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What the research has found is that the brains of trans people are unique: neither female nor male, exactly, but something distinct.

But what does that mean, a male brain, or a female brain, or even a transgender one?

It’s a fraught topic, because brains are a collection of characteristics, rather than a binary classification of either/or

yet scientists continue to study the brain in hopes of understanding whether a sense of the gendered self can, at least in part, be the result of neurology

Well, not entirely. Because not every person with a Y chromosome is male, and not every person with a double X is female. The world is full of people with other combinations: XXY (or Klinefelter Syndrome), XXX (or Trisomy X), XXXY, and so on. There’s even something called Androgen Insensitivity Syndrome, a condition that keeps the brains of people with a Y from absorbing the information in that chromosome. Most of these people develop as female, and may not even know about their condition until puberty — or even later.

t there’s a problem with using neurology as an argument for trans acceptance — it suggests that, on some level, there is something wrong with transgender people, that we are who we are as a result of a sickness or a biological hiccup.

trying to open people’s hearts by saying “Check out my brain!” can do more harm than good, because this line of argument delegitimizes the experiences of many trans folks. It suggests that there’s only one way to be trans — to feel trapped in the wrong body, to go through transition, and to wind up, when all is said and done, on the opposite-gender pole. It suggests that the quest trans people go on can only be considered successful if it ends with fitting into the very society that rejected us in the first place.

All the science tells us, in the end, is that a biological male — or female — is not any one thing, but a collection of possibilities.

No one who embarks upon a life as a trans person in this country is doing so out of caprice, or a whim, or a delusion. We are living these wondrous and perilous lives for one reason only — because our hearts demand it.

what we need now is not new legislation to make things harder. What we need now is understanding, not cruelty. What we need now is not hatred, but love.

the important thing is not that they feel like a woman, or a man, or something else. What matters most is the plaintive desire, to be free to feel the way I feel.

we lack practical knowledge about how to give one another the attention we crave

Some days it seems like we have intentionally built a society that gives people little guidance on how to perform the most important activities of life.

If I can shine positive attention on others, I can help them to blossom. If I see potential in others, they may come to see potential in themselves. True understanding is one of the most generous gifts any of us can give to another.

I see the results, too, in the epidemic of invisibility I encounter as a journalist. I often find myself interviewing people who tell me they feel unseen and disrespected

I’ve been working on a book called “How to Know a Person: The Art of Seeing Others Deeply and Being Deeply Seen.” I wanted it to be a practical book — so that I would learn these skills myself, and also, I hope, teach people how to understand others, how to make them feel respected, valued and understood.

I wanted to learn these skills for utilitarian reasons

If I’m going to work with someone, I don’t just want to see his superficial technical abilities. I want to understand him more deeply — to know whether he is calm in a crisis, comfortable with uncertainty or generous to colleagues.

I wanted to learn these skills for moral reasons

Many of the most productive researchers were in the habit of having breakfast or lunch with an electrical engineer named Harry Nyquist. Nyquist really listened to their challenges, got inside their heads, brought out the best in them. Nyquist, too, was an illuminator.

Finally, I wanted to learn these skills for reasons of national survival

We evolved to live with small bands of people like ourselves. Now we live in wonderfully diverse societies, but our social skills are inadequate for the divisions that exist. We live in a brutalizing time.

In any collection of humans, there are diminishers and there are illuminators. Diminishers are so into themselves, they make others feel insignificant

They stereotype and label. If they learn one thing about you, they proceed to make a series of assumptions about who you must be.

Illuminators, on the other hand, have a persistent curiosity about other people.

hey have been trained or have trained themselves in the craft of understanding others. They know how to ask the right questions at the right times — so that they can see things, at least a bit, from another’s point of view. They shine the brightness of their care on people and make them feel bigger, respected, lit up.

A biographer of the novelist E.M. Forster wrote, “To speak with him was to be seduced by an inverse charisma, a sense of being listened to with such intensity that you had to be your most honest, sharpest, and best self.” Imagine how good it would be to offer people that kind of hospitality.

social clumsiness I encounter too frequently. I’ll be leaving a party or some gathering and I’ll realize: That whole time, nobody asked me a single question. I estimate that only 30 percent of the people in the world are good question askers. The rest are nice people, but they just don’t ask. I think it’s because they haven’t been taught to and so don’t display basic curiosity about others.

Many years ago, patent lawyers at Bell Labs were trying to figure out why some employees were much more productive than others.

Illuminators are a joy to be around

The gift of attention.

Each of us has a characteristic way of showing up in the world. A person who radiates warmth will bring out the glowing sides of the people he meets, while a person who conveys formality can meet the same people and find them stiff and detached. “Attention,” the psychiatrist Iain McGilchrist writes, “is a moral act: It creates, brings aspects of things into being.”

When Jimmy sees a person — any person — he is seeing a creature with infinite value and dignity, made in the image of God. He is seeing someone so important that Jesus was willing to die for that person.

Accompaniment.

Accompaniment is an other-centered way of being with people during the normal routines of life.

If we are going to accompany someone well, we need to abandon the efficiency mind-set. We need to take our time and simply delight in another person’s way of being

I know a couple who treasure friends who are what they call “lingerable.” These are the sorts of people who are just great company, who turn conversation into a form of play and encourage you to be yourself. It’s a great talent, to be lingerable.

Other times, a good accompanist does nothing more than practice the art of presence, just being there.

The art of conversation.

If you tell me something important and then I paraphrase it back to you, what psychologists call “looping,” we can correct any misimpressions that may exist between us.

Be a loud listener. When another person is talking, you want to be listening so actively you’re burning calories.

He’s continually responding to my comments with encouraging affirmations, with “amen,” “aha” and “yes!” I love talking to that guy.

I no longer ask people: What do you think about that? Instead, I ask: How did you come to believe that? That gets them talking about the people and experiences that shaped their values.

Storify whenever possible

People are much more revealing and personal when they are telling stories.

Do the looping, especially with adolescents

If you want to know how the people around you see the world, you have to ask them. Here are a few tips I’ve collected from experts on how to become a better conversationalist:

Turn your partner into a narrator

People don’t go into enough detail when they tell you a story. If you ask specific follow-up questions — Was your boss screaming or irritated when she said that to you? What was her tone of voice? — then they will revisit the moment in a more concrete way and tell a richer story

If somebody tells you he is having trouble with his teenager, don’t turn around and say: “I know exactly what you mean. I’m having incredible problems with my own Susan.” You may think you’re trying to build a shared connection, but what you are really doing is shifting attention back to yourself.

Don’t be a topper

Big questions.

The quality of your conversations will depend on the quality of your questions

As adults, we get more inhibited with our questions, if we even ask them at all. I’ve learned we’re generally too cautious. People are dying to tell you their stories. Very often, no one has ever asked about them.

So when I first meet people, I tend to ask them where they grew up. People are at their best when talking about their childhoods. Or I ask where they got their names. That gets them talking about their families and ethnic backgrounds.

After you’ve established trust with a person, it’s great to ask 30,000-foot questions, ones that lift people out of their daily vantage points and help them see themselves from above.

These are questions like: What crossroads are you at? Most people are in the middle of some life transition; this question encourages them to step back and describe theirs

I’ve learned it’s best to resist this temptation. My first job in any conversation across difference or inequality is to stand in other people’s standpoint and fully understand how the world looks to them. I’ve found it’s best to ask other people three separate times and in three different ways about what they have just said. “I want to understand as much as possible. What am I missing here?”

Can you be yourself where you are and still fit in? And: What would you do if you weren’t afraid? Or: If you died today, what would you regret not doing?

“What have you said yes to that you no longer really believe in?

“What is the no, or refusal, you keep postponing?”

“What is the gift you currently hold in exile?,” meaning, what talent are you not using

“Why you?” Why was it you who started that business? Why was it you who ran for school board? She wants to understand why a person felt the call of responsibility. She wants to understand motivation.

“How do your ancestors show up in your life?” But it led to a great conversation in which each of us talked about how we’d been formed by our family heritages and cultures. I’ve come to think of questioning as a moral practice. When you’re asking good questions, you’re adopting a posture of humility, and you’re honoring the other person.

Stand in their standpoint

I used to feel the temptation to get defensive, to say: “You don’t know everything I’m dealing with. You don’t know that I’m one of the good guys here.”

If the next five years is a chapter in your life, what is the chapter about?

every conversation takes place on two levels

The official conversation is represented by the words we are saying on whatever topic we are talking about. The actual conversations occur amid the ebb and flow of emotions that get transmitted as we talk. With every comment I am showing you respect or disrespect, making you feel a little safer or a little more threatened.

If we let fear and a sense of threat build our conversation, then very quickly our motivations will deteriorate

If, on the other hand, I show persistent curiosity about your viewpoint, I show respect. And as the authors of “Crucial Conversations” observe, in any conversation, respect is like air. When it’s present nobody notices it, and when it’s absent it’s all anybody can think about.

the novelist and philosopher Iris Murdoch argued that the essential moral skill is being considerate to others in the complex circumstances of everyday life. Morality is about how we interact with each other minute by minute.

I used to think the wise person was a lofty sage who doled out life-altering advice in the manner of Yoda or Dumbledore or Solomon. But now I think the wise person’s essential gift is tender receptivity.

The illuminators offer the privilege of witness. They take the anecdotes, rationalizations and episodes we tell and see us in a noble struggle. They see the way we’re navigating the dialectics of life — intimacy versus independence, control versus freedom — and understand that our current selves are just where we are right now on our long continuum of growth.

The really good confidants — the people we go to when we are troubled — are more like coaches than philosopher kings.

They take in your story, accept it, but prod you to clarify what it is you really want, or to name the baggage you left out of your clean tale.

They’re not here to fix you; they are here simply to help you edit your story so that it’s more honest and accurate. They’re here to call you by name, as beloved

They see who you are becoming before you do and provide you with a reputation you can then go live into.

there has been a comprehensive shift in my posture. I think I’m more approachable, vulnerable. I know more about human psychology than I used to. I have a long way to go, but I’m evidence that people can change, sometimes dramatically, even in middle and older age.

the stage was set for the major transformation, which began in 2009: the intensification of viral dynamics.

Before 2009, Facebook had given users a simple timeline––a never-ending stream of content generated by their friends and connections, with the newest posts at the top and the oldest ones at the bottom

That began to change in 2009, when Facebook offered users a way to publicly “like” posts with the click of a button. That same year, Twitter introduced something even more powerful: the “Retweet” button, which allowed users to publicly endorse a post while also sharing it with all of their followers.

“Like” and “Share” buttons quickly became standard features of most other platforms.

Facebook developed algorithms to bring each user the content most likely to generate a “like” or some other interaction, eventually including the “share” as well.

Later research showed that posts that trigger emotions––especially anger at out-groups––are the most likely to be shared.

By 2013, social media had become a new game, with dynamics unlike those in 2008. If you were skillful or lucky, you might create a post that would “go viral” and make you “internet famous”

If you blundered, you could find yourself buried in hateful comments. Your posts rode to fame or ignominy based on the clicks of thousands of strangers, and you in turn contributed thousands of clicks to the game.

This new game encouraged dishonesty and mob dynamics: Users were guided not just by their true preferences but by their past experiences of reward and punishment,

As a social psychologist who studies emotion, morality, and politics, I saw this happening too. The newly tweaked platforms were almost perfectly designed to bring out our most moralistic and least reflective selves. The volume of outrage was shocking.

It was just this kind of twitchy and explosive spread of anger that James Madison had tried to protect us from as he was drafting the U.S. Constitution.

The Framers of the Constitution were excellent social psychologists. They knew that democracy had an Achilles’ heel because it depended on the collective judgment of the people, and democratic communities are subject to “the turbulency and weakness of unruly passions.”

The key to designing a sustainable republic, therefore, was to build in mechanisms to slow things down, cool passions, require compromise, and give leaders some insulation from the mania of the moment while still holding them accountable to the people periodically, on Election Day.

The tech companies that enhanced virality from 2009 to 2012 brought us deep into Madison’s nightmare.

a less quoted yet equally important insight, about democracy’s vulnerability to triviality.

Madison notes that people are so prone to factionalism that “where no substantial occasion presents itself, the most frivolous and fanciful distinctions have been sufficient to kindle their unfriendly passions and excite their most violent conflicts.”

Social media has both magnified and weaponized the frivolous.

It’s not just the waste of time and scarce attention that matters; it’s the continual chipping-away of trust.

a democracy depends on widely internalized acceptance of the legitimacy of rules, norms, and institutions.

when citizens lose trust in elected leaders, health authorities, the courts, the police, universities, and the integrity of elections, then every decision becomes contested; every election becomes a life-and-death struggle to save the country from the other side

The most recent Edelman Trust Barometer (an international measure of citizens’ trust in government, business, media, and nongovernmental organizations) showed stable and competent autocracies (China and the United Arab Emirates) at the top of the list, while contentious democracies such as the United States, the United Kingdom, Spain, and South Korea scored near the bottom (albeit above Russia).

The literature is complex—some studies show benefits, particularly in less developed democracies—but the review found that, on balance, social media amplifies political polarization; foments populism, especially right-wing populism; and is associated with the spread of misinformation.

When people lose trust in institutions, they lose trust in the stories told by those institutions. That’s particularly true of the institutions entrusted with the education of children.

Facebook and Twitter make it possible for parents to become outraged every day over a new snippet from their children’s history lessons––and math lessons and literature selections, and any new pedagogical shifts anywhere in the country

The motives of teachers and administrators come into question, and overreaching laws or curricular reforms sometimes follow, dumbing down education and reducing trust in it further.

young people educated in the post-Babel era are less likely to arrive at a coherent story of who we are as a people, and less likely to share any such story with those who attended different schools or who were educated in a different decade.

former CIA analyst Martin Gurri predicted these fracturing effects in his 2014 book, The Revolt of the Public. Gurri’s analysis focused on the authority-subverting effects of information’s exponential growth, beginning with the internet in the 1990s. Writing nearly a decade ago, Gurri could already see the power of social media as a universal solvent, breaking down bonds and weakening institutions everywhere it reached.

he notes a constructive feature of the pre-digital era: a single “mass audience,” all consuming the same content, as if they were all looking into the same gigantic mirror at the reflection of their own society. I

The digital revolution has shattered that mirror, and now the public inhabits those broken pieces of glass. So the public isn’t one thing; it’s highly fragmented, and it’s basically mutually hostile

Facebook, Twitter, YouTube, and a few other large platforms unwittingly dissolved the mortar of trust, belief in institutions, and shared stories that had held a large and diverse secular democracy together.

I think we can date the fall of the tower to the years between 2011 (Gurri’s focal year of “nihilistic” protests) and 2015, a year marked by the “great awokening” on the left and the ascendancy of Donald Trump on the right.

Twitter can overpower all the newspapers in the country, and stories cannot be shared (or at least trusted) across more than a few adjacent fragments—so truth cannot achieve widespread adherence.

fter Babel, nothing really means anything anymore––at least not in a way that is durable and on which people widely agree.

Politics After Babel

“Politics is the art of the possible,” the German statesman Otto von Bismarck said in 1867. In a post-Babel democracy, not much may be possible.

The ideological distance between the two parties began increasing faster in the 1990s. Fox News and the 1994 “Republican Revolution” converted the GOP into a more combative party.

So cross-party relationships were already strained before 2009. But the enhanced virality of social media thereafter made it more hazardous to be seen fraternizing with the enemy or even failing to attack the enemy with sufficient vigor.

What changed in the 2010s? Let’s revisit that Twitter engineer’s metaphor of handing a loaded gun to a 4-year-old. A mean tweet doesn’t kill anyone; it is an attempt to shame or punish someone publicly while broadcasting one’s own virtue, brilliance, or tribal loyalties. It’s more a dart than a bullet

from 2009 to 2012, Facebook and Twitter passed out roughly 1 billion dart guns globally. We’ve been shooting one another ever since.

“devoted conservatives,” comprised 6 percent of the U.S. population.

the warped “accountability” of social media has also brought injustice—and political dysfunction—in three ways.

First, the dart guns of social media give more power to trolls and provocateurs while silencing good citizens.

a small subset of people on social-media platforms are highly concerned with gaining status and are willing to use aggression to do so.

Across eight studies, Bor and Petersen found that being online did not make most people more aggressive or hostile; rather, it allowed a small number of aggressive people to attack a much larger set of victims. Even a small number of jerks were able to dominate discussion forums,

Additional research finds that women and Black people are harassed disproportionately, so the digital public square is less welcoming to their voices.

Second, the dart guns of social media give more power and voice to the political extremes while reducing the power and voice of the moderate majority.

The “Hidden Tribes” study, by the pro-democracy group More in Common, surveyed 8,000 Americans in 2017 and 2018 and identified seven groups that shared beliefs and behaviors.

Social media has given voice to some people who had little previously, and it has made it easier to hold powerful people accountable for their misdeeds

The group furthest to the left, the “progressive activists,” comprised 8 percent of the population. The progressive activists were by far the most prolific group on social media: 70 percent had shared political content over the previous year. The devoted conservatives followed, at 56 percent.

These two extreme groups are similar in surprising ways. They are the whitest and richest of the seven groups, which suggests that America is being torn apart by a battle between two subsets of the elite who are not representative of the broader society.

they are the two groups that show the greatest homogeneity in their moral and political attitudes.

likely a result of thought-policing on social media:

political extremists don’t just shoot darts at their enemies; they spend a lot of their ammunition targeting dissenters or nuanced thinkers on their own team.

Finally, by giving everyone a dart gun, social media deputizes everyone to administer justice with no due process. Platforms like Twitter devolve into the Wild West, with no accountability for vigilantes.

Enhanced-virality platforms thereby facilitate massive collective punishment for small or imagined offenses, with real-world consequences, including innocent people losing their jobs and being shamed into suicide

we don’t get justice and inclusion; we get a society that ignores context, proportionality, mercy, and truth.

Since the tower fell, debates of all kinds have grown more and more confused. The most pervasive obstacle to good thinking is confirmation bias, which refers to the human tendency to search only for evidence that confirms our preferred beliefs

search engines were supercharging confirmation bias, making it far easier for people to find evidence for absurd beliefs and conspiracy theorie

The most reliable cure for confirmation bias is interaction with people who don’t share your beliefs. They confront you with counterevidence and counterargument.

In his book The Constitution of Knowledge, Jonathan Rauch describes the historical breakthrough in which Western societies developed an “epistemic operating system”—that is, a set of institutions for generating knowledge from the interactions of biased and cognitively flawed individuals

English law developed the adversarial system so that biased advocates could present both sides of a case to an impartial jury.

Newspapers full of lies evolved into professional journalistic enterprises, with norms that required seeking out multiple sides of a story, followed by editorial review, followed by fact-checking.

Universities evolved from cloistered medieval institutions into research powerhouses, creating a structure in which scholars put forth evidence-backed claims with the knowledge that other scholars around the world would be motivated to gain prestige by finding contrary evidence.

Part of America’s greatness in the 20th century came from having developed the most capable, vibrant, and productive network of knowledge-producing institutions in all of human history

But this arrangement, Rauch notes, “is not self-maintaining; it relies on an array of sometimes delicate social settings and understandings, and those need to be understood, affirmed, and protected.”

This, I believe, is what happened to many of America’s key institutions in the mid-to-late 2010s. They got stupider en masse because social media instilled in their members a chronic fear of getting darted

it was so pervasive that it established new behavioral norms backed by new policies seemingly overnight

Participants in our key institutions began self-censoring to an unhealthy degree, holding back critiques of policies and ideas—even those presented in class by their students—that they believed to be ill-supported or wrong.

The stupefying process plays out differently on the right and the left because their activist wings subscribe to different narratives with different sacred values.

The “Hidden Tribes” study tells us that the “devoted conservatives” score highest on beliefs related to authoritarianism. They share a narrative in which America is eternally under threat from enemies outside and subversives within; they see life as a battle between patriots and traitors.

they are psychologically different from the larger group of “traditional conservatives” (19 percent of the population), who emphasize order, decorum, and slow rather than radical change.

The traditional punishment for treason is death, hence the battle cry on January 6: “Hang Mike Pence.”

Right-wing death threats, many delivered by anonymous accounts, are proving effective in cowing traditional conservatives

The wave of threats delivered to dissenting Republican members of Congress has similarly pushed many of the remaining moderates to quit or go silent, giving us a party ever more divorced from the conservative tradition, constitutional responsibility, and reality.

The stupidity on the right is most visible in the many conspiracy theories spreading across right-wing media and now into Congress.

The Democrats have also been hit hard by structural stupidity, though in a different way. In the Democratic Party, the struggle between the progressive wing and the more moderate factions is open and ongoing, and often the moderates win.

The problem is that the left controls the commanding heights of the culture: universities, news organizations, Hollywood, art museums, advertising, much of Silicon Valley, and the teachers’ unions and teaching colleges that shape K–12 education. And in many of those institutions, dissent has been stifled:

Liberals in the late 20th century shared a belief that the sociologist Christian Smith called the “liberal progress” narrative, in which America used to be horrifically unjust and repressive, but, thanks to the struggles of activists and heroes, has made (and continues to make) progress toward realizing the noble promise of its founding.

It is also the view of the “traditional liberals” in the “Hidden Tribes” study (11 percent of the population), who have strong humanitarian values, are older than average, and are largely the people leading America’s cultural and intellectual institutions.

when the newly viralized social-media platforms gave everyone a dart gun, it was younger progressive activists who did the most shooting, and they aimed a disproportionate number of their darts at these older liberal leaders.

Confused and fearful, the leaders rarely challenged the activists or their nonliberal narrative in which life at every institution is an eternal battle among identity groups over a zero-sum pie, and the people on top got there by oppressing the people on the bottom. This new narrative is rigidly egalitarian––focused on equality of outcomes, not of rights or opportunities. It is unconcerned with individual rights.

The universal charge against people who disagree with this narrative is not “traitor”; it is “racist,” “transphobe,” “Karen,” or some related scarlet letter marking the perpetrator as one who hates or harms a marginalized group.

The punishment that feels right for such crimes is not execution; it is public shaming and social death.

anyone on Twitter had already seen dozens of examples teaching the basic lesson: Don’t question your own side’s beliefs, policies, or actions. And when traditional liberals go silent, as so many did in the summer of 2020, the progressive activists’ more radical narrative takes over as the governing narrative of an organization.

This is why so many epistemic institutions seemed to “go woke” in rapid succession that year and the next, beginning with a wave of controversies and resignations at The New York Times and other newspapers, and continuing on to social-justice pronouncements by groups of doctors and medical associations

The problem is structural. Thanks to enhanced-virality social media, dissent is punished within many of our institutions, which means that bad ideas get elevated into official policy.

In a 2018 interview, Steve Bannon, the former adviser to Donald Trump, said that the way to deal with the media is “to flood the zone with shit.” He was describing the “firehose of falsehood” tactic pioneered by Russian disinformation programs to keep Americans confused, disoriented, and angry.

artificial intelligence is close to enabling the limitless spread of highly believable disinformation. The AI program GPT-3 is already so good that you can give it a topic and a tone and it will spit out as many essays as you like, typically with perfect grammar and a surprising level of coherence.

Renée DiResta, the research manager at the Stanford Internet Observatory, explained that spreading falsehoods—whether through text, images, or deep-fake videos—will quickly become inconceivably easy. (She co-wrote the essay with GPT-3.)

American factions won’t be the only ones using AI and social media to generate attack content; our adversaries will too.

In the 20th century, America’s shared identity as the country leading the fight to make the world safe for democracy was a strong force that helped keep the culture and the polity together.

In the 21st century, America’s tech companies have rewired the world and created products that now appear to be corrosive to democracy, obstacles to shared understanding, and destroyers of the modern tower.

What changes are needed?

I can suggest three categories of reforms––three goals that must be achieved if democracy is to remain viable in the post-Babel era.

We must harden democratic institutions so that they can withstand chronic anger and mistrust, reform social media so that it becomes less socially corrosive, and better prepare the next generation for democratic citizenship in this new age.

Harden Democratic Institutions

we must reform key institutions so that they can continue to function even if levels of anger, misinformation, and violence increase far above those we have today.

Reforms should reduce the outsize influence of angry extremists and make legislators more responsive to the average voter in their district.

One example of such a reform is to end closed party primaries, replacing them with a single, nonpartisan, open primary from which the top several candidates advance to a general election that also uses ranked-choice voting

A second way to harden democratic institutions is to reduce the power of either political party to game the system in its favor, for example by drawing its preferred electoral districts or selecting the officials who will supervise elections

These jobs should all be done in a nonpartisan way.

Reform Social Media

Social media’s empowerment of the far left, the far right, domestic trolls, and foreign agents is creating a system that looks less like democracy and more like rule by the most aggressive.

it is within our power to reduce social media’s ability to dissolve trust and foment structural stupidity. Reforms should limit the platforms’ amplification of the aggressive fringes while giving more voice to what More in Common calls “the exhausted majority.”

the main problem with social media is not that some people post fake or toxic stuff; it’s that fake and outrage-inducing content can now attain a level of reach and influence that was not possible before

Perhaps the biggest single change that would reduce the toxicity of existing platforms would be user verification as a precondition for gaining the algorithmic amplification that social media offers.

One of the first orders of business should be compelling the platforms to share their data and their algorithms with academic researchers.

Prepare the Next Generation

Childhood has become more tightly circumscribed in recent generations––with less opportunity for free, unstructured play; less unsupervised time outside; more time online. Whatever else the effects of these shifts, they have likely impeded the development of abilities needed for effective self-governance for many young adults

Depression makes people less likely to want to engage with new people, ideas, and experiences. Anxiety makes new things seem more threatening. As these conditions have risen and as the lessons on nuanced social behavior learned through free play have been delayed, tolerance for diverse viewpoints and the ability to work out disputes have diminished among many young people

Students did not just say that they disagreed with visiting speakers; some said that those lectures would be dangerous, emotionally devastating, a form of violence. Because rates of teen depression and anxiety have continued to rise into the 2020s, we should expect these views to continue in the generations to follow, and indeed to become more severe.

The most important change we can make to reduce the damaging effects of social media on children is to delay entry until they have passed through puberty.

The age should be raised to at least 16, and companies should be held responsible for enforcing it.

et them out to play. Stop starving children of the experiences they most need to become good citizens: free play in mixed-age groups of children with minimal adult supervision

while social media has eroded the art of association throughout society, it may be leaving its deepest and most enduring marks on adolescents. A surge in rates of anxiety, depression, and self-harm among American teens began suddenly in the early 2010s. (The same thing happened to Canadian and British teens, at the same time.) The cause is not known, but the timing points to social media as a substantial contributor—the surge began just as the large majority of American teens became daily users of the major platforms.

What would it be like to live in Babel in the days after its destruction? We know. It is a time of confusion and loss. But it is also a time to reflect, listen, and build.

In recent years, Americans have started hundreds of groups and organizations dedicated to building trust and friendship across the political divide, including BridgeUSA, Braver Angels (on whose board I serve), and many others listed at BridgeAlliance.us. We cannot expect Congress and the tech companies to save us. We must change ourselves and our communities.

when we look away from our dysfunctional federal government, disconnect from social media, and talk with our neighbors directly, things seem more hopeful. Most Americans in the More in Common report are members of the “exhausted majority,” which is tired of the fighting and is willing to listen to the other side and compromise. Most Americans now see that social media is having a negative impact on the country, and are becoming more aware of its damaging effects on children.

The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms. A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.

This concerned me, but didn’t feel I was in the position to sound some kind of alarm back then. There was a team of about eight of us, and only one other person brought up the kinds of questions I had. Anyone who raised doubts ran the risk of being called a transphobe. 

I certainly saw this at the center. One of my jobs was to do intake for new patients and their families. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school. 

There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are. 

The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.

To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription. 

When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable. Our patients were told about some side effects, including sterility. But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor.

Many encounters with patients emphasized to me how little these young people understood the profound impacts changing gender would have on their bodies and minds. But the center downplayed the negative consequences, and emphasized the need for transition. As the center’s website said, “Left untreated, gender dysphoria has any number of consequences, from self-harm to suicide. But when you take away the gender dysphoria by allowing a child to be who he or she is, we’re noticing that goes away. The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.” 

Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).

Here’s an example. On Friday, May 1, 2020, a colleague emailed me about a 15-year-old male patient: “Oh dear. I am concerned that [the patient] does not understand what Bicalutamide does.” I responded: “I don’t think that we start anything honestly right now.”

Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects, and this patient experienced one of them: liver toxicity. He was sent to another unit of the hospital for evaluation and immediately taken off the drug. Afterward, his mother sent an electronic message to the Transgender Center saying that we were lucky her family was not the type to sue.

How little patients understood what they were getting into was illustrated by a call we received at the center in 2020 from a 17-year-old biological female patient who was on testosterone. She said she was bleeding from the vagina. In less than an hour she had soaked through an extra heavy pad, her jeans, and a towel she had wrapped around her waist. The nurse at the center told her to go to the emergency room right away.

when there was a dispute between the parents, it seemed the center always took the side of the affirming parent.

Other girls were disturbed by the effects of testosterone on their clitoris, which enlarges and grows into what looks like a microphallus, or a tiny penis. I counseled one patient whose enlarged clitoris now extended below her vulva, and it chafed and rubbed painfully in her jeans. I advised her to get the kind of compression undergarments worn by biological men who dress to pass as female. At the end of the call I thought to myself, “Wow, we hurt this kid.”

There are rare conditions in which babies are born with atypical genitalia—cases that call for sophisticated care and compassion. But clinics like the one where I worked are creating a whole cohort of kids with atypical genitals—and most of these teens haven’t even had sex yet. They had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist.

Being put on powerful doses of testosterone or estrogen—enough to try to trick your body into mimicking the opposite sex—-affects the rest of the body. I doubt that any parent who's ever consented to give their kid testosterone (a lifelong treatment) knows that they’re also possibly signing their kid up for blood pressure medication, cholesterol medication, and perhaps sleep apnea and diabetes. 

Besides teenage girls, another new group was referred to us: young people from the inpatient psychiatric unit, or the emergency department, of St. Louis Children’s Hospital. The mental health of these kids was deeply concerning—there were diagnoses like schizophrenia, PTSD, bipolar disorder, and more. Often they were already on a fistful of pharmaceuticals.

no matter how much suffering or pain a child had endured, or how little treatment and love they had received, our doctors viewed gender transition—even with all the expense and hardship it entailed—as the solution.

Another disturbing aspect of the center was its lack of regard for the rights of parents—and the extent to which doctors saw themselves as more informed decision-makers over the fate of these children.

We found out later this girl had had intercourse, and because testosterone thins the vaginal tissues, her vaginal canal had ripped open. She had to be sedated and given surgery to repair the damage. She wasn’t the only vaginal laceration case we heard about.

During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility. 

I left the clinic in November of last year because I could no longer participate in what was happening there. By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to “do no harm.” Instead, we are permanently harming the vulnerable patients in our care.

Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.

Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling.

For almost four years, I worked at The Washington University School of Medicine Division of Infectious Diseases with teens and young adults who were HIV positive. Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a transman, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt. 

The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus. 

All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children's Hospital, which had been established a year earlier. 

Secondly as Stuart Ritchie points out in this excellent article, to date the evidence assembled by proponents of the social media theory like Jonathan Haidt and Jean Twenge, has shown correlations not causal relationships. Yes, it seems that young people who use social media a lot have worse mental health, but that could easily be because young people with worse mental health choose to use social media more!  

recently I’ve shifted to thinking it probably is a major cause for three reasons:

1.       I can’t think of anything else that fits. Other suggested causes just don’t work.

Social media does fit, the big increase in take up maps well on to the mental health data and it happened everywhere in rich countries at the same time. The most affected group, teenage girls, are also the ones who report that social media makes them more anxious and body conscious in focus groups

It is of course true that correlation doesn’t prove anything but if there’s only one strongly related correlation it’s pretty likely there’s a relationship.

2.       There is no doubt that young people are spending a huge amount of time online now. And that, therefore, must have replaced other activities that involve being out with friends in real life. Three quarters of 12 year olds now have a social media profile and 95% of teenagers use social media regularly. Over half who say they’ve been bullied, say it was on social media.

  We finally have the first evidence of a direct causal relationship via a very clever US study using the staged rollout of Facebook across US college campuses to assess the impact on mental health. Not only does it show that mental illness increased after the introduction of Facebook but it also shows that it was particularly pronounced amongst those who were more likely to view themselves unfavourably alongside their peers due to being e.g. overweight or having lower socio-economic status. It is just one study but it nudges me even further towards thinking this a major cause of the problem.

I have blocked my (12 year old) twins from all social media apps and will hold out as long as possible. The evidence isn’t yet rock solid but it’s solid enough to make me want to protect them as best I can.

New financial constraints on family formation are a potential cause, as implied by another striking finding in the Journal poll — 78 percent of adults lack confidence this generation of children will enjoy a better life than they do.

Yet a recent analysis for the Aspen Economic Strategy Group by Melissa S. Kearney and Phillip B. Levine, economics professors at the University of Maryland and Wellesley College, respectively, determined that “beyond the temporary effects of the Great Recession, no recent economic or policy change is responsible for a meaningful share of the decline in the US fertility rate since 2007.”

Their study took account of such factors as the high cost of child care, student debt service and housing as well as Medicaid coverage and the wider availability of long-acting reversible contraception. Yet they had “no success finding evidence” that any of these were decisive.

Kearney and Levine speculated instead that the answers lie in the cultural zeitgeist — “shifting priorities across cohorts of young adults,”

A possibility worth considering, they suggested, is that young adults who experienced “intensive parenting” as children now balk at the heavy investment of time and resources needed to raise their own kids that way: It would clash with their career and leisure goals.

another event that year: Apple released the first iPhone, a revolutionary cultural moment if there ever was one. The ensuing smartphone-enabled social media boom — Facebook had opened membership to anyone older than 13 in 2006 — forever changed how human beings relate with one another.

We are just beginning to understand this development’s effect on mental health, education, religious observance, community cohesion — everything. Why wouldn’t it also affect people’s willingness to have children?

one indirect way new media affect childbearing rates is through “time competition effects” — essentially, hours spent watching the tube cannot be spent forming romantic partnerships.

a 2021 review of survey data on young adults and adolescents in the United States and other countries, the years between 2009 and 2018 saw a marked decline in reported sexual activity.

the authors hypothesized that people are distracted from the search for partners by “increasing use of computer games and social media.

during the late 20th century, Brazil’s fertility rates fell after women who watched soap operas depicting smaller families sought to emulate them by having fewer children themselves.

This may be an area where incentives do not influence behavior, at least not enough. Whether the cultural shift to lower birthrates occurs on an accelerated basis, as in the United States after 2007, or gradually, as it did in Japan, it appears permanent — “sticky,” as policy wonks say.