Are you aware of any way to search for doctors/NPs aligned with UT subscribers? If not, would you consider putting something like that in the subscriber community?

Years ago, I considered something like this, building a list of physicians and other medical professionals who broadly shared the UT philosophy (which I would broadly call deeply cynical about pharma, judging vaccines individually, hands-on, treating symptoms rather than bloodwork, interventions as a last resort), but I didn’t want to be trying to vet doctors.

But idea this has come up a few times. Maybe the answer is a simple list, sorted by state and specialty, open to anyone who wants to join. Offer a sentence or two about who you are, if you take insurance. Or just include your name and location. Patients can email/call your office directly.

I don’t know how much interest there will be, but if the list gets big enough, I can export the names, make it a permanent tab on the homepage; if not, well, we tried.

So here goes. In the interest of giving this the best shot possible, I’ll open comments on this email to free subscribers too (Substack just started allowing that option).

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Earlier today, I posted a piece explaining why the GLP-1 anti-obesity/diabetes drugs may be so important.

Medicine has overpromised and underdelivered for at least a generation, if not since the post-World War 2 era, when new antibiotics and sanitation made hospitals safer and drug companies and scientists created whole new classes of cheap small-molecule medicines. Chronic conditions from asthma to heart failure suddenly had treatments and hope, even if it was not always fulfilled.

Since at least the 1990s we have faced in the opposite pattern, spending more and more for tinier and tinier improvements in a system everyone seems to hate. As I have written more than once, the signal event this century in American healthcare is the opioid epidemic, which exploded not just because of Purdue Pharma but systemic changes that encouraged increased opioid prescriptions.

The GLP-1s are a throwback to an earlier, more optimistic era. Barring disastrous long-term side effects, they at least have the potential to slow the obesity and metabolic disease epidemic that has done so much damage to American health.

I am not generally optimistic about American medicine or drug development. But it is hard not to be optimistic about the GLPs.

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(Cynicism, when it’s required (usually). Optimism, when it’s warranted. With your help.)

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So this morning I ran the firsthand account of a woman about to lose her hundredth pound on a GLP-1, after decades of fighting and losing a battle against her weight.

Her email was long, so I decided to hold the questions I’d asked her (and her answers) for a second post. Here they are.

If you have not read the original post, I recommend you read it first, though if you are knowledgeable about the GLPs these questions may stand on their own.

The questions, and answers, are unedited.

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Q: Have you seen any of the other personality-related effects Eugyppius (a Substacker who wrote about how GLP-1s had increased his energy and focus as well as helping his weight) mentioned?

A: Other than sweets/carbs I don’t really have an addictive personality. I’ve never drunk, smoked, etc. I can’t say my get-up-and-go has improved —I wish. I was surprised at how much it changed Eugyppius and happy for him. I’m never surprised anymore at what these drugs do for people.

A thought: Eugyppius is on retatrutide (Note: the newest and apparently most potent of the GLP-1s). Semaglutide and tirzepatide (earlier generations of GLP-1s) are known for making people feel sluggish even though they curb cravings. Adding glucagon, which retatrutide does, is known to improve the tired, sluggish feelings. Reta also is better at reducing visceral fat, which is why the gym boys love it so much.

On a tangent. My question is what has caused us to lose the ability to produce GLP-1, GIP and glucagon (the hormones these drugs mimic)? Is it processed food, pesticides, contaminated water, polyester clothing…? Something we did in the mid-twentieth century has messed up our hormones.

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(Hopefully the drugs aren’t THIS effective. From the days when Stephen King terrified us with his novels and not his political rants.)

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Q: How much does your regimen now cost? Do you have any desire to get the prescription brand-name version of these peptides, or are you satisfied sourcing them directly?

A: I pay less than $20 a month. If costs were less than $100 a month I would switch to name brand. Crypto is a pain. Ordering on the gray market has some serious risks: losing money to a scam, getting peptides that are not what they are supposed to be, getting sterile medicine, customs seizures, figuring dosage, making sure that my medicine is properly stored and sterile, etc.

I like not having to deal with a doctor. [emphasis added] At some point I became the expert for myself. Although I would listen to medical advice, in regards to this medicine, I know more about it than a doctor who hasn’t been on it. That said I would never presume to be an expert on it for anyone else.

Just yesterday a friend (the only person in my life who knows my meds are gray) who’s been paying $450 a month for name brand asked about teaching her how to buy gray. I will only point her in directions. I cannot feel responsible if she loses money, gets bad product, over doses, etc. And I will not buy for anyone else, that’s called drug dealing.

Some people are not detail people and wouldn’t be suited for going gray. Novo and Lilly (Note: the companies that sell prescription GLP-1s) would make so much money if they’d simply lower their prices to where these drugs are accessible to everyone.

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(Then everyone would have more money for donations to Unreported Truths! Support my work with a one-time donation!)

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Q: Can I use your story - ideally with your name?

A: You can use my story but not my name. I’ve told you a lot here I’ve never told anyone else. Until recently I didn’t tell anyone I was on tirzepatide because when I started there was a real stigma against these drugs.

Whenever I have lost a significant amount of weight everyone immediately asks “how did you do it?” They’re hoping I found an easy solution because everyone wants to lose weight. Ten years ago it was 100% diet and exercise, not what anyone wants to hear.

Now we have these miracle drugs. The drugs not only solve the hormone problem they are also such a mental revelation. We’ve been told our whole lives we weren’t trying hard enough, we were slobs, just get off the couch and put down the fork!

Now we know it’s not our fault.

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(But not subscribing IS. So get off the fence and do it!)

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(Second of two parts. Part One is below.)

A lot of you have spoken out on the GLP-1 weight-loss/diabetes drugs since I asked about them on Tuesday.

First, almost 3,000 UT readers answered the poll. Of the almost 1,000 who had actually taken GLPs, two-thirds had a good experience. Only 1 in 8 said they had not worked.

Your comments and emails are even more striking.

People who have not taken the drugs express wariness of their side effects and long-term risks. They also pass on secondhand tales of woe.

But many people who have used them report good news. Not totally good. The GLPs cause constipation and other digestive problems, as well as more serious side effects.

Even so, they work. Putting aside the (mostly favorable) personality changes the Substacker Eugyppius reported, they cause significant, lasting weight loss in many patients. These are not celebrities using GLPs to lose a few pounds, but obese or morbidly obese people shedding enough weight to change their lives.

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Is this effectiveness a surprise? Yes and no.

The clinical trials from Eli Lilly and Novo Nordisk, the companies that sell these drugs in prescription form, clearly showed they cause significant weight loss.

Yet we all have good reasons to be wary of clinical trial data. Clinical trials are the gold standard of medical research. Even so their results frequently translate poorly into the real world, especially for medicines designed for long-term use. The short-term improvement they capture often makes little difference clinically, especially for diseases that wax and wane on their own.

But for many Americans, obesity and the metabolic changes associated with it only worsen over time. The fact these drugs can reverse that trend for many is stunning.

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We have grown used — too used — to drugs that do not really work, drugs that are barely better than placebo or far cheaper, older generics, drugs that are heavily advertised but do not justify their hype. More recently, drug companies have focused on complex and expensive large-molecule biological medicines as maintenance treatments for diseases like rheumatoid arthritis. Even when they work, those biologics may affect the immune system long-term in ways we don’t really understand.

If the GLPs continue to demonstrate this level of efficacy with relatively modest side effects, even for a minority of patients, they will mark a return to an era that no longer seemed to exist in medicine, when relatively simple compounds offered life-changing benefits for millions of people — and for society as a whole — at low cost. The last drugs to have that kind of impact were HIV medicines.

(And, yes, the GLPs are effectively very cheap for the patients who get them on the grey market, a large group that happens to include both Eugyppius and the woman whose email follows. That issue is separate, and worthy of future attention.)

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So, without further throat-clearing, here’s the GLP email that hit the hardest of any that have arrived so far. I don’t think anyone reading it could doubt this woman wanted badly to lose weight and did everything reasonably possible to do so for years if not decades.

I present it unedited and cut only for length. These are her words, and her graph at the bottom. She asked for anonymity, which is fine by me, as she reveals detailed personal health information throughout.

It’s fairly long, even after the cuts, so I am going to offer a second part including with the questions I answered and her responses.

I hope you find it as striking as I did. It is easy now for me to see why so many physicians are optimistic about the GLPs. If even one-quarter patients have outcomes like this, these drugs will be the biggest advance in medicine in generations.

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Dear Mr. Berenson,

You wanted information in regards to GLP1s. I have a lot to say (sorry). I can’t afford to subscribe to your Substack at this time, but I wanted to have my say.

I found out I was insulin resistant 30 years ago (age 33) when I was dealing with infertility. At the time the only solution was to go on the diabetes drug, Metformin. I was on Metformin for the next 25 years. After 8 years of infertility treatment I had to give up the dream of a second child (baby number one was conceived easily).

I had many of the problems associated with insulin resistance: fatty liver (high liver enzymes), infertility, PCOS [Polycystic Ovary Syndrome], borderline high A1C [blood glucose], obesity, raging sweet/carb tooth, no real satiety instinct, etc. Metformin didn’t help any of those things but it was supposedly preventing me from becoming diabetic so I kept taking it.

My weight. I gained weight, overnight, in my mid-20s and weighed over 200 lbs from age 25. I”m 5’2”. I was obese when I got pregnant with my daughter at 30…

In 2013 on my 50th birthday at 245 lbs, I decided to give weight loss a big try. Over the course of 2 years I lost 75 lbs, my lowest since age 25, but no matter what I did I couldn’t lose more…

Still not giving up I worked out with a trainer. I saw a nutritionist. I did 5 months of the Atkins diet, provably in ketosis, Nothing. I could not lose another pound and if I gained a pound, I couldn’t lose it either. I did everything. My weight snuck up to 190 lbs. Then Covid hit and I gave up and I gained back to my starting weight, 245 lbs. I don’t know why I could lose 75 lbs but no more and could not lose any small gains.

Two years ago I decided to try tirzepatide (Note: sold by Eli Lilly as Zepbound) with the attitude that it probably wouldn’t work but I’d give it a try. I bought my medicine through a medispa, which I suspect got it on the gray market. It was a miracle from the first dose. I didn’t care about food including anything sweet. I got full easily and couldn’t eat more than half portions.

But mostly, I was steadily losing weight. It wasn’t falling off. I was losing 1-2 lbs a week, a healthy rate. After my years of weight struggles, I am an expert at counting calories, balancing protein, carbs and fats and working out. When I saw this thing just might work, it was easy to transition back to tracking my food and moving. For me, the satiety, elimination of “food noise” and loss of sweet/carb tooth are secondary. I’m primarily interested in the health benefits and weight loss.

Two years later, I have lost almost 100 lbs (1 1/2 lbs away!). My liver enzymes are well in the normal range (no fatty liver), my a1c is normal, I still get full really easily, and I’m still losing weight, just much slower, and am 16 lbs to goal…

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Side effects: I had terrible indigestion at first. One morning I woke up thinking I was having a heart attack but an EKG proved it was very bad heartburn. Certain foods cause worse indigestion and I stay away from them. I have also had bouts of constipation but I manage it by prioritizing fiber. I’ve had two brief bouts of allodynia [Note: extreme sensitivity to touch], small, hand-size areas for less than a day each time. I’ve learned to manage the side effects and don’t have problems anymore.

After a few months of getting tirzepatide from the medispa, I learned how to order research peptides on the gray market. I’ve been getting my medicine that way since.

Today I would have another child if I had had access to tirzepatide 30 years ago. It is truly a miracle and I’m pretty sure millions of women suffering PCOS and insulin resistance will get pregnant thanks to these drugs.

If you made it this far, sorry for the long email. I feel strongly about these medicines and their life-changing effects.

I’m including a fun picture of my weight in chart form spanning 13 years of weight. I started logging my weight in 2013 all the way down, back up and then down to where I am today.

Best regards,

XXX

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First of two parts.

In the second paragraph of its article on the racial gaps, the Times wrote:

About 62 percent of the students in the city’s public schools are Black or Hispanic. But at its eight most prestigious high schools, about 10 percent of the students in the incoming freshman class are expected to be Black or Hispanic... About 80 percent of the seats went to Asian and white students.

That gap sounds — at a minimum — racially problematic, though the Times then explained it comes from a 114-question test that is the city’s only criteria for admission to these schools, which include nationally known schools like Stuyvesant.

Still, the article’s clear implication: intentionally or not, the test helps white students and hurts black ones.

There’s just one problem.

Twelve paragraphs further down, with the article more than half done, the Times finally gave readers the truth: it is Asian students, not white ones, who are vastly overrepresented at these selective schools:

About 19 percent of all public school students are Asian, but they received 57 percent [emphasis added] of the offers for the specialized schools for the fall.

The Times never explicitly explained what this astounding fact means, so I will. White kids make up just under 20 percent of public high school students in New York City - and 24 percent of the students at top schools. They are essentially just holding their own, demographically speaking.

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Even the Daily News, a New York tabloid that generally leans left, presented the facts far more honestly than the Times, explaining at the top of its article on the gaps:

Black students received 3.5% and Hispanic students 6.5% of acceptance letters — broadly consistent with last year’s 3% and 6.9%…

Asian students received 56.5% and white students 23.5% of offers to specialized high schools, compared to 53.5% and 25.9% in the prior admissions cycle.

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(Correcting the record. With your help.)

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A test that hugely benefits one minority at the expense of another can hardly be called racist.

The real numbers suggest that the real story here is about Asian kids — many from lower- or middle-class backgrounds — outcompeting everyone else on a high-stakes one-shot exam that requires intelligence, preparation, and, ideally, parental support.

In fact, the Times itself grudgingly calls the test “a grueling assessment of students’ mastery of math and English that rewards multistep problem-solving skills and time management.”

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(“Asian and white” is doing a lot of work there)

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But hey, far easier to imply racism is what’s driving the gaps at the top of the article, while offering a more accurate though still incomplete picture lower down. That way the paper and its reporters can’t be accused of (entirely) hiding the truth.

The problem isn’t one article (though it is). The framing here shows the Times knows exactly what it’s doing, offering readers a convenient excuse for a racial gap they find unpleasant but cannot ignore.

Legacy media outlets from the Times to NPR to the networks have made this sort of racially tinged propaganda, particularly on education and crime reporting, a habit for decades.

It is no wonder that they have sparked a fierce and still growing backlash.

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Spoiler alert: I cannot believe the meningitis jabs (at least the newer ones) are approved for human use. The clinical trial and safety data on them makes the mRNA Covid shot studies look like revealed truth from on high. Details to come.

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(Support my work investigating vaccines. Not demonizing them. Investigating them, following the data, and reporting the truth — whatever it may be. I don’t think ANY other journalist out there will actually consider and report on the pros and cons of every shot individually. I’m not bragging, it’s pathetic that this issue is so polarizing. But if my work is important to you, you know what to do:)

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But a piece today from the great German Substacker Eugyppius about the GLP-1 weight loss drugs grabbed my attention.

Over the last couple of years, many of you have asked me about the GLPs, obesity drugs like Ozempic and Mounjaro. I have answered honestly. I don’t have a strong opinion. Long ago, I wrote a piece for the New York Times about exenatide, an Eli Lilly diabetes drug that is the forerunner of the modern GLP-class, and thinking, wow, people lose a lot of weight on this, I wonder if it could be a blockbuster. (It wasn’t. It was too hard to tolerate.)

These new drugs are far more effective at taking and keeping off weight, at least for a while, but I haven’t looked at the clinical trial data or the real-world evidence supporting them. And in general, I am deeply allergic to media hype about new medicines, whether pharmaceuticals or vaccines. In general, even when they work, their benefits are more modest than the earlier trials suggest, and side effects tend to emerge over time and grow with continued use. So I haven’t had much to say about the GLPs.

And as those of you who read him know, Eugyppius is every bit as skeptical about drugs (and politics, and climate change fanaticism, and everything else) as I am.

So when I saw Eugyppius was writing about the GLPs, I figured he’d roast them as a cheap, or not-so-cheap, pharmaceutical response to the obesity epidemic that we seem otherwise unable to control.

That is not where he went. Eugyppius has been taking grey-market retatrutide, the newest and apparently most effective yet GLP-1 inhibitor, for about a month. Here’s his description:

It’s been a curious experience, mostly because the food thing is not the half of it. The drug has subtly realigned aspects of my personality (generally for the better), and given me new perspective on some basic human struggles. I hope that doesn’t sound too dramatic but I’m serious…

I’m losing weight at the pace I wanted to… I’m never really hungry and confining myself to my set food schedule requires no effort at all...

In general I feel incredibly focused all the time – much as I do after my first cup of coffee in the morning, but this lasts all day. Alcohol is much less interesting to me, and the same goes for nicotine.. spend vastly less time dicking around on X, YouTube and other social media sites. I still have to use these platforms because they’re part of my routine as a blogger, but the stuff the algorithm feeds me just doesn’t hold my interest anymore. Oh, and perhaps most unexpectedly, I’m shopping less…

I’m doing more of the stuff I always theoretically wanted to do but got sidetracked trying to do before. Because things moving on screens has lost its attraction, I’m reading a lot more, and with luck this reading will supply material for interesting blog posts before long…

We evolved to survive in conditions of ruthless scarcity, but via our own ingenuity we have plunged ourselves into environments that provide nearly everything. For this reason we have long prized self-denial as a virtue… this struggle has been central to human culture for millennia, and now these dodgy once-weekly injections just resolve it entirely, at least in some people. That seems like a big deal.
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(Weight, down. Stock, up!)

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Yeah. It sure does.

That is… quite an endorsement.

But, as much as I like his writing, Eugyppius is just one guy. (Again, find the whole piece here, though it may be paywalled.)

So. I want to hear from you, in the poll and the comments:

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This one matters. Depending on what you have to say, the GLPs may become a major line of reporting going forward.

So vote — and if you are a subscriber, comment! (If you’re not a subscriber, you can change that here… you’ll also get to hear the podcast with Ben Ryan tomorrow!)

Speak now, or forever hold your waistline.

Some of you felt he’d both-sided the debate and Republican moves against puberty blockers and surgeries for adolescents shouldn’t be seen as politically motivated (though conservatives clearly have political winds at their back on the issue).

Ben defended his views in the comments, and I appreciate that everyone debated respectfully. But this issue — and Ben’s reporting — deserves a longer conversation.

So at 2 p.m. Eastern Wednesday we’re having a podcast chat.

The live version will be open to subscribers, who will be able to throw out questions. I’m also going to push Ben on some places where I disagree with him. (We’re also going to talk about the gonorrhea vaccine failure. Sexual health is another topic Ben’s been covering for a long time.)

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(Sign up now, listen to the podcast Wednesday!)

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If you don’t subscribe, you’ll be able to see the podcast after. But I encourage you to sign up!

By the way, after the trans piece, a reader complained Ben had been pro-Covid jab — and even last year, he seemed to get fooled by a junk observation study suggesting mRNA shots might help fight cancer (mRNA shots do not help fight cancer).

I am not sure how Ben feels about the shots now, and if his opinions have changed over the years, but you are welcome to ask him about that too — respectfully!

See you at 2 p.m. Eastern Wednesday.

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(Ben’s story last week!)

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Though not fatal, gonorrhea is unpleasant and increases risk for HIV. Like other sexually transmitted diseases, it is far more common in gay men. English authorities offered the vaccine, originally designed for meningitis, after studies showed it cut infections by about 40 percent. The shot could have a “huge impact,” England’s top vaccine regulator told the BBC.

Or not.

Last week, the New England Journal of Medicine published results from a trial of the vaccine in gay men in Australia. It failed to prevent gonorrhea — and some men who received it reported serious side effects.

The media has buried the trial’s results. Not one mainstream American news outlet reported the vaccine’s failure. And, after giving over 30,000 men the jab, English authorities are so far still recommending it despite the new results.

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(Unearthing the results the media buries. For pennies a day. With your help.)

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But the failure of what is called the 4CMenB vaccine (the “Men” in the shot’s name stands for meningitis) is not just about one vaccine.

It offers much larger lessons — ones health bureaucrats and the media are almost certain not to heed.

The gap between the earlier reports showing the vaccine worked and last week’s findings it didn’t are not a coincidence or an accident.

The earlier studies were based on observational real-world data, like the studies the Centers for Disease Control now uses to justify flu and Covid jabs.

The new study was much smaller, covering only about 600 men, but it was not observational. It was a randomized controlled trial that split subjects into two groups. One received two shots of the actual vaccine. The other received placebo injections.

The two groups were matched by age, reported sexual activity in the previous six months, and other factors. And the trial was blinded, meaning no one receiving the shots knew whether they were getting the vaccine or the placebo.

Blinded randomized trials control for hidden biases that observational data cannot. And the trial’s results were unequivocal. Men in it had a better than even chance of getting gonorrhea whether the received the vaccine or not. (The sex recession does not seem to have reached gay men in Australia. About 60 percent of the trialists reported having 11 or more partners in the six months before it began, including almost 10 percent who reported more than 50. Roughly 70 percent said they had had group sex at least once in the previous six months.)

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(Unreported Truths is a serious news site!)

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The trial’s failure is among the most compelling evidence yet that the observational studies that health bureaucrats and the media rely on to push the Covid and flu vaccines are little more than pro-jab propaganda.

In the real world, people who get vaccines differ from those who remain unvaccinated in crucial ways. They may be more concerned about their health, more likely to seek medical care or use condoms during sex (or stay home if they’re afraid of Covid). Researchers can try to correct for these differences, and good ones do.

But they inevitably fail, and the hidden biases almost always make vaccines look better. (I say “almost always” to be safe, but “always” is probably more accurate.)

The phenomenon even has a name: healthy vaccinee bias.

Healthy vaccinee bias is not a small effect. It typically gives vaccines a 40 to 50 percent advantage in observational studies — exactly the edge that the gonorrhea vaccine seemed to have but did not.

It is also no coincidence the Covid boosters, which have appeared essentially useless in clinical trials since Omicron emerged, often have about a 50 percent edge in observational trials. (Pfizer and Moderna have basically stopped running any randomized clinical trials on Covid jabs in the last couple of years, and governments and the bureaucracies have stopped making them do so; that’s not a coincidence either. You can’t find a vaccine doesn’t work if you don’t test it properly.)

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But you can support Unreported Truths with a one-time donation! No subscription required, if subscriptions aren’t your thing.

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Meanwhile, stunningly, the study’s authors did not catalog ordinary side effects from the vaccine in the gonorrhea trial, claiming that its side-effect profile is understood from its use as a meningitis vaccine. (Yes, that’s what they said.)

However, they did record serious adverse events, those requiring hospitalization. Not doing so would have been a major ethical breach.

And, yes, the vaccine was linked to notably more of those serious events. Eighteen participants who received the vaccine reported them, compared to nine who did not. In the study’s appendix, the investigators said the vaccine might have caused the serious side effects in four cases, though — as is typical — they offered no details about specific cases to explain their judgments.

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(GoGo to the hospital, do not pass go!)

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Barring stunningly unexpected results in two other trials that are still happening, this trial should mark the immediate end of efforts to use the meningitis vaccine for gonorrhea prevention. Most heterosexual adults, and even many gay men in committed relationships, are at very low risk for gonorrhea anyway.

Yet public health bureaucrats are refusing to change course. As the BBC reported:

The UK Health Security Agency said it was not making any changes at this time. Dr Mary Ramsay, director of public health programmes at UKHSA UK, said it was “important to consider a range of evidence.”

The losers here will be gay men, who may believe they are protected by a vaccine that doesn’t work, rather than focusing on safer sex practices that actually do, like using condoms and being regularly tested for sexually transmitted diseases.

Ahh, the public health vaccine fetish! More powerful than leather at an all-male after-hours club.

But I want to ask you: on this kind of story, which is timely but based on public information (call it a semi-exclusive, I doubt anyone else is writing it right now, the legacy media won’t touch it), would you rather I publish as soon as I am done, even if that means a summer weekend afternoon or early evening? Are you likely to read it no matter what?

Or would you prefer I put it out in the morning — or even wait for Monday, when it may land harder? Obviously, this question isn’t just about this piece - one of the advantages of being my own editor is that I can control my schedule.

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(And while you are mulling your answer, I hope you’ll mull a subscription!)

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Meanwhile, Ben Ryan and I are planning a podcast conversation to explore the trans issues he wrote about on Thursday more deeply. I know that piece generated a lot of feedback/pushback — this would be a chance for subscribers to talk to Ben directly!

Back to the vax piece, which will be out shortly (possibly today, depending on the poll).

None more amazing than this: New York-Presbyterian, a “non-profit” with $11.5 billion in sales and a half-billion in profits last year1, calls itself a rural hospital under Medicare rules so it can take advantage of federal programs for distressed rural hospitals!

But New York-Presbyterian also claims it’s an urban hospital under different Medicare rules that offer more money to hospitals in high-cost cities.

It’s not just New York-Presbyterian. This “dual classification” grift has exploded since 2016. Many of the richest medical centers in America now pretend to be struggling rural hospitals for Medicare purposes, collectively costing taxpayers billions of dollars.

Best of all (from the hospital executive point of view), the scheme is legal. Hey, you think Dr. Steven Corwin, who made $22.3 million running New York-Presbyterian in 2024, was paid to miss loopholes?

(Subscriber-only special bonus! To find out more about how this game works, and how it’s taken off, subscribe to Unreported Truths!)

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Ben has published investigations and scoops documenting the field’s recklessness, including an investigation with Compact magazine based on conference videos from a top trans medical organization.

Ben has proven himself fearless and fair. If he has one flaw, it is that he is so knowledgeable about transgender medicine he sometimes loses himself in its details.

So after the Supreme Court’s ruling supporting the rights of biological girls to compete in sports without facing transgender athletes, I asked Ben if he could offer Unreported Truths readers an overview of the current debate around trans issues. Keep it at the 50,000-foot level, I said!

His response follows. I don’t necessarily agree with every word, but I hope you find it as interesting as I did. You can find Hazard Ratio, his Substack, here!

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(But first, sign up for Unreported Truths — to support writing like mine, and Ben’s!)

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(By Benjamin Ryan)

American doctors charged with caring for the vulnerable — and often troubled — young people who identify as transgender have catastrophically failed them.

Through an overzealous campaign to promote medicalized gender transitions for adolescents, they have permitted progressive identity politics to overwhelm common sense and caution.

Gradually, then all at once, they triggered a backlash — from cynical right-wing politicians who seized upon a new culture-war wedge issue, as well as justifiably concerned parents — that has toppled much of their medical field in the United States.

Last year, the Supreme Court’s conservative supermajority effectively blessed state bans of gender-transition treatments for minors. And last month, the court affirmed state laws barring athletes born male from girls’ and women’s sports.

These rulings dovetailed with public opinion that has moved against the rigid demands of the transgender advocacy movement.

But the battles over the explosion of transgender identification among adolescents have come at a devastating cost, especially for one tiny group of youths.

These people start expressing a cross-sex identity as young children and will likely hold a transgender identity for life. Absent medical transition, they may suffer from permanent gender-related distress. They have been known as the “true transsexuals,” destined to identify as the opposite sex throughout their lives.

They’ve been forgotten in this fight. They shouldn’t be.

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(William “Lia” Thomas, whose Division I collegiate swimming championship in the women’s 500-yard freestyle in March 2022 helped spark a backlash against trans athletes in women’s sports.)

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Liberals and conservatives each deserve blame for approaching this complex issue with anything but the deft hand it required.

The left cooked up a civil rights movement that shut down dissent and made a litmus test of supporting radical, irreversible and often unethical medical interventions to troubled adolescents. The right responded with brute force.

Amid the rubble of this political collision are dashed hopes that researchers might determine how best to treat the gender-related distress some young people genuinely face. The existing research is of poor quality, which is especially concerning given the serious and unique risk of harm these medical interventions pose.

But the American leaders in this medical field are too concerned with being seen as white-knight saviors of vulnerable youth to conduct rigorous research and to report it honestly and promptly if those findings show concerning results.

Partly in response to these blunders, conservatives have done everything they can to dismantle the nation’s research apparatus — and robbed the public of potential scientific findings that might better guide the care of young people who are often mentally ill and are frequently autistic as well.

But the pipeline of adolescents coming into a transgender identity hasn’t simply dried up. These distressed young people are headed for a blockade erected by statehouse Republicans and the Trump administration. And conservatives have offered them no solutions.

The left’s contribution to this sociopolitical tragedy has remained underexamined, given the liberal bias of the legacy media. In a better world, media outlets would investigate and atone for their own failure to have covered this complex subject with the dispassionate circumspection it demands.

—

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The current crisis had its origins in a clinic in the Netherlands.

In the 1990s, Dutch researchers launched a strict, cautious protocol to address the question that had long haunted adult transgender people: What if I could have gone through the opposite-sex puberty? The Dutch recruited a small cohort of youth who exhibited gender-related distress starting at a young age.

If these youth were “consistent, insistent and persistent” in their cross-sex identity, they could begin puberty blockers, later transition to cross-sex hormones and ultimately undergo gender-transition surgery. The study participants had to demonstrate stable mental health and have families supporting their transition.

The Dutch researchers’ findings, published in the early 2010s, were hardly grounded in high-quality science. They didn’t even have a control group. Still, they unleashed a new medical field — pediatric gender medicine — across the Western world.

Then American medical providers took this narrow protocol and went hog wild. They tossed aside rigorous psychosocial assessments and instead prioritized access. By 2018, it became Boston Children’s Hospital’s policy, for example, to provide minors seeking gender-transition drugs with only a two-hour appointment with a psychologist to determine whether to refer the child to a medication specialist.

The nation’s first medical-malpractice trial waged by a detransitioner — a person who medically transitioned and then reverted to identifying as their birth sex — heard testimony in January from a 22-year-old plaintiff who, as a seriously unstable 16-year-old girl, underwent a gender-transition mastectomy after publicly identifying as transgender for less than a year.

Such practices should shock anyone who wishes the best for all children struggling not just with their gender but with identity confusion writ large during the daunting social media era.

—

(Ahh, social media fads. The Benadryl TikTok challenge is, well, to take a lot of Benadryl. And, yes, teens actually do this. Some, anyway.)

—

The swift expansion of this new medical field coincided with the onset of what psychologist Jonathan Haidt has witheringly dubbed the “phone-based childhood.” Beginning around 2012, tweens and adolescents gained access to an algorithm-based virtual world in which to question and cultivate their senses of self.

As any parent who has had children in a progressive private school can attest, it was during this period that clusters of friends — biological girls in particular — suddenly started professing cross-sex identities.

—

But the leaders of pediatric gender medicine refused to consider whether adopting a transgender identity might sometimes be a socially-formed coping mechanism to deal with the anxieties wrought by Tumblr, Instagram and TikTok.

To such doctors, these were transgender children, bar none. And as the American Academy of Pediatrics wrote in a foundational, practically spiritual, and astonishingly flawed 2018 policy statement on the so-called gender-affirming care method, transgender kids know their gender as well as anyone.

Buttressed by that philosophy, a niche medical field designed for a tiny population of young people exploded. Scores of pediatric gender clinics opened their doors to aid transitions in kids not even old enough to drive.

Supply appeared to create its own demand.

By 2023, over 3 percent of teenagers reported identifying as transgender and over 1 in 250 natal girls were taking testosterone by age 17 in super-liberal Oregon. The World Professional Association for Transgender Health, or WPATH, an influential, quasi-activist-medical group, professed the following year that the majority of transgender adolescents should undergo medical transitions.

—

(Testosterone shots: Not just for MMA fighters anymore!)

—

The leaders in this field, social-justice warriors to the core, rarely acknowledged that online trends could have encouraged this groundswell. In WPATH’s conferences, dissent or debate about this novel field remained shockingly absent, as I discovered from watching recordings I obtained of over 100 such conference sessions.

The imposed silence about this seismic cultural shift among adolescents extended to other scientists, concerned parents, journalists, and politicians.

Dr. Lisa Littman, a researcher who sought to study what in 2018 she dubbed “rapid-onset gender dysphoria,” was shunned. Reporters like Jesse Singal who dared write even circumspectly about pediatric gender medicine were defamed and banished.

Parents could have child protective services called on them if they resisted their children’s demands for a medicalized gender transition. Democratic politicians were pilloried if, like Representative Seth Moulton of Massachusetts, they questioned how communities should respond to the proliferation of youth identifying as transgender in schools and sports.

—

Exerting thought control is not a healthy way for scientists and society alike to explore how best to care for troubled children.

Nor, often, is the blunt instrument of the law.

In the wake of gay marriage’s Supreme Court win in 2015, and amid rising support for gay rights, conservatives pivoted to leveraging transgender issues as a political wedge issue. Republicans saw pediatric gender medicine’s recklessness and were all too happy to express their horror at it with a show of authoritarian force. Starting in 2021, conservatives blanketed over half the states with bans of these practices, which the Supreme Court solidified in 2025.

Some youths will be saved from harmful and unnecessary medical interventions as a result — though many, primed by gender-medicine advocates to believe such treatments were vital to their health, will endure protracted suffering from the letdown.

A smaller group could pay an especially heavy price.

It is at least arguable that a select population of youths are best served by medically transitioning in early adolescence — namely, those “true transsexuals” who would have qualified under the original Dutch protocol.

But few people in gender medicine are even trying to discern those children from others for whom the risks of medical intervention, including infertility and the loss of healthy body parts, dwarf likely benefits. Many leading voices in this field want to end assessments entirely. They believe that whatever a kid says should go, and that questioning such impulses is stigmatizing and harmful.

This leaves the average person to wonder: Have you ever met a teenager?

Had pediatric gender medicine remained as cautious as the Dutch had first established it to be, it’s possible these medical practices would have kept operating quietly in the shadows. But the leaders in this movement egregiously overplayed their hands — and provided so much fodder for anxious parents and the field’s enemies on the right they effectively robbed the tiny minority of youth who truly might have benefitted from these interventions of a chance to receive them quietly in private.

That’s an American tragedy, and it’s still unfolding.

—

Benjamin Ryan is a veteran health and science journalist who covers pediatric gender medicine on his Substack, Hazard Ratio.

How could they ALL have missed it? I need to get it out. NOW.

I’ve had that thought before. But never for a story about the President of the United States, a man covered by hundreds of news organizations.

Saturday, July 6, 2024. I was searching White House visitor logs for potential physician visits to Joe Biden - and finding, to my shock, that a Parkinson’s disease specialist had come to the West Wing repeatedly.

Biden’s infirmities and cognitive decline had been obvious for years. (In October 2023, federal prosecutor Robert K. Hur found Biden unable to recall when he had served as vice-president or his son Beau had died.)

Yet even as Biden’s decline became clearer, the legacy media went the other way, arguing the videos of him wandering off or freezing in silence were manipulated. Ultimately, the spin and half-truths blew up on June 27, 2024, when Biden froze during his debate with Donald Trump, famously stammering “We finally beat Medicare” to the world. (We sure did!)

Even then, the legacy media hesitated, maybe from embarrassment at how badly it had failed its most basic job, reporting on the fitness of the man in the Oval Office, maybe from residual loyalty to Biden or dislike of Trump.

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So it was that the White House visitor logs remained untouched, until the New York Post reported on a single visit by Dr. Kevin Cannard, and I checked them and found the rest. (I was familiar with them. I’d pored through them for visits from Pfizer chairman Albert Bourla or other Pfizer officials to the Biden Administration in 2021.)

Two days later, The New York Times picked up my piece — without crediting me, to my complete lack of surprise. The rest is history.

Biden certainly would have had to drop out with or without the reporting on Cannard’s visits, which to this day no one has adequately explained, but they made clear just how badly the legacy media had failed in covering him.

—

(I have no idea where I am. Or who I am. We definitely beat Medicare, though.)

—

I thought of these media profiles in cowardice again this week, as Graham Platner, a Democrat running for Senate from Maine, faced highly credible allegations of sexual misconduct and assault.

Obviously, a single senator is far less important than the President. But Platner has received more than his share of media attention this year, and his case has a lot in common with Biden’s. Both times, legacy and left-leaning reporters simply refused to follow obvious lines of reporting — and ultimately embarrassed themselves badly.

Why did anyone care about Platner? Because he was 2026’s Great White Hope for the Democrats.

He checks all the boxes. He’s white (duh!), he’s a Marine, he’s an oyster farmer (ish), he’s young, he’s decent-looking without being, umm, suspiciously handsome, and he’s not Jewish (Josh Shapiro cannot say the same).

In fact, Platner is so not Jewish that he had a giant Nazi-themed tattoo inked on his chest in 2007 in Croatia. When reports of the tattoo emerged last year, Platner claimed he didn’t know what it meant. Sure. It not like Croatia was a hotbed of Nazi support during World War 2, no tattooist there would have any idea what a skull-and-crossbones SS emblem meant.

The tattoo was only one in a veritable parade of red flags that popped up almost the moment Platner began running for Senate last year. At some point, these stopped proving Platner’s authenticity and instead became signs of something much darker, something far more than routine political narcissism.

Yet the media ignored the obvious and repeated evidence of what can only be called Platner’s sociopathy and violent streak, just as it had ignored the obvious and repeated evidence of Biden’s dementia.

The fact that Biden and Platner are both white men with a perceived appeal to working-class white guys is no coincidence. Democrats and the media have been desperate for a decade to find a candidate who can talk white dude jive (they’re biting today, bro, let’s get some Nattys and take that Prowler of yours out) and bridge what they have convinced themselves is a cultural gap.

—

(Welcome to the Lake of the Ozarks! Nazi tattoo not required!)

—

This attitude is condescending and snobbish.

In fact, working-class white men have lots of very real pocketbook reasons to dislike the progressive left’s economic policies.

To name just four:

Diversity, equity, and inclusion policies based on race put them last in hiring;

Decarbonization efforts are a direct attack on many working-class jobs in energy and transportation;

Blue-state restrictive zoning and anti-growth policies cost even more homebuilding and trades jobs;

The Biden Administration tried to give college graduates a trillion-dollar subsidy by canceling student-loan debt.

Further, Medicare For All, the great beacon of progressive politics, has at best minor appeal for most young men. On average men under 50 make little use of healthcare; many (correctly) see Medicare expansion as likely to create yet another massive tax-funded entitlement.

—

This isn’t to say that all Republican policies — before or during the Trump presidency — benefit the working class. Some do, some don’t.

But it’s far easier for the legacy media, Hollywood, academia, and Democrats to pretend that (white) working-class men just aren’t smart enough to see and protect their own economic interests — and that if they could just get the right (faux) working-class hero in place, Dustin and Lucas would happily support the left!

Biden was the old-man version of this, Platner the young. And it connects directly to the believe-in-science snobbery of 2020 and 2021, which has held up less than perfectly.

—

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Platner will likely drop out of the Senate race very soon.

Even if he doesn’t, I’m not going to chase his story the way I chased Biden’s. I have too many other topics to follow, and one senatorial race simply doesn’t rate. (And, frankly, if the people of Maine elect this guy after what has already come out, the United States is in deep trouble.)

But what seems clear after the last six years is that the legacy media simply cannot course-correct. Even the failure to question the President’s obvious cognitive decline two years ago could not keep left-leaning reporters for falling for the shiny object that was Graham Platner.

These media failures will keep happening.

And independent voices matter more than ever.

—

(The 2024 piece. Paywalled — subscribe here to read)

A lot of you liked this idea.

However, some of you felt T-shirts (last year’s gift) were better swag and/or that the UT Founding Membership price should have stayed at $300, not $350. As a wise man once said, no good deed goes unpunished.

I ain’t changing the chips! I like the chips! (Maybe in 2027 we’ll go back to T-shirts, or hats, or whatever. Okay? Happy?!?)

But I am going to drop the founding membership rate back to $300 for anyone who joins now. You win! (If you are already a founding member, don’t worry about this, you are paying $300 either way.)

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So if you are, or choose to become, a founding member, please send along your address if you would like a chip! (I changed the design slightly, it is cleaner and neater.)

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The truth needs allies! Become one for $300, and get cool swag to boot!

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Graham Platner’s campaign to become Maine’s next senator is imploding as allegations of sexual misconduct and assault pile up against him.

Planter’s campaign is on life support and may not last the day. The biggest loser, besides Platner himself, will likely be The New York Times — which again has shown it has one reporting standard for Democrats, another for Republicans.

This morning, Lindsay Fifield, who told the Times this spring how Platner had intimidated her and once held her in a bathroom against her will, wrote on X about how the Times dismissed the evidence she provided to support her story. Meanwhile, another woman came forward yesterday to allege Platner sexually assaulted her in 2021. She says she did so partly because of how the Times treated Fifield.

The combination is devastating for Platner — and the Times. Even more than its whitewash of Joe Biden’s cognitive decline, the Platner fiasco makes the Times look like a wholly owned wing of the Democratic National Committee.

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Platner is the Marine veteran who became a sensation on the left thanks to his story as a faux working-class oysterman (he sells much of his crop to his mother’s restaurant). He easily won Maine’s Democratic Senate primary despite questions about his drinking, potential infidelities, and a Nazi-themed tattoo.

But last month, Platner faced even more serious allegations. Former girlfriends said he had physically intimidated and abused them in an article in the Times.

I use the term “article,” not “investigation,” intentionally.

For the Times went out of its way to downplay the allegations. The piece’s second paragraph referred to Platner’s “messy personal life.” (Boys will be boys!) The fourth, before describing any of the allegations, explained that:

In interviews with The New York Times on Wednesday, several women did just that, describing Mr. Platner as a fun and caring partner, and saying they felt safe with him. Some remain friends with him to this day, years after their relationships ended.

Fun and caring, sure.

—

(Put your shirt back on, please. Please?)

—

The Times went on to describe Fifield, the woman who had made the most serious allegations against Platner, as “a Virginia conservative who has worked for right-leaning groups and Republican campaigns.”

It briefly described her allegations, including that Platner had shoved her into a room and refused to let her leave for hours. Then it wrote twice it couldn’t “corroborate” her account.

Not surprisingly, Platner and his supporters shrugged off the allegations, and he cruised to victory in the senatorial primary a few days later.

But yesterday, a Maine woman named Jenny Racicot told CNN and Politico that Platner had sexually assaulted her. In 2021, a drunk Platner entered her apartment and had sex with her even after she begged him to stop, Racicot said.

As a Times columnist who had previously lauded Platner wrote, Racicot’s story “is completely believable and completely devastating.”

—

What makes this turn of events equally devastating for the Times is that it also interviewed Racicot for last month’s story. She hadn’t publicly mentioned the rape allegations, in part because she supported Platner’s political views.

But after Racicot saw the way the Times dismissed Fifield, she decided she had to come forward — and not to the Times, she told Politico:

SOURCE

—

Following Racicot’s allegations, Fifield published her own description of how the Times had treated her on X Tuesday morning:

I actually understand why Democrat leaders didn't take our stories seriously when the Times reported them in June but are taking them seriously now.

It was by design.

The line most shared from the piece was the claim that the Times “could not corroborate” my story despite talking to two of my friends.

I gave them the contact information for five friends.

They called the two who I clarified would not know about the abuse but would be able to affirm our relationship timeline, events, etc.

They simply did not call the other three.

I also gave them the names of all my former roommates who remembered him stalking our row house (which was about 5 houses down from his) and waiting for me to return. I gave them screenshots of messages between these roommates and I discussing it.

I gave them the names of other men I dated who might have remembered him following us around the hill and showing up on my stoop after we walked home from dates to confront us. I gave them emails to my landlord urgently ending my lease and moving to an apartment across town and diary entries talking about it - all time marked.

I told them that during pre-marital counseling I had spoken to my ex-fiance about the abuse because I had to explain to him why I reacted with such terror any time he lost his temper. They said oh NO we don't need to bother HIM (or my priest). Besides, I had written about it in my diary in detail, they reassured.

As the weeks dragged on I stopped trying to give them evidence because the amount I had already given them seemed to overwhelm them and I thought it meant they clearly had more than enough to verify my every claim…

But tell me again how they “could not corroborate.”

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To say the least, this is a terrible look for the Times. The paper’s reporters failed to do the work necessary to find out Fifield’s allegations were credible — and then smeared her in print. You can judge for yourself if they would have done the same if Fyfield was a Democrat and Platner a Republican.

In the paleolithic days when I was a reporter for the paper, this level of journalistic malfeasance would have led, at a minimum, to a serious internal investigation, with the findings publicly released.

Let’s hope the same standards hold now.

I’m not optimistic.

NOTE/CORRECTION: This piece originally spelled “Fifield” as “Fyfield” throughout. I regret the (inexplicable) error.

They were a hit. But the days have passed, as days do. Summer is back. So I’ve spent more time lately than I’d like to admit thinking about what freebie to offer for 2026.

Then — as I wrote the July 4 piece about why poker is the ultimate American game — it hit me.

Poker chips. Poker is about fighting as hard as you can, even when the cards don’t fall your way. So is UT. (And let’s hope for some luck at the Second Circuit!)

So if you are a Unreported Truths founding member who would like a custom UTFM chip, please send along your address. (And unlike the T-shirts, you don’t have to include your size!)

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(All-in on the truth!)

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Again, the chips is available only to founding members, the $300+ annual Substack level. This once-a-year swag is the main perk they receive compared to other paid subscribers, so I’m committed to keeping it exclusively for them.

But if you’re not currently a founding member, and you’d like a chip, you know what to do!

I’ll be collecting addresses for a week (I reserve the right to extend the deadline), so don’t wait - send yours now.

Whew! Swag solved until 2027!

How corrupt? In 2015, federal prosecutors in Brooklyn indicted nine officials at FIFA, the Swiss federation that owns the World Cup soccer tournament, on bribery charges.1

How corrupt? The 2018 World Cup was played in Russia. The 2022 cup was in Qatar — in December, because Qatar is too hot for soccer in summer, when the tourney should be played. Both countries allegedly bribed officials to win the chance to host.

How corrupt? Maybe the most famous goal in World Cup history came in 1986 when the Argentinian striker Diego Maradona punched in a score. Yes, I mean “punched” literally. You may be aware soccer generally frowns on using hands. No matter, the goal stood. Argentina beat England 2-1. Maradona said later he’d used his hand as revenge for the Falklands War. The goal became known as the “Hand of God.”

Getting the picture?

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I mention all this not-so-ancient history because the usual suspects were up in their usual arms last night, baying about the malign influence of Donald Trump.

What did Trump do this time?

Well.

On Wednesday, as the United States played Bosnia in Santa Clara in an elimination game in the 2026 World Cup, the referee gave a red card to Folarin Balogun, the American striker.

A red card is the most severe penalty a player can receive. It leads to his immediate expulsion. Further, he cannot be replaced, so his team must play a man down for the rest of the game. however long that might be.

Red cards are reserved for acts that are intentional and violent, dangerous, or unsportsmanlike (like spitting, or knocking over an opposing player about to score). In last week’s game, Balogun raked his right foot over a Bosnian player’s right heel. Soccer shoes have hard cleats, so Balogun’s move was painful, but it wasn’t intentional, and it didn’t do deep damage. The Bosnian player played the full game.

My son now plays soccer competitively (and well), so I’ve watched a lot of soccer lately. This call was — at best — extremely marginal. Soccer is a surprisingly physical game. Players are constantly jockeying for position, and they regularly tangle up their legs and feet. Watching replays at real-time speed, it is clear Balogun had no intent to hurt the other player.

—

(Diego Maradona, 1986. SOMEBODY put a hand on that ball, for sure.)

—

No matter, the ref gave a red.

The United States had to play 10 on 11 the rest of the game. But the American team won, reaching the round of 16, where it will play Belgium tonight, Monday, in Seattle.

The two teams will be at full strength, 11 on 11. But the red card meant that Balogun couldn’t play tonight. His suspension marked a significant loss for the United States; he’s been the best American player so far this World Cup.

So the Trump administration asked FIFA if… it could take another look at the penalty.

Guess what?

FIFA could!

Turns out that under FIFA’s Article 27, the federation can “suspend” the suspension for up to four years, essentially putting a player on probation. And that’s what it did.

On the merits, letting Balogun play is clearly the right move. Bouncing him for one game for a marginal foul was bad enough. Forcing him to sit for a second would have been totally unfair.

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The reversal gave the American left a perfect chance to act bipartisan (while giving up nothing substantive). It could have congratulated President Trump for encouraging FIFA to fix the suspension and let the 22 best players from the United States and Belgium compete tonight.

After all, that’s the point of the World Cup.

Except, because FIFA only acted after Trump got involved, Democrats not only wouldn’t take his side, they whined endlessly that Trump had somehow damaged FIFA’s perfect integrity and processes by getting involved.

“Man does this look awful for FIFA and it will make the rest of the world feel like the tournament was rigged,” podcaster and former Obama staffer Tommy Vietor posted on X.

New York Times columnist Nick Kristof added:

This will appear to the world as favoritism and as FIFA bowing to political influence. If the U.S. wins, I fear that much of the world will see it as a win with an asterisk and as Trump’s America making its own rules even in the sports world.

And the Times itself harrumphed that it was the “first time since 1962 that FIFA has allowed a player to appear in a game when they should have been suspended.”

—

—

1962?

Actually, FIFA used the same loophole in last November to let Cristiano Ronaldo play in this World Cup. As the Times should have known, considering it covered the story.

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(2025 is the new 1962)

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Ronaldo had received his red card for elbowing another player in the back, a far clearer violation that’s far more deserving of a suspension.

But FIFA’s decision to let him play didn’t cause any weeping or gnashing of teeth from all the people whining about the group’s holy and unimpeachable processes today.

Ronaldo is among the world’s best-known, best-paid, and most popular players. He’d have to do a lot more than throw an elbow to get kicked out of the World Cup.

And — to go back to the initial point — soccer and FIFA are no one’s idea of pure. What happened last night is a little like the old saw about the judge who asked for bribes from both sides so he could decide on the merits.

The right result was reached. In its unwillingness to admit that reality, the left looks not just petty but anti-American. No wonder Democrats are even more unpopular than Republicans.

If the left wants America to love — or even like — it, it has to start by not hating America.

Even if you have never touched a card, you may have heard of the WSOP “Main Event,” the $10,000 buy-in tourney that’s drawn fortune-seekers to the desert since 1970. Other tournaments now have higher entry fees, but the Main remains poker’s championship, with the biggest prize pool. Last year it had 9,735 entrants — and paid its winner, Michael Mizrachi, $10 million.

I wasn’t in Vegas for the Main, though. It is fantastic, but it takes time1 I couldn’t afford this year. The World Series now includes 100 events with different games and entry fees — up to $250,000. I had come out for two smaller, faster events, each lasting three days at most.

Note I haven’t used the word gambling once so far.

That’s because poker is not gambling. Not really.

—

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These big tourneys offer the best proof. In them, most entrants lose all their money. Payouts start when 15 percent of players remain. (The long footnote below explains how tournaments are structured, if you are interested.2)

By tourney’s end, the last player has all the chips and gets 10 to 20 percent of the total initial prize pool — sometimes up to 1,000 times the buy-in. In other words, pay $1,000 to enter, sit on your rear playing cards for a couple of days, win $1,000,000.

Easy, right? That’s why these big “multi-table tournaments” are so appealing.

Yet.

Despite the huge entry fields, the same few hundred people wind up finishing high up or winning them over and over, in a way that randomness cannot begin to explain.

—

(All-in on ‘Merica!)

—

Mizrachi is one.

Before winning the Main Event, he had won seven other “bracelets” — World Series events. Other players have won even more. Phil Ivey, sometimes considered the greatest living poker player, has taken home 11.

These guys are not poker players. They are professional poker players, and they have an enormous edge over amateurs like me.

Of course, poker is not entirely skill. Like Scrabble, it features an element of luck, which is why weaker players can beat stronger ones, briefly. I would have no chance, none at all, to beat Garry Kasparov in chess, which is a game of perfect information where luck plays no role. But in a WSOP tournament last year, I played next to Ivey for a while (fortunately, he was on my right, better for me). I walked away with my chips and pride intact.

In time, though, the better players win.

And time does not mean years. Days or weeks will separate the strong and the weak, the skilled from the lucky. Luck evens out. Luck does not exist in the long run.

The professional player who seems to run perfectly, who always has the winning cards, doesn’t really. He just knows how to bluff with his losers — and when to fold them and hide them away.

The truth is that most people who enter these tournaments have no real chance of winning them. Many recreational players will never even reach the “min cash,” the 15 percent stage where they receive their entry fee back, plus a small payout.

A 2015 study that examined results from 456 million hands played online for real money confirmed that skill plays a large role in poker — players who did well in one period tended to do well in later periods. This study probably underestimated the element of skill at big cash tournaments, which attract both the world’s best players and a lot of recreational players looking for a million-dollar payout. In other words, the gap between the best and worst player is probably higher at the World Series than anywhere else.

But you don’t have to read papers to know that poker is a game of skill, not luck.

You don’t even have to know how to play.

Just sit at a table for an hour or two and the bad players will announce themselves. I mean that word literally. They will lose. They will tell stories about how good they are and then make bad plays and whine while other players nod or encourage them.

Don’t tap the tank, an old poker saying goes. The tank is a fish tank. The bad players are the fish. And the good players eat them.

—

One reason I have realized I prefer playing tournaments to cash games: to make significant money in cash games you have to take advantage of real, obvious desperation.

People who barely know how to play or are drunk or high or addicted to gambling or all of the above will show up and buy in for the maximum allowed at the table — $1,000 or $2,000, maybe — and lose quickly. They’ll throw in all their money in completely nonsensical ways, buy in again and lose again.

Sometimes they will lose five or 10 buy-ins in a night before they give up and walk away. Then the better players will nod and get back to playing with each other.

Sometimes they’ll lose their cars, or houses, or businesses, or spouses in a few weeks or months before they give up and walk away. Sometimes they’ll kill themselves before they give up and walk away.

Tournaments do not have that dynamic.

That’s not to say they don’t attract their share of degenerate gamblers. But they require a patience desperate players don’t have. And while they have plenty of bad players, picking on the bad players alone will not get you far. By the time the cash is in sight, those players are gone.

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(Phil Ivey, one of the world’s best poker players. He’s not the one who belongs to Jesus.)

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Tournaments are also fairer than cash games.

Because seat assignments are random and cannot be changed, players cannot collude with each other, or outright cheat, or simply move tables to find weaker players, as they do at cash games.

So: tournaments are the way.

Except they require a lot of luck (luck may not exist in the long run, but in any single hand it is very real); and a lot of patience. To fold hand after hand as the tournament clock is ticking and your stack is slowly shrinking is hard; to have the strength not to play a marginal hand when one finally shows up is harder. To stay focused after 10 hours of play, knowing that a single mistake can end your tournament when you are just short of the cash, is exhausting.

The truest words ever said about poker: Poker’s a hard way to make an easy living.

Why, then?

Why am I writing about poker on this Fourth of July, on the 250th anniversary of this great country?

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Because tournament poker — not baseball, not football, not even basketball — is the truest American game.

It is open to all. No licenses or degrees required. Anyone who can get to Las Vegas is allowed to enter the World Series (including some I wish wouldn’t be, guys who use annoying other players as an intentional strategy). On Thursday a 34-year-old named Biao Ding was two seats from me. I hadn’t heard of him. Probably I should have. He’s considered the best player in China.

The rules are defined in advance and the same for everyone. The casino and dealers are state-regulated and impartial — fairer than any judge, they have no politics, no reason to pick one side over another.

And so the fight is fair and honest. You put up your capital and compete.

Poker is the not the American dream.

It is the American ideal at a nine-handed table, a chance to win or lose in open competition, to test one’s skills in real time. At the end of each hand, the chips move one way or another. At the end of the tournament, one player still stands. The game can be cruel, but it is never a lie.

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(Unreported Truths. Never a lie. Stand with me.)

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I played two events this week, both Texas Hold ‘em no-limit, the simplest and purest form of poker. About 30 hours of poker over three days. I hardly left the hotel.

I finished 993rd in the $1,000 “mini-main” (better than it sounds, there were 5,908 players) and 37th in the $3,000 out of 1,792 players, a $17,240 cash. That’s the second straight year I have cashed in the $3,000.

I put Biao Ding on tilt, too. I took a big stack of his chips when an aggressive play I’d made paid off (I was behind, sure, but sometimes fortune favors the bold), and shortly thereafter he busted. He shook his head as he walked off.

America 1, China 0.

Next year I’m not going to finish 37th. I’m going to finish first.

Not in the $3,000. In the Main.

There’s no point in getting in the ring if you don’t plan to win.

God bless you, your family, and the United States of America.

Have a fantastic Fourth of July.

For four months, Kean, a Republican from New Jersey, didn’t show up for House votes. Or talk to his constituents. Or the media. Or other Republicans. In May, his chief of staff told a reporter, “There’s no cameras where Tom is,” a comment that hardly put the questions to rest.

On Tuesday, Kean reappeared, with an explanation for his vanishing act. Sort of.

In a five-minute speech on the House floor, Kean — who is running for reelection — claimed he had been hospitalized for depression after “some testing” at a “hospital.”

And that was, essentially, all he said.

He took no questions. He didn’t name the hospital, or how long he’d been hospitalized. Or offer any details about his diagnosis, or if it was related in any way to drug or alcohol use. Or what treatments he’d received, and whether they included medicine, electroshock, or both. Or whether he continues to take medication.

Sorry, Congressman. You cannot expect voters to respect that story. If that’s the best you can do, you need to quit your reelection campaign. This is not a partisan issue; it’s about the minimum standards we can expect of public officeholders — and of the reasonable expectations we can have for people with severe mental illness.

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(The truth, even when it’s hard.)

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Of course politicians, like everyone else, have some expectation of privacy on personal health matters (with the possible exception of the Presidency, given the unique importance and demands of the job), as long as they’re doing their jobs.

Kean failed to do his. For one-sixth of his entire term, he was gone.

Assume Kean is telling the truth, and not using a depression diagnosis to hide a substance abuse problem. He still doesn’t get a pass.

If Kean had cancer or congestive heart failure or some other physical ailment severe enough to keep him hospitalized for months, voters would rightly expect him to explain his diagnosis and treatment enough to allow them to judge his health for themselves. Trust me, I’m better, would not be an acceptable answer.

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(Tom Kean, in the flesh)

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Instead, Kean seems to think that “I was depressed” is an all-purpose defense against follow-up health questions. The opposite is true. Psychiatric illness requiring prolonged inpatient treatment is even more relevant to Kean’s capacity to serve than a disease like cancer.

Suppose Kean had been diagnosed with schizophrenia or another psychotic disorder. Almost no one would suggest he should remain in Congress. But severe depression can include elements of psychosis. Did Kean’s? Is that why he was hospitalized for so long? We have no idea, because he didn’t say. Even assuming it did not, people with severe depression frequently relapse. How can Kean offer any reasonable promise he won’t be back in the hospital again next term?

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Severe mental illness is deeply painful, and people suffering it deserve compassion and support.

But in the last 20 years American culture has gone from stigmatizing mental illness to almost valorizing it, encouraging people to talk endlessly about their diagnoses. Along the way, we have grown to pretend truly severe mental illness is a get-out-of-jail free card that once played exempts its sufferers from ordinary standards of behavior and work.

Serving in Congress is a privilege, not a right. At a minimum, Tom Kean needs to explain to voters why he deserves that privilege.

If he can’t, he should leave his seat to someone who can..

I am a widower going on eight years now. Your book was somewhat basic with no-frills or convoluted flowery philosophy like all the self-appraising authors sound like. Instead, it was straight to the point and authentic because dads don't have time to read anything other than maintenance manuals for the car. That takes guts because it's not politically correct. Being authentic and being based in reality is not exactly the narrative of today…

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Thank you, Michael G. No-frills is exactly right. I wrote The Fatherhood Manifesto because I believe we have forgotten simple, common-sense centrism.

(Audiobook now also available!)

On nearly every issue, an insane, self-reinforcing, and self-defeating polarization grips our politics and culture. The left’s decades-long monopoly on Hollywood, the legacy media, academia, and the administrative state has bred an anger on the right that sometimes goes too far in the other direction.

I am working on a piece about our never-ending abortion battles, and the reality that abortion has become more common since the Supreme Court overturned Roe v. Wade. But our anger and polarization encompasses seemingly every cultural issue — including, astonishingly, the simple value of fatherhood and masculinity.

I wrote the Fatherhood Manifesto to stand up for fatherhood against femininized “gentle parenting,” but also against the testosterone (injection)-fueled culture that Andrew Tate and other “influencers” have promoted for the last decade.

The tips it offers are simple and useful (I hope) but its overarching philosophy is crucial. It is not a guide, it is a manifesto, and I wrote it for every day of the year, not just Father’s Day. And you seem to agree, it has a near perfect ranking on Amazon.

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So if you haven’t picked it up, I hope you will. I am considering expanding it into a full-length book — and the sales it posts in the next few weeks will play a crucial role in my (and a traditional publisher’s) enthusiasm.

Finally, several of you have asked when The Fatherhood Manifesto audiobook would be available. As mentioned above, the answer is NOW! And at just over an hour and an easy listen, the audiobook may be the best version of all.

So if you’ve been waiting, download it here!

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(The New York Times, making matters worse.)

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(And speaking of abortion, my 2022 piece following the Supreme Court’s decision to overturn Roe v. Wade. Paywalled, subscribe to read.)