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"content": "\u003cp>Starting this year, routine pediatric visits for millions of California children could involve questions about touchy family topics, such as divorce, unstable housing or a parent who struggles with alcoholism.\u003c/p>\n\u003cp>California now will pay doctors to screen patients for traumatic events known as adverse childhood experiences, or ACEs, if the patient is covered by Medi-Cal.\u003c/p>\n\u003cp>The screening program is rooted in \u003ca href=\"https://californiahealthline.org/news/california-looks-to-lead-nation-aces-screening-childhood-trauma/\" target=\"_blank\" rel=\"noopener noreferrer\">decades of research\u003c/a> that suggests children who endure sustained stress in their day-to-day lives undergo biochemical changes to their brains and bodies that can dramatically increase their risk of developing serious health problems, including heart disease, asthma, depression and cancer.\u003c/p>\n\u003cp>Health and welfare advocates hope that widespread screening of children for ACEs, accompanied by early intervention, will help reduce the ongoing stresses and skirt the onset of physical illness, or at least ensure an illness is treated.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Dayna Long, a pediatrician at UCSF\"]‘We’re not going to make all the hard things go away, but we can help families build resilience and reduce stress.’[/pullquote]\u003c/p>\n\u003cp>The higher the number of such adverse events — and so, the higher a child’s ACEs “score” — the higher the risk of chronic illness and premature death. About 63% of Californians have experienced at least one adverse childhood event, and nearly 18% have faced four or more, according to state health officials.\u003c/p>\n\u003cp>California is the first state to create a formal reimbursement strategy for ACEs screening, and the program will be open to both children and adults enrolled in Medi-Cal. The initiative is part of a larger \u003ca href=\"https://www.dhcs.ca.gov/Documents/ACEs-AWARE-INITIATIVE.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">ACEs awareness campaign\u003c/a> championed by the state’s first surgeon general, \u003ca href=\"https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime/discussion?CMP\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Nadine Burke Harris\u003c/a>, who is a national leader in the ACEs movement.\u003c/p>\n\u003cp>The public health impact could be significant as Medi-Cal covers 5.3 million kids — roughly 40% of all California children — and 6.3 million adults.\u003c/p>\n\u003cp>“It is a profound shift that’s going to change the type of prevention and management we do with families,” said Dr. Dayna Long, a pediatrician who is director of the Center for Child and Community Health at UCSF Benioff Children’s Hospital Oakland and helped develop the state-approved screening tool for children and teens. “We’re not going to make all the hard things go away, but we can help families build resilience and reduce stress.”\u003c/p>\n\u003cp>Here are five key things to know about ACEs and the state’s new screening program:\u003c/p>\n\u003ch4>1. How it Works\u003c/h4>\n\u003cp>At a typical well-child visit, parents or caregivers will be asked to fill out a state-approved \u003ca href=\"https://www.acesaware.org/wp-content/uploads/2019/12/PEARLS-Tool-Child-Parent-Caregiver-Report-De-Identified-English.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">questionnaire\u003c/a> about potentially stressful experiences in their children’s lives. For children under age 12, caregivers fill out the survey. Young people ages 12-19 will complete their own questionnaire in addition to their caregivers’ questionnaire.\u003c/p>\n\u003cp>The questions will touch on 10 categories of adversity spanning the first 18 years of life: physical, emotional or sexual abuse; physical or emotional neglect; and experiences that could indicate household dysfunction, such as a parent who has a serious mental illness or addiction, having parents who are incarcerated or living in a home with domestic violence.\u003c/p>\n\u003cp>[aside postID=mindshift_54373 label='Does every moment matter?' hero=\"https://cdn.kqed.org/wp-content/uploads/sites/23/2019/09/happy-childhood-photos-de61f9ac60f2b9d24a1196c86e0d47be30eebaea-1020x765.jpg\"]The screening will measure for experiences that could regularly trigger fear and anxiety, including homelessness, not having enough food or the right kinds of food, and growing up in a neighborhood marred by drugs and violence.\u003c/p>\n\u003cp>Dr. Long acknowledged some caregivers and children might be reluctant or unwilling to disclose sensitive information, particularly if they fear shame or repercussions. “We acknowledge it takes time to build trust,” she said. “But we want to encourage families to have hard conversations with their doctors and to understand how stressful events over the life of the child are impacting that child’s health.”\u003c/p>\n\u003cp>Physicians will review the responses and discuss them with caregivers during the visit. Doctors will have access to free online training on how to communicate with families and connect them to community resources. Physicians will be eligible for a $29 reimbursement for each Medi-Cal patient screened.\u003c/p>\n\u003cp>The responses are considered confidential patient information and won’t be shared with state officials. But researchers hope that aggregated information will be studied to improve care for patients with high ACEs scores.\u003c/p>\n\u003ch4>2. Screenings Are Voluntary\u003c/h4>\n\u003cp>Doctors do not need to offer them, and patients and their caregivers do not have to participate. Doctors will need to complete online training before they can be paid for screening patients. The state will cover the costs of screening once a year for children and once in a lifetime for adults. But children are the main focus of the screening campaign.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch4>3. What Happens After the Screening Is Less Clear\u003c/h4>\n\u003cp>Community clinics often have social workers or “navigators” available to connect families to aid like food stamps or counseling. Doctors in private practice, however, are less likely to have those resources, said Dr. Eric Ball, an Orange County pediatrician who served on a committee advising the surgeon general on the ACEs campaign. Ball said local chapters of the American Academy of Pediatrics will work to educate doctors on how to help children who register high ACEs scores, because social services vary so much by county.\u003c/p>\n\u003cp>Doctors “are not going to get rich doing ACEs screenings, that’s not the point,” Ball said. “If we can pick up kids at higher risk for these issues down the road and mitigate it, that’s really exciting to me.”\u003c/p>\n\u003ch4>4. Researchers Aren’t Yet Sure Which Interventions Will Best Help Kids With High ACEs Scores\u003c/h4>\n\u003cp>Long and her UCSF Benioff colleagues are \u003ca href=\"https://clinicaltrials.ucsf.edu/trial/NCT04182906\" target=\"_blank\" rel=\"noopener noreferrer\">continuing to study\u003c/a> how well the ACEs screening works and what interventions might be most effective. It’s one thing to help hungry families sign up for food stamps and free school lunches. It’s less clear how to help a child whose parent is in prison. Researchers have identified protective factors that can help children better resist the effects of toxic stress, including nurturing relationships with trusted adults, such as grandparents or teachers.\u003c/p>\n\u003cp>“The fact of screening is also an intervention,” Long said. “Being able to sit in a room with a pediatrician is not going to make those hard experiences go away, but it creates a freedom to talk about some things that are solvable. That’s therapeutic in and of itself.”\u003c/p>\n\u003ch4>5. Not Everyone Agrees That Widespread ACEs Screening Is a Good Idea\u003c/h4>\n\u003cp>Sociologist David Finkelhor, director of the Crimes against Children Research Center at the University of New Hampshire, is among those who caution that universal screening for ACEs is premature, given there is little consensus about the potential negative effects of screening or the best interventions.\u003c/p>\n\u003cp>[aside postID=\"science_1938819,news_11724781,futureofyou_439851\" label=\"Related Coverage\"]“The good news is that we are focusing on these adversities that are clearly the source of so many downstream health and mental health problems,” Finkelhor said. “But the bad news is we’re moving way too fast, before we know how to best conduct this kind of screening and intervention, and we could get it wrong with pretty disastrous consequences.”\u003c/p>\n\u003cp>“Mostly, we don’t know what to do with somebody who has a high ACE score,” he said. “There are already long waits to get into family counseling or child mental health programs.”\u003c/p>\n\u003cp>For example, a doctor might be legally required to report previous abuse to authorities, upending a family even if the child no longer is exposed to the abuser, Finkelhor said.\u003c/p>\n\u003cp>“These are tough questions,” Long of UCSF acknowledged. Still, she said, screening is important, because it encourages physicians to engage in difficult conversations they might not otherwise have and pushes clinics to create links to supportive services and resources.\u003c/p>\n\u003cp>“That is the next phase, and that is important,” Long said. “We’re doing this because we care about your child and want them to grow into healthy adults.”\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org/\" target=\"_blank\" rel=\"noopener noreferrer\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "California now will pay doctors to screen patients for traumatic events known as adverse childhood experiences, or ACEs, if the patient is covered by Medi-Cal.",
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"title": "5 Things to Know as California Starts Screening Children for Toxic Stress | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Starting this year, routine pediatric visits for millions of California children could involve questions about touchy family topics, such as divorce, unstable housing or a parent who struggles with alcoholism.\u003c/p>\n\u003cp>California now will pay doctors to screen patients for traumatic events known as adverse childhood experiences, or ACEs, if the patient is covered by Medi-Cal.\u003c/p>\n\u003cp>The screening program is rooted in \u003ca href=\"https://californiahealthline.org/news/california-looks-to-lead-nation-aces-screening-childhood-trauma/\" target=\"_blank\" rel=\"noopener noreferrer\">decades of research\u003c/a> that suggests children who endure sustained stress in their day-to-day lives undergo biochemical changes to their brains and bodies that can dramatically increase their risk of developing serious health problems, including heart disease, asthma, depression and cancer.\u003c/p>\n\u003cp>Health and welfare advocates hope that widespread screening of children for ACEs, accompanied by early intervention, will help reduce the ongoing stresses and skirt the onset of physical illness, or at least ensure an illness is treated.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We’re not going to make all the hard things go away, but we can help families build resilience and reduce stress.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The higher the number of such adverse events — and so, the higher a child’s ACEs “score” — the higher the risk of chronic illness and premature death. About 63% of Californians have experienced at least one adverse childhood event, and nearly 18% have faced four or more, according to state health officials.\u003c/p>\n\u003cp>California is the first state to create a formal reimbursement strategy for ACEs screening, and the program will be open to both children and adults enrolled in Medi-Cal. The initiative is part of a larger \u003ca href=\"https://www.dhcs.ca.gov/Documents/ACEs-AWARE-INITIATIVE.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">ACEs awareness campaign\u003c/a> championed by the state’s first surgeon general, \u003ca href=\"https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime/discussion?CMP\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Nadine Burke Harris\u003c/a>, who is a national leader in the ACEs movement.\u003c/p>\n\u003cp>The public health impact could be significant as Medi-Cal covers 5.3 million kids — roughly 40% of all California children — and 6.3 million adults.\u003c/p>\n\u003cp>“It is a profound shift that’s going to change the type of prevention and management we do with families,” said Dr. Dayna Long, a pediatrician who is director of the Center for Child and Community Health at UCSF Benioff Children’s Hospital Oakland and helped develop the state-approved screening tool for children and teens. “We’re not going to make all the hard things go away, but we can help families build resilience and reduce stress.”\u003c/p>\n\u003cp>Here are five key things to know about ACEs and the state’s new screening program:\u003c/p>\n\u003ch4>1. How it Works\u003c/h4>\n\u003cp>At a typical well-child visit, parents or caregivers will be asked to fill out a state-approved \u003ca href=\"https://www.acesaware.org/wp-content/uploads/2019/12/PEARLS-Tool-Child-Parent-Caregiver-Report-De-Identified-English.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">questionnaire\u003c/a> about potentially stressful experiences in their children’s lives. For children under age 12, caregivers fill out the survey. Young people ages 12-19 will complete their own questionnaire in addition to their caregivers’ questionnaire.\u003c/p>\n\u003cp>The questions will touch on 10 categories of adversity spanning the first 18 years of life: physical, emotional or sexual abuse; physical or emotional neglect; and experiences that could indicate household dysfunction, such as a parent who has a serious mental illness or addiction, having parents who are incarcerated or living in a home with domestic violence.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The screening will measure for experiences that could regularly trigger fear and anxiety, including homelessness, not having enough food or the right kinds of food, and growing up in a neighborhood marred by drugs and violence.\u003c/p>\n\u003cp>Dr. Long acknowledged some caregivers and children might be reluctant or unwilling to disclose sensitive information, particularly if they fear shame or repercussions. “We acknowledge it takes time to build trust,” she said. “But we want to encourage families to have hard conversations with their doctors and to understand how stressful events over the life of the child are impacting that child’s health.”\u003c/p>\n\u003cp>Physicians will review the responses and discuss them with caregivers during the visit. Doctors will have access to free online training on how to communicate with families and connect them to community resources. Physicians will be eligible for a $29 reimbursement for each Medi-Cal patient screened.\u003c/p>\n\u003cp>The responses are considered confidential patient information and won’t be shared with state officials. But researchers hope that aggregated information will be studied to improve care for patients with high ACEs scores.\u003c/p>\n\u003ch4>2. Screenings Are Voluntary\u003c/h4>\n\u003cp>Doctors do not need to offer them, and patients and their caregivers do not have to participate. Doctors will need to complete online training before they can be paid for screening patients. The state will cover the costs of screening once a year for children and once in a lifetime for adults. But children are the main focus of the screening campaign.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch4>3. What Happens After the Screening Is Less Clear\u003c/h4>\n\u003cp>Community clinics often have social workers or “navigators” available to connect families to aid like food stamps or counseling. Doctors in private practice, however, are less likely to have those resources, said Dr. Eric Ball, an Orange County pediatrician who served on a committee advising the surgeon general on the ACEs campaign. Ball said local chapters of the American Academy of Pediatrics will work to educate doctors on how to help children who register high ACEs scores, because social services vary so much by county.\u003c/p>\n\u003cp>Doctors “are not going to get rich doing ACEs screenings, that’s not the point,” Ball said. “If we can pick up kids at higher risk for these issues down the road and mitigate it, that’s really exciting to me.”\u003c/p>\n\u003ch4>4. Researchers Aren’t Yet Sure Which Interventions Will Best Help Kids With High ACEs Scores\u003c/h4>\n\u003cp>Long and her UCSF Benioff colleagues are \u003ca href=\"https://clinicaltrials.ucsf.edu/trial/NCT04182906\" target=\"_blank\" rel=\"noopener noreferrer\">continuing to study\u003c/a> how well the ACEs screening works and what interventions might be most effective. It’s one thing to help hungry families sign up for food stamps and free school lunches. It’s less clear how to help a child whose parent is in prison. Researchers have identified protective factors that can help children better resist the effects of toxic stress, including nurturing relationships with trusted adults, such as grandparents or teachers.\u003c/p>\n\u003cp>“The fact of screening is also an intervention,” Long said. “Being able to sit in a room with a pediatrician is not going to make those hard experiences go away, but it creates a freedom to talk about some things that are solvable. That’s therapeutic in and of itself.”\u003c/p>\n\u003ch4>5. Not Everyone Agrees That Widespread ACEs Screening Is a Good Idea\u003c/h4>\n\u003cp>Sociologist David Finkelhor, director of the Crimes against Children Research Center at the University of New Hampshire, is among those who caution that universal screening for ACEs is premature, given there is little consensus about the potential negative effects of screening or the best interventions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The good news is that we are focusing on these adversities that are clearly the source of so many downstream health and mental health problems,” Finkelhor said. “But the bad news is we’re moving way too fast, before we know how to best conduct this kind of screening and intervention, and we could get it wrong with pretty disastrous consequences.”\u003c/p>\n\u003cp>“Mostly, we don’t know what to do with somebody who has a high ACE score,” he said. “There are already long waits to get into family counseling or child mental health programs.”\u003c/p>\n\u003cp>For example, a doctor might be legally required to report previous abuse to authorities, upending a family even if the child no longer is exposed to the abuser, Finkelhor said.\u003c/p>\n\u003cp>“These are tough questions,” Long of UCSF acknowledged. Still, she said, screening is important, because it encourages physicians to engage in difficult conversations they might not otherwise have and pushes clinics to create links to supportive services and resources.\u003c/p>\n\u003cp>“That is the next phase, and that is important,” Long said. “We’re doing this because we care about your child and want them to grow into healthy adults.”\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org/\" target=\"_blank\" rel=\"noopener noreferrer\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "could-changing-how-transgender-inmates-are-housed-make-prison-safer-for-them",
"title": "Transgender Prisoners Say They 'Never Feel Safe.' Could a Proposed Law Help?",
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"headTitle": "Transgender Prisoners Say They ‘Never Feel Safe.’ Could a Proposed Law Help? | KQED",
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"content": "\u003cp>\u003cem>Reader advisory: \u003ci>Some accounts of violence in this story contain explicit details and strong language that some may find upsetting.\u003c/i>\u003c/em>\u003c/p>\n\u003cp>Carmen Guerrero spent less than nine hours with her new cellmate before he murdered her.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Jonathan Wilson, boyfriend of Carmen Guerrero, a transgender woman killed by her prison cellmate']‘Carmen died being who she wanted to be as a woman and it cost her her life.’[/pullquote]\u003c/p>\n\u003cp>Miguel Crespo had told corrections officers at Kern Valley State Prison that he would kill Guerrero, a transgender woman who wore her hair long and tweezed her eyebrows, if he was forced to share a cell with her, according to an inmate who witnessed the incident and testified at Crespo’s murder trial.\u003c/p>\n\u003cp>When Crespo moved in, Guerrero, 48, began filling out a form that prosecutors believe she intended to use as part of a transfer request.\u003c/p>\n\u003cp>“He stated he is not compatible with me. I’m worried to be raped again,” Guerrero wrote.\u003c/p>\n\u003cfigure id=\"attachment_11794398\" class=\"wp-caption alignnone\" style=\"max-width: 480px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11794398\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_GuerreroK06560-qut.jpg\" alt=\"A prison photo of Carmen Guerrero, a transgender woman killed by her cellmate at Kern Valley State Prison in late 2013. Her cellmate, Miguel Crespo, was sentenced to death in her murder in December 2019. Her family said in court that they didn't have any photos of Carmen because they were lost in a house fire.\" width=\"480\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_GuerreroK06560-qut.jpg 480w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_GuerreroK06560-qut-160x200.jpg 160w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">A prison photo of Carmen Guerrero, a transgender woman killed by her cellmate at Kern Valley State Prison in late 2013. Her cellmate, Miguel Crespo, was sentenced to death in her murder in December 2019. Her family said in court that they didn’t have any photos of Carmen because they were lost in a house fire. \u003ccite>(Courtesy of California Department of Corrections and Rehabilitation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Prison guards told Crespo the move would be temporary, the other inmate testified. Later that night, after Crespo strangled Guerrero, he called the guards over and said, “You didn’t believe me. I told you I was gonna kill [Guerrero],” according to the inmate.\u003c/p>\n\u003cp>Crespo, who told the trial judge he had previously attacked a gay prisoner, argued in court he shouldn’t have been housed with Guerrero. In December, the judge sentenced Crespo to death for the 2013 murder.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.cdcr.ca.gov\" target=\"_blank\" rel=\"noopener noreferrer\">California Department of Corrections and Rehabilitation\u003c/a> would not comment specifically on the Guerrero case, but said it is “committed to addressing the safety concerns” of transgender, intersex and nonbinary prisoners. The department also said it introduced a \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A031dfb3b-7149-4fc0-97db-82b5323c027a\" target=\"_blank\" rel=\"noopener noreferrer\">screening form\u003c/a> in 2017 intended to prevent potential abusers and victims from residing in the same cell.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Jennifer Levi, director of advocacy group GLAD’s Transgender Rights Project']‘We are seeing a trend towards a greater understanding of the need to provide humane housing and treatment of transgender people who are incarcerated.’[/pullquote]\u003c/p>\n\u003cp>But advocates backing a bill pending in the California State Legislature on safe housing for transgender prisoners said the killing was an example of how CDCR has failed transgender inmates. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB132\" target=\"_blank\" rel=\"noopener noreferrer\">Senate Bill 132\u003c/a> would allow prisoners to live with those who match the gender they identify with — not the one they were assigned at birth.\u003c/p>\n\u003cp>“[Crespo] should never have been in the cell with the girl,” said \u003ca href=\"https://www.linkedin.com/in/fatima-shabazz-b5058a176/\" target=\"_blank\" rel=\"noopener noreferrer\">Fatima Shabazz\u003c/a>, a former inmate and transgender prisoner activist who is working on SB 132. “The whole point in the bill is to prevent things like this from happening.”\u003c/p>\n\u003cp>Shawn Meerkamper, an attorney at the \u003ca href=\"https://transgenderlawcenter.org\" target=\"_blank\" rel=\"noopener noreferrer\">Transgender Law Center\u003c/a>, agreed the pair should not have been housed together and said the U.S. Constitution requires prisons to protect inmates they know to be in danger.\u003c/p>\n\u003cp>“It’s hard to get a lot clearer than having someone saying, ‘I am going to kill this person,’ and then doing it,” Meerkamper said.\u003c/p>\n\u003ch2>‘A Greater Understanding’\u003c/h2>\n\u003cp>Transgender inmates have long been identified as a vulnerable population. Neither California nor the federal government tracks prison homicides by gender identity, but the \u003ca href=\"https://www.bjs.gov/content/pub/pdf/svpjri1112.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">most recent federal data\u003c/a>, from 2011-12, found 40% of transgender prisoners reported being the victim of a sexual assault within the previous 12 months — 10 times the percentage of non-transgender inmates.\u003c/p>\n\u003cp>SB 132 is the latest in a growing number of efforts nationwide to drive those numbers down and make prison less overtly hostile for transgender people. Spurred by advocates, inmates, state lawmakers and some corrections officials, the initiatives include gender-affirming housing, medical care, clothing and other services.\u003c/p>\n\u003cp>“We are seeing a trend towards a greater understanding of the need to provide humane housing and treatment of transgender people who are incarcerated,” said Jennifer Levi, director of the Transgender Rights Project for advocacy group GLBTQ Legal Advocates & Defenders (\u003ca href=\"https://www.glad.org\" target=\"_blank\" rel=\"noopener noreferrer\">GLAD\u003c/a>). “There’s also a growing understanding within corrections systems of the need to respond to transgender people humanely.”\u003c/p>\n\u003cp>Still, the situation portrayed by transgender prisoners and their advocates is complex, with the acknowledgment of progress tempered by violent incidents and allegations they say are indicative of how far the penitentiary system still has to go in providing a safe environment.\u003c/p>\n\u003cp>“CDCR is like trying to push a boulder uphill,” said one inmate, Ava Fey. “There’s that inertia principle where once it’s stopped and it’s happy with how it is, it does not want to change or move.”\u003c/p>\n\u003ch2>‘I Fought Constantly’: Pushing for Change From Inside Prison\u003c/h2>\n\u003cp>At the California Medical Facility, a state prison in Vacaville, one of the new transgender-related accommodations is a workout club.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Amy Miller, associate director of CDCR’s Female Offender Programs and Services, adult division']‘The sentence in coming to state prison, that’s the punishment. Right? You shouldn’t be required to identify a different way simply because you committed a crime and you’ve been given a sentence.’[/pullquote]Last summer, a group of transgender women, who were wearing sports bras, leggings, shorts and tank tops, shot hoops, walked laps, peddled on stationary bikes and paused to gossip in what looked like an ordinary high school gym. The women are among the state’s 1,200 inmates who identify as transgender, gender-nonconforming or intersex — a little less than 1% of the prison population.\u003c/p>\n\u003cp>“I fought constantly and constantly with staff to do something for the girls here at CMF,” inmate Jazzie Paradize Scott, serving time for second-degree robbery, said to a soundtrack of hip-hop and buzzing black fans. “I wanted them to have a safe place where they can wear their shorts, their bras and their tops and their little tennis shoes and come out and just be ladies and be able to work out.”\u003c/p>\n\u003cfigure id=\"attachment_11794376\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794376\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-800x450.jpg\" alt=\"Makayla Fennell, a transgender woman housed at the California Medical Facility in Vacaville, plays basketball with two other transgender women, including Yekaterina Wesa Patience (right), on June 11, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Makayla Fennell, a transgender woman housed at the California Medical Facility in Vacaville, plays basketball with two other transgender women, including Yekaterina Wesa Patience (right), on June 11, 2019. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In a circle of women stretching, Mark Peaches Cates, 58, said she’d never had the chance to exercise with just transgender women. Gym time with men had made her uncomfortable.\u003c/p>\n\u003cp>“You couldn’t be yourself,” said Cates, who is in prison for second-degree murder.\u003c/p>\n\u003cfigure id=\"attachment_11794378\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794378\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-800x450.jpg\" alt=\"Dallas Rachael Goosen, a transgender woman housed at the California Medical Facility in Vacaville on June 11, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dallas Rachael Goosen, a transgender woman housed at the California Medical Facility in Vacaville on June 11, 2019. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In California, many transgender-related services have been implemented after an inmate sued the state prison system over its refusal to provide her with gender-affirmation surgery.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Candice Destiny-Rene Love, who accuses CDCR of failing to protect gay and transgender inmates']‘I love who I am and I love being me, but after the rape and attack, I wondered, if I wasn’t trans, would I still be going through what I’m going through? I don’t think so.’[/pullquote]CDCR \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A02f599b4-42fc-40d2-8764-6bcf65de4ad5\" target=\"_blank\" rel=\"noopener noreferrer\">settled\u003c/a> with the prisoner, Shiloh Heavenly Quine, in 2015, agreeing to perform the surgery and becoming the \u003ca href=\"https://www.nbcnews.com/feature/nbc-out/transgender-inmate-says-women-s-prison-torture-n737676\" target=\"_blank\" rel=\"noopener noreferrer\">first prison system\u003c/a> in the nation to set \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A4dace6e8-5ad9-481f-912c-91f7ebd25398\" target=\"_blank\" rel=\"noopener noreferrer\">guidelines\u003c/a> for other transgender inmates to seek approval for the operation. As of September, CDCR said at least four prisoners had undergone the surgery. About 175 have applied and 19 have been approved as of November, according to the department.\u003c/p>\n\u003cp>The judge in the Quine case also \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3Ac3321e30-eed1-4ead-b908-67ebf68f59db\" target=\"_blank\" rel=\"noopener noreferrer\">ordered\u003c/a> California prisons to make available to transgender inmates such gender-affirming items as clothing, jewelry and makeup.\u003c/p>\n\u003cp>The benefits of that order could be seen at a transgender support group at the prison in Vacaville, where women put makeup on one another and talked about having to previously resort to DIY tricks in order to fashion cosmetics — using pastels, wax pencils, Kool-Aid, cocoa and coffee.\u003c/p>\n\u003cfigure id=\"attachment_11794368\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794368\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-800x450.jpg\" alt=\"James Star Henderson (left) puts makeup on Dallas Rachael Goosen during a transgender support group meeting at the California Medical Facility in Vacaville on July 25, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">James Star Henderson (left) puts makeup on Dallas Rachael Goosen during a transgender support group meeting at the California Medical Facility in Vacaville on July 25, 2019. \u003ccite>(Monica Lam/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One hack, according to 59-year-old Cary Smith: Running a Q-tip over baby oil pooled on a Colgate toothpaste box. The result: pink eyeshadow.\u003c/p>\n\u003cp>Wearing makeup “makes me feel like I’m a step closer to being who I really am. … I feel like I can keep going,” said Smith, who is serving time for assault with a deadly weapon.\u003c/p>\n\u003cfigure id=\"attachment_11794371\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794371\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-800x450.jpg\" alt=\"Jarrett Angel Williams, a transgender woman housed at the California Medical Facility in Vacaville, on July 25, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jarrett Angel Williams, a transgender woman housed at the California Medical Facility in Vacaville, on July 25, 2019. \u003ccite>(Monica Lam/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘You Were Here to Serve Others’\u003c/h2>\n\u003cp>CDCR said it doesn’t track violence in California prisons for any subset of inmates, including those who are transgender. A rare data point comes from a \u003ca href=\"https://ucicorrections.seweb.uci.edu/files/2013/06/BulletinVol2Issue2.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">2007 study\u003c/a> that included interviews with 39 transgender prisoners at a single state prison: 59% reported being sexually assaulted, 13 times the rate for non-transgender prisoners.\u003c/p>\n\u003cp>“There was a time when being a transgender in prison, it was pretty hopeless. It was dark. You were here to serve others,” Cary Smith said.\u003c/p>\n\u003cp>The transgender prisoners at CMF had plenty of traumatic incidents to recount. Yekaterina Wesa Patience said she was playing dominoes and smoking a joint with her cellmate in Pelican Bay State Prison in the late 1990s when he suddenly got on top of her and raped her. That sent her into the closet for nearly 20 years.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Yekaterina West Patience, who said she was twice raped in prison in the 1990s']‘I immediately cut all my hair off, kept my head bald … I grew a mustache and a goatee, and tried to adopt the hardest walk I could on the yard. I was terrified of it happening again, and I was not going to be out for somebody else to do it.’[/pullquote]“I immediately cut all my hair off, kept my head bald … I grew a mustache and a goatee, and tried to adopt the hardest walk I could on the yard,” said Patience, imprisoned for first-degree murder and other crimes. “I was terrified of it happening again, and I was not going to be out for somebody else to do it.”\u003c/p>\n\u003cp>Still, Patience said, she was raped again, about 18 months later at Mule Creek State Prison. (KQED could not verify most of the alleged attacks reported by Patience and the other prisoners in this story; CDCR said it investigates allegations, but federal law prevents it from sharing details about specific cases.)\u003c/p>\n\u003cp>David Bella Birrell, imprisoned for first-degree murder, also said she’d been sexually assaulted in prison. “They had a motto back in those days: It was either fight or fuck.”\u003c/p>\n\u003cfigure id=\"attachment_11794370\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794370\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-800x450.jpg\" alt=\"David Bella Birrell (left) and Jarrett Angel Williams, transgender women housed at the California Medical Facility in Vacaville, on June 11, 2019, in the prison gym.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">David Bella Birrell (left) and Jarrett Angel Williams, transgender women housed at the California Medical Facility in Vacaville, on June 11, 2019, in the prison gym. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘Life-Saving Legislation’\u003c/h2>\n\u003cp>In recent years, a flurry of laws and \u003ca href=\"https://chicago.suntimes.com/2019/5/8/18618926/transgender-inmate-seeks-clemency-cites-retaliation-after-reporting-abuse\" target=\"_blank\" rel=\"noopener noreferrer\">lawsuits\u003c/a>, many from prisoners like Quine, have forced systemic \u003ca href=\"https://www.wbur.org/news/2019/01/26/transgender-inmate-transferred-womens-prison\" target=\"_blank\" rel=\"noopener noreferrer\">changes\u003c/a> in the way penal systems in some states treat transgender prisoners. In\u003ca href=\"https://chicago.suntimes.com/2019/5/8/18618926/transgender-inmate-seeks-clemency-cites-retaliation-after-reporting-abuse\"> Illinois, \u003c/a>\u003ca href=\"https://www.acluofnorthcarolina.org/en/news/kanautica-zayre-brown-transferred-womens-facility\"> North Carolina\u003c/a> and \u003ca href=\"https://www.bostonglobe.com/metro/2019/01/24/transgender-inmate-moved-women-prison/Nf2k5Oqa3Ojnh1yH1IwWkL/story.html\" target=\"_blank\" rel=\"noopener noreferrer\">Massachusetts\u003c/a>, transgender inmates have won in court the right to transfer to women’s prisons.\u003c/p>\n\u003cp>In recent months, transgender prisoners in Colorado \u003ca href=\"http://transgenderlawcenter.org/wp-content/uploads/2019/11/Class-Action-Trans-Women-Complaint.pdf\"> brought a class action against\u003c/a> state prison officials over a lack of safe housing; and three transgender inmates in Texas filed a lawsuit seeking to \u003ca href=\"https://dfw.cbslocal.com/2019/12/06/transgender-women-fight-texas-law-that-restricts-inmates-from-changing-name/\"> legally change their names.\u003c/a>\u003c/p>\n\u003cp>In California, a law allowing prisoners to change their \u003ca href=\"https://www.ebar.com/news/news/275618\" target=\"_blank\" rel=\"noopener noreferrer\">gender and name\u003c/a> took effect in late 2018. SB 132, the California bill that would let transgender inmates choose, with some exceptions, whether to be imprisoned in a men’s or women’s facility, is similar to measures enacted in \u003ca href=\"https://www.newsweek.com/connecticut-transgender-prisoners-first-us-win-right-be-housed-according-947312\" target=\"_blank\" rel=\"noopener noreferrer\">Connecticut\u003c/a> and \u003ca href=\"https://www.mass.gov/info-details/mass-general-laws-c127-ss-32a\" target=\"_blank\" rel=\"noopener noreferrer\">Massachusetts\u003c/a>.\u003c/p>\n\u003cp>“Transgender inmates are some of the most marginalized members of society,” said \u003ca href=\"https://sd11.senate.ca.gov\" target=\"_blank\" rel=\"noopener noreferrer\">state Sen. Scott Wiener\u003c/a>, D-San Francisco, SB 132’s sponsor. “They need more support. The housing aspect is one piece of the puzzle. And it’s a really significant one.”\u003c/p>\n\u003cp>Passage of Wiener’s bill would be “lifesaving,” said \u003ca href=\"http://bambysalcedo.com\">Bamby Salcedo\u003c/a>, a Los Angeles-based transgender activist who spent 14 years in California jails and prisons. Salcedo said the measure would allow transgender inmates to do their time “away from harassment and violence.”\u003c/p>\n\u003cp>The bill passed the state Senate last year, but did not get a floor vote in the Assembly. Wiener, who put the measure on hold until this year to discuss the issue with prisoners, believes it will pass.\u003c/p>\n\u003ch2>Federal Standards Not Met\u003c/h2>\n\u003cp>Wiener’s bill would also bring California in line with federal standards laid out in the Prison Rape Elimination Act, or PREA. These regulations, \u003ca href=\"https://www.federalregister.gov/documents/2012/06/20/2012-12427/national-standards-to-prevent-detect-and-respond-to-prison-rape\" target=\"_blank\" rel=\"noopener noreferrer\">which took effect in August 2012\u003c/a>, recognize transgender inmates as a vulnerable population and stipulate that transgender housing assignments must ensure prisoners’ health and safety. Audits for each facility must be conducted every three years.\u003c/p>\n\u003cp>In 2017, a \u003ca href=\"https://www.cdcr.ca.gov/wp-content/uploads/sites/186/2019/06/cmf-2017-prea-report.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">federal audit\u003c/a> found that CDCR’s policy of housing transgender inmates based solely on their biological sex ran afoul of PREA guidelines and that the department didn’t take into account the prisoners’ own views about their safety.\u003c/p>\n\u003cp>In response, CDCR said, it implemented a \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A031dfb3b-7149-4fc0-97db-82b5323c027a\" target=\"_blank\" rel=\"noopener noreferrer\">screening tool\u003c/a> used to assess risk of victimization. The agency also said its current housing policy requires every inmate receive a case-by-case review of where they are imprisoned, with no restriction on living in a men’s or women’s facility based solely on anatomy.\u003c/p>\n\u003cp>“We recognize that when we’re dealing with our transgender men and women, that our staff need much more guidance when they’re looking at what appropriate housing looks like,” said Amy Miller, associate director of CDCR’s Female Offender Programs and Services, adult division.\u003c/p>\n\u003cfigure id=\"attachment_11794375\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794375\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-800x450.jpg\" alt=\"James Star Henderson (right) and Mark Peaches Cate, two transgender woman housed at the California Medical Facility in Vacaville, take their pulse after exercising in the prison gym on June 11, 2019. Pictured left is their coach, Jeremiah Holland.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">James Star Henderson (right) and Mark Peaches Cate, two transgender woman housed at the California Medical Facility in Vacaville, take their pulse after exercising in the prison gym on June 11, 2019. Pictured left is their coach, Jeremiah Holland. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Still, CDCR couldn’t point to any transgender prisoners, besides the few who had undergone gender-affirmation surgery, who had been allowed to switch facilities. The department said it doesn’t track that information.\u003c/p>\n\u003cp>Harper Jean Tobin, policy director at the \u003ca href=\"https://transequality.org\" target=\"_blank\" rel=\"noopener noreferrer\">National Center for Transgender Equality\u003c/a>, said while some states have improved their rules on transgender housing, frequently the policies “only exist on paper.”\u003c/p>\n\u003cp>“Today, contrary to the federal PREA rules, most transgender prisoners continue to be housed automatically with the sex they were assigned at birth, which is often dangerous for them,” Tobin said.\u003c/p>\n\u003ch2>‘You Never Feel Safe’\u003c/h2>\n\u003cp>At CMF, transgender women had mixed reactions to the idea of changing living facilities.\u003c/p>\n\u003cp>Birrell, 67, called Wiener’s housing bill “insanity” and worried about potential conflicts with the existing female prisoner population. She already likes the community resulting from CDCR’s present system of transgender hubs — 14 prisons that offer special medical and mental health care.\u003c/p>\n\u003cp>But inmate Ava Fey said she would likely “run” to a women’s prison for reasons of safety. Living with women would also offer something that’s eluded her for decades: women whom she could emulate.\u003c/p>\n\u003cp>“I’ve been hiding so long — the mannerisms — I’ve kind of tucked them in and locked it away,” said Fey, who was convicted of first-degree murder.\u003c/p>\n\u003cfigure id=\"attachment_11794380\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794380\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-800x450.jpg\" alt=\"Ava Fey, a transgender woman who started taking hormone replacement therapy in January, at the California Medical Facility in Vacaville on June 11, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ava Fey, a transgender woman who started taking hormone replacement therapy in January, at the California Medical Facility in Vacaville on June 11, 2019. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yekaterina Wesa Patience, 44, said she’d “love” to transfer to a women’s prison as well: “I think that would eliminate a lot of the problems of being sexually assaulted or being raped, pressured.”\u003c/p>\n\u003cp>“You just never feel safe here,” she said. “You never feel like you can let your guard down.”\u003c/p>\n\u003cp>Other women, many who live on their own in single cells, said they were fine staying at CMF. Jazzie Paradize Scott, 47, who said she lives in a dorm with 150 men and a few other transgender women, sees the benefits of moving to a women’s prison, but views her current housing choice as a form of activism.\u003c/p>\n\u003cp>“I want them to be able to see me for who I [am],” she said. “I thought it would be a good idea for me to come out and mingle — not just for the trans women and to show that we can conquer even in the dorm living situation — but just to be able to exist with the males in CMF.”\u003c/p>\n\u003cfigure id=\"attachment_11794377\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794377\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-800x450.jpg\" alt=\"Jazzie Paradize Scott, a transgender woman housed at the California Medical Facility in Vacaville on June 11, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jazzie Paradize Scott, a transgender woman housed at the California Medical Facility in Vacaville on June 11, 2019. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Transgender men at the Central California Women’s Facility in Chowchilla had a different take.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='State Sen. Scott Wiener on SB 132, housing legislation he has proposed for transgender prisoners']‘Transgender inmates are some of the most marginalized members of society. They need more support. The housing aspect is one piece of the puzzle. And it’s a really significant one.’[/pullquote]“I already fight for my life in this prison. How do you think I’m going to fare in a male institution even before surgery?” said 52-year-old Diamond Vargas, serving time for assault with a semiautomatic firearm. “There’s not a hormone shot in the world [we could take so that] we’re going to make it.”\u003c/p>\n\u003cp>Shiloh Heavenly Quine, 60, whose lawsuit spurred many of the changes around incarcerating transgender inmates in the state, is one of a few prisoners to have lived in both men’s and women’s prisons. Despite experiencing some bullying that she said landed her in administrative segregation, she feels much safer in the women’s facility.\u003c/p>\n\u003cp>“People get sliced every now and then. … People get hit with locks every now and then, you have that, but all in all it’s pretty mellow here,” said Quine, who is incarcerated at CCWF for first-degree murder. “This is easy time. I call it Prisneyland.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>State Prisons Adapt\u003c/h2>\n\u003cp>California prison officials say they’re trying to stay part of the national conversation on transgender issues. Besides creating support groups, \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A0a3108af-70bc-4032-9efc-54290f73af5d\" target=\"_blank\" rel=\"noopener noreferrer\">changes in recent years\u003c/a> include directives to prison staff to use preferred pronouns and the hosting of events like a post-release transgender resource fair.\u003c/p>\n\u003cp>After the Quine settlement, CDCR polled transgender inmates about preferred cosmetic and hygenic items and then mandated that prison canteens carry them. \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3Af24b92e1-6def-406b-9978-c651981f9dc5\" target=\"_blank\" rel=\"noopener noreferrer\">Options for clothing\u003c/a> have expanded: Available items now include scoop-necked shirts for transgender women and chest-flattening binders for transgender men.\u003c/p>\n\u003cp>“The sentence in coming to state prison, that’s the punishment. Right?” said CDCR’s Miller. “You shouldn’t be required to identify a different way simply because you committed a crime and you’ve been given a sentence.”\u003c/p>\n\u003cfigure id=\"attachment_11794369\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794369\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-800x450.jpg\" alt=\"James Star Henderson (left) and Cary Smith, share a laugh during a transgender support group meeting at the California Medical Facility in Vacaville on July 25, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">James Star Henderson (left) and Cary Smith, share a laugh during a transgender support group meeting at the California Medical Facility in Vacaville on July 25, 2019. \u003ccite>(Monica Lam/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the meantime, a number of the transgender prisoners at CMF said conditions for them have improved. Birrell said the situation took a positive turn in the mid-2000s: “It’s been a long process. But things are a lot better today than they have been.”\u003c/p>\n\u003cp>Advocates said they expect that lawsuits and laws will continue to force changes.\u003c/p>\n\u003cp>“That will have to continue because of just so much pervasive lack of information across correction systems,” said Levi of GLAD. “But I’m also hopeful that won’t be the exclusive way in which we see things move.”\u003c/p>\n\u003cfigure id=\"attachment_11794372\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794372\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-800x450.jpg\" alt=\"Yekaterina Wesa Patience, a transgender woman housed at the California Medical Facility in Vacaville on July 25, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Yekaterina Wesa Patience, a transgender woman housed at the California Medical Facility in Vacaville on July 25, 2019. \u003ccite>(Monica Lam/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘If I Wasn’t Trans …’\u003c/h2>\n\u003cp>Despite these changes, transgender prisoners have continued to allege mistreatment.\u003c/p>\n\u003cp>“Somebody hit me in the side and then just choked me out, just choked me out,” Fey said of an attack earlier this year in the kitchen at CMF, which she attributed to her gender identity. Fey provided KQED with documentation of the attack.\u003c/p>\n\u003cp>A \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A2a0aab67-79b7-4295-b7cc-d4f2478ac864\" target=\"_blank\" rel=\"noopener noreferrer\">transgender woman\u003c/a> and a gender-fluid person have filed \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3Ac96c3d9c-a558-4e9f-b3d2-750bf5aaf3ba\" target=\"_blank\" rel=\"noopener noreferrer\">federal lawsuits\u003c/a> alleging they were physically assaulted and verbally harassed by officers in 2017 at CCWF because of their gender identity (CDCR declined to comment on pending litigation). And a \u003ca href=\"https://www.cdcr.ca.gov/wp-content/uploads/sites/186/2019/06/svsp-2018-prea-report.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">federal prison audit\u003c/a> in 2018 noted reports from transgender inmates in Salinas Valley State Prison that they had been sexually abused and “targeted” because of their gender identity.\u003c/p>\n\u003cp>Also at Salinas Valley State Prison, a transgender woman was found dead in her cell in April 2017, with a pencil shoved through her ear and down her neck. The Monterey County coroner’s office said the cause of death is \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A11627193-07a9-4d73-9f40-ed93c62aba08\" target=\"_blank\" rel=\"noopener noreferrer\">undetermined\u003c/a>; the county’s district attorney, Jeannine Pacioni, said it had rejected the case due to lack of evidence indicating a murder.\u003c/p>\n\u003cp>[aside postID=news_11794850,news_11795125]At CMF, a transgender woman, Candice Destiny-Rene Love, \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3Abe0f3c18-4fef-4c13-9008-f64e502a503f\" target=\"_blank\" rel=\"noopener noreferrer\">alleged in a federal lawsuit\u003c/a> that she was slashed in the head and face with a box cutter by a former boyfriend in 2016, and raped at the California Substance Abuse Treatment Facility and State Prison in Corcoran a year earlier.\u003c/p>\n\u003cp>Love, 34, accuses CDCR of failing to protect gay and transgender inmates and of not giving her adequate medical care after the 2016 attack led to the development of keloids, bulbous folds of scar tissue she said have caused painful nerve damage and hearing loss. CDCR declined to comment.\u003c/p>\n\u003cp>“I love who I am and I love being me, but after the rape and attack, I wondered, if I wasn’t trans, would I still be going through what I’m going through? I don’t think so,” wrote Love, who is serving time for vehicle theft, in a letter to KQED.\u003c/p>\n\u003ch2>‘The Complete Me’\u003c/h2>\n\u003cp>As the prison system attempts to adapt to the transgender rights movement in society at large, a number of transgender prisoners can finally transition, too.\u003c/p>\n\u003cp>After nearly two decades closeted in prison, Patience came out as transgender in 2015.\u003c/p>\n\u003cp>Despite hearing that some transgender women had difficulties going into a women’s prison, she said: “It still wouldn’t detract or turn me away from trying to be the complete me.”\u003c/p>\n\u003cp>Fey feels the same.\u003c/p>\n\u003cp>“Somebody has got to be the forerunner for this stuff. If somebody goes in and acts right … it opens the door for the next girl behind you. And after a while, if you’re acceptable, you’ll be accepted,” Fey said.\u003c/p>\n\u003cp>[aside label='Resources' link1='https://www.blackandpink.org/penpal-newsletter, Black and Pink' link2='https://transequality.org/about-transgender, National Center for Transgender Equality' link3='http://www.tgijp.org/, TGI Justice Project' link4='https://www.wcl.american.edu/impact/initiatives-programs/center/programs/access-to-justice/project-for-transgender-incarcerated-survivors/, Project for Transgender Incarcerated Survivors' link5='https://transgenderlawcenter.org/volunteer, Transgender Law Center']For Carmen Guerrero’s family, there isn’t much solace. At her killer’s trial, her mom, Mary Talamantez Flores, testified that the youngest of her six kids liked to bake, and that she was beloved by an older sister, who watched out for her at school.\u003c/p>\n\u003cp>While in prison, Guerrero, serving time for second-degree murder, often wrote home and seemed OK, Flores said. She learned via telegram that Guerrero had been killed.\u003c/p>\n\u003cp>“My baby was gone,” she said.\u003c/p>\n\u003cp>Guerrero’s boyfriend, Jonathan Wilson, also an inmate, said he has struggled with grief and depression after her death. At the trial, he confirmed her handwriting on the form where she said she feared being raped by her killer. What she wrote told him she was pleading for her life.\u003c/p>\n\u003cp>Wilson wrote KQED in August: “Carmen died being who she wanted to be as a woman and it cost her her life.”\u003c/p>\n\u003cp>\u003ci>KQED News’ Monica Lam contributed to this report.\u003c/i>\u003c/p>\n\u003cp>\u003cem>Questions? Comments for the reporter? Contact her: mleitsinger@kqed.org\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Transgender inmates suffer high rates of violence in prison. A flurry of lawsuits and laws, including a new state housing bill, aims to drive down that violence — but will it work?",
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"title": "Transgender Prisoners Say They 'Never Feel Safe.' Could a Proposed Law Help? | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Reader advisory: \u003ci>Some accounts of violence in this story contain explicit details and strong language that some may find upsetting.\u003c/i>\u003c/em>\u003c/p>\n\u003cp>Carmen Guerrero spent less than nine hours with her new cellmate before he murdered her.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘Carmen died being who she wanted to be as a woman and it cost her her life.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Miguel Crespo had told corrections officers at Kern Valley State Prison that he would kill Guerrero, a transgender woman who wore her hair long and tweezed her eyebrows, if he was forced to share a cell with her, according to an inmate who witnessed the incident and testified at Crespo’s murder trial.\u003c/p>\n\u003cp>When Crespo moved in, Guerrero, 48, began filling out a form that prosecutors believe she intended to use as part of a transfer request.\u003c/p>\n\u003cp>“He stated he is not compatible with me. I’m worried to be raped again,” Guerrero wrote.\u003c/p>\n\u003cfigure id=\"attachment_11794398\" class=\"wp-caption alignnone\" style=\"max-width: 480px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11794398\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_GuerreroK06560-qut.jpg\" alt=\"A prison photo of Carmen Guerrero, a transgender woman killed by her cellmate at Kern Valley State Prison in late 2013. Her cellmate, Miguel Crespo, was sentenced to death in her murder in December 2019. Her family said in court that they didn't have any photos of Carmen because they were lost in a house fire.\" width=\"480\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_GuerreroK06560-qut.jpg 480w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_GuerreroK06560-qut-160x200.jpg 160w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">A prison photo of Carmen Guerrero, a transgender woman killed by her cellmate at Kern Valley State Prison in late 2013. Her cellmate, Miguel Crespo, was sentenced to death in her murder in December 2019. Her family said in court that they didn’t have any photos of Carmen because they were lost in a house fire. \u003ccite>(Courtesy of California Department of Corrections and Rehabilitation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Prison guards told Crespo the move would be temporary, the other inmate testified. Later that night, after Crespo strangled Guerrero, he called the guards over and said, “You didn’t believe me. I told you I was gonna kill [Guerrero],” according to the inmate.\u003c/p>\n\u003cp>Crespo, who told the trial judge he had previously attacked a gay prisoner, argued in court he shouldn’t have been housed with Guerrero. In December, the judge sentenced Crespo to death for the 2013 murder.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.cdcr.ca.gov\" target=\"_blank\" rel=\"noopener noreferrer\">California Department of Corrections and Rehabilitation\u003c/a> would not comment specifically on the Guerrero case, but said it is “committed to addressing the safety concerns” of transgender, intersex and nonbinary prisoners. The department also said it introduced a \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A031dfb3b-7149-4fc0-97db-82b5323c027a\" target=\"_blank\" rel=\"noopener noreferrer\">screening form\u003c/a> in 2017 intended to prevent potential abusers and victims from residing in the same cell.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We are seeing a trend towards a greater understanding of the need to provide humane housing and treatment of transgender people who are incarcerated.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But advocates backing a bill pending in the California State Legislature on safe housing for transgender prisoners said the killing was an example of how CDCR has failed transgender inmates. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB132\" target=\"_blank\" rel=\"noopener noreferrer\">Senate Bill 132\u003c/a> would allow prisoners to live with those who match the gender they identify with — not the one they were assigned at birth.\u003c/p>\n\u003cp>“[Crespo] should never have been in the cell with the girl,” said \u003ca href=\"https://www.linkedin.com/in/fatima-shabazz-b5058a176/\" target=\"_blank\" rel=\"noopener noreferrer\">Fatima Shabazz\u003c/a>, a former inmate and transgender prisoner activist who is working on SB 132. “The whole point in the bill is to prevent things like this from happening.”\u003c/p>\n\u003cp>Shawn Meerkamper, an attorney at the \u003ca href=\"https://transgenderlawcenter.org\" target=\"_blank\" rel=\"noopener noreferrer\">Transgender Law Center\u003c/a>, agreed the pair should not have been housed together and said the U.S. Constitution requires prisons to protect inmates they know to be in danger.\u003c/p>\n\u003cp>“It’s hard to get a lot clearer than having someone saying, ‘I am going to kill this person,’ and then doing it,” Meerkamper said.\u003c/p>\n\u003ch2>‘A Greater Understanding’\u003c/h2>\n\u003cp>Transgender inmates have long been identified as a vulnerable population. Neither California nor the federal government tracks prison homicides by gender identity, but the \u003ca href=\"https://www.bjs.gov/content/pub/pdf/svpjri1112.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">most recent federal data\u003c/a>, from 2011-12, found 40% of transgender prisoners reported being the victim of a sexual assault within the previous 12 months — 10 times the percentage of non-transgender inmates.\u003c/p>\n\u003cp>SB 132 is the latest in a growing number of efforts nationwide to drive those numbers down and make prison less overtly hostile for transgender people. Spurred by advocates, inmates, state lawmakers and some corrections officials, the initiatives include gender-affirming housing, medical care, clothing and other services.\u003c/p>\n\u003cp>“We are seeing a trend towards a greater understanding of the need to provide humane housing and treatment of transgender people who are incarcerated,” said Jennifer Levi, director of the Transgender Rights Project for advocacy group GLBTQ Legal Advocates & Defenders (\u003ca href=\"https://www.glad.org\" target=\"_blank\" rel=\"noopener noreferrer\">GLAD\u003c/a>). “There’s also a growing understanding within corrections systems of the need to respond to transgender people humanely.”\u003c/p>\n\u003cp>Still, the situation portrayed by transgender prisoners and their advocates is complex, with the acknowledgment of progress tempered by violent incidents and allegations they say are indicative of how far the penitentiary system still has to go in providing a safe environment.\u003c/p>\n\u003cp>“CDCR is like trying to push a boulder uphill,” said one inmate, Ava Fey. “There’s that inertia principle where once it’s stopped and it’s happy with how it is, it does not want to change or move.”\u003c/p>\n\u003ch2>‘I Fought Constantly’: Pushing for Change From Inside Prison\u003c/h2>\n\u003cp>At the California Medical Facility, a state prison in Vacaville, one of the new transgender-related accommodations is a workout club.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘The sentence in coming to state prison, that’s the punishment. Right? You shouldn’t be required to identify a different way simply because you committed a crime and you’ve been given a sentence.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Last summer, a group of transgender women, who were wearing sports bras, leggings, shorts and tank tops, shot hoops, walked laps, peddled on stationary bikes and paused to gossip in what looked like an ordinary high school gym. The women are among the state’s 1,200 inmates who identify as transgender, gender-nonconforming or intersex — a little less than 1% of the prison population.\u003c/p>\n\u003cp>“I fought constantly and constantly with staff to do something for the girls here at CMF,” inmate Jazzie Paradize Scott, serving time for second-degree robbery, said to a soundtrack of hip-hop and buzzing black fans. “I wanted them to have a safe place where they can wear their shorts, their bras and their tops and their little tennis shoes and come out and just be ladies and be able to work out.”\u003c/p>\n\u003cfigure id=\"attachment_11794376\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794376\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-800x450.jpg\" alt=\"Makayla Fennell, a transgender woman housed at the California Medical Facility in Vacaville, plays basketball with two other transgender women, including Yekaterina Wesa Patience (right), on June 11, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Mikayla-bball3-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Makayla Fennell, a transgender woman housed at the California Medical Facility in Vacaville, plays basketball with two other transgender women, including Yekaterina Wesa Patience (right), on June 11, 2019. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In a circle of women stretching, Mark Peaches Cates, 58, said she’d never had the chance to exercise with just transgender women. Gym time with men had made her uncomfortable.\u003c/p>\n\u003cp>“You couldn’t be yourself,” said Cates, who is in prison for second-degree murder.\u003c/p>\n\u003cfigure id=\"attachment_11794378\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794378\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-800x450.jpg\" alt=\"Dallas Rachael Goosen, a transgender woman housed at the California Medical Facility in Vacaville on June 11, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-6-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dallas Rachael Goosen, a transgender woman housed at the California Medical Facility in Vacaville on June 11, 2019. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In California, many transgender-related services have been implemented after an inmate sued the state prison system over its refusal to provide her with gender-affirmation surgery.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I love who I am and I love being me, but after the rape and attack, I wondered, if I wasn’t trans, would I still be going through what I’m going through? I don’t think so.’",
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"citation": "Candice Destiny-Rene Love, who accuses CDCR of failing to protect gay and transgender inmates",
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"content": "\u003cdiv class=\"post-body\">\u003cp>CDCR \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A02f599b4-42fc-40d2-8764-6bcf65de4ad5\" target=\"_blank\" rel=\"noopener noreferrer\">settled\u003c/a> with the prisoner, Shiloh Heavenly Quine, in 2015, agreeing to perform the surgery and becoming the \u003ca href=\"https://www.nbcnews.com/feature/nbc-out/transgender-inmate-says-women-s-prison-torture-n737676\" target=\"_blank\" rel=\"noopener noreferrer\">first prison system\u003c/a> in the nation to set \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A4dace6e8-5ad9-481f-912c-91f7ebd25398\" target=\"_blank\" rel=\"noopener noreferrer\">guidelines\u003c/a> for other transgender inmates to seek approval for the operation. As of September, CDCR said at least four prisoners had undergone the surgery. About 175 have applied and 19 have been approved as of November, according to the department.\u003c/p>\n\u003cp>The judge in the Quine case also \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3Ac3321e30-eed1-4ead-b908-67ebf68f59db\" target=\"_blank\" rel=\"noopener noreferrer\">ordered\u003c/a> California prisons to make available to transgender inmates such gender-affirming items as clothing, jewelry and makeup.\u003c/p>\n\u003cp>The benefits of that order could be seen at a transgender support group at the prison in Vacaville, where women put makeup on one another and talked about having to previously resort to DIY tricks in order to fashion cosmetics — using pastels, wax pencils, Kool-Aid, cocoa and coffee.\u003c/p>\n\u003cfigure id=\"attachment_11794368\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794368\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-800x450.jpg\" alt=\"James Star Henderson (left) puts makeup on Dallas Rachael Goosen during a transgender support group meeting at the California Medical Facility in Vacaville on July 25, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Rachel-makeup-Star-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">James Star Henderson (left) puts makeup on Dallas Rachael Goosen during a transgender support group meeting at the California Medical Facility in Vacaville on July 25, 2019. \u003ccite>(Monica Lam/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One hack, according to 59-year-old Cary Smith: Running a Q-tip over baby oil pooled on a Colgate toothpaste box. The result: pink eyeshadow.\u003c/p>\n\u003cp>Wearing makeup “makes me feel like I’m a step closer to being who I really am. … I feel like I can keep going,” said Smith, who is serving time for assault with a deadly weapon.\u003c/p>\n\u003cfigure id=\"attachment_11794371\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794371\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-800x450.jpg\" alt=\"Jarrett Angel Williams, a transgender woman housed at the California Medical Facility in Vacaville, on July 25, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-lipstick-1-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jarrett Angel Williams, a transgender woman housed at the California Medical Facility in Vacaville, on July 25, 2019. \u003ccite>(Monica Lam/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘You Were Here to Serve Others’\u003c/h2>\n\u003cp>CDCR said it doesn’t track violence in California prisons for any subset of inmates, including those who are transgender. A rare data point comes from a \u003ca href=\"https://ucicorrections.seweb.uci.edu/files/2013/06/BulletinVol2Issue2.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">2007 study\u003c/a> that included interviews with 39 transgender prisoners at a single state prison: 59% reported being sexually assaulted, 13 times the rate for non-transgender prisoners.\u003c/p>\n\u003cp>“There was a time when being a transgender in prison, it was pretty hopeless. It was dark. You were here to serve others,” Cary Smith said.\u003c/p>\n\u003cp>The transgender prisoners at CMF had plenty of traumatic incidents to recount. Yekaterina Wesa Patience said she was playing dominoes and smoking a joint with her cellmate in Pelican Bay State Prison in the late 1990s when he suddenly got on top of her and raped her. That sent her into the closet for nearly 20 years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I immediately cut all my hair off, kept my head bald … I grew a mustache and a goatee, and tried to adopt the hardest walk I could on the yard. I was terrified of it happening again, and I was not going to be out for somebody else to do it.’",
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"citation": "Yekaterina West Patience, who said she was twice raped in prison in the 1990s",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I immediately cut all my hair off, kept my head bald … I grew a mustache and a goatee, and tried to adopt the hardest walk I could on the yard,” said Patience, imprisoned for first-degree murder and other crimes. “I was terrified of it happening again, and I was not going to be out for somebody else to do it.”\u003c/p>\n\u003cp>Still, Patience said, she was raped again, about 18 months later at Mule Creek State Prison. (KQED could not verify most of the alleged attacks reported by Patience and the other prisoners in this story; CDCR said it investigates allegations, but federal law prevents it from sharing details about specific cases.)\u003c/p>\n\u003cp>David Bella Birrell, imprisoned for first-degree murder, also said she’d been sexually assaulted in prison. “They had a motto back in those days: It was either fight or fuck.”\u003c/p>\n\u003cfigure id=\"attachment_11794370\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794370\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-800x450.jpg\" alt=\"David Bella Birrell (left) and Jarrett Angel Williams, transgender women housed at the California Medical Facility in Vacaville, on June 11, 2019, in the prison gym.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Angel-Bella-1-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">David Bella Birrell (left) and Jarrett Angel Williams, transgender women housed at the California Medical Facility in Vacaville, on June 11, 2019, in the prison gym. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘Life-Saving Legislation’\u003c/h2>\n\u003cp>In recent years, a flurry of laws and \u003ca href=\"https://chicago.suntimes.com/2019/5/8/18618926/transgender-inmate-seeks-clemency-cites-retaliation-after-reporting-abuse\" target=\"_blank\" rel=\"noopener noreferrer\">lawsuits\u003c/a>, many from prisoners like Quine, have forced systemic \u003ca href=\"https://www.wbur.org/news/2019/01/26/transgender-inmate-transferred-womens-prison\" target=\"_blank\" rel=\"noopener noreferrer\">changes\u003c/a> in the way penal systems in some states treat transgender prisoners. In\u003ca href=\"https://chicago.suntimes.com/2019/5/8/18618926/transgender-inmate-seeks-clemency-cites-retaliation-after-reporting-abuse\"> Illinois, \u003c/a>\u003ca href=\"https://www.acluofnorthcarolina.org/en/news/kanautica-zayre-brown-transferred-womens-facility\"> North Carolina\u003c/a> and \u003ca href=\"https://www.bostonglobe.com/metro/2019/01/24/transgender-inmate-moved-women-prison/Nf2k5Oqa3Ojnh1yH1IwWkL/story.html\" target=\"_blank\" rel=\"noopener noreferrer\">Massachusetts\u003c/a>, transgender inmates have won in court the right to transfer to women’s prisons.\u003c/p>\n\u003cp>In recent months, transgender prisoners in Colorado \u003ca href=\"http://transgenderlawcenter.org/wp-content/uploads/2019/11/Class-Action-Trans-Women-Complaint.pdf\"> brought a class action against\u003c/a> state prison officials over a lack of safe housing; and three transgender inmates in Texas filed a lawsuit seeking to \u003ca href=\"https://dfw.cbslocal.com/2019/12/06/transgender-women-fight-texas-law-that-restricts-inmates-from-changing-name/\"> legally change their names.\u003c/a>\u003c/p>\n\u003cp>In California, a law allowing prisoners to change their \u003ca href=\"https://www.ebar.com/news/news/275618\" target=\"_blank\" rel=\"noopener noreferrer\">gender and name\u003c/a> took effect in late 2018. SB 132, the California bill that would let transgender inmates choose, with some exceptions, whether to be imprisoned in a men’s or women’s facility, is similar to measures enacted in \u003ca href=\"https://www.newsweek.com/connecticut-transgender-prisoners-first-us-win-right-be-housed-according-947312\" target=\"_blank\" rel=\"noopener noreferrer\">Connecticut\u003c/a> and \u003ca href=\"https://www.mass.gov/info-details/mass-general-laws-c127-ss-32a\" target=\"_blank\" rel=\"noopener noreferrer\">Massachusetts\u003c/a>.\u003c/p>\n\u003cp>“Transgender inmates are some of the most marginalized members of society,” said \u003ca href=\"https://sd11.senate.ca.gov\" target=\"_blank\" rel=\"noopener noreferrer\">state Sen. Scott Wiener\u003c/a>, D-San Francisco, SB 132’s sponsor. “They need more support. The housing aspect is one piece of the puzzle. And it’s a really significant one.”\u003c/p>\n\u003cp>Passage of Wiener’s bill would be “lifesaving,” said \u003ca href=\"http://bambysalcedo.com\">Bamby Salcedo\u003c/a>, a Los Angeles-based transgender activist who spent 14 years in California jails and prisons. Salcedo said the measure would allow transgender inmates to do their time “away from harassment and violence.”\u003c/p>\n\u003cp>The bill passed the state Senate last year, but did not get a floor vote in the Assembly. Wiener, who put the measure on hold until this year to discuss the issue with prisoners, believes it will pass.\u003c/p>\n\u003ch2>Federal Standards Not Met\u003c/h2>\n\u003cp>Wiener’s bill would also bring California in line with federal standards laid out in the Prison Rape Elimination Act, or PREA. These regulations, \u003ca href=\"https://www.federalregister.gov/documents/2012/06/20/2012-12427/national-standards-to-prevent-detect-and-respond-to-prison-rape\" target=\"_blank\" rel=\"noopener noreferrer\">which took effect in August 2012\u003c/a>, recognize transgender inmates as a vulnerable population and stipulate that transgender housing assignments must ensure prisoners’ health and safety. Audits for each facility must be conducted every three years.\u003c/p>\n\u003cp>In 2017, a \u003ca href=\"https://www.cdcr.ca.gov/wp-content/uploads/sites/186/2019/06/cmf-2017-prea-report.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">federal audit\u003c/a> found that CDCR’s policy of housing transgender inmates based solely on their biological sex ran afoul of PREA guidelines and that the department didn’t take into account the prisoners’ own views about their safety.\u003c/p>\n\u003cp>In response, CDCR said, it implemented a \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A031dfb3b-7149-4fc0-97db-82b5323c027a\" target=\"_blank\" rel=\"noopener noreferrer\">screening tool\u003c/a> used to assess risk of victimization. The agency also said its current housing policy requires every inmate receive a case-by-case review of where they are imprisoned, with no restriction on living in a men’s or women’s facility based solely on anatomy.\u003c/p>\n\u003cp>“We recognize that when we’re dealing with our transgender men and women, that our staff need much more guidance when they’re looking at what appropriate housing looks like,” said Amy Miller, associate director of CDCR’s Female Offender Programs and Services, adult division.\u003c/p>\n\u003cfigure id=\"attachment_11794375\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794375\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-800x450.jpg\" alt=\"James Star Henderson (right) and Mark Peaches Cate, two transgender woman housed at the California Medical Facility in Vacaville, take their pulse after exercising in the prison gym on June 11, 2019. Pictured left is their coach, Jeremiah Holland.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Coach-Star-Peaches-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">James Star Henderson (right) and Mark Peaches Cate, two transgender woman housed at the California Medical Facility in Vacaville, take their pulse after exercising in the prison gym on June 11, 2019. Pictured left is their coach, Jeremiah Holland. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Still, CDCR couldn’t point to any transgender prisoners, besides the few who had undergone gender-affirmation surgery, who had been allowed to switch facilities. The department said it doesn’t track that information.\u003c/p>\n\u003cp>Harper Jean Tobin, policy director at the \u003ca href=\"https://transequality.org\" target=\"_blank\" rel=\"noopener noreferrer\">National Center for Transgender Equality\u003c/a>, said while some states have improved their rules on transgender housing, frequently the policies “only exist on paper.”\u003c/p>\n\u003cp>“Today, contrary to the federal PREA rules, most transgender prisoners continue to be housed automatically with the sex they were assigned at birth, which is often dangerous for them,” Tobin said.\u003c/p>\n\u003ch2>‘You Never Feel Safe’\u003c/h2>\n\u003cp>At CMF, transgender women had mixed reactions to the idea of changing living facilities.\u003c/p>\n\u003cp>Birrell, 67, called Wiener’s housing bill “insanity” and worried about potential conflicts with the existing female prisoner population. She already likes the community resulting from CDCR’s present system of transgender hubs — 14 prisons that offer special medical and mental health care.\u003c/p>\n\u003cp>But inmate Ava Fey said she would likely “run” to a women’s prison for reasons of safety. Living with women would also offer something that’s eluded her for decades: women whom she could emulate.\u003c/p>\n\u003cp>“I’ve been hiding so long — the mannerisms — I’ve kind of tucked them in and locked it away,” said Fey, who was convicted of first-degree murder.\u003c/p>\n\u003cfigure id=\"attachment_11794380\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794380\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-800x450.jpg\" alt=\"Ava Fey, a transgender woman who started taking hormone replacement therapy in January, at the California Medical Facility in Vacaville on June 11, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Ava-table-3-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ava Fey, a transgender woman who started taking hormone replacement therapy in January, at the California Medical Facility in Vacaville on June 11, 2019. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yekaterina Wesa Patience, 44, said she’d “love” to transfer to a women’s prison as well: “I think that would eliminate a lot of the problems of being sexually assaulted or being raped, pressured.”\u003c/p>\n\u003cp>“You just never feel safe here,” she said. “You never feel like you can let your guard down.”\u003c/p>\n\u003cp>Other women, many who live on their own in single cells, said they were fine staying at CMF. Jazzie Paradize Scott, 47, who said she lives in a dorm with 150 men and a few other transgender women, sees the benefits of moving to a women’s prison, but views her current housing choice as a form of activism.\u003c/p>\n\u003cp>“I want them to be able to see me for who I [am],” she said. “I thought it would be a good idea for me to come out and mingle — not just for the trans women and to show that we can conquer even in the dorm living situation — but just to be able to exist with the males in CMF.”\u003c/p>\n\u003cfigure id=\"attachment_11794377\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794377\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-800x450.jpg\" alt=\"Jazzie Paradize Scott, a transgender woman housed at the California Medical Facility in Vacaville on June 11, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_stretch-3-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Jazzie Paradize Scott, a transgender woman housed at the California Medical Facility in Vacaville on June 11, 2019. \u003ccite>(Sruti Mamidanna/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Transgender men at the Central California Women’s Facility in Chowchilla had a different take.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘Transgender inmates are some of the most marginalized members of society. They need more support. The housing aspect is one piece of the puzzle. And it’s a really significant one.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I already fight for my life in this prison. How do you think I’m going to fare in a male institution even before surgery?” said 52-year-old Diamond Vargas, serving time for assault with a semiautomatic firearm. “There’s not a hormone shot in the world [we could take so that] we’re going to make it.”\u003c/p>\n\u003cp>Shiloh Heavenly Quine, 60, whose lawsuit spurred many of the changes around incarcerating transgender inmates in the state, is one of a few prisoners to have lived in both men’s and women’s prisons. Despite experiencing some bullying that she said landed her in administrative segregation, she feels much safer in the women’s facility.\u003c/p>\n\u003cp>“People get sliced every now and then. … People get hit with locks every now and then, you have that, but all in all it’s pretty mellow here,” said Quine, who is incarcerated at CCWF for first-degree murder. “This is easy time. I call it Prisneyland.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>State Prisons Adapt\u003c/h2>\n\u003cp>California prison officials say they’re trying to stay part of the national conversation on transgender issues. Besides creating support groups, \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A0a3108af-70bc-4032-9efc-54290f73af5d\" target=\"_blank\" rel=\"noopener noreferrer\">changes in recent years\u003c/a> include directives to prison staff to use preferred pronouns and the hosting of events like a post-release transgender resource fair.\u003c/p>\n\u003cp>After the Quine settlement, CDCR polled transgender inmates about preferred cosmetic and hygenic items and then mandated that prison canteens carry them. \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3Af24b92e1-6def-406b-9978-c651981f9dc5\" target=\"_blank\" rel=\"noopener noreferrer\">Options for clothing\u003c/a> have expanded: Available items now include scoop-necked shirts for transgender women and chest-flattening binders for transgender men.\u003c/p>\n\u003cp>“The sentence in coming to state prison, that’s the punishment. Right?” said CDCR’s Miller. “You shouldn’t be required to identify a different way simply because you committed a crime and you’ve been given a sentence.”\u003c/p>\n\u003cfigure id=\"attachment_11794369\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794369\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-800x450.jpg\" alt=\"James Star Henderson (left) and Cary Smith, share a laugh during a transgender support group meeting at the California Medical Facility in Vacaville on July 25, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_CJ-Star-laughing-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">James Star Henderson (left) and Cary Smith, share a laugh during a transgender support group meeting at the California Medical Facility in Vacaville on July 25, 2019. \u003ccite>(Monica Lam/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the meantime, a number of the transgender prisoners at CMF said conditions for them have improved. Birrell said the situation took a positive turn in the mid-2000s: “It’s been a long process. But things are a lot better today than they have been.”\u003c/p>\n\u003cp>Advocates said they expect that lawsuits and laws will continue to force changes.\u003c/p>\n\u003cp>“That will have to continue because of just so much pervasive lack of information across correction systems,” said Levi of GLAD. “But I’m also hopeful that won’t be the exclusive way in which we see things move.”\u003c/p>\n\u003cfigure id=\"attachment_11794372\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11794372\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-800x450.jpg\" alt=\"Yekaterina Wesa Patience, a transgender woman housed at the California Medical Facility in Vacaville on July 25, 2019.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/01/PHOTO_Kat-ID-1-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Yekaterina Wesa Patience, a transgender woman housed at the California Medical Facility in Vacaville on July 25, 2019. \u003ccite>(Monica Lam/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘If I Wasn’t Trans …’\u003c/h2>\n\u003cp>Despite these changes, transgender prisoners have continued to allege mistreatment.\u003c/p>\n\u003cp>“Somebody hit me in the side and then just choked me out, just choked me out,” Fey said of an attack earlier this year in the kitchen at CMF, which she attributed to her gender identity. Fey provided KQED with documentation of the attack.\u003c/p>\n\u003cp>A \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A2a0aab67-79b7-4295-b7cc-d4f2478ac864\" target=\"_blank\" rel=\"noopener noreferrer\">transgender woman\u003c/a> and a gender-fluid person have filed \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3Ac96c3d9c-a558-4e9f-b3d2-750bf5aaf3ba\" target=\"_blank\" rel=\"noopener noreferrer\">federal lawsuits\u003c/a> alleging they were physically assaulted and verbally harassed by officers in 2017 at CCWF because of their gender identity (CDCR declined to comment on pending litigation). And a \u003ca href=\"https://www.cdcr.ca.gov/wp-content/uploads/sites/186/2019/06/svsp-2018-prea-report.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">federal prison audit\u003c/a> in 2018 noted reports from transgender inmates in Salinas Valley State Prison that they had been sexually abused and “targeted” because of their gender identity.\u003c/p>\n\u003cp>Also at Salinas Valley State Prison, a transgender woman was found dead in her cell in April 2017, with a pencil shoved through her ear and down her neck. The Monterey County coroner’s office said the cause of death is \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A11627193-07a9-4d73-9f40-ed93c62aba08\" target=\"_blank\" rel=\"noopener noreferrer\">undetermined\u003c/a>; the county’s district attorney, Jeannine Pacioni, said it had rejected the case due to lack of evidence indicating a murder.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>At CMF, a transgender woman, Candice Destiny-Rene Love, \u003ca href=\"https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3Abe0f3c18-4fef-4c13-9008-f64e502a503f\" target=\"_blank\" rel=\"noopener noreferrer\">alleged in a federal lawsuit\u003c/a> that she was slashed in the head and face with a box cutter by a former boyfriend in 2016, and raped at the California Substance Abuse Treatment Facility and State Prison in Corcoran a year earlier.\u003c/p>\n\u003cp>Love, 34, accuses CDCR of failing to protect gay and transgender inmates and of not giving her adequate medical care after the 2016 attack led to the development of keloids, bulbous folds of scar tissue she said have caused painful nerve damage and hearing loss. CDCR declined to comment.\u003c/p>\n\u003cp>“I love who I am and I love being me, but after the rape and attack, I wondered, if I wasn’t trans, would I still be going through what I’m going through? I don’t think so,” wrote Love, who is serving time for vehicle theft, in a letter to KQED.\u003c/p>\n\u003ch2>‘The Complete Me’\u003c/h2>\n\u003cp>As the prison system attempts to adapt to the transgender rights movement in society at large, a number of transgender prisoners can finally transition, too.\u003c/p>\n\u003cp>After nearly two decades closeted in prison, Patience came out as transgender in 2015.\u003c/p>\n\u003cp>Despite hearing that some transgender women had difficulties going into a women’s prison, she said: “It still wouldn’t detract or turn me away from trying to be the complete me.”\u003c/p>\n\u003cp>Fey feels the same.\u003c/p>\n\u003cp>“Somebody has got to be the forerunner for this stuff. If somebody goes in and acts right … it opens the door for the next girl behind you. And after a while, if you’re acceptable, you’ll be accepted,” Fey said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"link1": "https://www.blackandpink.org/penpal-newsletter, Black and Pink",
"link2": "https://transequality.org/about-transgender, National Center for Transgender Equality",
"link3": "http://www.tgijp.org/, TGI Justice Project",
"link4": "https://www.wcl.american.edu/impact/initiatives-programs/center/programs/access-to-justice/project-for-transgender-incarcerated-survivors/, Project for Transgender Incarcerated Survivors",
"link5": "https://transgenderlawcenter.org/volunteer, Transgender Law Center"
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"content": "\u003cdiv class=\"post-body\">\u003cp>For Carmen Guerrero’s family, there isn’t much solace. At her killer’s trial, her mom, Mary Talamantez Flores, testified that the youngest of her six kids liked to bake, and that she was beloved by an older sister, who watched out for her at school.\u003c/p>\n\u003cp>While in prison, Guerrero, serving time for second-degree murder, often wrote home and seemed OK, Flores said. She learned via telegram that Guerrero had been killed.\u003c/p>\n\u003cp>“My baby was gone,” she said.\u003c/p>\n\u003cp>Guerrero’s boyfriend, Jonathan Wilson, also an inmate, said he has struggled with grief and depression after her death. At the trial, he confirmed her handwriting on the form where she said she feared being raped by her killer. What she wrote told him she was pleading for her life.\u003c/p>\n\u003cp>Wilson wrote KQED in August: “Carmen died being who she wanted to be as a woman and it cost her her life.”\u003c/p>\n\u003cp>\u003ci>KQED News’ Monica Lam contributed to this report.\u003c/i>\u003c/p>\n\u003cp>\u003cem>Questions? Comments for the reporter? Contact her: mleitsinger@kqed.org\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "U.S. Agency Formalizes Border Medical Plan After Migrants Die",
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"content": "\u003cp>U.S. Customs and Border Protection on Tuesday formalized a medical plan formed in the wake of a massive surge of migrant families to the U.S.-Mexico border and a series of deaths in immigration custody.\u003c/p>\n\u003cp>The goal was to increase medical care and efficiency. According to the directive, the codified plan includes a sustainable proposal for triage, plus screenings for respiratory systems, instructions to isolate sick migrants to prevent the spread of disease, vaccines for staff and a supply of face masks and hand sanitizer. More than 500 medical professionals are on contract to help administer care.\u003c/p>\n\u003cp>The \u003ca href=\"https://apnews.com/5e470e143dcc47bface2354d1a2e4719\" target=\"_blank\" rel=\"noopener noreferrer\">outcry over medical care\u003c/a> began when two children died in Border Patrol custody in December 2018, followed by the deaths of others this year. A year later, \u003ca href=\"https://apnews.com/f66701c00438b5cdfa78bd9b15f77e19\" target=\"_blank\" rel=\"noopener noreferrer\">Homeland Security’s watchdog\u003c/a> found no misconduct or wrongdoing in the deaths of the two Guatemalan children, a 7-year-old girl and an 8-year-old boy.\u003c/p>\n\u003cp>[aside tag='immigration' label='More Coverage.']At the height of the crisis, tens of thousands of migrant families crossed into the U.S. and were held in cramped, overcrowded conditions. \u003ca href=\"https://apnews.com/70685d23da774abea1a78561757e4dfd\" target=\"_blank\" rel=\"noopener noreferrer\">A flu outbreak in May\u003c/a> sickened more than 30 migrants. A 16-year-old boy died from the illness, and \u003ca href=\"https://apnews.com/7f6b350a313d6071634c33684fcd3eb9\" target=\"_blank\" rel=\"noopener noreferrer\">video later obtained by ProPublica\u003c/a> showed the teen collapsed on the floor for hours, alone, before he died. The video threw into question Border Patrol’s version of the teen’s death. An investigation is ongoing.\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/b923da1cb2254ad59846a033dd670be7\" target=\"_blank\" rel=\"noopener noreferrer\">Over the budget year that ended Sept. 30\u003c/a>, there were 859,510 apprehensions by Border Patrol, plus an additional 110,000 encounters of people who tried to enter legally but were deemed inadmissible. There were nearly 1 million crossings from the early 2000s, but those were mostly single men from Mexico who were easily returned, not families from Central America who require much more care.\u003c/p>\n\u003cp>Immigration officials were involved in more than 20,000 hospital visits this year.\u003c/p>\n\u003cp>Homeland Security worked with the Centers for Disease Control and Prevention on creating and implementing recommendations. The department set a goal of formalizing the policies by the end of the year.\u003c/p>\n\u003cp>“We continue to look at new ways to improve care for those in our temporary custody,” a CBP spokesman said.\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/e8f6a91850434b0e8c15124324bae2c8\" target=\"_blank\" rel=\"noopener noreferrer\">Crossings have declined steeply since a peak in May\u003c/a>, due in part to a policy that has forced more than 50,000 asylum-seekers back over the border to wait out their claims in Mexico, where dozens have been sickened and subjected to violence in some parts. And agreements with Central American nations are leading to migrants being sent back to Guatemala and eventually Honduras and El Salvador.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "The plan comes after a public outcry over the medical care of migrants in border custody, and the deaths of children.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>U.S. Customs and Border Protection on Tuesday formalized a medical plan formed in the wake of a massive surge of migrant families to the U.S.-Mexico border and a series of deaths in immigration custody.\u003c/p>\n\u003cp>The goal was to increase medical care and efficiency. According to the directive, the codified plan includes a sustainable proposal for triage, plus screenings for respiratory systems, instructions to isolate sick migrants to prevent the spread of disease, vaccines for staff and a supply of face masks and hand sanitizer. More than 500 medical professionals are on contract to help administer care.\u003c/p>\n\u003cp>The \u003ca href=\"https://apnews.com/5e470e143dcc47bface2354d1a2e4719\" target=\"_blank\" rel=\"noopener noreferrer\">outcry over medical care\u003c/a> began when two children died in Border Patrol custody in December 2018, followed by the deaths of others this year. A year later, \u003ca href=\"https://apnews.com/f66701c00438b5cdfa78bd9b15f77e19\" target=\"_blank\" rel=\"noopener noreferrer\">Homeland Security’s watchdog\u003c/a> found no misconduct or wrongdoing in the deaths of the two Guatemalan children, a 7-year-old girl and an 8-year-old boy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>At the height of the crisis, tens of thousands of migrant families crossed into the U.S. and were held in cramped, overcrowded conditions. \u003ca href=\"https://apnews.com/70685d23da774abea1a78561757e4dfd\" target=\"_blank\" rel=\"noopener noreferrer\">A flu outbreak in May\u003c/a> sickened more than 30 migrants. A 16-year-old boy died from the illness, and \u003ca href=\"https://apnews.com/7f6b350a313d6071634c33684fcd3eb9\" target=\"_blank\" rel=\"noopener noreferrer\">video later obtained by ProPublica\u003c/a> showed the teen collapsed on the floor for hours, alone, before he died. The video threw into question Border Patrol’s version of the teen’s death. An investigation is ongoing.\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/b923da1cb2254ad59846a033dd670be7\" target=\"_blank\" rel=\"noopener noreferrer\">Over the budget year that ended Sept. 30\u003c/a>, there were 859,510 apprehensions by Border Patrol, plus an additional 110,000 encounters of people who tried to enter legally but were deemed inadmissible. There were nearly 1 million crossings from the early 2000s, but those were mostly single men from Mexico who were easily returned, not families from Central America who require much more care.\u003c/p>\n\u003cp>Immigration officials were involved in more than 20,000 hospital visits this year.\u003c/p>\n\u003cp>Homeland Security worked with the Centers for Disease Control and Prevention on creating and implementing recommendations. The department set a goal of formalizing the policies by the end of the year.\u003c/p>\n\u003cp>“We continue to look at new ways to improve care for those in our temporary custody,” a CBP spokesman said.\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/e8f6a91850434b0e8c15124324bae2c8\" target=\"_blank\" rel=\"noopener noreferrer\">Crossings have declined steeply since a peak in May\u003c/a>, due in part to a policy that has forced more than 50,000 asylum-seekers back over the border to wait out their claims in Mexico, where dozens have been sickened and subjected to violence in some parts. And agreements with Central American nations are leading to migrants being sent back to Guatemala and eventually Honduras and El Salvador.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The \u003ca href=\"https://www.britannica.com/topic/Hagia-Sophia\" target=\"_blank\" rel=\"noopener noreferrer\">Hagia Sophia cathedral\u003c/a> in Istanbul is incredibly reverberant — a sound will echo around and remain audible for eleven seconds. That reverberance shaped nearly a thousand years of music written to be performed inside the cathedral. But no one has been able to listen to what it’s like to hear a church choir sing inside the Hagia Sophia for over 500 years. That is, until now.\u003c/p>\n\u003cp>[aside tag='california-sounds' label='Related Coverage.']When the Hagia Sophia was completed in 537 AD, it was the largest building in the world, and for a thousand years it was the biggest cathedral on the planet. Countless songs were written for the acoustics of the Hagia Sophia. The architecture of this one building influenced the whole trajectory of Eastern Orthodox church music.\u003c/p>\n\u003cp>At the end of the 15th century, the Ottomans crushed the Byzantine Empire. They turned the Hagia Sophia into a mosque, and in 1935 it became a museum. Church choirs are not allowed to perform inside, so it has been centuries since anyone heard the music as it was supposed to sound inside the Hagia Sophia.\u003c/p>\n\u003cp>But thanks to some professors at Stanford, that’s no longer the case.\u003c/p>\n\u003cp>About a decade ago, art history professor \u003ca href=\"https://art.stanford.edu/people/bissera-pentcheva\" target=\"_blank\" rel=\"noopener noreferrer\">Bissera Pentcheva\u003c/a> and computer music professor Jonathan Abel started a mission to map the acoustic profile of the Hagia Sophia and created a digital filter that could be applied to any sound. The feat required the latest theories of “convolution reverb,” a few trips to Istanbul and at least one pack of balloons.\u003c/p>\n\u003cp>Finally, to replicate the music heard inside of the Hagia Sophia, they shared their filter with Cappella Romana, a Portland-based choir that specializes in Byzantine chants. Take a listen to hear how Pentcheva, Abel and Cappella Romana have brought back music that hasn’t been heard exactly as it was intended for over 500 years.\u003c/p>\n\u003cp>For the full surround sound effect, throw on a pair of headphones before you listen!\u003c/p>\n\u003chr>\n\u003cp>This story comes to us from Chris Hoff and Sam Harnett of \u003ca href=\"http://www.theworldaccordingtosound.org/\" target=\"_blank\" rel=\"noopener noreferrer\">The World According to Sound podcast\u003c/a>. They’re partnering with the \u003ca href=\"http://lighthouse-sf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">LightHouse for the Blind and Visually Impaired\u003c/a> in San Francisco to help us reimagine California in the rich way blind people experience it every day. The project has additional support from\u003ca href=\"https://calhum.org/\" target=\"_blank\" rel=\"noopener noreferrer\"> California Humanities\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>When the Hagia Sophia was completed in 537 AD, it was the largest building in the world, and for a thousand years it was the biggest cathedral on the planet. Countless songs were written for the acoustics of the Hagia Sophia. The architecture of this one building influenced the whole trajectory of Eastern Orthodox church music.\u003c/p>\n\u003cp>At the end of the 15th century, the Ottomans crushed the Byzantine Empire. They turned the Hagia Sophia into a mosque, and in 1935 it became a museum. Church choirs are not allowed to perform inside, so it has been centuries since anyone heard the music as it was supposed to sound inside the Hagia Sophia.\u003c/p>\n\u003cp>But thanks to some professors at Stanford, that’s no longer the case.\u003c/p>\n\u003cp>About a decade ago, art history professor \u003ca href=\"https://art.stanford.edu/people/bissera-pentcheva\" target=\"_blank\" rel=\"noopener noreferrer\">Bissera Pentcheva\u003c/a> and computer music professor Jonathan Abel started a mission to map the acoustic profile of the Hagia Sophia and created a digital filter that could be applied to any sound. The feat required the latest theories of “convolution reverb,” a few trips to Istanbul and at least one pack of balloons.\u003c/p>\n\u003cp>Finally, to replicate the music heard inside of the Hagia Sophia, they shared their filter with Cappella Romana, a Portland-based choir that specializes in Byzantine chants. Take a listen to hear how Pentcheva, Abel and Cappella Romana have brought back music that hasn’t been heard exactly as it was intended for over 500 years.\u003c/p>\n\u003cp>For the full surround sound effect, throw on a pair of headphones before you listen!\u003c/p>\n\u003chr>\n\u003cp>This story comes to us from Chris Hoff and Sam Harnett of \u003ca href=\"http://www.theworldaccordingtosound.org/\" target=\"_blank\" rel=\"noopener noreferrer\">The World According to Sound podcast\u003c/a>. They’re partnering with the \u003ca href=\"http://lighthouse-sf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">LightHouse for the Blind and Visually Impaired\u003c/a> in San Francisco to help us reimagine California in the rich way blind people experience it every day. The project has additional support from\u003ca href=\"https://calhum.org/\" target=\"_blank\" rel=\"noopener noreferrer\"> California Humanities\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Whether you’re looking for fireworks or you prefer avoiding the crowds, the Bay Area offers a variety of budget-friendly ways to ring in the new year.\u003c/p>\n\u003ch2>Fireworks\u003c/h2>\n\u003cp>One of the most iconic parts of New Year’s Eve is the fireworks. Lucky for us, you don’t have to go far to find them.\u003c/p>\n\u003cp>The \u003ca href=\"https://sfport.com/event/new-year%E2%80%99s-eve-fireworks-celebration-0\" target=\"_blank\" rel=\"noopener noreferrer\">fireworks show\u003c/a> along San Francisco’s Embarcadero starts Tuesday evening as midnight approaches. The fireworks will be launched from the bay, \u003ca href=\"https://www.sfmta.com/press-releases/ride-muni-free-new-years-eve-2019\" target=\"_blank\" rel=\"noopener noreferrer\">south of the Ferry Building\u003c/a>, so keep that in mind when scouting out the best spots to watch from.\u003c/p>\n\u003cp>It’s expected to be partly cloudy in San Francisco on Tuesday night. For the most accurate forecast — or when deciding on how many layers to bring — check the weather before going out.\u003c/p>\n\u003cp>Word to the wise: If you don’t like crowds, avoid the Embarcadero area around midnight.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>Free (or cheap) events\u003c/h2>\n\u003cp>If you’re looking for free parties, here’s \u003ca href=\"https://sf.funcheap.com/city-guide/years-eve-party-guide-2/\">a quick collection\u003c/a> — though some may involve a cover fee.\u003c/p>\n\u003cp>Looking for something a little calmer? There are a \u003ca href=\"https://www.eventbrite.com/e/new-years-eve-meditation-vigil-and-service-tickets-81878076531?aff=ebdssbdestsearch\" target=\"_blank\" rel=\"noopener noreferrer\">bunch\u003c/a> of \u003ca href=\"https://www.eventbrite.com/e/new-years-eve-meditation-celebration-tickets-72190486689?aff=ebdssbdestsearch\" target=\"_blank\" rel=\"noopener noreferrer\">meditation\u003c/a> \u003ca href=\"https://www.eventbrite.com/e/alternative-nye-celebration-creating-inner-and-outer-peace-tickets-87629114039?aff=ebdssbdestsearch\" target=\"_blank\" rel=\"noopener noreferrer\">events\u003c/a> across the Bay Area.\u003c/p>\n\u003cp>Take a hike. No really, you can take a \u003ca href=\"https://www.meetup.com/sanfranciscobay/events/257900900/\" target=\"_blank\" rel=\"noopener noreferrer\">moonlit hike\u003c/a> Tuesday evening from Ohlone College to Mission Peak summit. If a stroll is on the agenda, you can walk past \u003ca href=\"https://sfgov.org/cityhall/lighting\" target=\"_blank\" rel=\"noopener noreferrer\">San Francisco City Hall\u003c/a> to see it enveloped in gold lighting for New Year’s Eve.\u003c/p>\n\u003cp>Arcade games more your speed? \u003ca href=\"https://www.facebook.com/events/2695983553792522/\" target=\"_blank\" rel=\"noopener noreferrer\">Coin-Op in San Francisco\u003c/a> will have free play until midnight if you want to get one more game of Pac-Man or pinball in before the ball drops.\u003c/p>\n\u003cp>[aside postID='news_11793277' label='Get Home Safe on New Year's Eve']\u003c/p>\n\u003ch2>For the kids\u003c/h2>\n\u003cp>In Santa Clara, Northside Branch Library is putting on a free “Noon Year’s Eve” event at 11 a.m. Tuesday for families to celebrate a little early. You can RSVP \u003ca href=\"https://www.eventbrite.com/e/northside-5th-annual-noon-years-eve-all-ages-tickets-83934047997\" target=\"_blank\" rel=\"noopener noreferrer\">here\u003c/a>.\u003c/p>\n\u003cp>The Albany Community Center is also hosting a “\u003ca href=\"https://www.albanyca.org/Home/Components/Calendar/Event/16464/561?backlist=%2fdepartments%2frecreation-community-services\" target=\"_blank\" rel=\"noopener noreferrer\">Noon Year’s Eve Celebration”\u003c/a> from 11 a.m. to 1 p.m. on Tuesday. The event and activities are geared toward families with kids 12 and under.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Whether you’re looking for fireworks or you prefer avoiding the crowds, the Bay Area offers a variety of budget-friendly ways to ring in the new year.\u003c/p>\n\u003ch2>Fireworks\u003c/h2>\n\u003cp>One of the most iconic parts of New Year’s Eve is the fireworks. Lucky for us, you don’t have to go far to find them.\u003c/p>\n\u003cp>The \u003ca href=\"https://sfport.com/event/new-year%E2%80%99s-eve-fireworks-celebration-0\" target=\"_blank\" rel=\"noopener noreferrer\">fireworks show\u003c/a> along San Francisco’s Embarcadero starts Tuesday evening as midnight approaches. The fireworks will be launched from the bay, \u003ca href=\"https://www.sfmta.com/press-releases/ride-muni-free-new-years-eve-2019\" target=\"_blank\" rel=\"noopener noreferrer\">south of the Ferry Building\u003c/a>, so keep that in mind when scouting out the best spots to watch from.\u003c/p>\n\u003cp>It’s expected to be partly cloudy in San Francisco on Tuesday night. For the most accurate forecast — or when deciding on how many layers to bring — check the weather before going out.\u003c/p>\n\u003cp>Word to the wise: If you don’t like crowds, avoid the Embarcadero area around midnight.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>Free (or cheap) events\u003c/h2>\n\u003cp>If you’re looking for free parties, here’s \u003ca href=\"https://sf.funcheap.com/city-guide/years-eve-party-guide-2/\">a quick collection\u003c/a> — though some may involve a cover fee.\u003c/p>\n\u003cp>Looking for something a little calmer? There are a \u003ca href=\"https://www.eventbrite.com/e/new-years-eve-meditation-vigil-and-service-tickets-81878076531?aff=ebdssbdestsearch\" target=\"_blank\" rel=\"noopener noreferrer\">bunch\u003c/a> of \u003ca href=\"https://www.eventbrite.com/e/new-years-eve-meditation-celebration-tickets-72190486689?aff=ebdssbdestsearch\" target=\"_blank\" rel=\"noopener noreferrer\">meditation\u003c/a> \u003ca href=\"https://www.eventbrite.com/e/alternative-nye-celebration-creating-inner-and-outer-peace-tickets-87629114039?aff=ebdssbdestsearch\" target=\"_blank\" rel=\"noopener noreferrer\">events\u003c/a> across the Bay Area.\u003c/p>\n\u003cp>Take a hike. No really, you can take a \u003ca href=\"https://www.meetup.com/sanfranciscobay/events/257900900/\" target=\"_blank\" rel=\"noopener noreferrer\">moonlit hike\u003c/a> Tuesday evening from Ohlone College to Mission Peak summit. If a stroll is on the agenda, you can walk past \u003ca href=\"https://sfgov.org/cityhall/lighting\" target=\"_blank\" rel=\"noopener noreferrer\">San Francisco City Hall\u003c/a> to see it enveloped in gold lighting for New Year’s Eve.\u003c/p>\n\u003cp>Arcade games more your speed? \u003ca href=\"https://www.facebook.com/events/2695983553792522/\" target=\"_blank\" rel=\"noopener noreferrer\">Coin-Op in San Francisco\u003c/a> will have free play until midnight if you want to get one more game of Pac-Man or pinball in before the ball drops.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>For the kids\u003c/h2>\n\u003cp>In Santa Clara, Northside Branch Library is putting on a free “Noon Year’s Eve” event at 11 a.m. Tuesday for families to celebrate a little early. You can RSVP \u003ca href=\"https://www.eventbrite.com/e/northside-5th-annual-noon-years-eve-all-ages-tickets-83934047997\" target=\"_blank\" rel=\"noopener noreferrer\">here\u003c/a>.\u003c/p>\n\u003cp>The Albany Community Center is also hosting a “\u003ca href=\"https://www.albanyca.org/Home/Components/Calendar/Event/16464/561?backlist=%2fdepartments%2frecreation-community-services\" target=\"_blank\" rel=\"noopener noreferrer\">Noon Year’s Eve Celebration”\u003c/a> from 11 a.m. to 1 p.m. on Tuesday. The event and activities are geared toward families with kids 12 and under.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A 2015 \u003ca href=\"https://www.kqed.org/stateofhealth/222927/californias-new-vaccine-law-expected-to-send-disease-rates-plummeting\" target=\"_blank\" rel=\"noopener noreferrer\">California law\u003c/a> that eliminated personal belief exemptions for childhood vaccines appears to be working, according to new research out Monday, which found a hike in vaccination rates among children statewide.\u003c/p>\n\u003cp>The UC San Francisco \u003ca href=\"https://www.ucsf.edu/news/2019/12/416271/barring-nonmedical-exemptions-increases-vaccination-rates-study-finds\" target=\"_blank\" rel=\"noopener noreferrer\">study,\u003c/a> published in the journal “PLOS Medicine,” concluded that the state’s stricter immunization requirements have resulted in more kids getting vaccinated.\u003c/p>\n\u003cp>Researchers estimated the number of children in California who would have received the vaccine for measles, mumps and rubella (MMR) without the law, and compared that to the number vaccinated after the legislation — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\" rel=\"noopener noreferrer\">SB 277\u003c/a> — went into effect.\u003c/p>\n\u003cp>[aside tag=\"vaccines\" label=\"Related coverage\"]The \u003ca href=\"https://www.latimes.com/science/sciencenow/la-sci-sn-vaccine-medical-exemptions-20181029-story.html\" target=\"_blank\" rel=\"noopener noreferrer\">law requires\u003c/a> every child taught in school classrooms or enrolled in a child care facility — with the exemption of students who receive medical exemptions from doctors — to be fully immunized against 10 communicable diseases: diphtheria, hepatitis B, haemophilus influenzae Type B, measles, mumps, pertussis (whooping cough), poliomyelitis, rubella, tetanus and varicella (chickenpox).\u003c/p>\n\u003cp>Researchers also compared California’s vaccination rates with those of other states that still have personal belief exemptions, factoring in demographic variations.\u003c/p>\n\u003cp>Vaccination rates went up across California, particularly in counties like Sonoma and Santa Cruz, where rates have lingered below the statewide average. the report found. Non-medical exemptions decreased statewide by 2.4%, while medical exemptions increased 0.4%.\u003c/p>\n\u003cp>“When we look at those high-risk counties, we see the largest increases in vaccine coverage. 10-plus percent jumps in those areas,” said UCSF public health researcher Dr. Nathan Lo.\u003c/p>\n\u003cp>These changes brought the vaccination rate to 95% in almost all California counties, enough to provide “herd” immunity, or rates high enough that a contagious disease is less likely to spread.\u003c/p>\n\u003cp>It also means that a significant number of parents who previously received non-medical exemptions ended up complying with the law.\u003c/p>\n\u003cp>“So that nudge is enough to push the majority of these children to get properly vaccinated,” Lo said, adding that other states and countries would be wise to follow California’s lead.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A 2015 \u003ca href=\"https://www.kqed.org/stateofhealth/222927/californias-new-vaccine-law-expected-to-send-disease-rates-plummeting\" target=\"_blank\" rel=\"noopener noreferrer\">California law\u003c/a> that eliminated personal belief exemptions for childhood vaccines appears to be working, according to new research out Monday, which found a hike in vaccination rates among children statewide.\u003c/p>\n\u003cp>The UC San Francisco \u003ca href=\"https://www.ucsf.edu/news/2019/12/416271/barring-nonmedical-exemptions-increases-vaccination-rates-study-finds\" target=\"_blank\" rel=\"noopener noreferrer\">study,\u003c/a> published in the journal “PLOS Medicine,” concluded that the state’s stricter immunization requirements have resulted in more kids getting vaccinated.\u003c/p>\n\u003cp>Researchers estimated the number of children in California who would have received the vaccine for measles, mumps and rubella (MMR) without the law, and compared that to the number vaccinated after the legislation — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\" rel=\"noopener noreferrer\">SB 277\u003c/a> — went into effect.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The \u003ca href=\"https://www.latimes.com/science/sciencenow/la-sci-sn-vaccine-medical-exemptions-20181029-story.html\" target=\"_blank\" rel=\"noopener noreferrer\">law requires\u003c/a> every child taught in school classrooms or enrolled in a child care facility — with the exemption of students who receive medical exemptions from doctors — to be fully immunized against 10 communicable diseases: diphtheria, hepatitis B, haemophilus influenzae Type B, measles, mumps, pertussis (whooping cough), poliomyelitis, rubella, tetanus and varicella (chickenpox).\u003c/p>\n\u003cp>Researchers also compared California’s vaccination rates with those of other states that still have personal belief exemptions, factoring in demographic variations.\u003c/p>\n\u003cp>Vaccination rates went up across California, particularly in counties like Sonoma and Santa Cruz, where rates have lingered below the statewide average. the report found. Non-medical exemptions decreased statewide by 2.4%, while medical exemptions increased 0.4%.\u003c/p>\n\u003cp>“When we look at those high-risk counties, we see the largest increases in vaccine coverage. 10-plus percent jumps in those areas,” said UCSF public health researcher Dr. Nathan Lo.\u003c/p>\n\u003cp>These changes brought the vaccination rate to 95% in almost all California counties, enough to provide “herd” immunity, or rates high enough that a contagious disease is less likely to spread.\u003c/p>\n\u003cp>It also means that a significant number of parents who previously received non-medical exemptions ended up complying with the law.\u003c/p>\n\u003cp>“So that nudge is enough to push the majority of these children to get properly vaccinated,” Lo said, adding that other states and countries would be wise to follow California’s lead.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>For decades, major tobacco companies have fought against raising the age limit to buy their products from 18 to 21. But recently, some cigarette and e-cigarette giants have started lobbying for the minimum age to rise.\u003c/p>\n\u003cp>“Raising the purchase age to 21 reduces underage access,” a radio ad from e-cigarette giant Juul \u003ca href=\"https://newsroom.juul.com/t21/\" target=\"_blank\" rel=\"noopener noreferrer\">declared\u003c/a>. “That’s why Juul Labs supports making 21+ the law nationwide.”\u003c/p>\n\u003cp>Last week, President Trump signed a congressional spending bill that includes a new federal regulation raising the age of purchase.\u003c/p>\n\u003cp>But health advocates are not wholeheartedly celebrating the change. They worry it may help the companies stave off further sweeping regulations of their industry and wonder how stringently it will be enforced.\u003c/p>\n\u003cp>Rob Crane, a physician at Ohio State University, has been campaigning to raise the minimum age for more than two decades through \u003ca href=\"https://tobacco21.org/\" target=\"_blank\" rel=\"noopener noreferrer\">his group Tobacco 21\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When it started pushing for firmer laws, “we were killed at every turn,” he remembers. “The industry hated this idea and they used their very potent political lobbying power to stifle it in every state.”\u003c/p>\n\u003cp>Archival tobacco industry documents show why the companies objected, says \u003ca href=\"https://tobacco.ucsf.edu/people/stanton-glantz-phd\" target=\"_blank\" rel=\"noopener noreferrer\">Stan Glantz\u003c/a>, the director of University of California San Francisco’s Center for Tobacco Control Research and Education.\u003c/p>\n\u003cp>“It’s because it made it harder to market to kids,” he says. “[It’s] very hard to design a marketing campaign where the nominal target [is] … people who are 21, and still pick up 12-year-olds.”\u003c/p>\n\u003cp>Since the beginning of the Tobacco 21 movement, the industry landscape has changed considerably. Now millions of teens are hooked on e-cigarettes, a source of considerable public concern.\u003c/p>\n\u003cp>Health advocates are currently pushing for more sweeping regulations than the age limit raise, such as banning flavors for e-cigarettes — something the industry has fought. University of Virginia historian \u003ca href=\"https://history.virginia.edu/people/profile/sem9dw\" target=\"_blank\" rel=\"noopener noreferrer\">Sarah Milov\u003c/a>, who wrote a book about tobacco, says the big companies have likely been willing to accept the stricter age limits “in order to take the public’s eyes off of other proposals for addressing youth vaping.”\u003c/p>\n\u003cp>Glantz says he thinks the new federal age restrictions give the industry “something they can argue: ‘Well, we’ve done enough. You don’t need to get rid of flavors,’ which in terms of reducing youth tobacco use is probably the single most important thing to do right now.”\u003c/p>\n\u003cp>Matthew Myers, the president of Campaign for Tobacco-Free Kids, echoed that idea. He said \u003ca href=\"https://www.tobaccofreekids.org/press-releases/2019_12_11_congress_health_bill\" target=\"_blank\" rel=\"noopener noreferrer\">in a statement\u003c/a> that the new law “will not bring about meaningful change, but will lead to the tobacco companies falsely claiming that the youth e-cigarette problem has been solved even as it continues to grow worse every day.”\u003c/p>\n\u003cp>In an op-ed earlier this year in \u003ca href=\"https://thehill.com/opinion/healthcare/431651-raise-the-legal-age-for-all-tobacco-products-to-21\" target=\"_blank\" rel=\"noopener noreferrer\">The Hill\u003c/a>, Altria CEO Howard Willard said the Food and Drug Administration made clear that the company might find itself in trouble with federal regulators unless it did more to address teen vaping.\u003c/p>\n\u003cp>“Put simply, we cannot continue to expand … [e-cigarettes] for adults unless we help curb youth access to all tobacco products, including e-vapor,” Willard said. Altria owns Philip Morris USA, which makes Marlboro cigarettes.\u003c/p>\n\u003cp>The federal age limit raise comes after a rapid succession of new laws at the state and local levels. At least 19 states and the District of Columbia have passed some form of the 21 age limit, many in the past year and with the support of big companies.\u003c/p>\n\u003cp>But Glantz says he sees a familiar strategy from the industry as these laws have passed. In this and previous fights, he says tobacco companies will preemptively lobby for bills that are weak or don’t spell out effective enforcement mechanisms.\u003c/p>\n\u003cp>[aside tag=\"vaping\" label=\"Related coverage\"]\u003c/p>\n\u003cp>“They’ve tried to co-opt the issue and started pushing bad legislation,” he said.\u003c/p>\n\u003cp>The two most prominent companies supporting the age restriction are Juul and Altria. When NPR reached out, they didn’t respond to these criticisms.\u003c/p>\n\u003cp>The federal legislation was put forward in the Senate by Democrat Tim Kaine and Republican Mitch McConnell, the majority leader who has long been seen as a friend to the tobacco industry. As \u003ca href=\"https://www.npr.org/2019/06/17/730496066/tobaccos-special-friend-what-internal-documents-say-about-mitch-mcconnell\" target=\"_blank\" rel=\"noopener noreferrer\">NPR’s Embedded podcast\u003c/a> found, “vaping and tobacco companies are currently employing McConnell’s \u003ca href=\"https://www.wfs-dc.com/about-us/\" target=\"_blank\" rel=\"noopener noreferrer\">former\u003c/a> \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2019/Q1/301038362.xml\" target=\"_blank\" rel=\"noopener noreferrer\">policy adviser\u003c/a>, his former \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2019/RR/301024486.xml\" target=\"_blank\" rel=\"noopener noreferrer\">policy director\u003c/a> and his \u003ca href=\"https://www.akingump.com/en/lawyers-advisors/hunter-bates.html\">former\u003c/a> \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2018/Q4/301009679.xml\" target=\"_blank\" rel=\"noopener noreferrer\">chief of staff\u003c/a> to lobby on their behalf.”\u003c/p>\n\u003cp>In a statement \u003ca href=\"https://www.mcconnell.senate.gov/public/index.cfm/pressreleases?ID=17523CAF-6BA1-4894-9BD0-45A67B1A2D96\" target=\"_blank\" rel=\"noopener noreferrer\">after the federal law passed\u003c/a>, McConnell called the recent spate of vaping-related illnesses an “urgent crisis” and stressed that the new measure will help “keep these dangerous products away from our children.”\u003c/p>\n\u003cp>The FDA has jurisdiction over enforcing the federal law. Crane, the longtime advocate for raising the age limit, has questions about how aggressive it will be.\u003c/p>\n\u003cp>He says he’s watched how the FDA regulated the previous age limit of 18, and says he would want to see more compliance checks and fewer violations allowed for tobacco retailers. He says the law will do little to keep tobacco products away from kids and young adults if it’s not enforced, and he believes local health authorities would be more effective.\u003c/p>\n\u003cp>“We know that waiting for the FDA is kind of like waiting for Godot. They don’t do anything. They bark but never bite,” Crane says.\u003c/p>\n\u003cp>FDA Commissioner Stephen Hahn praised the new age limit and \u003ca href=\"https://twitter.com/SteveFDA/status/1208232123833958401?s=20\">said in a tweet \u003c/a>that “more details will be forthcoming as we update our regulations to carry out this provision of law.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Crane says his group is going to continue pushing for even tougher laws at the state and local levels.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit \u003ca href=\"https://www.npr.org\" target=\"_blank\" rel=\"noopener noreferrer\">https://www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Tobacco+Industry+Giants+Backed+Raising+The+Minimum+Age+Of+Purchase&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When it started pushing for firmer laws, “we were killed at every turn,” he remembers. “The industry hated this idea and they used their very potent political lobbying power to stifle it in every state.”\u003c/p>\n\u003cp>Archival tobacco industry documents show why the companies objected, says \u003ca href=\"https://tobacco.ucsf.edu/people/stanton-glantz-phd\" target=\"_blank\" rel=\"noopener noreferrer\">Stan Glantz\u003c/a>, the director of University of California San Francisco’s Center for Tobacco Control Research and Education.\u003c/p>\n\u003cp>“It’s because it made it harder to market to kids,” he says. “[It’s] very hard to design a marketing campaign where the nominal target [is] … people who are 21, and still pick up 12-year-olds.”\u003c/p>\n\u003cp>Since the beginning of the Tobacco 21 movement, the industry landscape has changed considerably. Now millions of teens are hooked on e-cigarettes, a source of considerable public concern.\u003c/p>\n\u003cp>Health advocates are currently pushing for more sweeping regulations than the age limit raise, such as banning flavors for e-cigarettes — something the industry has fought. University of Virginia historian \u003ca href=\"https://history.virginia.edu/people/profile/sem9dw\" target=\"_blank\" rel=\"noopener noreferrer\">Sarah Milov\u003c/a>, who wrote a book about tobacco, says the big companies have likely been willing to accept the stricter age limits “in order to take the public’s eyes off of other proposals for addressing youth vaping.”\u003c/p>\n\u003cp>Glantz says he thinks the new federal age restrictions give the industry “something they can argue: ‘Well, we’ve done enough. You don’t need to get rid of flavors,’ which in terms of reducing youth tobacco use is probably the single most important thing to do right now.”\u003c/p>\n\u003cp>Matthew Myers, the president of Campaign for Tobacco-Free Kids, echoed that idea. He said \u003ca href=\"https://www.tobaccofreekids.org/press-releases/2019_12_11_congress_health_bill\" target=\"_blank\" rel=\"noopener noreferrer\">in a statement\u003c/a> that the new law “will not bring about meaningful change, but will lead to the tobacco companies falsely claiming that the youth e-cigarette problem has been solved even as it continues to grow worse every day.”\u003c/p>\n\u003cp>In an op-ed earlier this year in \u003ca href=\"https://thehill.com/opinion/healthcare/431651-raise-the-legal-age-for-all-tobacco-products-to-21\" target=\"_blank\" rel=\"noopener noreferrer\">The Hill\u003c/a>, Altria CEO Howard Willard said the Food and Drug Administration made clear that the company might find itself in trouble with federal regulators unless it did more to address teen vaping.\u003c/p>\n\u003cp>“Put simply, we cannot continue to expand … [e-cigarettes] for adults unless we help curb youth access to all tobacco products, including e-vapor,” Willard said. Altria owns Philip Morris USA, which makes Marlboro cigarettes.\u003c/p>\n\u003cp>The federal age limit raise comes after a rapid succession of new laws at the state and local levels. At least 19 states and the District of Columbia have passed some form of the 21 age limit, many in the past year and with the support of big companies.\u003c/p>\n\u003cp>But Glantz says he sees a familiar strategy from the industry as these laws have passed. In this and previous fights, he says tobacco companies will preemptively lobby for bills that are weak or don’t spell out effective enforcement mechanisms.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“They’ve tried to co-opt the issue and started pushing bad legislation,” he said.\u003c/p>\n\u003cp>The two most prominent companies supporting the age restriction are Juul and Altria. When NPR reached out, they didn’t respond to these criticisms.\u003c/p>\n\u003cp>The federal legislation was put forward in the Senate by Democrat Tim Kaine and Republican Mitch McConnell, the majority leader who has long been seen as a friend to the tobacco industry. As \u003ca href=\"https://www.npr.org/2019/06/17/730496066/tobaccos-special-friend-what-internal-documents-say-about-mitch-mcconnell\" target=\"_blank\" rel=\"noopener noreferrer\">NPR’s Embedded podcast\u003c/a> found, “vaping and tobacco companies are currently employing McConnell’s \u003ca href=\"https://www.wfs-dc.com/about-us/\" target=\"_blank\" rel=\"noopener noreferrer\">former\u003c/a> \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2019/Q1/301038362.xml\" target=\"_blank\" rel=\"noopener noreferrer\">policy adviser\u003c/a>, his former \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2019/RR/301024486.xml\" target=\"_blank\" rel=\"noopener noreferrer\">policy director\u003c/a> and his \u003ca href=\"https://www.akingump.com/en/lawyers-advisors/hunter-bates.html\">former\u003c/a> \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2018/Q4/301009679.xml\" target=\"_blank\" rel=\"noopener noreferrer\">chief of staff\u003c/a> to lobby on their behalf.”\u003c/p>\n\u003cp>In a statement \u003ca href=\"https://www.mcconnell.senate.gov/public/index.cfm/pressreleases?ID=17523CAF-6BA1-4894-9BD0-45A67B1A2D96\" target=\"_blank\" rel=\"noopener noreferrer\">after the federal law passed\u003c/a>, McConnell called the recent spate of vaping-related illnesses an “urgent crisis” and stressed that the new measure will help “keep these dangerous products away from our children.”\u003c/p>\n\u003cp>The FDA has jurisdiction over enforcing the federal law. Crane, the longtime advocate for raising the age limit, has questions about how aggressive it will be.\u003c/p>\n\u003cp>He says he’s watched how the FDA regulated the previous age limit of 18, and says he would want to see more compliance checks and fewer violations allowed for tobacco retailers. He says the law will do little to keep tobacco products away from kids and young adults if it’s not enforced, and he believes local health authorities would be more effective.\u003c/p>\n\u003cp>“We know that waiting for the FDA is kind of like waiting for Godot. They don’t do anything. They bark but never bite,” Crane says.\u003c/p>\n\u003cp>FDA Commissioner Stephen Hahn praised the new age limit and \u003ca href=\"https://twitter.com/SteveFDA/status/1208232123833958401?s=20\">said in a tweet \u003c/a>that “more details will be forthcoming as we update our regulations to carry out this provision of law.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Crane says his group is going to continue pushing for even tougher laws at the state and local levels.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit \u003ca href=\"https://www.npr.org\" target=\"_blank\" rel=\"noopener noreferrer\">https://www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Tobacco+Industry+Giants+Backed+Raising+The+Minimum+Age+Of+Purchase&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>For many Americans, hallucinogens still evoke the psychedelic ’60s, bringing to mind the sex-and-drugs lifestyle of the hippie counterculture.\u003c/p>\n\u003cp>But that stereotype lags behind reality, by several decades. Today, psychedelic experimentation is more likely to refer to dozens of clinical trials taking place at universities and research facilities. The psychedelics under study range from psilocybin, the active ingredient in psychedelic mushrooms, to MDMA (also known as Ecstasy or Molly), to LSD, among others. Researchers are studying them for their therapeutic potential in treating hard-to-treat conditions such as PTSD, addiction, depression and anxiety.\u003c/p>\n\u003cp>[aside tag='smoking' label='More Coverage.']\u003c/p>\n\u003cp>The promise of freedom from cigarettes was what compelled Carine Chen-McLaughlin, 65, to enroll in an experimental study of psilocybin therapy for smokers. She was desperate to break free from her decades-long physical addiction to nicotine. Quitting smoking had felt impossible for so long.\u003c/p>\n\u003cp>“It’s basically saying good-bye to a very old friend, and worrying about: Am I going to be OK without this good friend?” the Baltimore resident says.\u003c/p>\n\u003cp>Like many of the 49 million \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6845a2.htm?s_cid=mm6845a2_w\" target=\"_blank\" rel=\"noopener noreferrer\">tobacco users\u003c/a> in the U.S., Chen-McLaughlin wanted to quit and had tried various methods: nicotine gum, the nicotine patch and even stopping cold turkey. But nothing worked for more than a couple days.\u003c/p>\n\u003cp>The clinical trial she joined took place in her hometown of Baltimore, at Johns Hopkins School of Medicine. While she was a bit anxious about the experiment, Chen-McLaughlin says she was nevertheless hopeful about trying something totally different.\u003c/p>\n\u003cp>“I think I was more excited that… maybe, \u003cem>maybe \u003c/em>this is it!” she says with a laugh.\u003c/p>\n\u003ch3>A research revival\u003c/h3>\n\u003cp>Therapeutic research on psilocybin, LSD and other psychedelic drugs isn’t new. Beginning in the 1950s, researchers investigated them as potential treatments for alcohol addiction, cancer-related anxiety, depression and other common psychological ills.\u003c/p>\n\u003cp>But then came the “psychedelic ’60s,” a time when American counterculture embraced these then-legal drugs. The resulting widespread use — and abuse — of psychedelics ultimately triggered a backlash that led the federal government to criminalize these substances. By the early 1970s, many ongoing studies into the potential medical benefits of psychedelics had halted.\u003c/p>\n\u003cp>“Unfortunately, all of that legitimate research was really sacrificed because of the association between psychedelics and the counterculture,” says \u003ca href=\"https://www.hopkinsmedicine.org/profiles/results/directory/profile/0800020/matthew-johnson\" target=\"_blank\" rel=\"noopener noreferrer\">Matthew Johnson\u003c/a>, an associate professor of psychiatry at Johns Hopkins School of Medicine and the lead investigator in the psilocybin study for smoking cessation.\u003c/p>\n\u003cp>Today, however, a new wave of psychedelic research has taken hold, with dozens of clinical studies happening at U.S. academic institutions. In fact, some of the experimental therapies involving psilocbyin\u003ca href=\"https://www.medscape.com/viewarticle/921789\" target=\"_blank\" rel=\"noopener noreferrer\"> have recently received \u003c/a>“breakthrough therapy” designations \u003ca href=\"https://www.fda.gov/patients/fast-track-breakthrough-therapy-accelerated-approval-priority-review/breakthrough-therapy\" target=\"_blank\" rel=\"noopener noreferrer\">from the FDA\u003c/a>, which can help speed their progress towards eventual market approval.\u003c/p>\n\u003cp>Although the studies are legal, the federal government does not provide any financial support for psychedelic research, so the researchers must rely on private organizations for funding. The Johns Hopkins study, for instance, is supported by the non-profit \u003ca href=\"https://heffter.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Heffter Research Institute\u003c/a> in New Mexico.\u003c/p>\n\u003cp>“We’re ever hopeful and we’re continuing to put in [funding] applications,” Johnson says. “But so far, the National Institutes of Health has not funded any therapeutic research with psilocybin.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Charles Grob']‘Slowly but surely, our colleagues throughout the health fields have started to recognize that these treatment models may have something very positive and very unique to offer.’[/pullquote]\u003c/p>\n\u003cp>Dr. Charles Grob, a psychiatrist at UCLA’s David Geffen School of Medicine, has studied the therapeutic potential of psychedelics since the 1980s. His \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20819978\" target=\"_blank\" rel=\"noopener noreferrer\">four-year-long pilot study\u003c/a> of psilocybin-assisted therapy on patients with anxiety and advanced-stage cancer was among the first studies to launch this modern-day era of psychedelic research. It was published in the Archives of General Psychiatry in 2011.\u003c/p>\n\u003cp>Grob attributes the resurgence of research interest in psychedelics to several factors: a dire need for new mental health treatments, a more sophisticated understanding of the underlying hallucinogenic compounds and a growing body of research literature showing promising results from around the world.\u003c/p>\n\u003cp>All those trends are helping to destigmatize the use of psychedelics for psychological healing, Grob says.\u003c/p>\n\u003cp>“Slowly but surely, our colleagues throughout the health fields have started to recognize that these treatment models may have something very positive and very unique to offer,” he says.\u003c/p>\n\u003ch3>Therapeutic advantages — and risks\u003c/h3>\n\u003cp>Studies show psychedelics aren’t physically addictive. And research has shown them to be safe when administered properly to healthy patients. But Johnson cautions that psychedelics can be abused.\u003c/p>\n\u003cp>“We are not encouraging people to [take psilocybin] on their own,” Johnson says. “There are definitely risks, we know what those are … and we have a way to address them in these research studies.”\u003c/p>\n\u003cp>In particular, a \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0028390818302296\" target=\"_blank\" rel=\"noopener noreferrer\">study by Johnson and his team\u003c/a>, published in 2018, shows psilocybin can cause harm to those with a predisposition to psychosis. So potential study participants undergo “a couple of very long days” of screening before they can be admitted into the clinical trial, he says.\u003c/p>\n\u003cp>For those deemed healthy and able to undergo this therapy, there are no long-term or ongoing prescriptions, as is the case with other therapies for quitting smoking, like Chantix.\u003c/p>\n\u003cp>In Johnson’s current study, the patient ingests only one dose of psilocybin during a special session that takes place about halfway through a series of 10 cognitive behavioral therapy sessions.\u003c/p>\n\u003ch3>Promising results for quitting cigarettes\u003c/h3>\n\u003cp>So far, about 40 out of 80 participants have completed the 13-week protocol for the Johns Hopkins study. It begins with four hours of preparatory counseling before the patient takes the lab-produced psilocybin in pill form.\u003c/p>\n\u003cp>The psilocybin session lasts about six hours and is supervised by two therapeutic “guides” who provide comfort and assurance as needed. As the hallucinogen kicks in, patients are counseled to close their eyes, go inward and experience whatever shows up.\u003c/p>\n\u003cp>So far, half of the 40 participants who’ve completed the current Johns Hopkins smoking cessation program have quit smoking, as confirmed by urine and breath samples, Johnson says.\u003c/p>\n\u003cp>That compares to a 10% to 35% success rate for conventional therapies such as nicotine-replacement medications or cognitive behavioral therapy alone, says Johnson.\u003c/p>\n\u003cp>Johnson says the evidence collected so far suggests a couple more doses of psilocybin might prove even more successful.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286320/\">his pilot study\u003c/a> published in 2014, 15 participants received a similar amount of counseling as those in Chen-McLaughlin’s group. But instead of one dose of psilocybin, they got three. Six months later, 80% were smoke-free, Johnson says.\u003c/p>\n\u003cp>Still, Johnson cautions against too much enthusiasm just yet, because the studies at this point are small.\u003c/p>\n\u003cp>He says if his current study maintains a favorable success rate, the U.S. Food and Drug Administration would then require him to replicate that success in larger, Phase 3 clinical trials before the agency could consider approving psilocybin-assisted therapy as a treatment for addicted smokers.\u003c/p>\n\u003cp>“The caveat to all this is that we have so much more to learn and to explore, to really understand what’s going on,” he says.\u003c/p>\n\u003ch3>A shift in perspective\u003c/h3>\n\u003cp>How psilocybin might help with addiction is not yet clear.\u003c/p>\n\u003cp>“Our best guess at this point is that while the drug is active, the brain is operating in a dramatically, qualitatively different fashion,” Johnson says.\u003c/p>\n\u003cp>Most notably, areas of the brain that normally don’t communicate begin to do so, while well-worn neural pathways go quiet. What’s more, because psychedelics don’t numb the mind in the way alcohol and some other drugs do, patients report leaving the session with their newfound insights intact.\u003c/p>\n\u003cp>“People often report a remarkable clarity,” Johnson says.”They know what’s going on [during the experience and] they can observe their life and themselves from a much different vantage point – a much broader vantage point.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Matthew Johnson']‘Our best guess at this point is that while the drug is active, the brain is operating in a dramatically, qualitatively different fashion.’[/pullquote]\u003c/p>\n\u003cp>This perspective shift is part of the “mystical experience” that recreational psilocybin users report, and that spiritual users, such as shamans, have described for centuries. One theory of how these drugs may help is that experiencing feelings of unity, sacredness and transcendence can help change thought patterns that fuel addiction.\u003c/p>\n\u003cp>That doesn’t mean the experience is necessarily easy, or even enjoyable. Chen-McLaughlin reported that as she lay for hours on the couch,the psilocybin unleashed a host of fears, which took the form of swirling dark clouds that she believed were trying to suffocate her.\u003c/p>\n\u003cp>“And that was really super, super scary,” she says. “And I cried, I think at least four out of five, six hours.”\u003c/p>\n\u003cp>Yet, she says, through the entire experience, she had a vision of her recently-deceased mother, who seemed to stand by as a sort of spiritual sentry, helping her to face those dark, cloud-like fears. At that very point, as she became determined to confront them, Chen-McLaughlin says, the dark clouds dissipated — and so did her desire to smoke.\u003c/p>\n\u003cp>“I haven’t smoked since March 23, 2018,” she says, adding that she has no clear idea why it worked.\u003c/p>\n\u003cp>Since her psilocybin experience, Chen-McLaughlin has not only quit smoking, she reports feeling physically repulsed by cigarettes. One day when she was feeling stressed, she asked her cigarette-smoking husband for a puff of his. But when she reached for it, she says, she couldn’t even make herself touch it.\u003c/p>\n\u003cp>“You could pay me $5,000 and I couldn’t do it,” she says. “I know it sounds really weird, but that’s what happened: Something in my brain sort of got switched.”\u003c/p>\n\u003cp>Still, she attributes her success in quitting smoking not just to psilocybin, but to a combination of the drug and all the hours of cognitive behavioral therapy she received along with it.\u003c/p>\n\u003cp>“If I just walked in and took a psilocybin pill,” she says, ” I don’t think it would have worked.”\u003c/p>\n\u003cp>\u003cem>Stephanie O’Neill is a health and science writer in California.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR’s reporting partnership with \u003c/em>\u003ca href=\"https://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Way+To+Quit%3F+Psychedelic+Therapy+Offers+Promise+For+Smoking+Cessation&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>[ad fullwidth]\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The promise of freedom from cigarettes was what compelled Carine Chen-McLaughlin, 65, to enroll in an experimental study of psilocybin therapy for smokers. She was desperate to break free from her decades-long physical addiction to nicotine. Quitting smoking had felt impossible for so long.\u003c/p>\n\u003cp>“It’s basically saying good-bye to a very old friend, and worrying about: Am I going to be OK without this good friend?” the Baltimore resident says.\u003c/p>\n\u003cp>Like many of the 49 million \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6845a2.htm?s_cid=mm6845a2_w\" target=\"_blank\" rel=\"noopener noreferrer\">tobacco users\u003c/a> in the U.S., Chen-McLaughlin wanted to quit and had tried various methods: nicotine gum, the nicotine patch and even stopping cold turkey. But nothing worked for more than a couple days.\u003c/p>\n\u003cp>The clinical trial she joined took place in her hometown of Baltimore, at Johns Hopkins School of Medicine. While she was a bit anxious about the experiment, Chen-McLaughlin says she was nevertheless hopeful about trying something totally different.\u003c/p>\n\u003cp>“I think I was more excited that… maybe, \u003cem>maybe \u003c/em>this is it!” she says with a laugh.\u003c/p>\n\u003ch3>A research revival\u003c/h3>\n\u003cp>Therapeutic research on psilocybin, LSD and other psychedelic drugs isn’t new. Beginning in the 1950s, researchers investigated them as potential treatments for alcohol addiction, cancer-related anxiety, depression and other common psychological ills.\u003c/p>\n\u003cp>But then came the “psychedelic ’60s,” a time when American counterculture embraced these then-legal drugs. The resulting widespread use — and abuse — of psychedelics ultimately triggered a backlash that led the federal government to criminalize these substances. By the early 1970s, many ongoing studies into the potential medical benefits of psychedelics had halted.\u003c/p>\n\u003cp>“Unfortunately, all of that legitimate research was really sacrificed because of the association between psychedelics and the counterculture,” says \u003ca href=\"https://www.hopkinsmedicine.org/profiles/results/directory/profile/0800020/matthew-johnson\" target=\"_blank\" rel=\"noopener noreferrer\">Matthew Johnson\u003c/a>, an associate professor of psychiatry at Johns Hopkins School of Medicine and the lead investigator in the psilocybin study for smoking cessation.\u003c/p>\n\u003cp>Today, however, a new wave of psychedelic research has taken hold, with dozens of clinical studies happening at U.S. academic institutions. In fact, some of the experimental therapies involving psilocbyin\u003ca href=\"https://www.medscape.com/viewarticle/921789\" target=\"_blank\" rel=\"noopener noreferrer\"> have recently received \u003c/a>“breakthrough therapy” designations \u003ca href=\"https://www.fda.gov/patients/fast-track-breakthrough-therapy-accelerated-approval-priority-review/breakthrough-therapy\" target=\"_blank\" rel=\"noopener noreferrer\">from the FDA\u003c/a>, which can help speed their progress towards eventual market approval.\u003c/p>\n\u003cp>Although the studies are legal, the federal government does not provide any financial support for psychedelic research, so the researchers must rely on private organizations for funding. The Johns Hopkins study, for instance, is supported by the non-profit \u003ca href=\"https://heffter.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Heffter Research Institute\u003c/a> in New Mexico.\u003c/p>\n\u003cp>“We’re ever hopeful and we’re continuing to put in [funding] applications,” Johnson says. “But so far, the National Institutes of Health has not funded any therapeutic research with psilocybin.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. Charles Grob, a psychiatrist at UCLA’s David Geffen School of Medicine, has studied the therapeutic potential of psychedelics since the 1980s. His \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20819978\" target=\"_blank\" rel=\"noopener noreferrer\">four-year-long pilot study\u003c/a> of psilocybin-assisted therapy on patients with anxiety and advanced-stage cancer was among the first studies to launch this modern-day era of psychedelic research. It was published in the Archives of General Psychiatry in 2011.\u003c/p>\n\u003cp>Grob attributes the resurgence of research interest in psychedelics to several factors: a dire need for new mental health treatments, a more sophisticated understanding of the underlying hallucinogenic compounds and a growing body of research literature showing promising results from around the world.\u003c/p>\n\u003cp>All those trends are helping to destigmatize the use of psychedelics for psychological healing, Grob says.\u003c/p>\n\u003cp>“Slowly but surely, our colleagues throughout the health fields have started to recognize that these treatment models may have something very positive and very unique to offer,” he says.\u003c/p>\n\u003ch3>Therapeutic advantages — and risks\u003c/h3>\n\u003cp>Studies show psychedelics aren’t physically addictive. And research has shown them to be safe when administered properly to healthy patients. But Johnson cautions that psychedelics can be abused.\u003c/p>\n\u003cp>“We are not encouraging people to [take psilocybin] on their own,” Johnson says. “There are definitely risks, we know what those are … and we have a way to address them in these research studies.”\u003c/p>\n\u003cp>In particular, a \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0028390818302296\" target=\"_blank\" rel=\"noopener noreferrer\">study by Johnson and his team\u003c/a>, published in 2018, shows psilocybin can cause harm to those with a predisposition to psychosis. So potential study participants undergo “a couple of very long days” of screening before they can be admitted into the clinical trial, he says.\u003c/p>\n\u003cp>For those deemed healthy and able to undergo this therapy, there are no long-term or ongoing prescriptions, as is the case with other therapies for quitting smoking, like Chantix.\u003c/p>\n\u003cp>In Johnson’s current study, the patient ingests only one dose of psilocybin during a special session that takes place about halfway through a series of 10 cognitive behavioral therapy sessions.\u003c/p>\n\u003ch3>Promising results for quitting cigarettes\u003c/h3>\n\u003cp>So far, about 40 out of 80 participants have completed the 13-week protocol for the Johns Hopkins study. It begins with four hours of preparatory counseling before the patient takes the lab-produced psilocybin in pill form.\u003c/p>\n\u003cp>The psilocybin session lasts about six hours and is supervised by two therapeutic “guides” who provide comfort and assurance as needed. As the hallucinogen kicks in, patients are counseled to close their eyes, go inward and experience whatever shows up.\u003c/p>\n\u003cp>So far, half of the 40 participants who’ve completed the current Johns Hopkins smoking cessation program have quit smoking, as confirmed by urine and breath samples, Johnson says.\u003c/p>\n\u003cp>That compares to a 10% to 35% success rate for conventional therapies such as nicotine-replacement medications or cognitive behavioral therapy alone, says Johnson.\u003c/p>\n\u003cp>Johnson says the evidence collected so far suggests a couple more doses of psilocybin might prove even more successful.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286320/\">his pilot study\u003c/a> published in 2014, 15 participants received a similar amount of counseling as those in Chen-McLaughlin’s group. But instead of one dose of psilocybin, they got three. Six months later, 80% were smoke-free, Johnson says.\u003c/p>\n\u003cp>Still, Johnson cautions against too much enthusiasm just yet, because the studies at this point are small.\u003c/p>\n\u003cp>He says if his current study maintains a favorable success rate, the U.S. Food and Drug Administration would then require him to replicate that success in larger, Phase 3 clinical trials before the agency could consider approving psilocybin-assisted therapy as a treatment for addicted smokers.\u003c/p>\n\u003cp>“The caveat to all this is that we have so much more to learn and to explore, to really understand what’s going on,” he says.\u003c/p>\n\u003ch3>A shift in perspective\u003c/h3>\n\u003cp>How psilocybin might help with addiction is not yet clear.\u003c/p>\n\u003cp>“Our best guess at this point is that while the drug is active, the brain is operating in a dramatically, qualitatively different fashion,” Johnson says.\u003c/p>\n\u003cp>Most notably, areas of the brain that normally don’t communicate begin to do so, while well-worn neural pathways go quiet. What’s more, because psychedelics don’t numb the mind in the way alcohol and some other drugs do, patients report leaving the session with their newfound insights intact.\u003c/p>\n\u003cp>“People often report a remarkable clarity,” Johnson says.”They know what’s going on [during the experience and] they can observe their life and themselves from a much different vantage point – a much broader vantage point.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This perspective shift is part of the “mystical experience” that recreational psilocybin users report, and that spiritual users, such as shamans, have described for centuries. One theory of how these drugs may help is that experiencing feelings of unity, sacredness and transcendence can help change thought patterns that fuel addiction.\u003c/p>\n\u003cp>That doesn’t mean the experience is necessarily easy, or even enjoyable. Chen-McLaughlin reported that as she lay for hours on the couch,the psilocybin unleashed a host of fears, which took the form of swirling dark clouds that she believed were trying to suffocate her.\u003c/p>\n\u003cp>“And that was really super, super scary,” she says. “And I cried, I think at least four out of five, six hours.”\u003c/p>\n\u003cp>Yet, she says, through the entire experience, she had a vision of her recently-deceased mother, who seemed to stand by as a sort of spiritual sentry, helping her to face those dark, cloud-like fears. At that very point, as she became determined to confront them, Chen-McLaughlin says, the dark clouds dissipated — and so did her desire to smoke.\u003c/p>\n\u003cp>“I haven’t smoked since March 23, 2018,” she says, adding that she has no clear idea why it worked.\u003c/p>\n\u003cp>Since her psilocybin experience, Chen-McLaughlin has not only quit smoking, she reports feeling physically repulsed by cigarettes. One day when she was feeling stressed, she asked her cigarette-smoking husband for a puff of his. But when she reached for it, she says, she couldn’t even make herself touch it.\u003c/p>\n\u003cp>“You could pay me $5,000 and I couldn’t do it,” she says. “I know it sounds really weird, but that’s what happened: Something in my brain sort of got switched.”\u003c/p>\n\u003cp>Still, she attributes her success in quitting smoking not just to psilocybin, but to a combination of the drug and all the hours of cognitive behavioral therapy she received along with it.\u003c/p>\n\u003cp>“If I just walked in and took a psilocybin pill,” she says, ” I don’t think it would have worked.”\u003c/p>\n\u003cp>\u003cem>Stephanie O’Neill is a health and science writer in California.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR’s reporting partnership with \u003c/em>\u003ca href=\"https://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Way+To+Quit%3F+Psychedelic+Therapy+Offers+Promise+For+Smoking+Cessation&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>\u003c/p>\u003c/div>",
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"content": "\u003cp>The Department of Labor’s workplace safety agency is getting ready to take new action to reduce workers’ exposure to dangerous \u003ca href=\"https://www.cdc.gov/niosh/topics/silica/default.html\" target=\"_blank\" rel=\"noopener noreferrer\">silica\u003c/a> dust that can irreparably damage the lungs.\u003c/p>\n\u003cp>But the agency’s new program doesn’t give special attention to the kitchen and bathroom countertop industry, which has recently seen \u003ca href=\"https://www.npr.org/sections/health-shots/2019/10/02/766028237/workers-are-falling-ill-even-dying-after-making-kitchen-countertops\" target=\"_blank\" rel=\"noopener noreferrer\">cases\u003c/a> of severe lung damage that have alarmed public health officials.\u003c/p>\n\u003cp>Physicians have found aggressive forms of the disease silicosis in young, previously healthy \u003ca href=\"https://www.npr.org/series/785708157/silicosis-in-u-s-countertop-workers\" target=\"_blank\" rel=\"noopener noreferrer\">workers\u003c/a> who cut and polished countertops made out of natural stone and \u003ca href=\"https://www.npr.org/sections/health-shots/2019/12/02/782958005/there-s-no-good-dust-what-happens-after-quartz-countertops-leave-the-factory\" target=\"_blank\" rel=\"noopener noreferrer\">engineered quartz\u003c/a>, a composite material that typically has a silica content of more than 90%. Some workers have died, and others will need lung transplants.\u003c/p>\n\u003cp>Finding silicosis in the countertop industry was something new for the United States, where over 2 million American workers are exposed to silica dust in other jobs like construction, \u003ca href=\"https://www.cdc.gov/features/preventing-silicosis/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">according\u003c/a> to the Centers for Disease Control and Prevention. The silica dust comes from cutting, grinding, mixing or demolishing materials like stone, concrete and brick.\u003c/p>\n\u003cp>In Australia, \u003ca href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30478-7/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">studies\u003c/a> of countertop workers have found that more than 10% have silicosis. It’s unknown how many of the estimated 100,000 countertop workers in the U. S. are affected.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lawmakers \u003ca href=\"https://www.npr.org/sections/health-shots/2019/10/07/767916317/lawmakers-seek-protections-for-workers-against-lung-damage-tied-to-making-counte\" target=\"_blank\" rel=\"noopener noreferrer\">wrote\u003c/a> to the Occupational Safety and Health Administration in October, calling for the agency to issue a new \u003ca href=\"https://www.osha.gov/enforcement/directives/nep\" target=\"_blank\" rel=\"noopener noreferrer\">National Emphasis Program\u003c/a> to focus agency resources on the engineered stone countertop fabrication industry and make it easier for inspectors to target those workplaces.\u003c/p>\n\u003cp>The American Public Health Association also wrote to OSHA in October, saying “there is an urgent need for OSHA enforcement and outreach on respirable silica in this industry. … Targeted inspections in the industry will help determine the magnitude of the problem.” As of Dec. 20, OSHA had not responded to the association.\u003c/p>\n\u003cp>On Dec. 19, however, the Department of Labor did \u003ca href=\"https://www.npr.org/documents/2019/dec/12-19-2019%20Scott%20RE-Silica%20NEP.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">inform lawmakers \u003c/a>that it \u003ca href=\"https://www.npr.org/documents/2019/dec/12-19-2019%20Adams%20RE-Silica%20NEP.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">intends to implement\u003c/a> a new \u003ca href=\"https://www.npr.org/documents/2019/dec/Silica_NEP.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">National Emphasis Program\u003c/a> for silica, which will replace a similar program that was \u003ca href=\"https://www.osha.gov/enforcement/directives/cpl-03-00-007-0\">canceled\u003c/a> in October of 2017.\u003c/p>\n\u003cp>[aside tag='health' label='More Coverage.']\u003c/p>\n\u003cp>A required 10-day notice was given to House and Senate appropriations committees on Dec. 17, which means the program could go into effect very soon. It will require that 2% of all OSHA inspections every year occur in workplaces at elevated risk of silica exposures.\u003c/p>\n\u003cp>But countertop fabricators are just one targeted industry in a long list that includes everything from iron foundries to concrete pipe manufacturing to machine shops.\u003c/p>\n\u003cp>“OSHA anticipates that the majority of the inspections will occur in construction,” according to a description of the program provided to lawmakers, because most exposures to silica dust occur on construction sites.\u003c/p>\n\u003cp>One congressional aide said it wasn’t clear how many additional inspections would actually occur at countertop fabrication shops, and called this a woefully inadequate response to what some public health experts fear is a potential crisis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The spending bill that passed this past week did provide OSHA with an increase of $24 million above its 2019 enacted funding level, however, which means more money will be available for inspections and enforcement.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Safety+Program+Takes+On+Silica+Dust+Amid+A+Possible+Crisis&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Department of Labor’s workplace safety agency is getting ready to take new action to reduce workers’ exposure to dangerous \u003ca href=\"https://www.cdc.gov/niosh/topics/silica/default.html\" target=\"_blank\" rel=\"noopener noreferrer\">silica\u003c/a> dust that can irreparably damage the lungs.\u003c/p>\n\u003cp>But the agency’s new program doesn’t give special attention to the kitchen and bathroom countertop industry, which has recently seen \u003ca href=\"https://www.npr.org/sections/health-shots/2019/10/02/766028237/workers-are-falling-ill-even-dying-after-making-kitchen-countertops\" target=\"_blank\" rel=\"noopener noreferrer\">cases\u003c/a> of severe lung damage that have alarmed public health officials.\u003c/p>\n\u003cp>Physicians have found aggressive forms of the disease silicosis in young, previously healthy \u003ca href=\"https://www.npr.org/series/785708157/silicosis-in-u-s-countertop-workers\" target=\"_blank\" rel=\"noopener noreferrer\">workers\u003c/a> who cut and polished countertops made out of natural stone and \u003ca href=\"https://www.npr.org/sections/health-shots/2019/12/02/782958005/there-s-no-good-dust-what-happens-after-quartz-countertops-leave-the-factory\" target=\"_blank\" rel=\"noopener noreferrer\">engineered quartz\u003c/a>, a composite material that typically has a silica content of more than 90%. Some workers have died, and others will need lung transplants.\u003c/p>\n\u003cp>Finding silicosis in the countertop industry was something new for the United States, where over 2 million American workers are exposed to silica dust in other jobs like construction, \u003ca href=\"https://www.cdc.gov/features/preventing-silicosis/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">according\u003c/a> to the Centers for Disease Control and Prevention. The silica dust comes from cutting, grinding, mixing or demolishing materials like stone, concrete and brick.\u003c/p>\n\u003cp>In Australia, \u003ca href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30478-7/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">studies\u003c/a> of countertop workers have found that more than 10% have silicosis. It’s unknown how many of the estimated 100,000 countertop workers in the U. S. are affected.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lawmakers \u003ca href=\"https://www.npr.org/sections/health-shots/2019/10/07/767916317/lawmakers-seek-protections-for-workers-against-lung-damage-tied-to-making-counte\" target=\"_blank\" rel=\"noopener noreferrer\">wrote\u003c/a> to the Occupational Safety and Health Administration in October, calling for the agency to issue a new \u003ca href=\"https://www.osha.gov/enforcement/directives/nep\" target=\"_blank\" rel=\"noopener noreferrer\">National Emphasis Program\u003c/a> to focus agency resources on the engineered stone countertop fabrication industry and make it easier for inspectors to target those workplaces.\u003c/p>\n\u003cp>The American Public Health Association also wrote to OSHA in October, saying “there is an urgent need for OSHA enforcement and outreach on respirable silica in this industry. … Targeted inspections in the industry will help determine the magnitude of the problem.” As of Dec. 20, OSHA had not responded to the association.\u003c/p>\n\u003cp>On Dec. 19, however, the Department of Labor did \u003ca href=\"https://www.npr.org/documents/2019/dec/12-19-2019%20Scott%20RE-Silica%20NEP.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">inform lawmakers \u003c/a>that it \u003ca href=\"https://www.npr.org/documents/2019/dec/12-19-2019%20Adams%20RE-Silica%20NEP.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">intends to implement\u003c/a> a new \u003ca href=\"https://www.npr.org/documents/2019/dec/Silica_NEP.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">National Emphasis Program\u003c/a> for silica, which will replace a similar program that was \u003ca href=\"https://www.osha.gov/enforcement/directives/cpl-03-00-007-0\">canceled\u003c/a> in October of 2017.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A required 10-day notice was given to House and Senate appropriations committees on Dec. 17, which means the program could go into effect very soon. It will require that 2% of all OSHA inspections every year occur in workplaces at elevated risk of silica exposures.\u003c/p>\n\u003cp>But countertop fabricators are just one targeted industry in a long list that includes everything from iron foundries to concrete pipe manufacturing to machine shops.\u003c/p>\n\u003cp>“OSHA anticipates that the majority of the inspections will occur in construction,” according to a description of the program provided to lawmakers, because most exposures to silica dust occur on construction sites.\u003c/p>\n\u003cp>One congressional aide said it wasn’t clear how many additional inspections would actually occur at countertop fabrication shops, and called this a woefully inadequate response to what some public health experts fear is a potential crisis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The spending bill that passed this past week did provide OSHA with an increase of $24 million above its 2019 enacted funding level, however, which means more money will be available for inspections and enforcement.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Safety+Program+Takes+On+Silica+Dust+Amid+A+Possible+Crisis&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Maria Isabel Bueso and her family have waited months to learn whether they could stay in the country. Bueso has lived in the Bay Area for 16 years under a special immigration status in order to get treatment for a rare genetic disease. \u003ca href=\"https://www.kqed.org/news/11771386/advocating-for-my-own-life-bay-area-woman-getting-lifesaving-care-faces-deportation\">In August\u003c/a>, she received a letter from U.S. Citizenship and Immigration Services demanding that she leave the country. But Bueso became a leading advocate on behalf of hundreds of immigrants who received similar letters, and her story highlighted the harm of President Trump’s sweeping immigration policies.\u003c/p>\n\u003cp>And on Dec. 6, Bueso \u003ca href=\"https://www.kqed.org/news/11790433/concord-woman-with-rare-disease-granted-reprieve-from-deportation\">got word\u003c/a> that she can stay in the U.S. for at least two more years.\u003c/p>\n\u003cp>Guest: \u003ca href=\"https://twitter.com/FaridaJhabvala\">Farida Jhabvala Romero\u003c/a>, KQED immigration reporter\u003c/p>\n\u003cdiv class=\"c-message_actions__container c-message__actions\" role=\"group\" aria-label=\"Message actions\">\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Maria Isabel Bueso and her family have waited months to learn whether they could stay in the country. Bueso has lived in the Bay Area for 16 years under a special immigration status in order to get treatment for a rare genetic disease. \u003ca href=\"https://www.kqed.org/news/11771386/advocating-for-my-own-life-bay-area-woman-getting-lifesaving-care-faces-deportation\">In August\u003c/a>, she received a letter from U.S. Citizenship and Immigration Services demanding that she leave the country. But Bueso became a leading advocate on behalf of hundreds of immigrants who received similar letters, and her story highlighted the harm of President Trump’s sweeping immigration policies.\u003c/p>\n\u003cp>And on Dec. 6, Bueso \u003ca href=\"https://www.kqed.org/news/11790433/concord-woman-with-rare-disease-granted-reprieve-from-deportation\">got word\u003c/a> that she can stay in the U.S. for at least two more years.\u003c/p>\n\u003cp>Guest: \u003ca href=\"https://twitter.com/FaridaJhabvala\">Farida Jhabvala Romero\u003c/a>, KQED immigration reporter\u003c/p>\n\u003cdiv class=\"c-message_actions__container c-message__actions\" role=\"group\" aria-label=\"Message actions\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Burmese doctors dish sushi at a restaurant, a Jordanian computer engineer drives for Uber, and a Nepali non-profit program officer stocks shelves at a Walmart.\u003c/p>\n\u003cp>Nearly two million college-educated immigrants labor in jobs for which they are overqualified, or cannot find work at all.\u003c/p>\n\u003cp>The so-called “brain waste” phenomenon is costing California and other states billions of dollars per year in lost individual earnings and tax revenues, according to estimates by the Migration Policy Institute. The problem is worsening as, among immigrants continuing to arrive in the United States, there’s a greater proportion of college-educated individuals, experts warn.\u003c/p>\n\u003cp>[audio src=\"https://od1.kqed.org/anon.kqed/radio/tcr/2020/01/JhabvalaRomeroRefugeeWorkforce.mp3\" /]\u003c/p>\n\u003cp>New immigrants face barriers to obtaining high-skilled jobs that may take years to overcome, \u003ca href=\"http://www.ncsl.org/research/labor-and-employment/barriers-to-work-immigrants-with-work-authorization.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">including\u003c/a> the lack of U.S. professional work experience and technical English fluency. The process for getting foreign credentials recognized in this country can be long, complicated and expensive, especially in highly regulated fields like health care.\u003c/p>\n\u003cp>Wilmer Garcia Ricardo, a physician in Cuba and Venezuela for seven years, was admitted to the U.S. in 2012 through a now-defunct government humanitarian parole program for Cuban medical professionals. But once he resettled in Louisville, Ky., Garcia Ricardo was left on his own to figure out how to work again as a doctor in America.\u003c/p>\n\u003cp>“It has been years of study and sacrifice,” said Garcia Ricardo, now 38 years old.\u003c/p>\n\u003cfigure id=\"attachment_11790706\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790706\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40416_Photo-2-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">International Rescue Committee staffer Saeideh Mahdavisefat leads a job interview workshop with recently arrived refugees at the resettlement agency’s offices in San Jose on Oct. 16, 2019. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He took classes to improve his English. He bought books online and looked into blogs and forums about other immigrant physicians going through the rigorous U.S. medical licensing process. Meanwhile, he got a job as a patient care aide at a nursing home to pay his bills.\u003c/p>\n\u003cp>“That was like, being a doctor in January 2012, and then, three months after, going to the bottom of the health care system in America,” said Garcia Ricardo. “It was frustrating.”\u003c/p>\n\u003cp>Professional demotion is typical among the recent immigrants, including refugees, asylees and other humanitarian migrants who get help adjusting to life in America through the International Rescue Committee, said Kevin Davis, career development coordinator at the resettlement agency’s offices in San Jose.\u003c/p>\n\u003cp>IRC’s program focuses on helping humanitarian migrants rebuild or start careers in the U.S. through training, coaching and scholarships.\u003c/p>\n\u003cp>While many of these immigrants come with limited English or professional work experience, Davis estimates about half of the 200 clients in his program per year are highly skilled or college educated.\u003c/p>\n\u003cp>Regardless of their talents and expertise, nearly all of them get what Davis calls “survival jobs” in retail, hospitality, security and other industries during their first months in the U.S.\u003c/p>\n\u003cp>“The survival job is like a stepping stone,” he said. “And once they can pay their immediate bills, then we will work with them to sort of say, ‘All right, well, what comes next?’”\u003c/p>\n\u003cfigure id=\"attachment_11790707\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790707\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40415_Photo-5-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A billboard at the International Rescue Committee San Jose office displays advice for newly arrived immigrants to handle job interviews. The resettlement agency provides training, coaching and scholarships for humanitarian migrants to start or rebuild careers in the U.S. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘Brain Waste’\u003c/h3>\n\u003cp>In California, about 450,000 immigrants with at least a bachelor’s degree are underemployed, meaning they have low-skilled jobs , or they can’t find work at all, according to an \u003ca href=\"https://www.migrationpolicy.org/research/untapped-talent-costs-brain-waste-among-highly-skilled-immigrants-united-states\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> by the Migration Policy Institute. About 25 percent of highly skilled immigrants are overqualified for their jobs in the state compared to 19 percent for the U.S. born workers.\u003c/p>\n\u003cp>The cost to California, the state with the largest immigrant population, is significant: about $9.4 billion in lost annual earnings that result in nearly $700 million foregone state and local taxes, said Jeanne Batalova, a senior policy analyst at the institute and co-author of the report.\u003c/p>\n\u003cp>Compared to the U.S., countries like Canada and Australia have invested more resources to help immigrants understand and navigate licensing and other requirements to make their way into professional occupations, she said.\u003c/p>\n\u003cp>“The United States has a fairly laissez faire approach to helping immigrants integrate into the labor market. And really the approach is sink or swim,” said Batalova. “Unfortunately, at the national level, there hasn’t really been a strategy developed to deal with what we call ‘brain waste.’”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The issue has become more pronounced as the U.S. economy increasingly depends on highly skilled workers. Moreover, in recent years, a larger proportion of immigrants — about \u003ca href=\"https://www.migrationpolicy.org/news/mpi-reveals-striking-finding-nearly-half-immigrant-adults-arriving-us-2011-have-college-degree\" target=\"_blank\" rel=\"noopener noreferrer\">48 percent\u003c/a> — arrive in the U.S. with at least a bachelor’s degree, said Batalova.\u003c/p>\n\u003cp>“That can become an important talent pool, if their skills are put to good use,” she said.\u003c/p>\n\u003cp>On the other hand, employers often don’t know how to interpret and determine the value of an applicant’s credentials from foreign universities, said Jina Krause-Vilmar, CEO at Upwardly Global, a non-profit founded in San Francisco that helps place high-skilled immigrants and refugees in professional careers in the U.S.\u003c/p>\n\u003cp>“How do you value somebody from the University of Baghdad versus somebody from UCLA?” said Krause-Vilmar, whose organization frequently works with employers. “Part of it is building that awareness amongst employers so that they can effectively understand what this untapped talent pool offers.”\u003c/p>\n\u003cfigure id=\"attachment_11790712\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790712\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40413_Photo-3-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Wilmer Garcia Ricardo is now a medical resident in the San Joaquin General Hospitals’ family medicine department. He said obtaining work experience in the U.S. through the UCLA International Medical Graduate program was key to obtaining his residency position. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>One Doctor’s Story\u003c/h3>\n\u003cp>Garcia Ricardo, who trained as a family medicine practitioner in Cuba, knew of the need for more physicians in the U.S. In the next decade, California will face a shortfall of 4,100 primary care clinicians, which is \u003ca href=\"https://calmatters.org/projects/california-doctor-shortage-free-med-school-loan-repayment-recruiting-solutions/\" target=\"_blank\" rel=\"noopener noreferrer\">already affecting\u003c/a> rural and low-income urban areas, \u003ca href=\"https://futurehealthworkforce.org/2019/02/04/ca-looming-workforce-crisis/\" target=\"_blank\" rel=\"noopener noreferrer\">according to\u003c/a> the California Future Health Workforce Commission.\u003c/p>\n\u003cp>[aside postID=\"news_11722933\" label=\"\"]The Cuban immigrant said he spent six years and more than $10,000 to eventually pass the U.S. medical licensing exams and apply for residency programs, which he needs to be licensed as a doctor in any state. He drove Uber and Lyft on the side to make ends meet, he said.\u003c/p>\n\u003cp>“I applied to 166 programs, and I received one interview invitation,” said Garcia Ricardo. “And at the end of a process, all that money was lost. I was not granted a position.”\u003c/p>\n\u003cp>He figures a big reason was that, unlike domestic medical graduates, he didn’t have any “hands-on medical experience” in this country.\u003c/p>\n\u003cp>“All my experience as a doctor was from Cuba and Venezuela, and all my work experience in the U.S. was as a patient assistant,” said Garcia Ricardo, with a shrug.\u003c/p>\n\u003cp>But he didn’t give up.\u003c/p>\n\u003cp>It was a unique program in California, the UCLA International Medical Graduate Program, that finally gave him the qualifications and training to better compete for coveted residency spots in family medicine.\u003c/p>\n\u003cp>Applying to residency programs is an extremely competitive process, and those positions are very limited, especially in rural and low-income communities, said Dr. Michelle Bholat, an associate professor at the UCLA Department of Family Medicine and co-director of the IMG program.\u003c/p>\n\u003cp>“If I had a magic wand, I would say ‘Let us get some additional residency positions available in our most underserved areas in California,’” said Bholat.\u003c/p>\n\u003cp>Thanks to a \u003ca href=\"https://sd30.senate.ca.gov/news/press-releases/2012-07-16-holly-mitchell-bill-will-add-new-doctors-underserved-communities\" target=\"_blank\" rel=\"noopener noreferrer\">state law\u003c/a> approved in 2012, Spanish-speaking physicians in the IMG program can work under supervision with patients at a Los Angeles family clinic and hospital, so they learn the U.S. health care system and gain valuable work experience.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Michelle Bholat, co-director of the IMG program\"]‘What we have seen, at least in our program, is that the residents that are from those backgrounds tend to want to stay in that community and serve those patients long term.’[/pullquote]Although there are hundreds of applicants to the program each year, only about 15 physicians are admitted, said Bholat.\u003c/p>\n\u003cp>In exchange for the training, the doctors commit to working at least two years in underserved medical communities once they are licensed. Since 2006, 140 doctors have graduated from the IMG program.\u003c/p>\n\u003cp>Bholat has high hopes for one of this year’s graduates, Garcia Ricardo. Now, he is a medical resident at San Joaquin General Hospital, south of Stockton. Most patients at the county hospital qualify for Medi-Cal, and about 40 percent speak Spanish, according to doctors.\u003c/p>\n\u003cp>“He’s going to be a role model for that Latino community to know that ‘You know what? I have a doctor that understands me. I have a doctor who’s going to be there for my family,”’ said Bholat.\u003c/p>\n\u003cp>Garcia Ricardo compared the years he struggled in America to regain his profession to feeling like a fish out of water, gasping for air and flopping around.\u003c/p>\n\u003cp>“And then you put the fish back in the water? That’s the same feeling I had when I had a white coat back on,” said Garcia Ricardo, and smiled.\u003c/p>\n\u003cp>Dr. Elyas Parsa, who oversees San Joaquin General Hospital’s family residency program, said it’s “invaluable” to have a physician like Garcia Ricardo who culturally understands patients and speaks their language. Immigrant physicians are also passionate about working with underserved communities, said Parsa.\u003c/p>\n\u003cp>“What we have seen, at least in our program, is that the residents that are from those backgrounds tend to want to stay in that community and serve those patients long term,” said Parsa, himself a political refugee from Iran.\u003c/p>\n\u003ch3>Rules Vary State by State\u003c/h3>\n\u003cp>While the federal government oversees immigration, state governments regulate the practice of occupations. Those requirements often vary across state lines and can be cumbersome to navigate.\u003c/p>\n\u003cp>[aside postID=\"news_11682562,news_11299596,news_13815450\" label=\"Related coverage\"]Some states like Utah and South Dakota have modified certain licensing requirements to make it easier for internationally trained professionals to re-enter fields such as occupational therapy or dentistry, according to a \u003ca href=\"http://www.ncsl.org/research/labor-and-employment/barriers-to-work-immigrants-with-work-authorization.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">report\u003c/a> by the National Conference of State Legislatures.\u003c/p>\n\u003cp>In recent years, U.S. Department of Labor has provided \u003ca href=\"https://www.dol.gov/newsroom/releases/eta/eta20180625\" target=\"_blank\" rel=\"noopener noreferrer\">grants\u003c/a> for states to study how to streamline occupational licensing rules, in part to make it easier for people to be recertified after they move to another state.\u003c/p>\n\u003cp>The federal government could also provide additional financial support to organizations that help internationally educated professionals integrate into the U.S. workforce, said Batalova of the Migration Policy Institute.\u003c/p>\n\u003cp>Refugees, asylees and other immigrants can access limited federal and local financial support while they look for work. But there’s a lot of pressure to earn income as soon as possible, especially in high-cost regions like the Bay Area. Davis at the IRC said his program often coaches immigrants to take gradual steps into careers in healthcare and other industries desperate for workers.\u003c/p>\n\u003cp>Eden Asfaha, 38, followed that trajectory.\u003c/p>\n\u003cfigure id=\"attachment_11790710\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790710\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40414_Photo-4-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Eden Asfaha, an asylee from Eritrea, works the cashier at a Holiday Inn restaurant in San Jose, Calif. on Nov. 14, 2019. Asfaha is finishing training to be licensed as a phlebotomy technician. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Starting a New Path\u003c/h3>\n\u003cp>Asfaha was a secretary for a European Union diplomatic office in her native Eritrea, and worked in community development for European-based non-profits.\u003c/p>\n\u003cp>After winning asylum in the U.S. in 2014, she attended an IRC job fair to land her first American job as a cashier and hostess at a San Jose restaurant. That allowed her to enroll in classes at De Anza Community College in Cupertino to become a phlebotomy technician.\u003c/p>\n\u003cp>“I decided to switch to something that’s practical that I can find a job in the laboratory,” said Asfaha, an evangelical Christian who fled Eritrea to escape religious persecution.\u003c/p>\n\u003cp>She eventually plans to go back to school to train as a medical lab technician, she said.\u003c/p>\n\u003cp>“When I came here, I knew I would be starting from scratch. I knew it was going to be a hard road ahead,” said Asfaha. “I just have to take the steps I need to get in there.”\u003c/p>\n\u003cp>\u003cem>The California Dream series is a statewide media collaboration of CalMatters, KPBS, KPCC, KQED and Capital Public Radio, with support from the Corporation for Public Broadcasting, the James Irvine Foundation and the College Futures Foundation.\u003c/em>\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11768052\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/08/CADreamBanner-1-800x219.jpg\" alt=\"\" width=\"800\" height=\"219\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/CADreamBanner-1-800x219.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/CADreamBanner-1-800x219-160x44.jpg 160w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Nearly 2 million college-educated immigrants labor in jobs for which they are overqualified. Many cannot find work at all.",
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"title": "‘Brain Waste': Highly Skilled Immigrants Struggle to Fill Workforce Gaps | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Burmese doctors dish sushi at a restaurant, a Jordanian computer engineer drives for Uber, and a Nepali non-profit program officer stocks shelves at a Walmart.\u003c/p>\n\u003cp>Nearly two million college-educated immigrants labor in jobs for which they are overqualified, or cannot find work at all.\u003c/p>\n\u003cp>The so-called “brain waste” phenomenon is costing California and other states billions of dollars per year in lost individual earnings and tax revenues, according to estimates by the Migration Policy Institute. The problem is worsening as, among immigrants continuing to arrive in the United States, there’s a greater proportion of college-educated individuals, experts warn.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>New immigrants face barriers to obtaining high-skilled jobs that may take years to overcome, \u003ca href=\"http://www.ncsl.org/research/labor-and-employment/barriers-to-work-immigrants-with-work-authorization.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">including\u003c/a> the lack of U.S. professional work experience and technical English fluency. The process for getting foreign credentials recognized in this country can be long, complicated and expensive, especially in highly regulated fields like health care.\u003c/p>\n\u003cp>Wilmer Garcia Ricardo, a physician in Cuba and Venezuela for seven years, was admitted to the U.S. in 2012 through a now-defunct government humanitarian parole program for Cuban medical professionals. But once he resettled in Louisville, Ky., Garcia Ricardo was left on his own to figure out how to work again as a doctor in America.\u003c/p>\n\u003cp>“It has been years of study and sacrifice,” said Garcia Ricardo, now 38 years old.\u003c/p>\n\u003cfigure id=\"attachment_11790706\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790706\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40416_Photo-2-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">International Rescue Committee staffer Saeideh Mahdavisefat leads a job interview workshop with recently arrived refugees at the resettlement agency’s offices in San Jose on Oct. 16, 2019. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He took classes to improve his English. He bought books online and looked into blogs and forums about other immigrant physicians going through the rigorous U.S. medical licensing process. Meanwhile, he got a job as a patient care aide at a nursing home to pay his bills.\u003c/p>\n\u003cp>“That was like, being a doctor in January 2012, and then, three months after, going to the bottom of the health care system in America,” said Garcia Ricardo. “It was frustrating.”\u003c/p>\n\u003cp>Professional demotion is typical among the recent immigrants, including refugees, asylees and other humanitarian migrants who get help adjusting to life in America through the International Rescue Committee, said Kevin Davis, career development coordinator at the resettlement agency’s offices in San Jose.\u003c/p>\n\u003cp>IRC’s program focuses on helping humanitarian migrants rebuild or start careers in the U.S. through training, coaching and scholarships.\u003c/p>\n\u003cp>While many of these immigrants come with limited English or professional work experience, Davis estimates about half of the 200 clients in his program per year are highly skilled or college educated.\u003c/p>\n\u003cp>Regardless of their talents and expertise, nearly all of them get what Davis calls “survival jobs” in retail, hospitality, security and other industries during their first months in the U.S.\u003c/p>\n\u003cp>“The survival job is like a stepping stone,” he said. “And once they can pay their immediate bills, then we will work with them to sort of say, ‘All right, well, what comes next?’”\u003c/p>\n\u003cfigure id=\"attachment_11790707\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790707\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40415_Photo-5-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A billboard at the International Rescue Committee San Jose office displays advice for newly arrived immigrants to handle job interviews. The resettlement agency provides training, coaching and scholarships for humanitarian migrants to start or rebuild careers in the U.S. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘Brain Waste’\u003c/h3>\n\u003cp>In California, about 450,000 immigrants with at least a bachelor’s degree are underemployed, meaning they have low-skilled jobs , or they can’t find work at all, according to an \u003ca href=\"https://www.migrationpolicy.org/research/untapped-talent-costs-brain-waste-among-highly-skilled-immigrants-united-states\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> by the Migration Policy Institute. About 25 percent of highly skilled immigrants are overqualified for their jobs in the state compared to 19 percent for the U.S. born workers.\u003c/p>\n\u003cp>The cost to California, the state with the largest immigrant population, is significant: about $9.4 billion in lost annual earnings that result in nearly $700 million foregone state and local taxes, said Jeanne Batalova, a senior policy analyst at the institute and co-author of the report.\u003c/p>\n\u003cp>Compared to the U.S., countries like Canada and Australia have invested more resources to help immigrants understand and navigate licensing and other requirements to make their way into professional occupations, she said.\u003c/p>\n\u003cp>“The United States has a fairly laissez faire approach to helping immigrants integrate into the labor market. And really the approach is sink or swim,” said Batalova. “Unfortunately, at the national level, there hasn’t really been a strategy developed to deal with what we call ‘brain waste.’”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The issue has become more pronounced as the U.S. economy increasingly depends on highly skilled workers. Moreover, in recent years, a larger proportion of immigrants — about \u003ca href=\"https://www.migrationpolicy.org/news/mpi-reveals-striking-finding-nearly-half-immigrant-adults-arriving-us-2011-have-college-degree\" target=\"_blank\" rel=\"noopener noreferrer\">48 percent\u003c/a> — arrive in the U.S. with at least a bachelor’s degree, said Batalova.\u003c/p>\n\u003cp>“That can become an important talent pool, if their skills are put to good use,” she said.\u003c/p>\n\u003cp>On the other hand, employers often don’t know how to interpret and determine the value of an applicant’s credentials from foreign universities, said Jina Krause-Vilmar, CEO at Upwardly Global, a non-profit founded in San Francisco that helps place high-skilled immigrants and refugees in professional careers in the U.S.\u003c/p>\n\u003cp>“How do you value somebody from the University of Baghdad versus somebody from UCLA?” said Krause-Vilmar, whose organization frequently works with employers. “Part of it is building that awareness amongst employers so that they can effectively understand what this untapped talent pool offers.”\u003c/p>\n\u003cfigure id=\"attachment_11790712\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790712\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40413_Photo-3-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Wilmer Garcia Ricardo is now a medical resident in the San Joaquin General Hospitals’ family medicine department. He said obtaining work experience in the U.S. through the UCLA International Medical Graduate program was key to obtaining his residency position. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>One Doctor’s Story\u003c/h3>\n\u003cp>Garcia Ricardo, who trained as a family medicine practitioner in Cuba, knew of the need for more physicians in the U.S. In the next decade, California will face a shortfall of 4,100 primary care clinicians, which is \u003ca href=\"https://calmatters.org/projects/california-doctor-shortage-free-med-school-loan-repayment-recruiting-solutions/\" target=\"_blank\" rel=\"noopener noreferrer\">already affecting\u003c/a> rural and low-income urban areas, \u003ca href=\"https://futurehealthworkforce.org/2019/02/04/ca-looming-workforce-crisis/\" target=\"_blank\" rel=\"noopener noreferrer\">according to\u003c/a> the California Future Health Workforce Commission.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The Cuban immigrant said he spent six years and more than $10,000 to eventually pass the U.S. medical licensing exams and apply for residency programs, which he needs to be licensed as a doctor in any state. He drove Uber and Lyft on the side to make ends meet, he said.\u003c/p>\n\u003cp>“I applied to 166 programs, and I received one interview invitation,” said Garcia Ricardo. “And at the end of a process, all that money was lost. I was not granted a position.”\u003c/p>\n\u003cp>He figures a big reason was that, unlike domestic medical graduates, he didn’t have any “hands-on medical experience” in this country.\u003c/p>\n\u003cp>“All my experience as a doctor was from Cuba and Venezuela, and all my work experience in the U.S. was as a patient assistant,” said Garcia Ricardo, with a shrug.\u003c/p>\n\u003cp>But he didn’t give up.\u003c/p>\n\u003cp>It was a unique program in California, the UCLA International Medical Graduate Program, that finally gave him the qualifications and training to better compete for coveted residency spots in family medicine.\u003c/p>\n\u003cp>Applying to residency programs is an extremely competitive process, and those positions are very limited, especially in rural and low-income communities, said Dr. Michelle Bholat, an associate professor at the UCLA Department of Family Medicine and co-director of the IMG program.\u003c/p>\n\u003cp>“If I had a magic wand, I would say ‘Let us get some additional residency positions available in our most underserved areas in California,’” said Bholat.\u003c/p>\n\u003cp>Thanks to a \u003ca href=\"https://sd30.senate.ca.gov/news/press-releases/2012-07-16-holly-mitchell-bill-will-add-new-doctors-underserved-communities\" target=\"_blank\" rel=\"noopener noreferrer\">state law\u003c/a> approved in 2012, Spanish-speaking physicians in the IMG program can work under supervision with patients at a Los Angeles family clinic and hospital, so they learn the U.S. health care system and gain valuable work experience.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Although there are hundreds of applicants to the program each year, only about 15 physicians are admitted, said Bholat.\u003c/p>\n\u003cp>In exchange for the training, the doctors commit to working at least two years in underserved medical communities once they are licensed. Since 2006, 140 doctors have graduated from the IMG program.\u003c/p>\n\u003cp>Bholat has high hopes for one of this year’s graduates, Garcia Ricardo. Now, he is a medical resident at San Joaquin General Hospital, south of Stockton. Most patients at the county hospital qualify for Medi-Cal, and about 40 percent speak Spanish, according to doctors.\u003c/p>\n\u003cp>“He’s going to be a role model for that Latino community to know that ‘You know what? I have a doctor that understands me. I have a doctor who’s going to be there for my family,”’ said Bholat.\u003c/p>\n\u003cp>Garcia Ricardo compared the years he struggled in America to regain his profession to feeling like a fish out of water, gasping for air and flopping around.\u003c/p>\n\u003cp>“And then you put the fish back in the water? That’s the same feeling I had when I had a white coat back on,” said Garcia Ricardo, and smiled.\u003c/p>\n\u003cp>Dr. Elyas Parsa, who oversees San Joaquin General Hospital’s family residency program, said it’s “invaluable” to have a physician like Garcia Ricardo who culturally understands patients and speaks their language. Immigrant physicians are also passionate about working with underserved communities, said Parsa.\u003c/p>\n\u003cp>“What we have seen, at least in our program, is that the residents that are from those backgrounds tend to want to stay in that community and serve those patients long term,” said Parsa, himself a political refugee from Iran.\u003c/p>\n\u003ch3>Rules Vary State by State\u003c/h3>\n\u003cp>While the federal government oversees immigration, state governments regulate the practice of occupations. Those requirements often vary across state lines and can be cumbersome to navigate.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Some states like Utah and South Dakota have modified certain licensing requirements to make it easier for internationally trained professionals to re-enter fields such as occupational therapy or dentistry, according to a \u003ca href=\"http://www.ncsl.org/research/labor-and-employment/barriers-to-work-immigrants-with-work-authorization.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">report\u003c/a> by the National Conference of State Legislatures.\u003c/p>\n\u003cp>In recent years, U.S. Department of Labor has provided \u003ca href=\"https://www.dol.gov/newsroom/releases/eta/eta20180625\" target=\"_blank\" rel=\"noopener noreferrer\">grants\u003c/a> for states to study how to streamline occupational licensing rules, in part to make it easier for people to be recertified after they move to another state.\u003c/p>\n\u003cp>The federal government could also provide additional financial support to organizations that help internationally educated professionals integrate into the U.S. workforce, said Batalova of the Migration Policy Institute.\u003c/p>\n\u003cp>Refugees, asylees and other immigrants can access limited federal and local financial support while they look for work. But there’s a lot of pressure to earn income as soon as possible, especially in high-cost regions like the Bay Area. Davis at the IRC said his program often coaches immigrants to take gradual steps into careers in healthcare and other industries desperate for workers.\u003c/p>\n\u003cp>Eden Asfaha, 38, followed that trajectory.\u003c/p>\n\u003cfigure id=\"attachment_11790710\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790710\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40414_Photo-4-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Eden Asfaha, an asylee from Eritrea, works the cashier at a Holiday Inn restaurant in San Jose, Calif. on Nov. 14, 2019. Asfaha is finishing training to be licensed as a phlebotomy technician. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Starting a New Path\u003c/h3>\n\u003cp>Asfaha was a secretary for a European Union diplomatic office in her native Eritrea, and worked in community development for European-based non-profits.\u003c/p>\n\u003cp>After winning asylum in the U.S. in 2014, she attended an IRC job fair to land her first American job as a cashier and hostess at a San Jose restaurant. That allowed her to enroll in classes at De Anza Community College in Cupertino to become a phlebotomy technician.\u003c/p>\n\u003cp>“I decided to switch to something that’s practical that I can find a job in the laboratory,” said Asfaha, an evangelical Christian who fled Eritrea to escape religious persecution.\u003c/p>\n\u003cp>She eventually plans to go back to school to train as a medical lab technician, she said.\u003c/p>\n\u003cp>“When I came here, I knew I would be starting from scratch. I knew it was going to be a hard road ahead,” said Asfaha. “I just have to take the steps I need to get in there.”\u003c/p>\n\u003cp>\u003cem>The California Dream series is a statewide media collaboration of CalMatters, KPBS, KPCC, KQED and Capital Public Radio, with support from the Corporation for Public Broadcasting, the James Irvine Foundation and the College Futures Foundation.\u003c/em>\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11768052\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/08/CADreamBanner-1-800x219.jpg\" alt=\"\" width=\"800\" height=\"219\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/CADreamBanner-1-800x219.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/CADreamBanner-1-800x219-160x44.jpg 160w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"planet-money": {
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
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},
"science-friday": {
"id": "science-friday",
"title": "Science Friday",
"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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},
"snap-judgment": {
"id": "snap-judgment",
"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
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}
