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On Interpreting by Deaf Interpreter David Cowan

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On Interpreting by Deaf Interpreter David Cowan

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"I went to a hearing school from elementary to high school and learned to read lips by interacting with others," said Cowan. "My family and I didn't know sign language, but, because we're family, we could always understand each other. My parents pushed me to live in a hearing world as a deaf person and find my way. Everyone knows the deaf kid, so I was pretty popular, but my personality has never really allowed me to hold back. I'm very extroverted and that has always helped me get through any awkwardness that might be present."

A turning point in Cowan's life came during his nine years at Gallaudet University in Washington D.C., the only liberal arts college in the world for the deaf.

"Yes, I was there for nine years. Everyone has a different route, especially the blonds and I'm a natural blond," joked Cowan, who is now known for his snow-white beard and shaved head.

"College is where I began to understand my identity as a deaf person," said Cowan. "I learned ASL for the first time and expunged myself of the negative stigma about being deaf. I embraced my identity and that's where I still am today."
>> RELATED: ASL is awesome: How and where your child can learn sign language
While in college, Cowan was a member of the Gallaudet Dance Company. He traveled all over the world with the troupe and still loves to dance - the cha-cha, merengue, jazz, salsa. Now, he and his friends often go to The Heretic in Atlanta to country line dance, and he travels a lot with his best friend.

Cowan's career as an interpreter began immediately after college graduation. Among his jobs, he worked as a supervisor for deaf services for the National AIDS Hotline under the Centers for Disease Control and Prevention and as a program director for the HIV/AIDS Foundation.

Cowan, as an ASL advocate, speaks out about a misconception in the field of audiology that says if you teach a deaf child sign language, they will never learn to make speech or acquire the skills to survive in the world.

"It's malarkey," said Cowan. "By holding back ASL, you're delaying kids' learning process. That treatment is language deprivation and can have very serious side effects on deaf individuals."

Cowan moved to Georgia in 1998, along with his parents, to be close to and help Cowan's sister, who had five young children at the time. Cowan lives in Snellville with his deaf cat, Blanco, and loves being a Georgia resident.

"I especially love Atlanta, Georgia," said Cowan. "The weather is phenomenal, and I live near the lake, so it's perfect for me to spend my time on the water. I barely need to winterize my boat. In Indiana, we had freezing waters, and lots of snow. Georgia has three-and-a-half seasons and no harsh winters - it's fantastic."

One of Cowan's favorite ways to spend his free time is on Norris Lake, driving his white-and-red MasterCraft water ski boat.

"We lived near the water when I was a kid. That's where my love of boats comes from," said Cowan, who enjoyed boating and water skiing throughout his childhood. "I still own an old wooden motorboat, built in 1960, that my dad gave me years ago. I have a pic of myself, standing on the seat, holding the steering wheel, wearing nothing but a diaper. I grew up on the water and that's where I love to be with friends and family."

Cowan has had many opportunities as an interpreter in Georgia. He served as the executive director for the Georgia Registry of Interpreters for the Deaf, and as a coordinator at the Georgia Interpreting Services Network. He also taught the Interpreting Training program at Georgia Perimeter College in Clarkston. Since 2016, he has worked as a freelance interpreter for All Hands On, a nonprofit that fosters relationships between the deaf and emergency managers in preparing for, responding to, and recovering from emergencies and disasters.

Cowan met Aaron Shoemaker, executive director of All Hands On, in 2016 at a training session.

"My first impression of David was that he was outgoing, bright, funny and a natural leader," said Shoemaker, 45. "We were looking for people who had the gift for teaching to join our Deaf Community Emergency Response Team (CERT) instructor cadre, and David was a natural choice. He became one of our first group of instructors."

Cowan and Shoemaker worked together for the first time at Dragon Con in 2016. Shoemaker, who is not deaf, signs to Cowan, and Cowan signs to the deaf audience.

A question the duo often receives is why it's necessary for Cowan to sign if Shoemaker can do it.

"It is the very same concept of a hearing person cranking up the volume to the right level so they don't have to strain to understand what's being spoken," said Cowan. "When I interpret through ASL, I use my entire body to make it 'louder' for the deaf audience, which enables them to relax and not have to strain to process what's being said.

"Being a linguist requires a great deal of study and self-critique. When I'd watch an interpretation on camera, as opposed to interpreting one-on-one, I saw that it was flat, like a monotone voice, no cadence change whatsoever. So, I figured out how to use my body and move in an exaggerated way so it appears more three-dimensional on camera. The way I'm expressing my body gives the message more meaning or removes meaning. It's not just how my hands are moving in space, it's what's happening on my face, too. It's a fully kinetic expression of language and it changed everything."

The feedback from the deaf community has affirmed Cowan's choices, as has the gratitude from Kemp and the Georgia Emergency Management and Homeland Security Agency (GEMA).

"His enthusiasm for delivering lifesaving information to Georgia's deaf and hard-of-hearing community is unparalleled," said Kemp. "He is an invaluable member of our team. He is admired and respected by countless people, and rightfully so. He effectively messages critical information to Georgians in every region of our state and brings a level of dedication to his work that no one can match."

Cowan says he is honored that Kemp, as well as former Gov. Nathan Deal, with whom he worked during Hurricane Irma, have kept their word to the deaf community to provide them access to critical information. Georgia has approximately 300,000 deaf and hard-of-hearing individuals, and they are often underserved. He knows this well, as he spends much of his free time volunteering with a variety of groups who need interpreters.

Cowan, who is gay, has volunteered as an interpreter at Atlanta Pride since 2000.
>> RELATED: Twitter can't get enough of this sign language interpreter's dancing at Atlanta Pride
"To be able to provide access to ASL to others who are gay in the community is pretty amazing," said Cowan. "My experience to gain accessibility to Pride led me to see there's lots of difficulty of access for deaf people who are homeless. I volunteer with a variety of small groups to inform them about community information, HIV testing, health risks and safe sex."

Atlanta Pride honored Cowan in 2017 by asking him to serve as the grand marshal.

"They said I'd be queen for the day, and I told them I'm not old enough for that," said Cowan. "I'll be a princess."

Cowan's spirited interpretation of Beyoncé's song "Get Me Bodied" at Atlanta Pride in October 2019 went viral. That widespread attention surprised him, but he hopes, more than anything, that it helped bring attention to implementation of the Americans with Disabilities Act, which is the law that requires public events to be accessible.

Cowan wants to continue advocating and interpreting indefinitely. It's a calling that he says he's proud to answer, and he hopes he can continue making a living through his freelance work.

"I've been interpreting all my life, but the vast majority has been for a volunteer purpose. It's nice to see that changing," said Cowan. "The work of a professional interpreter is seasonal. It ebbs and flows, but it is a very necessary profession and I'm proud to live in Georgia, where we are leading the way in embedding interpreters in all operations."

When asked if he has any big dreams for the future, Cowan laughs.

"Doesn't everyone want to eventually move to Hawaii?"

With his dance experience and expressive ASL, there is no doubt he will become an expert at the hula.

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At Gov. Kemp's COVID-19 conferences, sign language interpreter often finds himself in spotlight

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"I went to a hearing school from elementary to high school and learned to read lips by interacting with others," said Cowan. "My family and I didn't know sign language, but, because we're family, we could always understand each other. My parents pushed me to live in a hearing world as a deaf person and find my way.

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John: We've been engaged in a global conversation about race and racism. You've probably had discussions at home, at school or at work, and in those conversations you've probably heard the term white privilege. You maybe even had this term used in a way that felt like an insult or an accusation. Others will have told you that it's all just made up to make white people feel bad... and none of this is right.

Privilege is a hard concept for people to understand, because normally when we talk of privilege we imagine immediate unearned riches and tangible benefits for anyone who has it. But white privilege and indeed all privilege is actually more about the absence of inconvenience, the absence of an impediment or challenge, and as such when you have it, you really don't notice it, but when it's absent, it affects everything you do.

There are lots of types of privilege out there, the privilege of being born into a wealthy family versus a poor family is kind of obvious, but then there's the privilege of being able-bodied versus having or acquiring a disability that most of us take for granted. I have two very close friends who are wheelchair users and I'll be honest, when I first met them I was completely ignorant about the everyday ways their lives are made harder through no fault of their own. Some of these ways are simply thoughtless, but some of them are just the way we live, just the way we build infrastructure, just the way everything works that just makes their life harder than mine. That's just one of the ways that I am privileged and understanding that, embracing that, doesn't make me a bad person, but ignoring it raises the chance that my friends will be excluded in ways that are not obvious to me and as their friend I can't allow that.

There's a good chance, as a white person watching this, your life is already hard. Every day you have to overcome some difficulty or challenge just to get by, but you can still have white privilege. White privilege doesn't mean you haven't worked hard or you don't deserve the success you've had. It doesn't mean that your life isn't hard or that you've never suffered. It simply means that your skin colour has not been the cause of your hardship or suffering.

There is nothing but a benefit to understanding our own privileges, white and otherwise. It brings us closer to those who are different. It helps us be vigilant about the ways we treat others different than us. It helps us make a society that is fairer and more equal. Having white privilege doesn't make your life easy, but understanding it can help you realise why some people's lives are harder than they should be.

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Psychologist John Amaechi talks about white privilege.

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Validating and vilifying, triumphant and traumatic. Groundbreaking artists reflect on trans representation in film and TV. Watch trailers & learn more.

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I am not sure that I had a true moment of realisation when it comes to being gay; it is just something I have always been.

I assumed that what I felt for certain girls was just what every other girl felt for her special friends ... and didn't we all want to marry Pocahontas? My parents teased me mildly about having "intense" friendships with a different girl every few months, but they are incredibly liberal and have enough gay people in their lives that it never felt that special when I hit my early teens and started wanting to kiss girls.

I don't think my family expected me to be one way or the other, so being an out lesbian was probably the least interesting part of my teenage years.

Being aware of my disabilities was also gradual - I had a lot of problems with my hearing as a baby, including my eardrums bursting on a number of occasions. After a few operations on my ears and eardrums, I was able to hear relatively well from the ages of five to 15 - so the songs I know best are, sadly, very late-90s/early 00s - although adults often complained that I was "dreamy" and "not listening" when I realise now I just couldn't hear them. I started to lose my hearing again at 16, but didn't realise it until I began university three years later.

It seems funny to think that I didn't realise, but I was struggling with a lot of other health problems at the time and as I spent most of my time in bed - either at home or in hospital - the only thing that noticeably changed was the volume at which I watched TV.

When I finally managed to make it to university and started interacting with people who were not my immediate family, it was painfully obvious that I couldn't hear what they were saying and that, when it came to conversation, I had pretty much been operating on guesswork for quite a while.

I am not profoundly deaf and, obviously, can hear more with my hearing aids in, although they only make things louder, not clearer. I can't hear any high-pitched sounds and, with my hearing aids in, I only properly catch one word in three.

When I was 17, I was diagnosed with hereditary neuropathy with liability to pressure palsies ( HNPP), which results in extreme palsy in my arms as well as patches of skin being numb, difficulty gripping things, weakness in limbs and severe fatigue. I also have mixed connective tissue disorder (MCTD), an autoimmune disease in which the body's defence system attacks itself. MCTD causes chronic joint pain, muscle inflammation, hypermobility and pulmonary hypertension alongside a long list of other symptoms.

My disabilities can hamper everything I do, but they are often invisible, although I don't think the days I have to use a wheelchair or wrist splints make them visible - they are just my aids.

I often have to explain myself when strangers think I am just being difficult. I get scoffed at in the street when I don't hear someone behind me or I walk into them because they are on myblind slide. I have been called out loudly by non-disabled people for using disabled toilets or parking spaces, challenged for being a picky eater when I cannot eat an ingredient in their food and yelled at for being inconsiderate. It doesn't matter when I explain that I am not just dozy or silly, but have a disability, because they have already worked themselves up into a self-righteous rage and nothing I can say will stop that.

It also hurts to have to explain painful, long and complicated reasons behind injuries when people expect a light-hearted story. "What happened to your hand? Accident while out on the town?"

"No." Deep breath ... "I have a disability that affects my nerves and ..." Although, to be honest, often I just lie.

When someone confronts you, asking what right you have to use a disabled toilet or why you were so stupid you didn't hear them asking you to get out of the way, your only options are to stand there and let them yell at you (plus points of being deaf: turn your hearing aids off and you only have to see the yelling) or you attempt to explain that you are disabled, which can be a pretty personal thing to share with a mean stranger who might not believe you anyway.

I understand that I look fine, but when most of the difficulties in my life come from the very fact that I look fine while actually needing help, that is not really a bonus.

Telling someone I am gay is instantly accepted, no questions asked, generally with a smile. Telling someone I am disabled comes with, "No, really? You don't look it", and a scrutinising look. Nobody has ever accused every single gay person of "scrounging off the state", but people have openly said that about disabled people, in front of me.

I definitely feel that there is a desexualisation of disabled people. When I was still dating, I could see the moment in my date's eyes when I explained my condition and suddenly stopped being an interesting potential prospect. I think disabled people are not just taboo when it comes to sex, but also dating, relationships and life in general. My wife is often told that she is a saint for marrying me or that she must be such a good person - as if I am a terrible burden and not the woman she loves. Businesses, the media and politicians need to start seeing disabled people for what we are: useful members of society who have something to bring to others.

I have always been an out-there dresser. I have probably toned it down now - I am less eccentric than I was. It has always felt important to spend time on my style because it is one thing about my body that I can control.

I believe in soft activism rather than shoving a message in people's faces and telling them they should change their opinion. I think it is better to subtly insert small changes into our everyday lives, such as having more disabled characters featured in the media - and in instances where being disabled is not the main story. We should have more disabled MPs, because although almost one in five people in the UK are disabled, we are underrepresented, especially since the Conservatives shut down the access to the elected office fund, which helped people with disabilites to go into political jobs.

I missed most of my teenage milestones because I was either in hospital or lying in the dark. I was too ill to open my eyes, to sit up or to eat, and I was made to feel like a burden, as if my presence was a hindrance to other people's lives.

I was never a problem to my parents or brother, but they would be told, "How good you are to look after her" while I was in the room. But there were some amazing people who stepped into my lonely space, took my hand and helped me through those rough years. They didn't mind helping out physically or spending time making me laugh and always let me know it was no big deal. I was never a burden to them.

I am so much better than I was but I still need help and I know the best way to repay that help is to live the best life I can - to be brave, to be bright, to be happy. I am proud of everything I have achieved and where I am now.
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People accept that I'm gay, but not that I'm disabled

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I am not sure that I had a true moment of realisation when it comes to being gay; it is just something I have always been. I assumed that what I felt for certain girls was just what every other girl felt for her special friends ...

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I'm often asked if I have any words of advice for psychotherapists and other professionals, on working with clients who are autistic and/or otherwise neurodivergent. Why, yes. Yes I do. And I've been meaning for some time to type up some of those words of advice and make them publicly available. The push that I needed finally came from Sarah Coenen and Helen Cha-Choe, two grad students pursuing their M.A. degrees in Counseling Psychotherapy at California Institute of Integral Studies (my own alma mater, where I currently teach in the undergraduate Interdisciplinary Studies program from time to time). In this project, Ms. Coenen and Ms. Cha-Choe are exploring the attitudes and perspectives of clinicians who work with autistic clients, and the impact those attitudes and perspectives have on the clients and on the quality of the clinicians' work. I was delighted to learn that Ms. Coenen and Ms. Cha-Choe are grounding this project in the neurodiversity paradigm - that is, they're approaching this as a diversity issue, recognizing that treating autistic clients as deficient or "lesser" is a manifestation of prejudice and lack of cultural competency, and recognizing that the pathology paradigm creates condescending and dismissive attitudes which manifest as microaggressions toward autistic clients. After reading a couple of my essays on the neurodiversity paradigm (Below are three of the questions they sent me, and my answers, which I hope will help psychotherapists and other professionals - especially the next generation of professionals, like Ms. Coenen and Ms. Cha-Choe - to better understand what it means to integrate the neurodiversity paradigm into their work. Ms. Cha-Choe, like myself, has a particular interest in somatically-oriented psychotherapy, so all of you fellow somatically-oriented professionals will be pleased to note that the third question specifically addresses the somatic angle. I'll be writing more on these topics in the future. A lot more, eventually. I commend Ms. Coenen and Ms. Cha-Choe for the great work they're doing, and for asking all of the right questions. And I welcome similar questions from other students who are engaged in the work of generating research, theory, and praxis based in the neurodiversity paradigm. Q: How would you address empathy deficits and poor communication skills in neurotypical people working with neurodivergent populations? Throw Away the Master's Tools and Neurodiversity: Some Basic Terms & Definitions), Ms. Coenen and Ms. Cha-Choe sent me a few follow-up questions as part of their research. I was happy to support their excellent research by answering their questions at length, provided that I could also publish my answers for public consumption. Ms. Coenen and Ms. Cha-Choe are collaborating on an excellent research project, for a Research Methods course taught by my dear friend and colleague Eri Çela.
The 20th Century political scientist Karl Deutsch said, "Power is the ability not to have to learn."

I quote this statement often, because I think it's one of the most important truths ever articulated about privilege, oppression, and social power relations.

When a social system is set up such that one particular group is almost always in a position of social power or privilege over another group, the members of the privileged group never truly need to learn or practice empathy or understanding for the members of the disempowered, oppressed group. Nor do the members of the privileged group need to learn to adapt to the communication style of the oppressed group.

Neurotypical privilege means that neurotypical people interacting with neurodivergent people - particularly when the neurotypical people in question are in positions of professional authority - have the luxury of never having to address or even acknowledge their own empathy deficits or poor communication skills, because they can blame all failures of empathy, understanding, and communication on the alleged deficits of the neurodivergent people.

Anthropologist Mary Catherine Bateson, writing about learning and power relations in colonialism, observed that "People who don't wear shoes learn the languages of people who do, not vice versa."

Bateson's wording of this insight is especially resonant for the autistic community, because, when autistic activists object to the pathologization and abuse of autistic children by neurotypical parents and professionals, or the murder of autistic children by neurotypical parents, neurotypicals often attempt to silence us by condescendingly admonishing us to "put ourselves in the shoes" of the perpetrators. Yet as neurodiversity activist Kassiane Asasumasu has pointed out, not only do these same neurotypical parents and professionals never seriously attempt to put themselves in the shoes of autistic people, they do not even "acknowledge that we have shoes," metaphorically speaking.

Power - or privilege, as we now more commonly call the particular kind of power to which Deutsch was referring - is the ability not to have to learn. There's a phrase, "check your privilege," that's often repeated but rarely understood or heeded by those privileged persons at whom it is directed. If we start from Deutsch's definition of power or privilege as the ability not to have to learn, we can understand "check your privilege" to mean, at least in part, " Learn! Be quiet, pay attention, and learn. Learn, even though the learning process, and the level of profound humility it requires, is going to be uncomfortable. Learn even though, because of your privilege, this sort of learning and humility is a discomfort that you have the luxury of being able to avoid - a luxury that we didn't have, when we had to learn your ways. Learn even though you don't have to."

Unfortunately, as members of all oppressed groups discover, most privileged people just won't do that. The states of profound and constant mindfulness, humility, openness to correction, and tolerance for uncertainty that such learning demands are too far outside of most people's comfort zones. Most human beings simply won't go that far outside of their comfort zones if they don't have to. And privilege means they don't have to.

The system is currently set up so that when neurotypical professionals work with neurodivergent individuals, the neurotypical professional is always in the role of greater authority: neurotypical therapist and neurodivergent client; neurotypical doctor and neurodivergent patient; neurotypical educator and neurodivergent student; neurotypical researcher and neurodivergent subject.

As long as this is the case, as long as neurotypical professionals only have regular, close contact with neurodivergent individuals in situations that are set up such that the neurotypical professionals hold greater authority and power, the neurotypical professionals will never have to subject themselves to the uncomfortable humility of checking their privilege, will never have to learn real empathy and understanding for the neurodivergent, and will never have to learn to understand and adapt to neurodivergent forms of communication.

And if they don't have to, most of them won't.

A related consideration is that when a person's entire experience of an oppressed group consists of situations in which the members of that group are in "inferior" roles, it inevitably shapes that person's perspective on the group in question. Just look at the Stanford Prison Experiment, for a glimpse of how quickly and powerfully this effect kicks in.

Anyone who understands this phenomenon will be unsurprised to learn that in my experience, the people who have the least empathy for neurodivergent persons, the least ability to communicate respectfully with neurodivergent persons, and the least genuine openness to learning from neurodivergent persons, are the neurotypical professionals who have spent their careers working with neurodivergent persons, in situations in which the professional always holds the authority, and the neurodivergent persons are always in the role of the patient, student, research subject, or "recipient of services."

It's nearly impossible for professionals of that sort to make the shift to the neurodiversity paradigm, to learn to check their neurotypical privilege, or to start respectfully listening to and learning from neurodivergent perspectives. They've simply become too entrenched in the habit of not seeing neurodivergent persons as equals.
Q: What advice and or suggestions can you offer psychotherapists working with neurodivergent populations?
So my answer to the question of how to address empathy deficits and poor communication skills in neurotypical people working with neurodivergent populations? Change the system, such that no neurotypical professional is permitted to work with neurodivergent populations unless all of the following conditions are met:

1.) The neurotypical professional must have received extensive training from neurodivergent teachers, using curricula designed or approved by neurodivergent experts. The neurodivergent teachers and experts in question must themselves be well-versed in the neurodiversity paradigm - and in realms of critical and liberatory theory like Critical Psychology, Liberation Psychology, Disability Studies, or Queer Studies - rather than tame, token neurodivergent persons (like Temple Grandin) who have themselves internalized and accepted the language of the pathology paradigm and the ableism of the dominant culture.

2.) The neurotypical professional must be licensed to work with neurodivergent populations, by a licensing board composed primarily of neurodivergent persons well-versed in the neurodiversity paradigm.

3.) The work of the neurotypical professional must be subject to supervision, input, and audit by neurodivergent representatives of the aforementioned licensing board, who have the authority to make recommendations to the board regarding the status of the neurotypical professional's license.

None of these suggestions are likely to be implemented in the society in which we currently live, of course. But it's a solution to the problems mentioned in your question - one of the only solutions to those problems that, if it were someday implemented, would actually work. And even when solutions seem a long way off, one must dare to dream.

Check your privilege.

Empty your cup, as the Zen Buddhists say.

Make the shift to the neurodiversity paradigm, completely. Throw out everything you've learned that's in any way based in the pathology paradigm, all the messages about neurodivergence that you've been fed by the dominant culture. Be ferociously, eternally diligent about this: sociocultural programming is a constantly ongoing process, so breaking your sociocultural programming must also be a constantly ongoing process, and you'll be swimming against the current. And it's harder for members of privileged groups than members of oppressed groups: the status quo works in your favor, makes you the authority, lets you stay in your comfort zone, so it requires enormous ongoing commitment to stay mindful of the insidious and pervasive influence of the dominant paradigm, and to go against it.

The master's tools will never dismantle the master's house, but throwing away the master's tools is hard - and it's ten times harder if, within the current status quo, you're one of the masters.

Recognize that nearly everything written or taught about neurodivergence by neurotypical "experts" is just plain wrong, and is harmful to your neurodivergent clients. The dominant culture's stereotypes about any oppressed group are not more true just because you read them in a book or article written by an "expert." Remember that there has been plenty of work published in the past by "experts" - including psychologists - that promoted sexist and racist stereotypes under the guise of "science."

Remember that an author, teacher, researcher, or other "expert" who refers to autism, for instance, as a "disorder," is no more of a trustworthy, unbiased, "objective" authority than an "expert" who refers to homosexuality as a "disorder," or than the "experts" who used to describe non-white peoples as "savage."

Remember that if you use the language of the pathology paradigm, you are reinforcing a social paradigm that harms your clients, and thus you are working against your clients' interests.

Seek out neurodivergent teachers, supervisors, and consultants who are well-versed in the neurodiversity paradigm. And pay them for their work. It's remarkable how many neurotypical professionals and organizations are happy to pay neurotypical "experts" to talk about neurodivergent people, but balk at paying the same rates for the harder-earned expertise of actual neurodivergent people.

Listen to neurodivergent people, and read what we write. Read neurodivergent scholars and activists like Melanie Yergeau, Kassiane Asasumasu, Amy Sequenzia, and myself. Read Melanie Yergeau's Authoring Autism and Clinically Significant Disturbance, the Typed Words, Loud Voices anthology, and Michael Scott Monje's novel
Q: How does your training in somatics (both as a therapeutic orientation and your aikido background) factor into your work in the Neurodiversity Movement?
Never attempt to cure your client of being neurodivergent. When you have an autistic client suffering from anxiety and depression, for instance, remember that your job is to treat the client for anxiety and depression, not for autism.

Professionals who truly understand the neurodiversity paradigm would no sooner attempt to "treat" a client's autism than attempt to "treat" a client's homosexuality, or attempt to "treat" a client's membership in an ethnic minority group.

Familiarize yourself with the field of Liberation Psychology, and be continually aware that many of the psychological issues with which your neurodivergent clients struggle will be issues created by social injustice and oppression, rather than by the client's innate qualities. And remember that a good treatment plan is likely to include helping a client recognize this fact - helping the client understand their own oppression, both external and internalized, as a cause of their suffering.

Indeed, remember that your client may have completely bought into the pathology paradigm and may be ignorant of and even resistant to the neurodiversity paradigm. In which case, in order to support your client's psychological well-being and liberation, it may be your duty as a therapist to introduce your client to the neurodiversity paradigm, and to educate your client by pointing them to writings like the ones mentioned above.

And above all, check your privilege.

I see cognitive liberty as a core value of the Neurodiversity Movement.

The term cognitive liberty was coined by Wrye Sententia and Richard Glen Boire, the founders of an excellent organization called the Center for Cognitive Liberty and Ethics. Cognitive liberty as an ethical value boils down to the idea that individuals have the right to absolute sovereignty over their own brains and their own cognitive processes. The good folks at CCLE, and other advocates of cognitive liberty, often break this idea down into two fundamental guiding ethical principles:

1.) Individuals have the right to not have their brains and cognitive processes tampered with non-consensually.

2.) Individuals have the right to tamper with their own brains and cognitive processes, or to voluntarily have them tampered with, in any way they choose.

Those of us who are deeply involved in transformative somatic practices or in the field of Somatic Psychology understand that the psyche is somatically organized, which means that each individual's distinctive neurocognitive processes are intimately entwined with that individual's style of movement and embodiment. Changes in movement and embodiment create changes in cognition.

This means that to tamper with a person's unique individual style of movement and embodiment (for instance, through the Behaviorist techniques that are frequently used to make autistic children suppress the outward signs of autism) is to tamper with that person's cognition, and thus to violate their cognitive liberty.

In other words, freedom of embodiment - that is, the freedom to indulge, adopt, and/or experiment with any styles or quirks of movement and embodiment, whether they come naturally to one or whether one chooses them - is an essential element of cognitive liberty, and thus an essential area of focus for the Neurodiversity Movement. The freedom to be neurodivergent necessarily includes the freedom to give bodily expression to one's neurodivergence.

For somatically-oriented psychotherapists, one important implication of all this is that neurodivergent clients will often have acquired habitual unconscious tensions (what Wilhelm Reich referred to as character armor) that prevent them from giving full expression to the movement style that is natural to their particular neurotype. These tensions will tend to be especially severe and deep-rooted in clients who, in childhood, were frequently shamed or otherwise abused for their physical expressions of neurodivergence, or who were subjected to Behaviorist "therapies" or other forms of coerced physical conformity.

An integration of the neurodiversity paradigm into the field of Somatic Psychology would include the recognition of these habitual tensions as somatic manifestations of internalized oppression. And it seems to me that somatically-oriented psychotherapists, once they have embraced the neurodiversity paradigm, are uniquely qualified to assist neurodivergent clients in the task of liberating themselves from the bonds of such tensions, and thus recovering their capacity for giving full expression to their divergent potentials.

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I'm often asked if I have any words of advice for psychotherapists and other professionals, on working with clients who are autistic and/or otherwise neurodivergent. Why, yes. Yes I do. And I've been meaning for some time to type up some of

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Everything You Know About Obesity is Wrong

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Everything You Know About Obesity is Wrong

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From the 16th century to the 19th, scurvy killed around 2 million sailors, more than warfare, shipwrecks and syphilis combined. It was an ugly, smelly death, too, beginning with rattling teeth and ending with a body so rotted out from the inside that its victims could literally be startled to death by a loud noise. Just as horrifying as the disease itself, though, is that for most of those 300 years, medical experts knew how to prevent it and simply failed to.

In the 1600s, some sea captains distributed lemons, limes and oranges to sailors, driven by the belief that a daily dose of citrus fruit would stave off scurvy's progress. The British Navy, wary of the cost of expanding the treatment, turned to malt wort, a mashed and cooked byproduct of barley which had the advantage of being cheaper but the disadvantage of doing nothing whatsoever to cure scurvy. In 1747, a British doctor named James Lind conducted an experiment where he gave one group of sailors citrus slices and the others vinegar or seawater or cider. The results couldn't have been clearer. The crewmen who ate fruit improved so quickly that they were able to help care for the others as they languished. Lind published his findings, but died before anyone got around to implementing them nearly 50 years later.

This kind of myopia repeats throughout history. Seat belts were invented long before the automobile but weren't mandatory in cars until the 1960s. The first confirmed death from asbestos exposure was recorded in 1906, but the U.S. didn't start banning the substance until 1973. Every discovery in public health, no matter how significant, must compete with the traditions, assumptions and financial incentives of the society implementing it.

Which brings us to one of the largest gaps between science and practice in our own time. Years from now, we will look back in horror at the counterproductive ways we addressed the obesity epidemic and the barbaric ways we treated fat people-long after we knew there was a better path.

I have never written a story where so many of my sources cried during interviews, where they shook with anger describing their interactions with doctors and strangers and their own families.

About 40 years ago, Americans started getting much larger. According to the Centers for Disease Control and Prevention, nearly 80 percent of adults and about one-third of children now meet the clinical definition of overweight or obese. More Americans live with "extreme obesity" than with breast cancer, Parkinson's, Alzheimer's and HIV put together.

And the medical community's primary response to this shift has been to blame fat people for being fat. Obesity, we are told, is a personal failing that strains our health care system, shrinks our GDP and saps our military strength. It is also an excuse to bully fat people in one sentence and then inform them in the next that you are doing it for their own good. That's why the fear of becoming fat, or staying that way, drives Americans to spend more on dieting every year than we spend on video games or movies. Forty-five percent of adults say they're preoccupied with their weight some or all of the time-an 11-point rise since 1990. Nearly half of 3- to 6- year old girls say they worry about being fat.

The emotional costs are incalculable. I have never written a story where so many of my sources cried during interviews, where they double- and triple-checked that I would not reveal their names, where they shook with anger describing their interactions with doctors and strangers and their own families. One remembered kids singing "Baby Beluga" as she boarded the school bus, another said she has tried diets so extreme she has passed out and yet another described the elaborate measures he takes to keep his spouse from seeing him naked in the light. A medical technician I'll call Sam (he asked me to change his name so his wife wouldn't find out he spoke to me) said that one glimpse of himself in a mirror can destroy his mood for days. "I have this sense I'm fat and I shouldn't be," he says. "It feels like the worst kind of weakness."

My interest in this issue is slightly more than journalistic. Growing up, my mother's weight was the uncredited co-star of every family drama, the obvious, unspoken reason why she never got out of the car when she picked me up from school, why she disappeared from the family photo album for years at a time, why she spent hours making meatloaf then sat beside us eating a bowl of carrots. Last year, for the first time, we talked about her weight in detail. When I asked if she was ever bullied, she recalled some guy calling her a "fat slob" as she biked past him years ago. "But that was rare," she says. "The bigger way my weight affected my life was that I waited to do things because I thought fat people couldn't do them." She got her master's degree at 38, her Ph.D. at 55. "I avoided so many activities where I thought my weight would discredit me."

But my mother's story, like Sam's, like everyone's, didn't have to turn out like this. For 60 years, doctors and researchers have known two things that could have improved, or even saved, millions of lives. The first is that diets do not work. Not just paleo or Atkins or Weight Watchers or Goop, but all diets. Since 1959, research has shown that 95 to 98 percent of attempts to lose weight fail and that two-thirds of dieters gain back more than they lost. The reasons are biological and irreversible. As early as 1969, research showed that losing just 3 percent of your body weight resulted in a 17 percent slowdown in your metabolism-a body-wide starvation response that blasts you with hunger hormones and drops your internal temperature until you rise back to your highest weight. Keeping weight off means fighting your body's energy-regulation system and battling hunger all day, every day, for the rest of your life.

The second big lesson the medical establishment has learned and rejected over and over again is that weight and health are not perfect synonyms. Yes, nearly every population-level study finds that fat people have worse cardiovascular health than thin people. But individuals are not averages: Studies have found that anywhere from one-third to three-quarters of people classified as obese are metabolically healthy. They show no signs of elevated blood pressure, insulin resistance or high cholesterol. Meanwhile, about a quarter of non-overweight people are what epidemiologists call "the lean unhealthy." A 2016 study that followed participants for an average of 19 years found that unfit skinny people were twice as likely to get diabetes as fit fat people. Habits, no matter your size, are what really matter. Dozens of indicators, from vegetable consumption to regular exercise to grip strength, provide a better snapshot of someone's health than looking at her from across a room.

The terrible irony is that for 60 years, we've approached the obesity epidemic like a fad dieter: If we just try the exact same thing one more time, we'll get a different result. And so it's time for a paradigm shift. We're not going to become a skinnier country. But we still have a chance to become a healthier one.

This is Corissa Enneking at her lightest: She wakes up, showers and smokes a cigarette to keep her appetite down. She drives to her job at a furniture store, she stands in four-inch heels all day, she eats a cup of yogurt alone in her car on her lunch break. After work, lightheaded, her feet throbbing, she counts out three Ritz crackers, eats them at her kitchen counter and writes down the calories in her food journal.

Or not. Some days she comes home and goes straight to bed, exhausted and dizzy from hunger, shivering in the Kansas heat. She rouses herself around dinnertime and drinks some orange juice or eats half a granola bar. Occasionally she'll just sleep through the night, waking up the next day to start all over again.

The last time she lived like this, a few years ago, her mother marched her to the hospital. "My daughter is sick," she told the doctor. "She's not eating." He looked Enneking up and down. Despite six months of starvation, she was still wearing plus sizes, still couldn't shop at J. Crew, still got unsolicited diet advice from colleagues and customers.

Enneking told the doctor that she used to be larger, that she'd lost some weight the same way she had lost it three or four times before-seeing how far she could get through the day without eating, trading solids for liquids, food for sleep. She was hungry all the time, but she was learning to like it. When she did eat, she got panic attacks. Her boss was starting to notice her erratic behavior.

"Well, whatever you're doing now," the doctor said, "it's working." He urged her to keep it up and assured her that once she got small enough, her body would start to process food differently. She could add a few hundred calories to her diet. Her period would come back. She would stay small, but without as much effort.

"If you looked at anything other than my weight," Enneking says now, "I had an eating disorder. And my doctor was congratulating me."

Ask almost any fat person about her interactions with the health care system and you will hear a story, sometimes three, the same as Enneking's: rolled eyes, skeptical questions, treatments denied or delayed or revoked. Doctors are supposed to be trusted authorities, a patient's primary gateway to healing. But for fat people, they are a source of unique and persistent trauma. No matter what you go in for or how much you're hurting, the first thing you will be told is that it would all get better if you could just put down the Cheetos.

Emily went to a gynecological surgeon to have an ovarian cyst removed. The physician pointed out her body fat on the MRI, then said, "Look at that skinny woman in there trying to get out."

This phenomenon is not merely anecdotal. Doctors have shorter appointments with fat patients and show less emotional rapport in the minutes they do have. Negative words-"noncompliant," "overindulgent," "weak willed"-pop up in their medical histories with higher frequency. In one study, researchers presented doctors with case histories of patients suffering from migraines. With everything else being equal, the doctors reported that the patients who were also classified as fat had a worse attitude and were less likely to follow their advice. And that's when they see fat patients at all: In 2011, the Sun-Sentinel polled OB-GYNs in South Florida and discovered that 14 percent had barred all new patients weighing more than 200 pounds.

Some of these doctors are simply applying the same presumptions as the society around them. An anesthesiologist on the West Coast tells me that as soon as a larger patient goes under, the surgeons start trading "high school insults" about her body over the operating table. Janice O'Keefe, a former nurse in Boston, tells me a doctor once looked at her, paused, then asked, "How could you do this to yourself?" Emily, a counselor in Eastern Washington, went to a gynecological surgeon to have an ovarian cyst removed. The physician pointed out her body fat on the MRI, then said, "Look at that skinny woman in there trying to get out."

"I was worried I had cancer," Emily says, "and she was turning it into a teachable moment about my weight."

Other physicians sincerely believe that shaming fat people is the best way to motivate them to lose weight. "It's the last area of medicine where we prescribe tough love," says Mayo Clinic researcher Sean Phelan.

In a 2013 journal article, bioethicist Daniel Callahan argued for more stigma against fat people. "People don't realize that they are obese or if they do realize it, it's not enough to stir them to do anything about it," he tells me. Shame helped him kick his cigarette habit, he argues, so it should work for obesity too.

This belief is cartoonishly out of step with a generation of research into obesity and human behavior. As one of the (many) stigma researchers who responded to Callahan's article pointed out, shaming smokers and drug users with D.A.R.E.-style "just say no" messages may have actually increased substance abuse by making addicts less likely to bring up their habit with their doctors and family members.

Plus, rather obviously, smoking is a behavior; being fat is not. Jody Dushay, an endocrinologist and obesity specialist at Beth Israel Deaconess Medical Center in Boston, says most of her patients have tried dozens of diets and have lost and regained hundreds of pounds before they come to her. Telling them to try again, but in harsher terms, only sets them up to fail and then blame themselves.

Not all physicians set out to denigrate their fat patients, of course; some of them do damage because of subtler, more unconscious biases. Most doctors, for example, are fit-"If you go to an obesity conference, good luck trying to get a treadmill at 5 a.m.," Dushay says-and have spent more than a decade of their lives in the high-stakes, high-stress bubble of medical schools. According to several studies, thin doctors are more confident in their recommendations, expect their patients to lose more weight and are more likely to think dieting is easy. Sarah (not her real name), a tech CEO in New England, once told her doctor that she was having trouble eating less throughout the day. "Look at me," her doctor said. "I had one egg for breakfast and I feel fine."

Then there are the glaring cultural differences. Kenneth Resnicow, a consultant who trains physicians to build rapport with their patients, says white, wealthy, skinny doctors will often try to bond with their low-income patients by telling them, "I know what it's like not to have time to cook." Their patients, who might be single mothers with three kids and two jobs, immediately think "No, you don't," and the relationship is irretrievably soured.

When Joy Cox, an academic in New Jersey, was 16, she went to the hospital with stomach pains. The doctor didn't diagnose her dangerously inflamed bile duct, but he did, out of nowhere, suggest that she'd get better if she stopped eating so much fried chicken. "He managed to denigrate my fatness and my blackness in the same sentence," she says.

Many of the financial and administrative structures doctors work within help reinforce this bad behavior. The problem starts in medical school, where, according to a 2015 survey, students receive an average of just 19 hours of nutrition education over four years of instruction-five hours fewer than they got in 2006. Then the trouble compounds once doctors get into daily practice. Primary care physicians only get 15 minutes for each appointment, barely enough time to ask patients what they ate today, much less during all the years leading up to it. And a more empathic approach to treatment simply doesn't pay: While procedures like blood tests and CT scans command reimbursement rates from hundreds to thousands of dollars, doctors receive as little as $24 to provide a session of diet and nutrition counseling.

Lesley Williams, a family medicine doctor in Phoenix, tells me she gets an alert from her electronic health records software every time she's about to see a patient who is above the "overweight" threshold. The reason for this is that physicians are often required, in writing, to prove to hospital administrators and insurance providers that they have brought up their patient's weight and formulated a plan to bring it down-regardless of whether that patient came in with arthritis or a broken arm or a bad sunburn. Failing to do that could result in poor performance reviews, low ratings from insurance companies or being denied reimbursement if they refer patients to specialized care.

Another issue, says Kimberly Gudzune, an obesity specialist at Johns Hopkins, is that many doctors, no matter their specialty, think weight falls under their authority. Gudzune often spends months working with patients to set realistic goals-playing with their grandkids longer, going off a cholesterol medication-only to have other doctors threaten it all. One of her patients was making significant progress until she went to a cardiologist who told her to lose 100 pounds. "All of a sudden she goes back to feeling like a failure and we have to start over," Gudzune says. "Or maybe she just never comes back at all."

And so, working within a system that neither trains nor encourages them to meaningfully engage with their higher-weight patients, doctors fall back on recommending fad diets and delivering bland motivational platitudes. Ron Kirk, an electrician in Boston, says that for years, his doctor's first resort was to put him on some diet he couldn't maintain for more than a few weeks. "They told me lettuce was a 'free' food," he says-and he'd find himself carving up a head of romaine for dinner.

In a study that recorded 461 interactions with doctors, only 13 percent of patients got any specific plan for diet or exercise and only 5 percent got help arranging a follow-up visit. "It can be stressful when [patients] start asking a lot of specific questions" about diet and weight loss, one doctor told researchers in 2012. "I don't feel like I have the time to sit there and give them private counseling on basics. I say, 'Here's some websites, look at this.'" A 2016 survey found that nearly twice as many higher-weight Americans have tried meal-replacement diets-the kind most likely to fail-than have ever received counseling from a dietician.

"It borders on medical malpractice," says Andrew (not his real name), a consultant and musician who has been large his whole life. A few years ago, on a routine visit, Andrew's doctor weighed him, announced that he was "dangerously overweight" and told him to diet and exercise, offering no further specifics. Should he go on a low-fat diet? Low-carb? Become a vegetarian? Should he do Crossfit? Yoga? Should he buy a fucking ThighMaster?

"She didn't even ask me what I was already doing for exercise," he says. "At the time, I was training for serious winter mountaineering trips, hiking every weekend and going to the gym four times a week. Instead of a conversation, I got a sound bite. It felt like shaming me was the entire purpose."

All of this makes higher-weight patients more likely to avoid doctors. Three separate studies have found that fat women are more likely to die from breast and cervical cancers than non-fat women, a result partially attributed to their reluctance to see doctors and get screenings. Erin Harrop, a researcher at the University of Washington, studies higher-weight women with anorexia, who, contrary to the size-zero stereotype of most media depictions, are twice as likely to report vomiting, using laxatives and abusing diet pills. Thin women, Harrop discovered, take around three years to get into treatment, while her participants spent an average of 13 and a half years waiting for their disorders to be addressed.

"A lot of my job is helping people heal from the trauma of interacting with the medical system," says Ginette Lenham, a counselor who specializes in obesity. The rest of it, she says, is helping them heal from the trauma of interacting with everyone else.

If Sonya ever forgets that she is fat, the world will remind her. She has stopped taking the bus, she tells me, because she can sense the aggravation of the passengers squeezing past her. Sarah, the tech CEO, tenses up when anyone brings bagels to a work meeting. If she reaches for one, are her employees thinking, "There goes the fat boss"? If she doesn't, are they silently congratulating her for showing some restraint?

Emily says it's the do-gooders who get to her, the women who stop her on the street and tell her how brave she is for wearing a sleeveless dress on a 95-degree day. Sam, the medical technician, avoids the subject of weight altogether. "Men aren't supposed to think about this stuff-and I think about it constantly," he admits. "So I never let myself talk about it. Which is weird because it's the most visible thing about me."

Again and again I hear stories of how the pressure to be a "good fatty" in public builds up and explodes. Jessica has four kids. Every week is a birthday party or family reunion or swimming pool social, another opportunity to stand around platters of spare ribs and dinner rolls with her fellow moms.

"Your conscious mind is busy the whole day with how many calories is in everything, what you can eat and who's watching," she says. After a few intrusive comments over the years- should you be eating that? -she has learned to be careful, to perform the role of the impeccable fat person. She nibbles on cherry tomatoes, drinks tap water, stays on her feet, ignores the dessert end of the buffet.

Then, as the gathering winds down, Jessica and the other parents divvy up the leftovers. She wraps up burgers or pasta salad or birthday cake, drives her children home and waits for the moment when they are finally in bed. Then, when she's alone, she eats all the leftovers by herself, in the dark.

"It's always hidden," she says. "I buy a package of ice cream, then eat it all. Then I have to go to the store to buy it again. For a week my family thinks there's a thing of ice cream in the fridge-but it's actually five different ones."

This is how fat-shaming works: It is visible and invisible, public and private, hidden and everywhere at the same time. Research consistently finds that larger Americans (especially larger women) earn lower salaries and are less likely to be hired and promoted. In a 2017 survey, 500 hiring managers were given a photo of an overweight female applicant. Twenty-one percent of them described her as unprofessional despite having no other information about her. What's worse, only a few cities and one state (nice work, Michigan) officially prohibit workplace discrimination on the basis of weight.

Paradoxically, as the number of larger Americans has risen, the biases against them have become more severe. More than 40 percent of Americans classified as obese now say they experience stigma on a daily basis, a rate far higher than any other minority group. And this does terrible things to their bodies. According to a 2015 study, fat people who feel discriminated against have shorter life expectancies than fat people who don't. "These findings suggest the possibility that the stigma associated with being overweight," the study concluded, "is more harmful than actually being overweight."

And, in a cruel twist, one effect of weight bias is that it actually makes you eat more. The stress hormone cortisol-the one evolution designed to kick in when you're being chased by a tiger or, it turns out, rejected for your looks-increases appetite, reduces the will to exercise and even improves the taste of food. Sam, echoing so many of the other people I spoke with, says that he drove straight to Jack in the Box last year after someone yelled, "Eat less!" at him across a parking lot.

There's a grim caveman logic to our nastiness toward fat people. "We're attuned to bodies that look different," says Janet Tomiyama, a stigma researcher at UCLA. "In our evolutionary past, that might have meant disease risk and been seen as a threat to your tribe." These biological breadcrumbs help explain why stigma begins so early. Kids as young as 3 describe their larger classmates with words like "mean," "stupid" and "lazy."

And yet, despite weight being the number one reason children are bullied at school, America's institutions of public health continue to pursue policies perfectly designed to inflame the cruelty. TV and billboard campaigns still use slogans like "Too much screen time, too much kid" and "Being fat takes the fun out of being a kid." Cat Pausé, a researcher at Massey University in New Zealand, spent months looking for a single public health campaign, worldwide, that attempted to reduce stigma against fat people and came up empty. In an incendiary case of good intentions gone bad, about a dozen states now send children home with "BMI report cards," an intervention unlikely to have any effect on their weight but almost certain to increase bullying from the people closest to them.

This is not an abstract concern: Surveys of higher-weight adults find that their worst experiences of discrimination come from their own families. Erika, a health educator in Washington, can still recite the word her father used to describe her: "husky." Her grandfather preferred "stocky." Her mother never said anything about Erika's body, but she didn't have to. She obsessed over her own, calling herself "enormous" despite being two sizes smaller than her daughter. By the time Erika was 11, she was sneaking into the woods behind her house and vomiting into the creek whenever social occasions made starving herself impossible.

And the abuse from loved ones continues well into adulthood. A 2017 survey found that 89 percent of obese adults had been bullied by their romantic partners. Emily, the counselor, says she spent her teens and 20s "sleeping with guys I wasn't interested in because they wanted to sleep with me." In her head, a guy being into her was a rare and depletable resource she couldn't afford to waste: "I was desperate for men to give me attention. Sex was a good way to do that."

Eventually, she ended up with someone abusive. He told her during sex that her body was beautiful and then, in the daylight, that it was revolting. "Whenever I tried to leave him, he would say, 'Where are you gonna find someone who will put up with your disgusting body?'" she remembers.

Emily finally managed to get away from him, but she is aware that her love life will always be fraught. The guy she's dating now is thin-"think Tony Hawk," she says-and she notices the looks they get when they hold hands in public. "That never used to happen when I dated fat dudes," she says. "Thin men are not allowed to be attracted to fat women."

The effects of weight bias get worse when they're layered on top of other types of discrimination. A 2012 study found that African-American women are more likely to become depressed after internalizing weight stigma than white women. Hispanic and black teenagers also have significantly higher rates of bulimia. And, in a remarkable finding, rich people of color have higher rates of cardiovascular disease than poor people of color-the opposite of what happens with white people. One explanation is that navigating increasingly white spaces, and increasingly higher stakes, exerts stress on racial minorities that, over time, makes them more susceptible to heart problems.

But perhaps the most unique aspect of weight stigma is how it isolates its victims from one another. For most minority groups, discrimination contributes to a sense of belongingness, a community in opposition to a majority. Gay people like other gay people; Mormons root for other Mormons. Surveys of higher-weight people, however, reveal that they hold many of the same biases as the people discriminating against them. In a 2005 study, the words obese participants used to classify other obese people included gluttonous, unclean and sluggish.

Andrea, a retired nurse in Boston, has been on commercial diets since she was 10 years old. She knows how hard it is to slim down, knows what women larger than her are going through, but she still struggles not to pass judgment when she sees them in public. "I think, 'How did they let it happen?'" she says. "It's more like fear. Because if I let myself go, I'll be that big too."

Her position is all-too understandable. As young as 9 or 10, I knew that coming out of the closet is what gay people do, even if it took me another decade to actually do it. Fat people, though, never get a moment of declaring their identity, of marking themselves as part of a distinct group. They still live in a society that believes weight is temporary, that losing it is urgent and achievable, that being comfortable in their bodies is merely "glorifying obesity." This limbo, this lie, is why it's so hard for fat people to discover one another or even themselves. "No one believes our It Gets Better story," says Tigress Osborn, the director of community outreach for the National Association to Advance Fat Acceptance. "You can't claim an identity if everyone around you is saying it doesn't or shouldn't exist."

Harrop, the eating disorders researcher, realized several years ago that her university had clubs for trans students, immigrant students, Republican students, but none for fat students. So she started one-and it has been a resounding, unmitigated failure. Only a handful of fat people have ever showed up; most of the time, thin folks sit around brainstorming about how to be better allies.

I ask Harrop why she thinks the group has been such a bust. It's simple, she says: "Fat people grow up in the same fat-hating culture that non-fat people do."

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Everything You Know About Obesity Is Wrong

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From the 16th century to the 19th, scurvy killed around 2 million sailors, more than warfare, shipwrecks and syphilis combined. It was an ugly, smelly death, too, beginning with rattling teeth and ending with a body so rotted out from the inside that its victims could literally be startled to death by a loud noise.

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Watch Crip Camp: A Disability Revolution | Netflix Official Site

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A groundbreaking summer camp galvanizes a group of teens with disabilities to help build a movement, forging a new path toward greater equality. Watch trailers & learn more.

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CW: Set up as a comedy, but addresses the consequences of rape.

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Watch Hannah Gadsby: Nanette | Netflix Official Site

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Australian comic Hannah Gadsby reshapes standard stand-up by pairing punchlines with personal revelations on gender, sexuality and childhood turmoil. Watch trailers & learn more.

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The behavior is necessary for advancement — but it takes a great psychological toll.

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Why boys crack up at rape jokes, think having a girlfriend is "gay," and still can't cry-and why we need to give them new and better models of masculinity

Anthony Blasko

Updated at 9:30 p.m. ET on December 20, 2019.
I knew nothing about Cole before meeting him; he was just a name on a list of boys at a private school outside Boston who had volunteered to talk with me (or perhaps had had their arm twisted a bit by a counselor). The afternoon of our first interview, I was running late. As I rushed down a hallway at the school, I noticed a boy sitting outside the library, waiting-it had to be him. He was staring impassively ahead, both feet planted on the floor, hands resting loosely on his thighs.

My first reaction was Oh no.

It was totally unfair, a scarlet letter of personal bias. Cole would later describe himself to me as a "typical tall white athlete" guy, and that is exactly what I saw. At 18, he stood more than 6 feet tall, with broad shoulders and short-clipped hair. His neck was so thick that it seemed to merge into his jawline, and he was planning to enter a military academy for college the following fall. His friends were "the jock group," he'd tell me. "They're what you'd expect, I guess. Let's leave it at that." If I had closed my eyes and described the boy I imagined would never open up to me, it would have been him.

But Cole surprised me. He pulled up a picture on his phone of his girlfriend, whom he'd been dating for the past 18 months, describing her proudly as "way smarter than I am," a feminist, and a bedrock of emotional support. He also confided how he'd worried four years earlier, during his first weeks as a freshman on a scholarship at a new school, that he wouldn't know how to act with other guys, wouldn't be able to make friends. "I could talk to girls platonically," he said. "That was easy. But being around guys was different. I needed to be a 'bro,' and I didn't know how to do that."

Whenever Cole uttered the word bro, he shifted his weight to take up more space, rocking back in his chair, and spoke from low in his throat, like he'd inhaled a lungful of weed. He grinned when I pointed that out. "Yeah," he said, "that's part of it: seeming relaxed and never intrusive, yet somehow bringing out that aggression on the sports field. Because a 'bro' "-he rocked back again-"is always, always an athlete."

Cole eventually found his people on the crew team, but it wasn't a smooth fit at first. He recalled an incident two years prior when a senior was bragging in the locker room about how he'd convinced one of Cole's female classmates-a young sophomore, Cole emphasized-that they were an item, then started hooking up with other girls behind her back. And the guy wasn't shy about sharing the details. Cole and a friend of his, another sophomore, told him to knock it off. "I started to explain why it wasn't appropriate," Cole said, "but he just laughed."

The next day, a second senior started talking about "getting back at" a "bitch" who'd dumped him. Cole's friend spoke up again, but this time Cole stayed silent. "And as I continued to step back" and the other sophomore "continued to step up, you could tell that the guys on the team stopped liking him as much. They stopped listening to him, too. It's almost as if he spent all his social currency" trying to get them to stop making sexist jokes. "Meanwhile, I was sitting there"-Cole thumped his chest-"too afraid to spend any of mine, and I just had buckets left.

"I don't know what to do," he continued earnestly. "Once I'm in the military, and I'm a part of that culture, I don't want to have to choose between my own dignity and my relationship with others I'm serving with. But ..." He looked me in the eye. "How do I make it so I don't have to choose?"

I've spent two years talking with boys across America-more than 100 of them between the ages of 16 and 21-about masculinity, sex, and love: about the forces, seen and unseen, that shape them as men. Though I spoke with boys of all races and ethnicities, I stuck to those who were in college or college-bound, because like it or not, they're the ones most likely to set cultural norms. Nearly every guy I interviewed held relatively egalitarian views about girls, at least their role in the public sphere. They considered their female classmates to be smart and competent, entitled to their place on the athletic field and in school leadership, deserving of their admission to college and of professional opportunities. They all had female friends; most had gay male friends as well. That was a huge shift from what you might have seen 50, 40, maybe even 20 years ago. They could also easily reel off the excesses of masculinity. They'd seen the headlines about mass shootings, domestic violence, sexual harassment, campus rape, presidential Twitter tantrums, and Supreme Court confirmation hearings. A Big Ten football player I interviewed bandied about the term toxic masculinity. "Everyone knows what that is," he said, when I seemed surprised.

Yet when asked to describe the attributes of "the ideal guy," those same boys appeared to be harking back to 1955. Dominance. Aggression. Rugged good looks (with an emphasis on height). Sexual prowess. Stoicism. Athleticism. Wealth (at least some day). It's not that all of these qualities, properly channeled, are bad. But while a 2018 national survey of more than 1,000 10-to-19-year-olds commissioned by Plan International USA and conducted by the polling firm PerryUndem found that young women believed there were many ways to be a girl-they could shine in math, sports, music, leadership (the big caveat being that they still felt valued primarily for their appearance)-young men described just one narrow route to successful masculinity.* One-third said they felt compelled to suppress their feelings, to "suck it up" or "be a man" when they were sad or scared, and more than 40 percent said that when they were angry, society expected them to be combative. In another survey, which compared young men from the U.S., the U.K., and Mexico, Americans reported more social pressure to be ever-ready for sex and to get with as many women as possible; they also acknowledged more stigma against homosexuality, and they received more messages that they should control their female partners, as in: Men "deserve to know" the whereabouts of their girlfriends or wives at all times.

Feminism may have provided girls with a powerful alternative to conventional femininity, and a language with which to express the myriad problems-that-have-no-name, but there have been no credible equivalents for boys. Quite the contrary: The definition of masculinity seems to be in some respects contracting. When asked what traits society values most in boys, only 2 percent of male respondents in the PerryUndem survey said honesty and morality, and only 8 percent said leadership skills-traits that are, of course, admirable in anyone but have traditionally been considered masculine. When I asked my subjects, as I always did, what they liked about being a boy, most of them drew a blank. "Huh," mused Josh, a college sophomore at Washington State. (All the teenagers I spoke with are identified by pseudonyms.) "That's interesting. I never really thought about that. You hear a lot more about what is wrong with guys."

From May 2000: The war against boys
While following the conventional script may still bring social and professional rewards to boys and men, research shows that those who rigidly adhere to certain masculine norms are not only more likely to harass and bully others but to themselves be victims of verbal or physical violence. They're more prone to binge-drinking, risky sexual behavior, and getting in car accidents. They are also less happy than other guys, with higher depression rates and fewer friends in whom they can confide.

Anthony Blasko

It wasn't always thus. According to Andrew Smiler, a psychologist who has studied the history of Western masculinity, the ideal late-19th-century man was compassionate, a caretaker, but such qualities lost favor as paid labor moved from homes to factories during industrialization. In fact, the Boy Scouts, whose creed urges its members to be loyal, friendly, courteous, and kind, was founded in 1910 in part to counter that dehumanizing trend. Smiler attributes further distortions in masculinity to a century-long backlash against women's rights. During World War I, women proved that they could keep the economy humming on their own, and soon afterward they secured the vote. Instead of embracing gender equality, he says, the country's leaders "doubled down" on the inalienable male right to power, emphasizing men's supposedly more logical and less emotional nature as a prerequisite for leadership.

Then, during the second half of the 20th century, traditional paths to manhood-early marriage, breadwinning-began to close, along with the positive traits associated with them. Today many parents are unsure of how to raise a boy, what sort of masculinity to encourage in their sons. But as I learned from talking with boys themselves, the culture of adolescence, which fuses hyperrationality with domination, sexual conquest, and a glorification of male violence, fills the void.
Read: Today's masculinity is stifling
For Cole, as for many boys, this stunted masculinity is a yardstick against which all choices, even those seemingly irrelevant to male identity, are measured. When he had a choice, he would team up with girls on school projects, to avoid the possibility of appearing subordinate to another guy. "With a girl, it feels safer to talk and ask questions, to work together or to admit that I did something wrong and want help," Cole said. During his junior year, he briefly suggested to his crew teammates that they go vegan for a while, just to show that athletes could. "And everybody was like, 'Cole, that is the dumbest idea ever. We'd be the slowest in any race.' That's somewhat true-we do need protein. We do need fats and salts and carbs that we get from meat. But another reason they all thought it was stupid is because being vegans would make us pussies."

LEARNING TO "MAN UP"

There is no difference between the sexes' need for connection in infancy, nor between their capacity for empathy-there's actually some evidence that male infants are more expressive than females. Yet, from the get-go, boys are relegated to an impoverished emotional landscape. In a classic study, adults shown a video of an infant startled by a jack-in-the-box were more likely to presume the baby was "angry" if they were first told the child was male. Mothers of young children have repeatedly been found to talk more to their girls and to employ a broader, richer emotional vocabulary with them; with their sons, again, they tend to linger on anger. As for fathers, they speak with less emotional nuance than mothers regardless of their child's sex. Despite that, according to Judy Y. Chu, a human-biology lecturer at Stanford who conducted a study of boys from pre-K through first grade, little boys have a keen understanding of emotions and a desire for close relationships. But by age 5 or 6, they've learned to knock that stuff off, at least in public: to disconnect from feelings of weakness, reject friendships with girls (or take them underground, outside of school), and become more hierarchical in their behavior.

Read: Psychology has a new approach to building healthier men
By adolescence, says the Harvard psychologist William Pollack, boys become "shame-phobic," convinced that peers will lose respect for them if they discuss their personal problems. My conversations bore this out. Boys routinely confided that they felt denied-by male peers, girlfriends, the media, teachers, coaches, and especially their fathers-the full spectrum of human expression. Cole, for instance, spent most of his childhood with his mother, grandmother, and sister-his parents split up when he was 10 and his dad, who was in the military, was often away. Cole spoke of his mom with unbridled love and respect. His father was another matter. "He's a nice guy," Cole said-caring and involved, even after the divorce-"but I can't be myself around him. I feel like I need to keep everything that's in here"-Cole tapped his chest again-"behind a wall, where he can't see it. It's a taboo-like, not as bad as incest, but ..."

Rob, an 18-year-old from New Jersey in his freshman year at a North Carolina college, said his father would tell him to "man up" when he was struggling in school or with baseball. "That's why I never talk to anybody about my problems." He'd always think, If you can't handle this on your own, then you aren't a man; you aren't trying hard enough. Other boys also pointed to their fathers as the chief of the gender police, though in a less obvious way. "It's not like my dad is some alcoholic, emotionally unavailable asshole with a pulse," said a college sophomore in Southern California. "He's a normal, loving, charismatic guy who's not at all intimidating." But "there's a block there. There's a hesitation, even though I don't like to admit that. A hesitation to talk about ... anything, really. We learn to confide in nobody. You sort of train yourself not to feel."

Read: How boys teach each other to be boys
I met Rob about four months after he'd broken up with his high-school girlfriend. The two had dated for more than three years-"I really did love her," he said-and although their colleges were far apart, they'd decided to try to stay together. Then, a few weeks into freshman year, Rob heard from a friend that she was cheating on him. "So I cut her off," he said, snapping his fingers. "I stopped talking to her and forgot about her completely." Only ... not really. Although he didn't use the word, Rob became depressed. The excitement he'd felt about leaving home, starting college, and rushing a fraternity all drained away, and, as the semester wore on, it didn't come back.

When I asked whom he talked to during that time, he shrugged. If he had told his friends he was "hung up" on a girl, "they'd be like, 'Stop being a bitch.' " Rob looked glum. The only person with whom he had been able to drop his guard was his girlfriend, but that was no longer an option.

Girlfriends, mothers, and in some cases sisters were the most common confidants of the boys I met. While it's wonderful to know they have someone to talk to-and I'm sure mothers, in particular, savor the role-teaching boys that women are responsible for emotional labor, for processing men's emotional lives in ways that would be emasculating for them to do themselves, comes at a price for both sexes. Among other things, that dependence can leave men unable to identify or express their own emotions, and ill-equipped to form caring, lasting adult relationships.

By Thanksgiving break, Rob was so distraught that he had what he called a "mental breakdown" one night while chatting in the kitchen with his mom. "I was so stressed out," he said. "Classes. The thing with my girlfriend." He couldn't describe what that "breakdown" felt like (though he did say it "scared the crap" out of his mom, who immediately demanded, "Tell me everything"). All he could say definitively was that he didn't cry. "Never," he insisted. "I don't cry, ever."

I paid close attention when boys mentioned crying-doing it, not doing it, wanting to do it, not being able to do it. For most, it was a rare and humiliating event-a dangerous crack in a carefully constructed edifice. A college sophomore in Chicago told me that he hadn't been able to cry when his parents divorced. "I really wanted to," he said. "I needed to cry." His solution: He streamed three movies about the Holocaust over the weekend. That worked.

As someone who, by virtue of my sex, has always had permission to weep, I didn't initially understand this. Only after multiple interviews did I realize that when boys confided in me about crying-or, even more so, when they teared up right in front of me-they were taking a risk, trusting me with something private and precious: evidence of vulnerability, or a desire for it. Or, as with Rob, an inability to acknowledge any human frailty that was so poignant, it made me want to, well, cry.

BRO CULTURE

While my interview subjects struggled when I asked what they liked about being a boy, the most frequent response was sports. They recalled their early days on the playing field with almost romantic warmth. But I was struck by how many had dropped athletics they'd enjoyed because they couldn't stand the Lord of the Flies mentality of teammates or coaches. Perhaps the most extreme example was Ethan, a kid from the Bay Area who had been recruited by a small liberal-arts college in New England to play lacrosse. He said he'd expected to encounter the East Coast " 'lax bro' culture," but he'd underestimated its intensity. "It was all about sex" and bragging about hooking up, and even the coaches endorsed victim-blaming, Ethan told me. "They weren't like that in class or around other people; it was a super-liberal school. But once you got them in the locker room ..." He shook his head. "It was one of the most jarring experiences of my life."

As a freshman, Ethan didn't feel he could challenge his older teammates, especially without support from the coaches. So he quit the team; not only that, he transferred. "If I'd stayed, there would've been a lot of pressure on me to play, a lot of resentment, and I would've run into those guys all the time. This way I didn't really have to explain anything." At his new school, Ethan didn't play lacrosse, or anything else.

What the longtime sportswriter Robert Lipsyte calls "jock culture" (or what the boys I talked with more often referred to as "bro culture") is the dark underbelly of male-dominated enclaves, whether or not they formally involve athletics: all-boys' schools, fraternity houses, Wall Street, Silicon Valley, Hollywood, the military. Even as such groups promote bonding, even as they preach honor, pride, and integrity, they tend to condition young men to treat anyone who is not "on the team" as the enemy (the only women who ordinarily make the cut are blood relatives- bros before hos!), justifying any hostility toward them. Loyalty is paramount, and masculinity is habitually established through misogynist language and homophobia.
From March 2014: Caitlin Flanagan on the dark power of fraternities
As a senior in high school, Cole was made captain of the crew team. He relished being part of a unit, a band of brothers. When he raced, he imagined pulling each stroke for the guy in front of him, for the guy behind him-never for himself alone. But not everyone could muster such higher purpose. "Crew demands you push yourself to a threshold of pain and keep yourself there," Cole said. "And it's hard to find something to motivate you to do that other than anger and aggression."

Anthony Blasko

I asked him about how his teammates talked in the locker room. That question always made these young men squirm. They'd rather talk about looking at porn, erectile dysfunction, premature ejaculation- anything else. Cole cut his eyes to the side, shifted in his seat, and sighed deeply. "Okay," he finally said, "so here's my best shot: We definitely say fuck a lot; fuckin' can go anywhere in a sentence. And we call each other pussies, bitches. We never say the N-word, though. That's going too far."

"What about fag?" I asked.

"No," he said, shaking his head firmly.

"So why can't you say fag or the N-word but you can say pussy and bitch? Aren't those just as offensive?"

"One of my friends said we probably shouldn't say those words anymore either, but what would we replace them with? We couldn't think of anything that bites as much."

" Bites?"

"Yeah. It's like ... for some reason pussy just works. When someone calls me a pussy-'Don't be a pussy! Come on! Fuckin' go! Pull! Pull! Pull!'-it just flows. If someone said, 'Come on, Cole, don't be weak! Be tough! Pull! Pull! Pull!,' it just wouldn't get inside my head the same way. I don't know why that is." He paused. "Well," he said, "maybe I do. Maybe I just try not to dig too deeply."

Although losing ground in more progressive circles, like the one Cole runs in, fag remained pervasive in the language of the boys I interviewed-including those who insisted that they would never use the word in reference to an actual homosexual. Fag has become less a comment on a boy's sexuality, says the University of Oregon sociology professor C. J. Pascoe, than a referendum on his manhood. It can be used to mock anything, she told me, even something as random as a guy "dropping the meat out of his sandwich." (Perhaps oddest to me, Pascoe found that one of the more common reasons boys get tagged with fag is for acting romantically with a girl. That's seen as heterosexual in the "wrong" way, which explains why one high-school junior told me that having a girlfriend was "gay.") That fluidity, the elusiveness of the word's definition, only intensifies its power, much like slut for girls.

Recently, Pascoe turned her attention to no homo, a phrase that gained traction in the 1990s. She sifted through more than 1,000 tweets, primarily by young men, that included the phrase. Most were expressing a positive emotion, sometimes as innocuous as "I love chocolate ice cream, #nohomo" or "I loved the movie The Day After Tomorrow, #nohomo." "A lot of times they were saying things like 'I miss you' to a friend or 'We should hang out soon,' " she said. "Just normal expressions of joy or connection." No homo is a form of inoculation against insults from other guys, Pascoe concluded, a "shield that allows boys to be fully human."

Just because some young men now draw the line at referring to someone who is openly gay as a fag doesn't mean, by the way, that gay men (or men with traits that read as gay) are suddenly safe. If anything, the gay guys I met were more conscious of the rules of manhood than their straight peers were. They had to be-and because of that, they were like spies in the house of hypermasculinity.

Mateo, 17, attended the same Boston-area high school as Cole, also on a scholarship, but the two could not have presented more differently. Mateo, whose father is Salvadoran, was slim and tan, with an animated expression and a tendency to wave his arms as he spoke. Where Cole sat straight and still, Mateo crossed his legs at the knee and swung his foot, propping his chin on one hand.

This was Mateo's second private high school. The oldest of six children, he had been identified as academically gifted and encouraged by an eighth-grade teacher to apply to an all-boys prep school for his freshman year. When he arrived, he discovered that his classmates were nearly all white, athletic, affluent, and, as far as he could tell, straight. Mateo-Latino and gay, the son of a janitor-was none of those things. He felt immediately conscious of how he held himself, of how he sat, and especially of the pitch of his voice. He tried lowering it, but that felt unnatural, so he withdrew from conversation altogether. He changed the way he walked as well, to avoid being targeted as "girly." "One of my only friends there was gay too," he said, "and he was a lot more outward about it. He just got destroyed."

Guys who identify as straight but aren't athletic, or are involved in the arts, or have a lot of female friends, all risk having their masculinity impugned. What has changed for this generation, though, is that some young men, particularly if they grew up around LGBTQ people, don't rise to the bait. "I don't mind when people mistake me for being gay," said Luke, a high-school senior from New York City. "It's more of an annoyance than anything, because I want people to believe me when I say I'm straight." The way he described himself did, indeed, tick every stereotypical box. "I'm a very thin person," he said. "I like clothing. I care about my appearance in maybe a more delicate way. I'm very in touch with my sensitive side. So when people think I'm gay?" He shrugged. "It can feel like more of a compliment. Like, 'Oh, you like the way I dress? Thank you!  ' "

One of Luke's friends, who was labeled "the faggot frosh" in ninth grade, is not so philosophical. "He treats everything as a test of his masculinity," Luke told me. "Like, once when I was wearing red pants, I heard him say to other people, 'He looks like such a faggot.' I didn't care, and maybe in that situation no one was really harmed, but when you apply that attitude to whole populations, you end up with Donald Trump as president."

W's AND L's

Sexual conquest-or perhaps more specifically, bragging about your experiences to other boys-is, arguably, the most crucial aspect of toxic masculinity. Nate, who attended a public high school in the Bay Area, knew this well. At a party held near the beginning of his junior year of high school, he sank deep into the couch, trying to look chill. Kids were doing shots and smoking weed. Some were Juuling. Nate didn't drink much himself and never got high. He wasn't morally opposed to it; he just didn't like the feeling of being out of control.

At 16, reputation meant everything to Nate, and certain things could cement your status. "The whole goal of going to a party is to hook up with girls and then tell your guys about it," he said. And there's this "race for experience," because if you get behind, by the time you do hook up with a girl "she'll have hit it with, like, five guys already. Then she's going to know how to do things" you don't-and that's a problem, if she tells people "you've got floppy lips" or "don't know how to get her bra off."

A lanky boy with dark, liquid eyes and curly hair that resisted all attempts at taming, Nate put himself in the middle of his school's social hierarchy: friends with both the "popular" and "lower" kids. Still, he'd hooked up with only three girls since ninth grade-kissing, getting under their shirts-but none had wanted a repeat. That left him worried about his skills. He is afraid of intimacy, he told me sincerely. "It's a huge self-esteem suck."

It would probably be more accurate to say that Nate was afraid of having drunken sexual interactions with a girl he did not know or trust. But it was all about credentialing. "Guys need to prove themselves to their guys," Nate said. To do that, "they're going to be dominating." They're going to "push." Because the girl is just there "as a means for him to get off and to brag."

Before the start of this school year, Nate's "dry spell" had seemed to be ending. He'd been in a relationship with a girl that lasted a full two weeks, until other guys told him she was "slutty"-their word, he hastened to add, not his. Although any hookup is marginally better than none, Nate said, you only truly earn points for getting sexual with the right kind of girl. "If you hook up with a girl below your status, it's an 'L,' " he explained. "A loss. Like, a bad move." So he stopped talking to the girl, which was too bad. He'd really liked her.

Anthony Blasko

After a short trip to the kitchen to watch his friend Kyle stand on a table and drunkenly try to pour Sprite from a can into a shot glass, Nate returned to the couch, starting to relax as people swirled around him. Suddenly Nicole, the party's host and a senior, plopped onto his lap, handing him a shot of vodka. Nate was impressed, if a little confused. Usually, if a girl wanted to hook up with you, there were texts and Snapchats, and if you said yes, it was on; everyone would be anticipating it, and expecting a postmortem.

Nate thought Nicole was "pretty hot"-she had a great body, he said-though he'd never been especially interested in her before this moment. Still, he knew that hooking up with her would be a "W." A big one. He glanced around the room subtly, wanting to make sure, without appearing to care, that everyone who mattered-everyone "relevant"-saw what was going down. A couple of guys gave him little nods. One winked. Another slapped him on the shoulder. Nate feigned nonchalance. Meanwhile, he told me, "I was just trying not to pop a boner."

Nicole took Nate's hand and led him to an empty bedroom. He got through the inevitable, cringey moments when you actually have to talk to your partner, then, finally, they started kissing. In his anxiety, Nate bit Nicole's lip. Hard. "I was thinking, Oh God! What do I do now? " But he kept going. He took off her top and undid her bra. He took off his own shirt. Then she took off her pants. "And that," he said, "was the first time I ever saw a vagina. I did not know what to do with it." He recalled that his friends had said girls go crazy if you stick your fingers up there and make the "come here" motion, so he tried it, but Nicole just lay there. He didn't ask what might feel better to her, because that would have been admitting ignorance.

After a few more agonizing minutes, Nicole announced that she wanted to see what was going on upstairs, and left, Nate trailing behind. A friend handed him a bottle of Jack Daniel's. Another high-fived him. A third said, "Dude, you hit that!" Maybe the hookup hadn't been a disaster after all: He still had bragging rights.

Then he heard a senior, a guy Nate considered kind of a friend, loudly ask Nicole, "Why would you hook up with Nate?"

She giggled. "Oh, I was drunk!" she said. "I was so drunk!"

They were calling him an "L."

By Monday morning, Nicole had spread the word that Nate was bad at hooking up: that he'd bit her lip, that he didn't know how to finger a girl. That his nails were ragged. "The stereotype is that guys go into gory detail," Nate said, but "it's the other way around." Guys will brag, but they're not specific. Girls will go into "what his penis looked like," every single thing he did.

Nate said he felt "completely emasculated," so mortified that he told his mom he was sick and stayed home from school the next day. "I was basically crying," he said. "I was like, Shit! I fucked up."

No question, gossip about poor "performance" can destroy a guy's reputation almost as surely as being called a "slut" or a "prude" can destroy a girl's. As a result, the boys I talked with were concerned with female satisfaction during a hookup; they just didn't typically define it as the girl having an orgasm. They believed it to be a function of their own endurance and, to a lesser extent, penis size. A college freshman in Los Angeles recalled a high-school classmate who'd had sex with a girl who told everyone he'd ejaculated really quickly: "He got the nickname Second Sam. That basically scared the crap out of all the other guys." A college senior in Boston recounted how he would glance at the clock when he started penetration. "I'd think, I have to last five minutes, minimum," he said. "And once I could do that, I'd think, I need to get to double digits. I don't know if it's necessarily about your partner's enjoyment. It's more about getting beyond the point where you'd be embarrassed, maintaining your pride. It turns sex into a task-one I enjoy to a certain degree, but one where you're monitoring your performance rather than living in the moment."

Eventually, Nate decided that he had to take a stand, if only to make returning to school bearable. He texted Nicole and said, " 'I'm sorry that you didn't enjoy it, [but] I would never roast you. Why are you doing this?' " She felt "really bad," he said. "She stopped telling people, but it took me until the next semester to recover."

HOW MISOGYNY BECOMES "HILARIOUS"

No matter how often I heard it, the brutal language that even a conscientious young man like Nate used to describe sexual contact- you hit that! -always unnerved me. In mixed-sex groups, teenagers may talk about hooking up (already impersonal), but when guys are on their own, they nail, they pound, they bang, they smash, they hammer. They tap that ass, they tear her up. It can be hard to tell whether they have engaged in an intimate act or just returned from a construction site.

It's not like I imagined boys would gush about making sweet, sweet love to the ladies, but why was their language so weaponized ? The answer, I came to believe, was that locker-room talk isn't about sex at all, which is why guys were ashamed to discuss it openly with me. The (often clearly exaggerated) stories boys tell are really about power: using aggression toward women to connect and to validate one another as heterosexual, or to claim top spots in the adolescent sexual hierarchy. Dismissing that as "banter" denies the ways that language can desensitize-abrade boys' ability to see girls as people deserving of respect and dignity in sexual encounters.

For evidence, look no further than the scandals that keep popping up at the country's top colleges: Harvard, Amherst, Columbia, Yale (the scene of an especially notorious 2010 fraternity chant, "No means yes; yes means anal"). Most recently, in the spring of 2019, at the politically progressive Swarthmore College, in Pennsylvania, two fraternities disbanded after student-run publications released more than 100 pages of "minutes" from house meetings a few years earlier that included, among other things, jokes about a "rape attic" and the acquiring of roofies, "finger blasting" a member's 10-year-old sister, and vomiting on women during sex.

When called out, boys typically claim that they thought they were just being "funny." And in a way that makes sense-when left unexamined, such "humor" may seem like an extension of the gross-out comedy of childhood. Little boys are famous for their fart jokes, booger jokes, poop jokes. It's how they test boundaries, understand the human body, gain a little cred among their peers. But, as can happen with sports, their glee in that can both enable and camouflage sexism. The boy who, at age 10, asks his friends the difference between a dead baby and a bowling ball may or may not find it equally uproarious, at 16, to share what a woman and a bowling ball have in common (you can Google it). He may or may not post ever-escalating "jokes" about women, or African Americans, or homosexuals, or disabled people on a group Snapchat. He may or may not send "funny" texts to friends about "girls who need to be raped," or think it's hysterical to surprise a buddy with a meme in which a woman is being gagged by a penis, her mascara mixed with her tears. He may or may not, at 18, scrawl the names of his hookups on a wall in his all-male dorm, as part of a year-long competition to see who can "pull" the most. Perfectly nice, bright, polite boys I interviewed had done one or another of these things.

How does that happen? I talked with a 15-year-old from the East Coast who had been among a group of boys suspended from school for posting more than 100 racist and sexist "jokes" about classmates on a group Finsta (a secondary, or "fake," Instagram account that is in many cases more genuine than a "Rinsta," or "real" account)."The Finsta became very competitive," he said. "You wanted to make your friends laugh, but when you're not face-to-face," you can't tell whether you'll get a reaction, "so you go one step beyond." It was "that combination of competitiveness and that ... disconnect that triggered it to get worse and worse."

​Anthony Blasko

At the most disturbing end of the continuum, "funny" and "hilarious" become a defense against charges of sexual harassment or assault. To cite just one example, a boy from Steubenville, Ohio, was captured on video joking about the repeated violation of an unconscious girl at a party by a couple of high-school football players. "She is so raped," he said, laughing. "They raped her quicker than Mike Tyson." When someone off camera suggested that rape wasn't funny, he retorted, "It isn't funny-it's hilarious!"

"Hilarious" is another way, under the pretext of horseplay or group bonding, that boys learn to disregard others' feelings as well as their own. "Hilarious" is a haven, offering distance when something is inappropriate, confusing, depressing, unnerving, or horrifying; when something defies boys' ethics. It allows them to subvert a more compassionate response that could be read as unmasculine-and makes sexism and misogyny feel transgressive rather than supportive of an age-old status quo. Boys may know when something is wrong; they may even know that true manhood-or maybe just common decency-compels them to speak up. Yet, too often, they fear that if they do, they'll be marginalized or, worse, themselves become the target of derision from other boys. Masculinity, then, becomes not only about what boys do say, but about what they don't-or won't, or can't-say, even when they wish they could. The psychologists Dan Kindlon and Michael Thompson, the authors of Raising Cain: Protecting the Emotional Life of Boys, have pointed out that silence in the face of cruelty or sexism is how too many boys become men. Charis Denison, a sex educator in the Bay Area, puts it another way: "At one time or another, every young man will get a letter of admission to 'dick school.' The question is, will he drop out, graduate, or go for an advanced degree?"

Midway through Cole's freshman year in military college, I FaceTimed him to see how he'd resolved the conflict between his personal values and those of the culture in which he found himself. As he'd expected, most of his classmates were male, and he said there was a lot of what passed for friendly ribbing: giving one another "love taps" on the back of the head; blocking one another's paths, then pretending to pick a fight; grabbing one another's asses; pretending to lean in for a kiss. Giving someone a hard time, Cole said, was always "easy humor," but it could spiral into something more troubling pretty quickly. When one of his dorm mates joked to another, "I'm going to piss on you in your sleep," for instance, the other boy shot back, "If you do, I'll fucking rape you." For better or worse, Cole said, that sort of comment no longer rattled him.

Although he had been adamantly against the epithet fag when we met, Cole found himself using it, reasoning, as other boys did, that it was "more like 'You suck' or 'You're lame.' " However, at least one of his friends had revealed himself to be legitimately homophobic, declaring that being gay was un-American ("I didn't know that about him until after we became friends," Cole insisted). And Cole had not met a single openly LGBTQ student at the school. He certainly wouldn't want to be out in this environment if he were gay. Nor, he said, would he want to be Asian-the two Asian American boys in his dorm were ostracized and treated like foreigners; both seemed miserable.

"I do feel kind of like a cop-out for letting all the little things slide," Cole said. "It's a cop-out to not fight the good fight. But, you know, there was that thing I tried sophomore year ... It just didn't work. I could be a social-justice warrior here, but I don't think anyone would listen to me. And I'd have no friends."

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The #MeToo movement has created an opportunity, a mandate not only to discuss sexual violence but to engage young men in authentic, long-overdue conversations about gender and intimacy. I don't want to suggest that this is easy. Back in the early 1990s, when I began writing about how girls' confidence drops during adolescence, parents would privately tell me that they were afraid to raise outspoken daughters, girls who stood up for themselves and their rights, because they might be excluded by peers and called "bossy" (or worse). Although there is still much work to be done, things are different for young women today. Now it's time to rethink assumptions about how we raise boys. That will require models of manhood that are neither ashamed nor regressive, and that emphasize emotional flexibility-a hallmark of mental health. Stoicism is valuable sometimes, as is free expression; toughness and tenderness can coexist in one human. In the right context, physical aggression is fun, satisfying, even thrilling. If your response to all of this is Obviously, I'd say: Sure, but it's a mistake to underestimate the strength and durability of the cultural machinery at work on adolescent boys. Real change will require a sustained, collective effort on the part of fathers, mothers, teachers, coaches. (A study of 2,000 male high-school athletes found significantly reduced rates of dating violence and a greater likelihood of intervening to stop other boys' abusive conduct among those who participated in weekly coach-led discussions about consent, personal responsibility, and respectful behavior.)
From December 2017: The lost boys of the alt-right
We have to purposefully and repeatedly broaden the masculine repertoire for dealing with disappointment, anger, desire. We have to say not just what we don't want from boys but what we do want from them. Instructing them to "respect women" and to "not get anyone pregnant" isn't enough. As one college sophomore told me, "That's kind of like telling someone who's learning to drive not to run over any little old ladies and then handing him the car keys. Well, of course you think you're not going to run over an old lady. But you still don't know how to drive." By staying quiet, we leave many boys in a state of confusion-or worse, push them into a defensive crouch, primed to display their manhood in the one way that is definitely on offer: by being a dick.

During our first conversation, Cole had told me that he'd decided to join the military after learning in high-school history class about the My Lai massacre-the infamous 1968 slaughter by U.S. troops of hundreds of unarmed Vietnamese civilians along with the mass rape of girls as young as 10. "I want to be able to be in the same position as someone like that commanding officer and not order people to do something like that," he'd said. I'd been impressed. Given that noble goal, was a single failure to call out sexism a reason to stop trying? I understood that the personal cost might be greater than the impact. I also understood that, developmentally, adolescents want and need to feel a strong sense of belonging. But if Cole didn't practice standing up, if he didn't figure out a way to assert his values and find others who shared them, who was he?

"I knew you were going to ask me something like that," he said. "I don't know. In this hyper-masculine culture where you call guys 'pussies' and 'bitches' and 'maggots'-"

"Did you say 'maggots,' or 'faggots?' " I interrupted.

"Maggots. Like worms. So you're equating maggots to women and to women's body parts to convince young men like me that we're strong. To go up against that, to convince people that we don't need to put others down to lift ourselves up ... I don't know. I would need to be some sort of superman." Cole fell silent.
This article is adapted from Peggy Orenstein's book Boys & Sex. * This article has been updated to reflect that the organization Plan International USA commissioned the 2018 survey of 10-to-19-year-olds conducted by the polling firm PerryUndem.
"Maybe the best I can do is to just be a decent guy," he continued. "The best I can do is lead by example." He paused again, furrowed his brow, then added, "I really hope that will make a difference."

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Why boys crack up at rape jokes, think having a girlfriend is "gay," and still can't cry-and why we need to give them new and better models of masculinity Updated at 9:30 p.m. ET on December 20, 2019.

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‘I thought I was a lost cause’: how therapy is failing people of colour

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‘I thought I was a lost cause’: how therapy is failing people of colour

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When Sana, then a student in London hailing from Coventry, was 20 years old, she was referred to a psychotherapist. Her father had died and, miles away from home, she had begun to spiral into a depression. She became withdrawn and would lock herself away in her bedroom. Eventually, her friends persuaded her to seek help.

"It had got to the point where I was basically paralysed and I needed some kind of escape," she recalls. "There was no other way out ... I forced myself to go to the doctor."

Sana was quickly assigned a therapist. It was the first therapist Sana had seen and she did not know what to expect. "My therapist was white, and I'm assuming hadn't had much exposure to minority people because of the way that she spoke to me."

That is because at the second session, "out of the blue", the therapist started to question Sana about forced marriage. Sana had not mentioned anything about marriage, but she had mentioned her Pakistani heritage.

"I said I'm here for depression and anxiety," she says. "My dad passed away, I was there for grief therapy, and I was quite clearly distressed about that particular issue."

Sana describes how the therapist seized upon one detail - her Pakistani heritage - to make the inappropriate suggestion of why she might really be upset. "She was so unaware of how what she was asking would make me feel. It felt like she was putting me into a box."

Experiencing this while she was at her most vulnerable made her feel worse. "I thought, if this professional can't help me then I'm a lost cause."

Nevertheless, Sana continued to attend sessions: "I didn't feel I could say could say anything because I was given the sessions through the NHS. I didn't want to be ungrateful.

"But I knew I couldn't open up to this woman. I was holding back every time she'd try to get deeper. I think she sensed it because after a few sessions she said: 'I don't think we're getting very far. I think you'd be better suited to somebody else.'"

Sana was assigned to a new therapist to complete the rest of her treatment.

Those from a black and minority ethnic (BME) community are at greater risk of developing mental health conditions than their white counterparts. There is a growing body of research to suggest that regular exposure to racism increases the chances of developing psychosis and depression, while other mental health risk factors such as poverty, higher unemployment and lower educational outcomes tend to have an impact on BME Brits.

Despite this need, an independent review of the Mental Health Act, which was submitted to the government in 2018, found that "profound inequalities" exist for BME patients accessing mental health services. The report focused primarily on the overrepresentation of BME in-patients in psychiatric units: black British people are four times more likely to be sectioned than white patients. BME patients are also more likely to be given medication rather than being offered talking therapies (eg counselling and psychotherapy).

These factors, alongside the lack of diversity in the mental health workforce, were identified as contributing to widespread distrust in the system, which may be preventing BME patients from accessing help at an earlier, more treatable stage.

Specific attitudes toward mental health may also be a factor. In south Asian communities, mental illness can carry a taboo, with some believing that it could affect marriage prospects, bring shame upon a family or that the causes and cures of illness can be linked to religion.

"There's a long history of oppression towards people of colour in psychiatry," says Eugene Ellis, the founder of the Black, African and Asian Therapy Network (BAATN). "And [BME patients] may see all of it - psychotherapy, counselling - as the same."

But the problems for BME patients are not limited to psychiatry. In 2013, the mental health charity Mind conducted a report for the coalition government on improving access to talking therapies. With BME patients, their findings were shocking: only 10% of those surveyed felt that their talking therapy service adequately took into consideration their cultural background, with a third of the respondents believing that the service was not fit for BME people.

However, surveyed professionals rated themselves more highly, with 75% of therapists saying their service did meet the cultural needs of BME patients. It is this difference that forms the loudest complaint from BME patients - that is, therapists don't "get it". BME patients complain about their therapists gaslighting them if they talk about racism they have experienced, with some even becoming defensive; others point to racial stereotyping and a lack of understanding about cultural nuances.

I have some personal experience with this. Years ago, I saw a therapist who I felt I was making progress with. We had spent time making sense of difficult past relationships, some of which had at points become abusive. Then one day, she advised me to cut off the problematic family members. This, I tried to explain, was not so simple for a woman of south Asian heritage where family units operate differently; if I were to cut off these members it would have consequences and I did not think I could cope with the additional drama.

Plus, I didn't agree with the assessment. I didn't want to remove my family - many of whom had suffered their own traumas - I simply wanted to move past what had happened, and ensure I made healthier choices in future.

But each week, she would ask me if I had yet severed the ties. I felt ashamed when I said I hadn't, as though I was a disappointment to her. It made our sessions tense and unproductive, and was an experience that put me off therapy for many years.

It is not a given that a therapist from an ethnic minority background will understand a BME patient in exactly the way they require. But in the same way a woman may feel more comfortable speaking to another woman when discussing experiences relating to their sex, a person of colour may feel safer speaking to someone with similar racialised experiences. A quick solution therefore might be for BME patients to be treated by therapists of colour.

However, this is not always possible. First there is the issue of geography, with patients living outside cities having fewer choices. Increasing the number of BME therapists may help this but, according to Ellis, there seems to be a higher dropout rate in therapy courses for BME candidates, who too can become frustrated by a lack of understanding about race from largely white therapy training providers.

This is something Ellis has noticed in his work at BAATN, which was set up as a place for patients to quickly locate a BME therapist, before growing to become a professional hub for therapists of colour offering events, training and membership.

"In psychotherapy as part of your training, you're invited to speak about yourself because you need to know yourself if you're going to help others," says Ellis. "A large part of that will be [the therapist of colour's] racial identity.

"But people don't know how to talk about race, they feel uncomfortable, the facilitators don't say anything, until eventually the comments come - 'Why do you keep talking about it?' or 'Get over it.'"

In response to this, BAATN has set up its own mentoring programme to give trainees a space to be heard and to speak more effectively in their training programmes.

Class also plays a large factor. "Everything in therapy - the way that people talk, their language and their expectations - is organised around middle-class values," says Ellis. People will have some experience of this approach if they have been to university, but it can be difficult for those who have not. It is interesting to note that people are more likely to train as therapists if they have received therapy previously, and are more likely to go to therapy if someone they know has. This is much more common in university-educated, middle-class circles.

But the hurdles continue even after training, as the system incentivises therapists to treat private patients who tend to be white and middle class.

"If you wanted to work within your community, it's more of a challenge," says Ellis. "You'll need to work in the NHS where you're likely to meet that same racism again. So a lot of people just get worn out and leave."

Ellis believes that all therapists - regardless of their own race - need to undergo some kind of training to help them treat BME patients, and to help therapists overcome their discomfort at talking about race. "Because it doesn't really matter what kind of identity you are as a therapist," says Ellis, pointing out that specialist counsellors in bereavement or sexual abuse don't necessarily have had to experience those things personally. Rather, they need space in training to get to grips with the issues. But "the profession just doesn't train counsellors to [deal with race] as standard".

The type of therapy may also have a bearing on outcomes for BME patients. Cognitive behavioural therapy (CBT) has become the dominant form of therapy offered by the NHS. CBT focuses on present moments rather than past experiences and is designed to alter negative thought patterns; it is a far cry from the stereotypical therapy setup of a patient on a chaise longue, spending years poring over childhood. Instead, CBT is a task-oriented, structured programme designed to quickly deliver results, often in as little as 10 sessions.

To its critics, CBT has become so common because it is inexpensive to administer and focused on getting people back to work. "You don't need a lot of training to give someone a CBT programme," says Ellis. "So staff [delivering it] can be paid fairly cheaply."

But at the heart of its approach is the notion that, whatever distress the patient is feeling, it is their thinking that needs to be changed. This approach may add to their trauma, particularly when therapists are dealing with communities that are likely to be expressing distress due to very real political and social issues.

In her essay, the psychologist Guilaine Kinouani criticises CBT for its silent assumptions, including "the division between the world (the objective) and us (our subjective reactions). The need for objective evidence to support our beliefs and, related to that, the requirement to doubt and reject our subjective reality and lived experience, if it cannot be objectively backed up.

"It is one thing to encourage people to seek 'objective evidence' to help disprove the belief that everyone hates them, but quite another to ask people of colour to back up their belief that they are experiencing racism."

Kinouani notes that this approach is the embodiment of western, rationalist thinking, but that there are many other worldviews that do not adhere to this. And for Ellis, this philosophical difference can have real impact on patients.

Ellis describes the western approach to thinking as linear. "It says, 'This comes first and then that comes next,' so we can logically rationalise and get to an answer at the other end."

But many people do not think in this linear way. Instead, they may "think of one thing, then something else in a more circular way. Just open to whatever's happening and then putting something together based on various bits they might be experiencing."

Ellis notes that the linear style of thinking is hammered home in schools and universities, so if a patient is schooled in the UK (and the further they go, the more experience they will have with this approach), regardless of race they can still benefit from therapies based on it. But for people educated outside the UK, or outside the west entirely, CBT may simply not work as an approach. Moreover, due to cuts to mental health services during austerity, funding for non-CBT-focused therapies, be they music or art therapies, have been slashed. Could this go some way to explain why BME patients who do manage to access talking therapies through the NHS are still less likely to regain their health?

Despite the problems, there are many, many BME therapy success stories. Mandi was working in the Welsh tech sector when she started seeing a counsellor. "There weren't many BME people in the general population, never mind the therapy profession," she recalls. "I had the space in that therapy relationship to explore all that I needed to ... any cultural nuances I needed to explain, I could.

"My positive experience makes me hopeful that more in the profession will exercise the same level of professionalism and kindness to help break down cultural barriers."

For those who don't find the right therapist the first time, recovery is still possible. Sana completed her sessions with her second therapist without issue. "She was much more focused on treating me for grief, which can happen to anyone."

But it is with her latest therapist - whom she has been seeing for well over a year - that she has made the most progress. "He is a white man. And he started off by asking me about my previous therapist - what I liked and did not like - so I told him about the first lady and the forced marriage thing. And he thought that was ridiculous and he made that very clear.

"I've not felt judged by him. If he doesn't understand something he asks me questions inquisitively, and is understanding. He is just so good. Because he listens and he never makes assumptions."
Topics

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'I thought I was a lost cause': how therapy is failing people of colour

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When Sana, then a student in London hailing from Coventry, was 20 years old, she was referred to a psychotherapist. Her father had died and, miles away from home, she had begun to spiral into a depression. She became withdrawn and would lock herself away in her bedroom.

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26 Mini-Films for Exploring Race, Bias and Identity With Students (Published 2017)

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To help teachers make the most of these films, we also provide a grab-bag of teaching ideas, related readings and student activities.