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There are signs that at the same time, so many other people are seeking to countenance diversity of thought, disavowing the comforts of the idea that their view is the only legitimate one and fostering an ideal under which our society frames difference of opinion as a norm rather than a threat. We can see it in aspects of linguistic behavio

To us WEIRD-os, by contrast, the ever-stronger purchase of individualism in our intellectual, moral and civic development seems natural. But it’s challenging, perhaps unnatural, to be an individual.

That realization makes less shocking to me, albeit utterly dismaying, the many dogmatic behaviors exhibited today that seem outwardly irrational or close to it. The kinds of things that make it seem as if so many of us are, so to speak, losing it are actually signs of how difficult it can be to get past what we seem to be hard-wired for. Fanatic beliefs, furious ideologies and even, potentially, a sense of duty to harm people in the name of certain beliefs reflect the eternal temptation of a sense of belonging to a group, of being part of a larger story, of having a guiding sense of purpose.

Casual American English, in ways we’re not always conscious of, is more overt in allowing room for disagreement than it used to be. For example, the use of “like” that so bothers purists is in reality a useful discursive hedge, along with phrases such as “sort of,” “kind of” and “you know.” In conversation, these expressions can be read as subtle indications that someone knows that there are other ways to view things, and to be too categorical is to imply a certainty that all may not share.

Moral Courage College, an alternative to the D.E.I. ritual, a program offering training in how to productively grapple with the wide range of views and experiences found in most workplaces, as well as colleges, universities and even K-12 schools

a method called Diversity Without Division. “This program doesn’t tell anybody what to think or believe,” she has said, “it teaches everybody to lower their emotional defenses so that contentious issues can be turned into constructive conversations and healthy teamwork.”

Courage is allowing that your own view may be but one legitimate one among many, that there are no easy answers, and that being your own self is a more gracious existence than joining a herd.

For this crew, the early success of their past companies or careers is usually prologue, and their skills will, of course, transfer to any area they choose to conquer (including magically solving free speech). But what they are actually doing is winging it.

There is a tendency, especially when it comes to the über-rich and powerful, to assume and to fantasize about what we can’t see. We ascribe shadowy brilliance or malevolence, which may very well be unearned or misguided.

What’s striking about the Musk messages, then, is the similarity between these men’s behavior behind closed doors and in public on Twitter. Perhaps the real revelation here is that the shallowness you see is the shallowness you get.

In 1972, using duct tape and spare parts in the basement on the campus of the University of California, Berkeley, Dr. Clauser and a graduate student, Stuart Freedman, who died in 2012, endeavored to perform Bell’s experiment to measure quantum entanglement. In a series of experiments, he fired thousands of light particles, or photons, in opposite directions to measure a property known as polarization, which could have only two values — up or down. The result for each detector was always a series of seemingly random ups and downs. But when the two detectors’ results were compared, the ups and downs matched in ways that neither “classical physics” nor Einstein’s laws could explain. Something weird was afoot in the universe. Entanglement seemed to be real.

in 2002, Dr. Clauser admitted that he himself had expected quantum mechanics to be wrong and Einstein to be right. “Obviously, we got the ‘wrong’ result. I had no choice but to report what we saw, you know, ‘Here’s the result.’ But it contradicts what I believed in my gut has to be true.” He added, “I hoped we would overthrow quantum mechanics. Everyone else thought, ‘John, you’re totally nuts.’”

the correlations only showed up after the measurements of the individual particles, when the physicists compared their results after the fact. Entanglement seemed real, but it could not be used to communicate information faster than the speed of light.

In 1982, Dr. Aspect and his team at the University of Paris tried to outfox Dr. Clauser’s loophole by switching the direction along which the photons’ polarizations were measured every 10 nanoseconds, while the photons were already in the air and too fast for them to communicate with each other. He too, was expecting Einstein to be right.

Quantum predictions held true, but there were still more possible loopholes in the Bell experiment that Dr. Clauser had identified

For example, the polarization directions in Dr. Aspect’s experiment had been changed in a regular and thus theoretically predictable fashion that could be sensed by the photons or detectors.

Anton Zeilinger

added even more randomness to the Bell experiment, using random number generators to change the direction of the polarization measurements while the entangled particles were in flight.

Once again, quantum mechanics beat Einstein by an overwhelming margin, closing the “locality” loophole.

as scientists have done more experiments with entangled particles, entanglement is accepted as one of main features of quantum mechanics and is being put to work in cryptology, quantum computing and an upcoming “quantum internet

One of its first successes in cryptology is messages sent using entangled pairs, which can send cryptographic keys in a secure manner — any eavesdropping will destroy the entanglement, alerting the receiver that something is wrong.

, with quantum mechanics, just because we can use it, doesn’t mean our ape brains understand it. The pioneering quantum physicist Niels Bohr once said that anyone who didn’t think quantum mechanics was outrageous hadn’t understood what was being said.

In his interview with A.I.P., Dr. Clauser said, “I confess even to this day that I still don’t understand quantum mechanics, and I’m not even sure I really know how to use it all that well. And a lot of this has to do with the fact that I still don’t understand it.”

we’re networked organisms who move around in shifting surroundings, environments that have the power to transform our thinking

Annie Murphy Paul’s new book, “The Extended Mind,” which exhorts us to use our entire bodies, our surroundings and our relationships to “think outside the brain.”

In 2011, she published “Origins,” which focused on all the ways we are shaped by the environment, before birth and minute to minute thereafter.

“In the nature-nurture dynamic, nurture begins at the time of conception. The food the mother eats, the air she breathes, the water she drinks, the stress or trauma she experiences — all may affect her child for better or worse, over the decades to come.”

a down-to-earth take on the science of epigenetics — how environmental signals become catalysts for gene expression

the parallel to this latest book is that the boundaries we commonly assume to be fixed are actually squishy. The moment of a child’s birth, her I.Q. scores or fMRI snapshots of what’s going on inside her brain — all are encroached upon and influenced by outside forces.

awareness of our internal signals, such as exactly when our hearts beat, or how cold and clammy our hands are, can boost our performance at the poker table or in the financial markets, and even improve our pillow talk

“Though we typically think of the brain as telling the body what to do, just as much does the body guide the brain with an array of subtle nudges and prods. One psychologist has called this guide our ‘somatic rudder,’

The “body scan” aspect of mindfulness meditation that has been deployed by the behavioral medicine pioneer Jon Kabat-Zinn may help people lower their heart rates and blood pressure,

techniques that help us pinpoint their signals can foster well-being

Tania Singer has shown how the neural circuitry underlying compassion is strengthened by meditation practice

our thoughts “are powerfully shaped by the way we move our bodies.” Gestures help us understand spatial concepts; indeed, “without gesture as an aid, students may fail to understand spatial ideas at all,”

looking out on grassy expanses near loose clumps of trees and a source of water helps us solve problems. “Passive attention,” she writes, is “effortless: diffuse and unfocused, it floats from object to object, topic to topic. This is the kind of attention evoked by nature, with its murmuring sounds and fluid motions; psychologists working in the tradition of James call this state of mind ‘soft fascination.’”

The chapters on the ways natural and built spaces reflect universal preferences and enhance the thinking process felt like a respite

a watchdog group, claimed that a candidate named Kevin had a ten to thirty per cent lower chance of being hired for a job than a competitor named Arthur.

Kevins also have a hard time in such countries as Germany, where the practice of name discrimination is referred to as “Kevinismus,” and an app that purports to help parents avoid it is called the Kevinometer.

Confirmation bias shows up most blatantly in our current political divide, where each side seems unable to allow that the other side is right about anything.

The whole idea of cognitive biases and faulty heuristics—the shortcuts and rules of thumb by which we make judgments and predictions—was more or less invented in the 1970s by Amos Tversky and Daniel Kahneman

versky died in 1996. Kahneman won the 2002 Nobel Prize in Economics for the work the two men did together, which he summarized in his 2011 best seller, Thinking, Fast and Slow. Another best seller, last year’s The Undoing Project, by Michael Lewis, tells the story of the sometimes contentious collaboration between Tversky and Kahneman

Another key figure in the field is the University of Chicago economist Richard Thaler. One of the biases he’s most linked with is the endowment effect, which leads us to place an irrationally high value on our possessions.

In an experiment conducted by Thaler, Kahneman, and Jack L. Knetsch, half the participants were given a mug and then asked how much they would sell it for. The average answer was $5.78. The rest of the group said they would spend, on average, $2.21 for the same mug. This flew in the face of classic economic theory, which says that at a given time and among a certain population, an item has a market value that does not depend on whether one owns it or not. Thaler won the 2017 Nobel Prize in Economics.

“The question that is most often asked about cognitive illusions is whether they can be overcome. The message … is not encouraging.”

that’s not so easy in the real world, when we’re dealing with people and situations rather than lines. “Unfortunately, this sensible procedure is least likely to be applied when it is needed most,” Kahneman writes. “We would all like to have a warning bell that rings loudly whenever we are about to make a serious error, but no such bell is available.”

At least with the optical illusion, our slow-thinking, analytic mind—what Kahneman calls System 2—will recognize a Müller-Lyer situation and convince itself not to trust the fast-twitch System 1’s perception

Kahneman and others draw an analogy based on an understanding of the Müller-Lyer illusion, two parallel lines with arrows at each end. One line’s arrows point in; the other line’s arrows point out. Because of the direction of the arrows, the latter line appears shorter than the former, but in fact the two lines are the same length.

Because biases appear to be so hardwired and inalterable, most of the attention paid to countering them hasn’t dealt with the problematic thoughts, judgments, or predictions themselves

Is it really impossible, however, to shed or significantly mitigate one’s biases? Some studies have tentatively answered that question in the affirmative.

what if the person undergoing the de-biasing strategies was highly motivated and self-selected? In other words, what if it was me?

Over an apple pastry and tea with milk, he told me, “Temperament has a lot to do with my position. You won’t find anyone more pessimistic than I am.”

I met with Kahneman

“I see the picture as unequal lines,” he said. “The goal is not to trust what I think I see. To understand that I shouldn’t believe my lying eyes.” That’s doable with the optical illusion, he said, but extremely difficult with real-world cognitive biases.

In this context, his pessimism relates, first, to the impossibility of effecting any changes to System 1—the quick-thinking part of our brain and the one that makes mistaken judgments tantamount to the Müller-Lyer line illusion

he most effective check against them, as Kahneman says, is from the outside: Others can perceive our errors more readily than we can.

“slow-thinking organizations,” as he puts it, can institute policies that include the monitoring of individual decisions and predictions. They can also require procedures such as checklists and “premortems,”

A premortem attempts to counter optimism bias by requiring team members to imagine that a project has gone very, very badly and write a sentence or two describing how that happened. Conducting this exercise, it turns out, helps people think ahead.

“My position is that none of these things have any effect on System 1,” Kahneman said. “You can’t improve intuition.

Perhaps, with very long-term training, lots of talk, and exposure to behavioral economics, what you can do is cue reasoning, so you can engage System 2 to follow rules. Unfortunately, the world doesn’t provide cues. And for most people, in the heat of argument the rules go out the window.

Kahneman describes an even earlier Nisbett article that showed subjects’ disinclination to believe statistical and other general evidence, basing their judgments instead on individual examples and vivid anecdotes. (This bias is known as base-rate neglect.)

over the years, Nisbett had come to emphasize in his research and thinking the possibility of training people to overcome or avoid a number of pitfalls, including base-rate neglect, fundamental attribution error, and the sunk-cost fallacy.

Nisbett’s second-favorite example is that economists, who have absorbed the lessons of the sunk-cost fallacy, routinely walk out of bad movies and leave bad restaurant meals uneaten.

When Nisbett asks the same question of students who have completed the statistics course, about 70 percent give the right answer. He believes this result shows, pace Kahneman, that the law of large numbers can be absorbed into System 2—and maybe into System 1 as well, even when there are minimal cues.

about half give the right answer: the law of large numbers, which holds that outlier results are much more frequent when the sample size (at bats, in this case) is small. Over the course of the season, as the number of at bats increases, regression to the mean is inevitabl

When Nisbett has to give an example of his approach, he usually brings up the baseball-phenom survey. This involved telephoning University of Michigan students on the pretense of conducting a poll about sports, and asking them why there are always several Major League batters with .450 batting averages early in a season, yet no player has ever finished a season with an average that high.

we’ve tested Michigan students over four years, and they show a huge increase in ability to solve problems. Graduate students in psychology also show a huge gain.”

, “I know from my own research on teaching people how to reason statistically that just a few examples in two or three domains are sufficient to improve people’s reasoning for an indefinitely large number of events.”

isbett suggested another factor: “You and Amos specialized in hard problems for which you were drawn to the wrong answer. I began to study easy problems, which you guys would never get wrong but untutored people routinely do … Then you can look at the effects of instruction on such easy problems, which turn out to be huge.”

Nisbett suggested that I take “Mindware: Critical Thinking for the Information Age,” an online Coursera course in which he goes over what he considers the most effective de-biasing skills and concepts. Then, to see how much I had learned, I would take a survey he gives to Michigan undergraduates. So I did.

he course consists of eight lessons by Nisbett—who comes across on-screen as the authoritative but approachable psych professor we all would like to have had—interspersed with some graphics and quizzes. I recommend it. He explains the availability heuristic this way: “People are surprised that suicides outnumber homicides, and drownings outnumber deaths by fire. People always think crime is increasing” even if it’s not.

When I finished the course, Nisbett sent me the survey he and colleagues administer to Michigan undergrads

It contains a few dozen problems meant to measure the subjects’ resistance to cognitive biases

I got it right. Indeed, when I emailed my completed test, Nisbett replied, “My guess is that very few if any UM seniors did as well as you. I’m sure at least some psych students, at least after 2 years in school, did as well. But note that you came fairly close to a perfect score.”

Nevertheless, I did not feel that reading Mindware and taking the Coursera course had necessarily rid me of my biases

For his part, Nisbett insisted that the results were meaningful. “If you’re doing better in a testing context,” he told me, “you’ll jolly well be doing better in the real world.”

The New York–based NeuroLeadership Institute offers organizations and individuals a variety of training sessions, webinars, and conferences that promise, among other things, to use brain science to teach participants to counter bias. This year’s two-day summit will be held in New York next month; for $2,845, you could learn, for example, “why are our brains so bad at thinking about the future, and how do we do it better?”

Philip E. Tetlock, a professor at the University of Pennsylvania’s Wharton School, and his wife and research partner, Barbara Mellers, have for years been studying what they call “superforecasters”: people who manage to sidestep cognitive biases and predict future events with far more accuracy than the pundits

One of the most important ingredients is what Tetlock calls “the outside view.” The inside view is a product of fundamental attribution error, base-rate neglect, and other biases that are constantly cajoling us into resting our judgments and predictions on good or vivid stories instead of on data and statistics

In 2006, seeking to prevent another mistake of that magnitude, the U.S. government created the Intelligence Advanced Research Projects Activity (iarpa), an agency designed to use cutting-edge research and technology to improve intelligence-gathering and analysis. In 2011, iarpa initiated a program, Sirius, to fund the development of “serious” video games that could combat or mitigate what were deemed to be the six most damaging biases: confirmation bias, fundamental attribution error, the bias blind spot (the feeling that one is less biased than the average person), the anchoring effect, the representativeness heuristic, and projection bias (the assumption that everybody else’s thinking is the same as one’s own).

most promising are a handful of video games. Their genesis was in the Iraq War

Together with collaborators who included staff from Creative Technologies, a company specializing in games and other simulations, and Leidos, a defense, intelligence, and health research company that does a lot of government work, Morewedge devised Missing. Some subjects played the game, which takes about three hours to complete, while others watched a video about cognitive bias. All were tested on bias-mitigation skills before the training, immediately afterward, and then finally after eight to 12 weeks had passed.

“The literature on training suggests books and classes are fine entertainment but largely ineffectual. But the game has very large effects. It surprised everyone.”

he said he saw the results as supporting the research and insights of Richard Nisbett. “Nisbett’s work was largely written off by the field, the assumption being that training can’t reduce bias,

even the positive results reminded me of something Daniel Kahneman had told me. “Pencil-and-paper doesn’t convince me,” he said. “A test can be given even a couple of years later. But the test cues the test-taker. It reminds him what it’s all about.”

Morewedge told me that some tentative real-world scenarios along the lines of Missing have shown “promising results,” but that it’s too soon to talk about them.

In the future, I will monitor my thoughts and reactions as best I can

The answer is the 1 percent, obviously (or those willing to incur credit card debt). Luca Solca, an analyst for Bernstein, estimates that the top 5 percent of luxury clients now account for more than 40 percent of sales for most luxury goods brands

As wealth inequality increases globally, luxury brands are doubling down on an ever smaller slice of their clientele

VF There’s a sort of warring imperative here between people who see it as a badge of honor not to buy full price and those who belong to the very tiny club that can. Economics are involved, but as much as anything, it’s also psychology.

VF Which brings me back to Phoebe Philo’s current scarcity model: We don’t even know how much of any piece they produced (the company wouldn’t say) but the message is the market will bear the prices, since the products are sold out. We think because it is more expensive, it has more value.

GT This is the stuff for which Daniel Kahneman won the Nobel. Subjects shown two identical cashmere sweaters, one at a far higher price, inevitably chose the more costly of the two. His point was that we don’t think. We act irrationally.

EP Speaking of dollars, a quarter of a trillion them have been wiped off the value of Europe’s seven biggest luxury businesses since April, and sales are generally down across most fashion groups. That is the aspirational middle class stepping away from the credit card machine.

The aim of an argument should not be proving who is right, but conveying that you care about the issues,

Show the person with whom you are speaking that you care about what he or she says.

The goal should be to state your views and to hear theirs. It should not be: “I am not leaving until you admit that you are wrong, or here is what I believe, and I am not budging from this,”

And when you listen, go all in

“Don’t half-listen while figuring out what you’re going to say next,”

Don’t ‘drop the anchor’

Some people start an argument by staking their position and refusing to budge, an impulse that Dr. Cuddy called “dropping the anchor.”Instead, try to understand the other person’s point of view; it does not mean you have to agree with him or her, or that you are abandoning deeply felt objections to, for example, racism or sexism, she said.

Mind your body languageYour body language can send messages that are more compelling than the words coming out of your mouth.Try to avoid gestures that are patronizing or defensive, like crossing your arms or clenching your jaw.

Maintain eye contact in a way that is not a stare-down.Lean forward slightly to show you are interested.And no eye-rolling,

Don’t argue to winDr. Gutting says it helps to use neutral or charitable language when acknowledging opposing viewpoints, especially during arguments over politics. It lays the groundwork for a more effective argument on points of genuine weakness.

Don’t think of an argument as an opportunity to convince the other person of your view; think of it as a way to test and improve your opinions, and to gain a better understanding of the other side.

“People do give up views because of rational arguments against them,” Dr. Gutting said in the interview. “But this is almost always a long process, not the outcome of a single decisive encounter.”

Know the factsA good argument is supported by evidence, but that is just a starting point. Sometimes, especially with political back-and-forths, one side will look only at evidence supporting its own position, conveniently leaving out the full picture,

Speak and listen fearlessly

“So for me, the condition for a conversation has to be that you are unafraid to speak courageously, and you are unafraid to tell your partner exactly what it is that you think about the world.”But a two-way argument also requires fearless listening, “even if it is me talking to a white supremacist who is trying to tell me that I am inferior,” he added. “One of the conditions for the possibility of a fruitful argument is to allow for some kind of opening up in myself to hear.”

“What you need to be able to do is to speak the same language,” he said. “They believe in God, and you would say: ‘You and I believe the same thing. How is it that this God who loves you can’t possibly love me?’ Is it possible that we can agree to disagree on some issues?”

Studies have found that simply talking on the phone while walking actually slows down and disrupts our gait

When our brain is processing complex emotions and stressors, it hinders our ability to function at our best.

As I tell my students, remember to play your whole movie — not just the clip of your latest stumble on repeat

If a phone call is enough to disrupt our performance of basic tasks, we should be especially mindful of cognitive loads associated with grief, loss and general uncertainty about what is to come. All are major triggers for depression and anxiety, and profoundly affect our ability to perform even the most routine, practiced tasks.

holding tightly on to our latest failures is a common phenomenon, thanks to the recency effect — a cognitive bias that prioritizes our most recent experiences over past ones. This natural tendency sends our brain the wrong messages, and makes us forget how skilled, credentialed or qualified we really are

Adult depression and anxiety has climbed by 5.1 percent since the start of the pandemic.

Those things won’t matter nearly as much as their willingness to try again.

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. 

This pervasive claim that “I have my rights” but “I don’t have responsibilities” is unraveling our country today.

But societal immunity “is a function of trust,”

“When trust in institutions, leaders and each other is high, people — in a crisis — are more willing to sublimate their cherished rights and demonstrate their sense of shared responsibilities toward others, even others they disagree with on important issues and even if it means making sacrifices.”

When our trust in each other erodes, though, as is happening in America today, fewer people think they have responsibilities to the other — only rights that protect them from being told by the other what to do.

completely ignored the four most important statistical facts about Covid-19 today that highlight our responsibilities — to our fellow citizens and, even more so, to the nurses and doctors risking their lives to take care of us in a pandemic.

First, unvaccinated adults 18 years and older are 16 times more likely to be hospitalized for Covid than fully vaccinated adults

Second: Adults 65 and older who are not vaccinated are around 50 times more likely to be hospitalized for Covid than those who have received a full vaccine course and a booster.

Third: Unvaccinated people are 20 times more likely to die of Covid than people who are vaccinated and boosted.

the emotional toll and other work conditions brought on by the pandemic contributed to some two-thirds of nurses giving thought to leaving the profession.

many hospitals today are experiencing an unprecedented 20 percent annual turnover rate of nurses — more than double the historical baseline. The more nurses leave, the more those left behind have had to work overtime.

Especially when so many dying unvaccinated patients tell their nurses, “I wish I had gotten vaccinated,”

none of these statistics were mentioned during that podcast

“You can listen to the entire 186-minute lovefest between Rogan and Malone and have no idea that our hospitals are overloaded with Covid cases,” wrote Levy, “and that on the day their conversation transpired, 7,559 people worldwide died of Covid, 1,410 of which were in the United States. The vast majority of them were unvaccinated.”

“When Malone uncorks questionable allegations about disastrous vaccine effects and the global cabal of politicians and drugmakers pulling strings, Rogan responds with uh-huhs and wows.”

That was Rogan’s right. That was Spotify C.E.O. Daniel Ek’s right.

But who was looking out for the doctors and nurses on the pandemic front lines whose only ask is that the politicians and media influencers who are privileged enough to have public platforms — especially one like Rogan with an average of 11 million listeners per episode — use them to reinforce our responsibilities to one another, not just our rights.

He could start by offering his listeners a 186-minute episode with intensive care nurses and doctors about what this pandemic of the unvaccinated has done to them.

That would be a teaching moment, not only about Covid, but also about putting our responsibilities to one another — and especially to those who care for us — at least on a par with our right to be as dumb and selfish as we want to be.

Reaching hesitant families means withholding the kind of judgment that kept her ashamed, and understanding that people have legitimate concerns that need to be addressed.

Being consistent and visible within the community is important, Autar said. “It can’t be just a moment here and now type of thing – ‘When we have a surge, we’re going to come back out and galvanize all those resources.’ No, we still are in a pandemic. And we need to still remain visible within hesitant communities. And that’s hard work.”

He added: “Our approach has always been ‘we’re here to educate you about the vaccine, your options, your choices’, rather than take the approach of ‘you need to get this vaccine’.”

“They may not change their mind overnight, but by taking your time, you’re ensuring that they could change their minds,” Greene said. “But if it becomes this conflict and it’s a negative experience, you’re basically closing that door off completely.”

“There’s so much pressure for moms to do everything perfectly,” Greene said. Among middle-class mothers, for instance, there’s a message that “you can afford all these products to do better, and so you don’t need vaccines – vaccines are for poor people

hose promises have also fueled anxiety over how people will be able to compete for jobs outsourced to eerily refined machines or trust the accuracy of what they see online.

Officials with the San Francisco lab said GPT-4’s “multimodal” training across text and images would allow it to escape the chat box and more fully emulate a world of color and imagery, surpassing ChatGPT in its “advanced reasoning capabilities.”

A person could upload an image and GPT-4 could caption it for them, describing the objects and scene.

AI language models often confidently offer wrong answers because they are designed to spit out cogent phrases, not actual facts. And because they have been trained on internet text and imagery, they have also learned to emulate human biases of race, gender, religion and class.

GPT-4 still makes many of the errors of previous versions, including “hallucinating” nonsense, perpetuating social biases and offering bad advice. It also lacks knowledge of events that happened after about September 2021, when its training data was finalized, and “does not learn from its experience,” limiting people’s ability to teach it new things.

Microsoft has invested billions of dollars in OpenAI in the hope its technology will become a secret weapon for its workplace software, search engine and other online ambitions. It has marketed the technology as a super-efficient companion that can handle mindless work and free people for creative pursuits, helping one software developer to do the work of an entire team or allowing a mom-and-pop shop to design a professional advertising campaign without outside help.

it could lead to business models and creative ventures no one can predict.

sparked criticism that the companies are rushing to exploit an untested, unregulated and unpredictable technology that could deceive people, undermine artists’ work and lead to real-world harm.

the company held back the feature to better understand potential risks. As one example, she said, the model might be able to look at an image of a big group of people and offer up known information about them, including their identities — a possible facial recognition use case that could be used for mass surveillance.

OpenAI researchers wrote, “As GPT-4 and AI systems like it are adopted more widely,” they “will have even greater potential to reinforce entire ideologies, worldviews, truths and untruths, and to cement them or lock them in.”

“We can agree as a society broadly on some harms that a model should not contribute to,” such as building a nuclear bomb or generating child sexual abuse material, she said. “But many harms are nuanced and primarily affect marginalized groups,” she added, and those harmful biases, especially across other languages, “cannot be a secondary consideration in performance.”

OpenAI said its new model would be able to handle more than 25,000 words of text, a leap forward that could facilitate longer conversations and allow for the searching and analysis of long documents.

OpenAI developers said GPT-4 was more likely to provide factual responses and less likely to refuse harmless requests

Duolingo, the language learning app, has already used GPT-4 to introduce new features, such as an AI conversation partner and a tool that tells users why an answer was incorrect.

The company did not share evaluations around bias that have become increasingly common after pressure from AI ethicists.

GPT-4 will have competition in the growing field of multisensory AI. DeepMind, an AI firm owned by Google’s parent company Alphabet, last year released a “generalist” model named Gato that can describe images and play video games. And Google this month released a multimodal system, PaLM-E, that folded AI vision and language expertise into a one-armed robot on wheels: If someone told it to go fetch some chips, for instance, it could comprehend the request, wheel over to a drawer and choose the right bag.

The systems, though — as critics and the AI researchers are quick to point out — are merely repeating patterns and associations found in their training data without a clear understanding of what it’s saying or when it’s wrong.

GPT-4, the fourth “generative pre-trained transformer” since OpenAI’s first release in 2018, relies on a breakthrough neural-network technique in 2017 known as the transformer that rapidly advanced how AI systems can analyze patterns in human speech and imagery.

The systems are “pre-trained” by analyzing trillions of words and images taken from across the internet: news articles, restaurant reviews and message-board arguments; memes, family photos and works of art.

Giant supercomputer clusters of graphics processing chips are mapped out their statistical patterns — learning which words tended to follow each other in phrases, for instance — so that the AI can mimic those patterns, automatically crafting long passages of text or detailed images, one word or pixel at a time.

In 2019, the company refused to publicly release GPT-2, saying it was so good they were concerned about the “malicious applications” of its use, from automated spam avalanches to mass impersonation and disinformation campaigns.

Altman has also marketed OpenAI’s vision with the aura of science fiction come to life. In a blog post last month, he said the company was planning for ways to ensure that “all of humanity” benefits from “artificial general intelligence,” or AGI — an industry term for the still-fantastical idea of an AI superintelligence that is generally as smart as, or smarter than, the humans themselves.

“My first and biggest wish is that we had known early that Covid-19 was airborne,”

, “Once you’ve realized that, it informs an entirely different strategy for protection.” Masking, ventilation and air cleaning become key, as well as avoiding high-risk encounters with strangers, he says.

Instead of washing our produce and wearing hand-sewn cloth masks, we could have made sure to avoid superspreader events and worn more-effective N95 masks or their equivalent. “We could have made more of an effort to develop and distribute N95s to everyone,” says Dr. Volckens. “We could have had an Operation Warp Speed for masks.”

We didn’t realize how important clear, straight talk would be to maintaining public trust. If we had, we could have explained the biological nature of a virus and warned that Covid-19 would change in unpredictable ways.  

We didn’t know how difficult it would be to get the basic data needed to make good public-health and medical decisions. If we’d had the data, we could have more effectively allocated scarce resources

In the face of a pandemic, he says, the public needs an early basic and blunt lesson in virology

and mutates, and since we’ve never seen this particular virus before, we will need to take unprecedented actions and we will make mistakes, he says.

Since the public wasn’t prepared, “people weren’t able to pivot when the knowledge changed,”

By the time the vaccines became available, public trust had been eroded by myriad contradictory messages—about the usefulness of masks, the ways in which the virus could be spread, and whether the virus would have an end date.

, the absence of a single, trusted source of clear information meant that many people gave up on trying to stay current or dismissed the different points of advice as partisan and untrustworthy.

“The science is really important, but if you don’t get the trust and communication right, it can only take you so far,”

people didn’t know whether it was OK to visit elderly relatives or go to a dinner party.

Doctors didn’t know what medicines worked. Governors and mayors didn’t have the information they needed to know whether to require masks. School officials lacked the information needed to know whether it was safe to open schools.

Had we known that even a mild case of Covid-19 could result in long Covid and other serious chronic health problems, we might have calculated our own personal risk differently and taken more care.

just months before the outbreak of the pandemic, the Council of State and Territorial Epidemiologists released a white paper detailing the urgent need to modernize the nation’s public-health system still reliant on manual data collection methods—paper records, phone calls, spreadsheets and faxes.

While the U.K. and Israel were collecting and disseminating Covid case data promptly, in the U.S. the CDC couldn’t. It didn’t have a centralized health-data collection system like those countries did, but rather relied on voluntary reporting by underfunded state and local public-health systems and hospitals.

doctors and scientists say they had to depend on information from Israel, the U.K. and South Africa to understand the nature of new variants and the effectiveness of treatments and vaccines. They relied heavily on private data collection efforts such as a dashboard at Johns Hopkins University’s Coronavirus Resource Center that tallied cases, deaths and vaccine rates globally.

For much of the pandemic, doctors, epidemiologists, and state and local governments had no way to find out in real time how many people were contracting Covid-19, getting hospitalized and dying

To solve the data problem, Dr. Ranney says, we need to build a public-health system that can collect and disseminate data and acts like an electrical grid. The power company sees a storm coming and lines up repair crews.

If we’d known how damaging lockdowns would be to mental health, physical health and the economy, we could have taken a more strategic approach to closing businesses and keeping people at home.

t many doctors say they were crucial at the start of the pandemic to give doctors and hospitals a chance to figure out how to accommodate and treat the avalanche of very sick patients.

The measures reduced deaths, according to many studies—but at a steep cost.

The lockdowns didn’t have to be so harmful, some scientists say. They could have been more carefully tailored to protect the most vulnerable, such as those in nursing homes and retirement communities, and to minimize widespread disruption.

Lockdowns could, during Covid-19 surges, close places such as bars and restaurants where the virus is most likely to spread, while allowing other businesses to stay open with safety precautions like masking and ventilation in place.  

The key isn’t to have the lockdowns last a long time, but that they are deployed earlier,

If England’s March 23, 2020, lockdown had begun one week earlier, the measure would have nearly halved the estimated 48,600 deaths in the first wave of England’s pandemic

If the lockdown had begun a week later, deaths in the same period would have more than doubled

It is possible to avoid lockdowns altogether. Taiwan, South Korea and Hong Kong—all countries experienced at handling disease outbreaks such as SARS in 2003 and MERS—avoided lockdowns by widespread masking, tracking the spread of the virus through testing and contact tracing and quarantining infected individuals.

With good data, Dr. Ranney says, she could have better managed staffing and taken steps to alleviate the strain on doctors and nurses by arranging child care for them.

Early in the pandemic, public-health officials were clear: The people at increased risk for severe Covid-19 illness were older, immunocompromised, had chronic kidney disease, Type 2 diabetes or serious heart conditions

t had the unfortunate effect of giving a false sense of security to people who weren’t in those high-risk categories. Once case rates dropped, vaccines became available and fear of the virus wore off, many people let their guard down, ditching masks, spending time in crowded indoor places.

it has become clear that even people with mild cases of Covid-19 can develop long-term serious and debilitating diseases. Long Covid, whose symptoms include months of persistent fatigue, shortness of breath, muscle aches and brain fog, hasn’t been the virus’s only nasty surprise

In February 2022, a study found that, for at least a year, people who had Covid-19 had a substantially increased risk of heart disease—even people who were younger and had not been hospitalized

respiratory conditions.

Some scientists now suspect that Covid-19 might be capable of affecting nearly every organ system in the body. It may play a role in the activation of dormant viruses and latent autoimmune conditions people didn’t know they had

 A blood test, he says, would tell people if they are at higher risk of long Covid and whether they should have antivirals on hand to take right away should they contract Covid-19.

If the risks of long Covid had been known, would people have reacted differently, especially given the confusion over masks and lockdowns and variants? Perhaps. At the least, many people might not have assumed they were out of the woods just because they didn’t have any of the risk factors.

In the summer of 2020, “public-health experts” decided that racism is a public-health crisis comparable to the coronavirus pandemic. It was therefore, they claimed, within their purview to express public support for the Black Lives Matter protests following the murder of George Floyd and to argue that the benefits of such protests outweighed the increased risk of spreading the disease. Those supposed experts actually knew nothing about the likely effects of the protests. They made no concrete predictions about whether they would in any way ameliorate racism in America, just as Nature can make no concrete predictions about whether its political endorsements will actually help a preferred candidate without jeopardizing its other important goals. The political action was expressive, not evidence-based...

as is often the case, a debate which appears to be about the neutrality of institutions is not really about neutrality at all... Rather, it is about whether there is any room left for soberly weighing our goals and values and thinking in a measured way about the consequences of our actions rather than simply reacting to situations in an impulsive and expressive manner, broadcasting our views to the world so that people know where we stand.

Our goals and values might not be “neutral” at all, but they might still be best served by procedures, institutions, and even individuals that follow neutral principles.

The Samsung threat represented the first potential crack in Google’s seemingly impregnable search business, which was worth $162 billion last year.

Modernizing its search engine has become an obsession at Google, and the planned changes could put new A.I. technology in phones and homes all over the world.

Google has been worried about A.I.-powered competitors since OpenAI, a San Francisco start-up that is working with Microsoft, demonstrated a chatbot called ChatGPT in November. About two weeks later, Google created a task force in its search division to start building A.I. products,

Google has been doing A.I. research for years. Its DeepMind lab in London is considered one of the best A.I. research centers in the world, and the company has been a pioneer with A.I. projects, such as self-driving cars and the so-called large language models that are used in the development of chatbots. In recent years, Google has used large language models to improve the quality of its search results, but held off on fully adopting A.I. because it has been prone to generating false and biased statements.

Now the priority is winning control of the industry’s next big thing. Last month, Google released its own chatbot, Bard, but the technology received mixed reviews.

The system would learn what users want to know based on what they’re searching when they begin using it. And it would offer lists of preselected options for objects to buy, information to research and other information. It would also be more conversational — a bit like chatting with a helpful person.

Magi would keep ads in the mix of search results. Search queries that could lead to a financial transaction, such as buying shoes or booking a flight, for example, would still feature ads on their results pages.

Last week, Google invited some employees to test Magi’s features, and it has encouraged them to ask the search engine follow-up questions to judge its ability to hold a conversation. Google is expected to release the tools to the public next month and add more features in the fall, according to the planning document.

The company plans to initially release the features to a maximum of one million people. That number should progressively increase to 30 million by the end of the year. The features will be available exclusively in the United States.

Google has also explored efforts to let people use Google Earth’s mapping technology with help from A.I. and search for music through a conversation with a chatbot

A tool called GIFI would use A.I. to generate images in Google Image results.

Tivoli Tutor, would teach users a new language through open-ended A.I. text conversations.

Yet another product, Searchalong, would let users ask a chatbot questions while surfing the web through Google’s Chrome browser. People might ask the chatbot for activities near an Airbnb rental, for example, and the A.I. would scan the page and the rest of the internet for a response.

“If we are the leading search engine and this is a new attribute, a new feature, a new characteristic of search engines, we want to make sure that we’re in this race as well,”

One calculation performed by an audience demographics firm found 32 million connections to male followers among the 5,000 accounts examined by The Times.

Interacting with the men opens the door to abuse. Some flatter, bully and blackmail girls and their parents to get racier and racier images. The Times monitored separate exchanges on Telegram, the messaging app, where men openly fantasize about sexually abusing the children they follow on Instagram and extol the platform for making the images so readily available.

The so-called creator economy surpasses $250 billion worldwide, according to Goldman Sachs, with U.S. brands spending more than $5 billion a year on influencers.

The troubling interactions on Instagram come as social media companies increasingly dominate the cultural landscape and the internet is seen as a career path of its own.

Nearly one in three preteens lists influencing as a career goal, and 11 percent of those born in Generation Z, between 1997 and 2012, describe themselves as influencers.

“It’s like a candy store

Health and technology experts have recently cautioned that social media presents a “profound risk of harm” for girls. Constant comparisons to their peers and face-altering filters are driving negative feelings of self-worth and promoting objectification of their bodies, researchers found.

he pursuit of online fame, particularly through Instagram, has supercharged the often toxic phenomenon, The Times found, encouraging parents to commodify their children’s images. Some of the child influencers earn six-figure incomes, according to interviews.