settlement wasn’t static, but likely waned as colonial infrastructure increased on the island. Our model implies that the area of suitable land for clandestine Maroon communities shrank by more than 90% in just 50 years.

It’s possible that over time there were fewer runaways. More likely, more Maroons left the island by boat for destinations such as Puerto Rico and Tortola.

Where we go from here

Though our findings still don’t provide an exact location for Maronberg, they get us one step closer to locating the physical remains of this centuries-old Maroon community. The next step will be to visit these sites and survey them for evidence of historical settlement. Archaeological research at these sites would help us understand more about the Maroons who turned a rugged landscape into a sanctuary for freedom.

Ultimately, identifying artifacts and historical sites within the newly established U.S. Virgin Islands Maroon Territorial Park would help us develop educational tours and honor the Maroon legacy.

The Conversation

Justin Dunnavant does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. Escaped slaves on St. Croix hid their settlements so well, they still haven’t been found – archaeologists using new mapping technology are on the hunt – https://theconversation.com/escaped-slaves-on-st-croix-hid-their-settlements-so-well-they-still-havent-been-found-archaeologists-using-new-mapping-technology-are-on-the-hunt-237291

Latin American literature contains warnings for American universities that yield to Trump

Source: The Conversation – USA (2) – By Charlotte Rogers, Associate Professor of Spanish, University of Virginia

Nobel Prize winner Gabriel García Márquez, who fled Colombia after learning that the government planned to arrest him, returns to his hometown, Aracataca, in 2007 for the first time in 20 years. Alejandra Vega/AFP via Getty Images

As university leaders work to make deals with the Trump administration, many college presidents are at an ethical crossroads. On the one hand, they must do all they can to restore funding for vital research. On the other, they risk ceding to the demands of a president with views that don’t align with their missions.

As the fall semester begins, academic administrators could look to literature for guidance. Latin America’s rich archive of fiction over the past century features this dilemma in numerous stories about living under dictatorships.

Among many others, Peruvian novelist Mario Vargas Llosa, Colombian writer and journalist Gabriel García Márquez and Argentine author Luisa Valenzuela have mined the region’s turbulent political history to explore how authoritarian rulers bend institutional leaders to their will by cultivating fear.

Lessons from the bookshelves

In these works, some threats are more overtly coercive than others.

Vargas Llosa’s “The Feast of the Goat” details how Dominican dictator Rafael Trujillo reportedly fed insubordinate underlings to voracious crocodiles, an image that, for me, has echoes in Florida’s Alligator Alcatraz. In García Márquez’s “The Autumn of the Patriarch,” an illiterate strongman takes over all institutions to such an extreme that “él solo era el gobierno” – he alone was the government.

Yet to me, the greatest danger that Latin American literature foretells for higher education is the insidious way capitulation to authoritarians changes both individuals and institutions.

This is the subject of “The Censors,” a 1976 short story by Valenzuela. Back then, all but four Latin American countries were dominated by authoritarian regimes.

The main character in Valenzuela’s story is an average Joe – aptly named Juan – who writes a letter to his beloved Mariana, now living in Paris. Soon after he mails the letter, Juan is beset by fear that despite its innocuous sentiments, his message will be construed by authorities as subversive. He worries that secret military forces will fly to Paris and kidnap Mariana from her apartment. (Masked men forcing people into unmarked vehicles is a common sight in dictatorships, then and now.)

Juan decides he must “sabotage the machinery, throw sand in its gears.” So he becomes a censor for the regime in hopes of intercepting his own letter as it works its way through the painfully slow Post Office Censorship Division.

University leaders, much like Juan, begin with the best of intentions. They initially collaborate with the government’s demands because they want to protect the university’s mission.

A woman with blonde hair presents a medal on a stage to an older woman with short, black, curly hair.
Journalist Silvia Lemus, left, presents an award to Argentine writer Luisa Valenzuela at the Guadalajara International Book Fair on Dec. 1, 2019.
Leonardo Alvarez Hernandez/Getty Images

But once the concessions are made, things begin to change.

In “The Censors,” Juan discovers he has a knack for redacting questionable letters. Assigned to a division that checks correspondence for explosives, he watches as a co-worker’s right hand gets blown off. Yet when a colleague tries to organize a demonstration advocating for safer working conditions, Juan reports him to the authorities and is rewarded with a swift promotion.

Juan justifies his opportunism as a one-off rather than a personal transformation: “Una vez no crea hábito” – “One time doesn’t create a habit” – he reassures himself as he leaves his boss’s office.

As he reaches the highest echelons of the censorship authority, Juan’s sense of purpose blurs beyond recognition. He now considers flagging subversive letters and condemning their authors to be “a truly patriotic task, both self-sacrificing and uplifting.”

At this exact moment, Juan encounters his own letter to Mariana. “Naturally,” the narrator declares acidly, “he censored it without regret.” In the last lines of the story, the narrator reveals that Juan was executed the following day.

Juan, Valenzuela concludes with devastating irony, is “one more victim of devotion to his work.”

Universities in the crosshairs

In his zeal to capitulate, Juan deals himself a death blow, and I can’t help but wonder if universities are heading down the same perilous path.

In an official statement, Brown University noted on July 30, 2025, that it will “comply with the Trump administration’s vision” on admissions practices. Likewise, Columbia University has agreed to direct governmental oversight of its Middle East studies department, while the University of Pennsylvania will no longer allow trans women on female sports teams.

At the University of Virginia, where I’m an associate professor of Spanish, President James E. Ryan resigned under intense pressure from the Department of Justice in June 2025.

For most of his seven years in leadership, Ryan set out to make the university more diverse and open doors for first-generation and low- to middle-income students.

Middle-aged man with short, brown hair, wearing a suit and tie.
University of Virginia President James E. Ryan resigned in June 2025.
Win McNamee/Getty Images

By the time of his resignation, however, the university had already yielded to demands from a conservative alumni group to de-emphasize the history of enslavement during campus tours. And it had adopted “institutional neutrality,” meaning it would no longer take a position on, say, mass starvation in Gaza.

In March 2025, the university’s governing board voted to dismantle the university’s diversity, equity and inclusion office at the behest of Virginia Gov. Glenn Youngkin.

Three months later, Ryan was gone.

More to come?

As the White House continues its pressure campaign, academic administrators may face more funding threats in the future. I worry that if humanities programs are cut – the University of Chicago just paused admissions to doctoral programs in literature, philosophy, the arts and languages, citing “this moment of uncertainty” – students will lose the opportunity to be introduced to works like “The Censors.”

Columbia maintains it has safeguarded academic freedom by making a deal. But as Wesleyan University President Michael Roth told PBS, the academic community remains skeptical about the durability of these agreements.

Perhaps some administrators believe, as Juan did, that “one time doesn’t create a habit.”

But higher education, I fear, is being swallowed by its leaders’ “devotion to their work.”

The Conversation

The perspectives in this article do not reflect the official position of the University of Virginia.

ref. Latin American literature contains warnings for American universities that yield to Trump – https://theconversation.com/latin-american-literature-contains-warnings-for-american-universities-that-yield-to-trump-262679

How stripping diversity, equity and inclusion from health care may make Americans sicker

Source: The Conversation – USA (3) – By Abigail Folberg, Assistant Professor of Psychology, University of Nebraska Omaha

The Trump administration has rescinded more than $1 billion in medical research funding, with one major target being research relating to diversity, equity and inclusion. Alina Kotliar/iStock via Getty Images Plus

President Donald Trump’s administration has dramatically reshaped health and medical research by rolling back federal funding from institutions that have diversity, equity and inclusion initiatives and by cutting federal funding for research projects that the administration considers related to DEI.

As of Aug. 20, 2025, the National Institutes of Health has terminated over 5,100 grants totaling over US$4.4 billion in research funding. Likewise, the National Science Foundation, which seeks among other things to advance the nation’s health, has rescinded over 1,700 research grants totaling over $1 billion in funding.

These terminations have disproportionately affected projects that study the experiences of marginalized groups and funding to scientists from social groups that are underrepresented in academia. The federal judge overseeing a case challenging cuts to NIH grants said that he had “never seen government racial discrimination like this.”

Many Americans may view these cuts to health-related research as disconnected from the health care they receive. However, as a psychologist and a chemical engineer who study how gender and racial inequality affect well-being and the incidence and progression of disease, we believe that these changes will make all Americans less healthy.

Health repercussions for minority groups

The Trump administration’s funding cuts will most directly affect the health of members of marginalized groups, including, but not limited to, people of color, women and people who identify as lesbian, gay, bisexual, intersex and transgender. The website grant.witness.us includes a list of the project descriptions of canceled grants. The NIH grants that were terminated include ones that funded research investigating the effects of food insecurity and stress on prenatal and birth outcomes among women of color, sex differences in major depression, and risk factors for suicidal behavior among gender minority adolescents.

The White House has also indicated that it intends to ax the National Institute on Minority Health and Health Disparities, which funds research on groups that tend to have poorer health outcomes, in its planned reorganization of the NIH.

Doctor measures a young child's height at a medical checkup.
Understanding why people from marginalized groups experience poorer health outcomes requires research.
Kiwis/iStock via Getty Images Plus

These cuts will likely make these groups’ health outcomes worse. One of the reasons for these health disparities is that the health experiences and outcomes of members of marginalized social groups, such as women of color, have historically received less attention. Health disparities cannot be closed without high-quality research.

The case of endometrial cancer

One example of a disease where differences in health outcomes vary depending on race is endometrial cancer. The endometrium is an inner layer of the uterus, and endometrial cancer therefore primarily affects women. As we discussed in a 2023 review article, Black women are more likely than white women to have worse disease outcomes and to die from endometrial cancer. Some of the reasons for these disparities are unclear. For example, researchers do not know why Black women are more likely to get the more aggressive of two subtypes of endometrial cancer. This knowledge gap underscores the need to study these disparities.

But many causes of these disparities are known – and they are social in nature. For example, researchers discovered that Black women were less likely than white women to know about the early warning signs of endometrial cancer, such as postmenopausal vaginal bleeding. Black women were, therefore, more likely to be diagnosed later and die from endometrial cancer. Additionally, many Black women use chemical hair straightening kits, or perm kits, which have recently been linked to endometrial cancer incidence.

Also, Black patients and members of other groups, such as LGBTQ people and women, also routinely experience discrimination from health care providers. For example, studies suggest that some providers may fail to provide the best possible medical care and express discriminatory attitudes toward Black and sexual minority patients, which may prompt patients to avoid seeking future medical care. More generally, the stress from experiencing discrimination can also lead to physiological changes in the body that contribute to poorer physical and mental health.

Silhouette of doctor in white coat with stethoscope and LGBTQ+ pin on pocket
Patients who experience discriminatory attitudes from clinicians may avoid seeking medical care in the future.
Nadzeya Haroshka/iStock via Getty Images Plus*

Addressing social factors that influence health

DEI initiatives may address some of these social factors. For example, efforts to promote diversity among medical professionals may be beneficial because patients of color may experience better outcomes when they are treated by doctors who share their racial or ethnic identity, and more diversity among primary care physicians may reduce racial health disparities. Black patients are also more likely to trust their providers when their providers signal awareness of systemic inequality – and trust, in turn, may encourage people to make use of preventive health services such as routine checkups.

Medical care is also supported by scientists from many disciplines who research the progression and treatment of disease. These researchers’ identities may influence what they choose to study and how they choose to study it. DEI initiatives, such as peer-mentoring programs and intentional efforts to recruit diverse faculty, help institutions to recruit and retain people whose backgrounds and experiences are traditionally underrepresented in academia. Better representation across many scientific fields may also contribute to the research and training of physicians and other scientists who contribute to the health of the nation.

Diversity in health care benefits everyone

Slashing support for DEI initiatives in health care as well as funding for minority health is likely to reshape the health of all Americans, not just people of color and others from underrepresented groups.

For example, the government has scrubbed the mention of words that are associated with DEI, such as “women,” “Black” and “bias” from federal agencies and has increased scrutiny of grants submitted to the NIH and the National Science Foundation. Among the canceled grants was research examining women’s reproductive health, which affects both women and anyone who wishes to become a parent, regardless of whether they carry or birth that child.

Other canceled research grants examined ways to reduce the incidence of new HIV/AIDS infections among transgender women and men of color. Although this research specifically examined transgender people, research on reducing the transmission of HIV is a key strategy for eradicating HIV/AIDS, which affects about 1.2 million people in the U.S. and about 40.8 million people worldwide.

Moreover, because trainees from many different research areas were supported by grants that support biomedical researchers from underrepresented groups, canceling those grants has curtailed the study of diseases that affect many people. For example, these cuts have hit research on Parkinson’s disease, which is rising in prevalence and affects more men than women.

Health disparities also have profound economic costs – and poorer care for people from marginalized social groups result in costs that are borne by everyone. A 2018 study, for example, estimated that in 2018 alone, racial health disparities cost society $421 billion to $451 billion in excess medical care expenses, lower labor force productivity and premature death. The same study estimated that health disparities among those who did and did not have a college education cost between $940 billion and $978 billion.

Abundant evidence shows that improving the nation’s health requires medical research and education that broadens participation in science and attends to the health and well-being of all Americans, including those whose experiences were historically overlooked in the biomedical and psychological sciences. In our view, a more inclusive and pluralistic vision of science and health care is the best way to promote better health care for all.

The Conversation

Abigail Folberg receives funding from the National Science Foundation. This article reflects her views and does not necessarily represent the views of the University of Nebraska at Omaha.

Brittany Givens Rassoolkhani receives funding from The Alfred P. Sloan Foundation and the National Institutes of Health. This article reflects her views and does not necessarily represent the views of the University of Kentucky.

ref. How stripping diversity, equity and inclusion from health care may make Americans sicker – https://theconversation.com/how-stripping-diversity-equity-and-inclusion-from-health-care-may-make-americans-sicker-249674

Pregnancy brings unique challenges for people with autoimmune diseases – but with early planning, pregnancy outcomes can be greatly improved

Source: The Conversation – USA (3) – By Kristen Demoruelle, Associate Professor of Rheumatology, University of Colorado Anschutz Medical Campus

Early discussions and proactive planning for pregnancy are critically important for those with autoimmune diseases. d3sign/Moment via Getty Images

Only a few decades ago, a diagnosis of lupus could mean giving up the dream of having children. Women with systemic autoimmune diseases like lupus were warned that pregnancy was too risky – both for them and their unborn babies. Fast forward to today, and the story is remarkably different.

Thanks to scientific research and medical advances, pregnancy outcomes have greatly improved over the past several decades, and the outlook for pregnancy in people with autoimmune disease is more hopeful than ever.

However, pregnant women with autoimmune diseases still face a far higher likelihood of having serious complications, including preterm birth or even fetal loss. So while the outlook has improved, navigating pregnancy with these conditions still comes with a unique set of challenges and considerations. This is due to the medicines used to treat the disease, the effects of inflammation on the body and imbalances of the immune system, including some that researchers like me don’t yet fully understand.

I’m a rheumatologist and biomedical researcher with medical training and expertise in rheumatology and reproductive health. Rheumatology is a medical specialty that treats people with systemic autoimmune and inflammatory diseases, like the ones discussed in this article. We’re sometimes thought of as arthritis doctors, but systemic autoimmune diseases can involve the whole body, and we care for all of those effects.

I think it is essential that women with autoimmune diseases are equipped with a realistic understanding of their potential pregnancy journey – both the advances that have made motherhood more possible for them and the risks that still remain.

Autoimmune diseases disproportionately affect women

Systemic autoimmune diseases are chronic medical conditions in which the immune system, which normally protects the body from infections, mistakenly attacks the body’s own tissues. These conditions can include lupus, rheumatoid arthritis and antiphospholipid syndrome, to name a few.

Some autoimmune diseases attack only one part of the body. For instance, the thyroid is the only part of the body targeted in a disease called Hashimoto’s thyroiditis. But in systemic autoimmune diseases, the immune system can attack multiple parts of the body, like the skin, lungs and kidneys in those with lupus.

Autoimmune diseases disproportionately affect women. Lupus, for instance, occurs nine times more often in women than in men, and rheumatoid arthritis is three times more common in women. Since many women are diagnosed with these conditions in their 20s and 30s, when women are in their prime childbearing years, pregnancy can introduce new and unexpected challenges to their health care.

Increased pregnancy complications

Preeclampsia – a high blood pressure complication of pregnancy – preterm birth and stillbirth all occur at higher rates in women with autoimmune diseases. This is especially true for women with lupus and a condition called antiphospholipid syndrome. Women with these autoimmune disorders are five times more likely to experience these complications.

Autoimmune diseases are also linked to higher rates of miscarriage and postpartum depression.

Some women with lupus and a condition called Sjogren’s syndrome have an antibody in their blood that can cross the placenta and cause a rare but serious congenital heart condition. Studies have also found higher rates of autism spectrum disorders in women with autoimmune diseases.

Smiling pregnant woman talking with a female doctor, with an ultrasound screen behind them.
Pregnancy during periods when the autoimmune disease is quiet, called remission, can lead to better outcomes.
Nastasic/E+ via Getty Images

Testing and early planning can improve outcomes

Fortunately, thanks to advances in research and medicine, doctors and researchers like me now have helpful tools to assess a woman’s individual risk. This allows people with autoimmune diseases to better understand and manage their health before getting pregnant.

Pregnancy and the postpartum period can sometimes lead to remission, which is a time when inflammation and the disease are quiet, and sometimes lead to flares, or flare-ups, when inflammation increases and the disease is very active. Importantly, women who conceive while their autoimmune disease is quiet, rather than during a flare, have healthier pregnancies. By waiting for a time when one’s autoimmune disease is in remission, a woman can improve her chances of a healthy pregnancy.

Certain blood tests can also give clues about a person’s risk for pregnancy complications. For example, a positive test for lupus anticoagulant, a blood test that looks for certain proteins that can increase the risk of blood clots, can identify women at the highest risk for preeclampsia, preterm birth and fetal loss.

Some women also have antibodies that target proteins inside their cells, called Ro, which are often found in people with Sjogren’s syndrome. If a pregnant person has high levels of anti-Ro antibodies, they are at risk for a serious pregnancy complication called fetal heart block. The good news is that certain medications can lower these risks in women who have these antibodies.

Medications and pregnancy

Researchers and rheumatologists like me also better understand how medications affect pregnancy, in both harmful and helpful ways.

Several medications that are commonly used to treat autoimmune diseases can harm a developing baby or reduce fertility. If a pregnancy is being planned, these medications must be stopped ahead of time and replaced with pregnancy-safe medications.

In cases of unplanned pregnancy, stopping potentially harmful medications quickly can be critical. For those not planning pregnancy, using effective birth control is an important safeguard. Notably, contraception choices can also be influenced by a woman’s underlying autoimmune disease and should be discussed with the person’s rheumatologist or other specialists.

On the other hand, some medications can improve pregnancy outcomes in people with autoimmune diseases. For example, a medication called hydroxychloroquine can reduce the risk of anti-Ro antibody-mediated fetal heart block. Low-dose aspirin taken during pregnancy can lower the risk of preeclampsia.

And recently, a study found that a drug named certolizumab improved pregnancy outcomes in women with antiphospholipid syndrome, which is an autoimmune condition with high rates of pregnancy complications.

Historically, pregnant women were excluded from research studies, but this is starting to change, which could lead to safer pregnancies for those with autoimmune disease.

Gloved hand holding a vial of blood used for a blood test, with a collection of vials in the background.
Certain blood tests can provide important clues about a person’s risk for pregnancy complications.
SyhinStas/iStock via Getty Images Plus

Looking ahead

With all this in mind, it’s important for people with systemic autoimmune disease to talk with their rheumatologist or other specialists when thinking about pregnancy and throughout the process. Planning ahead gives the best chance for a healthy pregnancy.

Still, even with careful planning, autoimmune disease flare-ups can happen during pregnancy, and treating them promptly is important for both the mom and the baby.

Ongoing care after delivery matters, too, as postpartum flares can interfere with a mother’s ability to care for her newborn. Fortunately, there are safe options available to treat flare-ups during pregnancy or breastfeeding.

Talking to your doctor

With better treatments and growing knowledge, most women with autoimmune disease are now having healthy pregnancies and thriving babies. Fertility options like in vitro fertilization are also safe for many with autoimmune diseases.

Some helpful questions to consider asking your rheumatologist include:

  • What should I expect if I want to get pregnant?
  • Is my disease under control enough to try for pregnancy now?
  • Are my current medications safe if I become pregnant?
  • Do I need to stop or start any medications before trying to conceive?
  • What are my chances of having a healthy pregnancy?
  • What are the possible complications I could face during pregnancy?
  • What treatment options would I have if my disease flared up during pregnancy or after delivery?
  • If I need to wait to get pregnant due to active disease, how long should I wait, and what contraception is best in the meantime?

The American College of Rheumatology and the European Alliance of Associations for Rheumatology offer clear, evidence-based recommendations for pregnancy.

There are also clinical tools available to rheumatologists and resources available to patients to help guide safe, personalized reproductive health care.

I believe it’s essential to have a care team that’s comfortable guiding you through these decisions, and it’s always OK to ask questions or explore additional resources.

The Conversation

Kristen Demoruelle receives research funding from the National Institutes of Health, Boehringer Ingelheim, and Bristol-Myers Squib for research projects that are unrelated to the topics in this article.

ref. Pregnancy brings unique challenges for people with autoimmune diseases – but with early planning, pregnancy outcomes can be greatly improved – https://theconversation.com/pregnancy-brings-unique-challenges-for-people-with-autoimmune-diseases-but-with-early-planning-pregnancy-outcomes-can-be-greatly-improved-254359

Why religious groups are pushing for psychedelics as sacrament

Source: The Conversation – USA (3) – By Pardis Mahdavi, Professor of Anthropology, University of La Verne

Congregants at Colorado’s first psychedelic church, in Colorado Springs, on Feb. 18, 2025. Jason Connolly/AFP via Getty Images

Texas passed a landmark law in June 2025, supported by former Gov. Rick Perry, that allocates US$50 million to support research on ibogaine, one of the most powerful psychedelics, for treating opioid addiction and treatment-resistant PTSD.

Arizona passed a similar law in May, funding research on ibogaine’s effectiveness for treating veterans and those with traumatic brain injuries.

These laws come on the heels of states such as Oregon, Colorado, Kentucky and Georgia legalizing ketamine – a psychedelic that has been used in emergency rooms as anesthesia – for therapeutic purposes in the past two years.

Psychedelics, broadly defined, are a class of psychoactive substances that alter perception, cognition and mood through their interaction with neurotransmitters such as serotonin.

As a medical anthropologist I have spent the past 25 years studying the rise of alternative approaches to mental health treatments and have specifically focused in the past four years on the impact of psychedelics on consciousness and spirituality.

The push to legalize psychedelics in America is not new. What distinguishes the latest round of advocacy, however, is its backing by a holy trinity of supporters: some scientists, politicians and clergy.

Several religious groups have historically used psychedelics for sacred healing. Some clergy who have been exposed to these medicines in the past few years are advocating their use for gaining mystical insights.

What does the science say?

There are several kinds of psychedelics. Classic psychedelics include compounds such as lysergic acid diethylamide, or LSD; psilocybin – the active component in “magic mushrooms”; and mescaline, which is derived from peyote and San Pedro cacti. Another psychedelic is N,N-dimethyltryptamine, or DMT, found in ayahuasca and other plants.

Beyond the “classic” category, other psychoactive compounds sometimes grouped with psychedelics include substances such as MDMA, a class of psychoactive drugs that can induce feelings of love, empathy and connectedness with others. A 2021 study on MDMA showed a 67% reduction of PTSD symptoms after three sessions of MDMA therapy. While the study had a limited sample size of 104, it marked a turning point in how the psychologists understood MDMA as a potential healing modality.

Dissociative agents such as ketamine, which can produce altered states of consciousness, are also included as a category of their own. Traditionally used as a medical anesthetic, ketamine has more recently gained attention for mental health treatment, particularly for its antidepressant effects.

Several people wearing headdresses and long robes appear to be blessing others, while some are kneeling before them.
A ceremony in Cameroon in which a spiritual leader is giving iboga to initiates.
Jorge Fernández/LightRocket via Getty Images

Derived from the iboga plant native to West Africa, ibogaine induces powerful visions and dreams. It has a long history of being used by traditional healers in villages throughout Africa to treat mental health issues, such as anxiety and depression. A 2022 National Institutes of Health review of 24 studies showed that ibogaine significantly reduced depression, PTSD and opioid addiction in at least two-thirds of the 743 study participants. This mirrors the scientific evidence provided in the 2024 Stanford brain study, which showed an 88% decrease in PTSD symptoms following use of ibogaine in 30 military veterans.

Clergy and psychedelics

Several mental health practitioners and scientists have been staunch advocates of psychedelic-assisted therapy based on this research. What is somewhat new, however, is the addition of a handful of high-profile clergy to the list of supporters.

A recent study published by New York University and Johns Hopkins University highlights a number of religious practitioners, ranging from Episcopal ministers to Catholic priests, rabbis and Zen monks: 24 of the 29 participants made the case that psychedelics can lead to profound spiritual experiences.

A May 2025 article in The New Yorker noted that several of the clergy who participated in the NYU/Johns Hopkins study went on to become vocal advocates of psychedelics as spiritual medicine. While the sample size was small and heavily composed of Christian religious leaders, the findings are noteworthy. Some 96% of study participants described the use of psychedelics as one of the top five “most spiritually significant experiences of their lives.”

An NIH study conducted in 2019 focused on spiritual encounters experienced through DMT, or N,N-dimethyltryptamine. The study revealed that 75% of the 42 participants reported an “intense mystical encounter” and believed that it brought them closer to the divine. They narrated the experience as one in which they saw flashes of white light, heard angelic sounds, felt tingling in their bodies and had an overall sensation of God’s love.

A ‘chairlift to God’

Leaders and members of churches that use psychedelics as “sacrament” describe the role of these substances as facilitating a deeper connection with the divine. The psychedelics are offered at the beginning of weekly services by the religious leader, and then the congregants move into singing, chanting or prayer. Several leaders of such churches whom I have interviewed have described the role of the psychedelics as facilitating a deeper focus on God for longer periods of time.

The Native American Church, which is considered the largest Indigenous church in America and is located throughout the Southwest, has been legally using peyote, a hallucinogen, for services since the 1990s.

The 1994 American Indian Religious Freedom Act allows Native American churches to use and transport peyote, even though it is a Schedule 1 substance, meaning that its use is technically illegal outside of special circumstances as provided by exemptions to the law. Congregants in the church note that they have been using natural plants like peyote for as long as they can remember – even before it was officially legal.

Two men, holding feathers and a small attached pot, praying with their eyes closed.
Leonard Crow Dog, a Lakota Sioux medicine man and spiritual leader, participates in a peyote ceremony on the Rosebud Reservation in South Dakota in 1968.
MPI/Getty Images

More recently there have been a series of churches opening up across the U.S. that use ayahuasca as their sacrament.

In May 2025, the Gaia Church in Spokane, Washington, became one of the first churches in America to receive the Drug Enforcement Administration exemption for the use of ayahuasca in religious ceremonies. The DEA exemption makes the use of the substances completely legal for all members of the church as long as it is taken as a sacrament and provided by the spiritual leaders.

One shaman who runs an ayahuasca-focused church in Hawaii whom I interviewed last year described psychedelics as a “chairlift to God” because of the numbers of people in his congregation who report seeing, feeling, glimpsing or sensing God after drinking ayahuasca.

“There is no doubt that psychedelics can induce profound spiritual experiences,” one priest who has become a psilocybin advocate told me. “If this is what can bring people back together and back to the church, then harmonizing the ways of the ancients with plant medicines, modern technologies and religion might be the way to heal societal ills.”

Proceeding with caution

Although most classic psychedelics are considered safe and nonaddictive, they also carry some risks. Psychedelic use can induce acute anxiety, cause panic attacks or lead to paranoia. In rare cases, they could lead to psychotic breakdowns and suicidal thoughts, particularly among individuals with a personal or family history of schizophrenia or other severe mental illnesses.

Psychedelics can also temporarily impair judgment and coordination, which may increase the risk of accidents or unsafe behaviors if taken in recreational settings. Risks can also be amplified by uncertain dosage, adulterated substances and the absence of certified and trained facilitators.

Most mental health practitioners and advocates of these medicines suggest that they be taken under the care of medical or spiritual professionals who have trained in administering and facilitating preparation and aftercare for psychedelic use.

Shamans and Indigenous practitioners have long regarded these substances as sacred medicines and used them for healing. Modern-day science is confirming some of their benefits in supporting future treatments of trauma and addiction. Moreover, the mystical experiences that these medicines offer as pathways to connect people to the divine are profound.

The Conversation

Pardis Mahdavi does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. Why religious groups are pushing for psychedelics as sacrament – https://theconversation.com/why-religious-groups-are-pushing-for-psychedelics-as-sacrament-259364