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Rachel Feltman: Happy Monday, listeners! For Scientific American’s Science Quickly, I’m Rachel Feltman. Hope your February is off to a great start. Let’s kick off the week by catching up on all the science news you might have missed.

First, a quick note on some presidential moves that might impact health and science. Robert F. Kennedy Jr. faced at least some bipartisan pushback during confirmation hearings for his nomination for secretary of the U.S. Department of Health and Human Services. On Thursday the chair of the Senate Committee on Health, Education, Labor and Pensions, Republican Bill Cassidy, pressed Kennedy to take a definitive pro-vaccine stance. Cassidy, who practiced medicine for decades, claims he has constituents who credit Kennedy—at least in part—for their decision not to vaccinate.

After a lot of back and forth, Cassidy asked Kennedy to agree that if he were to be confirmed, the U.S. Food and Drug Administration would not “deprioritize or delay review and/or approval of new vaccines and that vaccine review standards will not change from historical norms.” Kennedy replied in the affirmative—but it’s important to note that the nominee has a long history of promoting vaccine misinformation.

You can read more about RFK Jr.’s health care track record at ScientificAmerican.com, and we’ll keep you updated on the confirmation hearings as they proceed.

Last week was also pretty chaotic in terms of executive orders, a federal funding freeze, and more. As of last Friday afternoon, there were reports of webpages disappearing from government health agency sites. Stat News reported that data from the Youth Risk Behavior Surveillance System, a large national survey on youth behavioral habits that includes information on gender and sexual identities, had disappeared and was no longer accessible to researchers. The CDC’s Social Vulnerability Index, which highlights groups particularly vulnerable to disasters because of factors like poverty, also appeared to be down on Friday, as did some resources about HIV. That’s not an exhaustive list by any means, and this story was very much still developing as of the time of this recording on the afternoon of January 31. We’re working on a deeper dive on these changes and their implications for this week’s Friday episode, so let us know if you have any specific questions. You can send those over to us at sciencequickly@sciam.com.

Feltman: Now let’s get into some public health news. You may have seen some headlines last week about a record-breaking outbreak of tuberculosis in Kansas. Initial reports dubbing it the nation’s largest TB outbreak since the CDC started keeping track of cases seem to have stemmed from an incorrect statement from the state health department. After the CDC refuted that, a state health official offered clarification, claiming this outbreak has seen the country’s highest case numbers over a one-year period.

The discrepancy has led to some confusion about the nature of this—very real and serious—outbreak. The health department says that as of January 31, more than 60 people in Wyandotte and Johnson counties have been diagnosed with active TB associated with the outbreak, though some have completed treatment since their diagnoses; “active” refers to a type of tuberculosis, not whether someone currently has the illness—more on that shortly. According to a state official, two people have died in the outbreak. Here to unpack the situation for us is Bek Shackelford-Nwanganga, a health equity reporter for the Kansas News Service and KCUR.

Bek Shackelford-Nwanganga: The first cases related to this specific outbreak were, we’ve been told, recorded in January of 2024. There was a pretty large spike over the summer, which is actually when the state came in and started assisting, and that’s when the CDC also came in and started assisting.

Shackelford-Nwanganga: They’re pretty confident that they’ve got the situation under control. They do expect to find more cases. They have to do a lot of contact tracing and a lot of investigations to try and figure out who is in touch with who. But for the most part, they are happy with how numbers are trending downward, and they are monitoring it pretty closely.

Tuberculosis is a bacterial infection. It can settle in other places in your body, but typically it settles in a person’s lungs. You know, when that person coughs or is singing, things like that, it can spread that way. Tuberculosis requires a lot of extended, close contact with a person to catch it.

And then there are two types of tuberculosis. There’s one that’s known as active tuberculosis. This is when a person is displaying symptoms—you know, persistent cough, coughing up blood, pain in the lungs, and then things like night sweats and fevers and weight loss. That means they have an active infection and they can spread it to others. For the other version of tuberculosis, latent tuberculosis—people sometimes call it sleeping tuberculosis—this means that someone has the bacteria in their body, but it’s not causing an active infection. It has to become active for it to spread to others. And if you have a latent case, you won’t be experiencing symptoms.

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Anaissa Ruiz Tejada/Scientific American

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Young people’s access to gender-affirming medical care has been making headlines this week.

Today, federal Health Minister Mark Butler announced a review into health care for trans and gender-diverse children and adolescents. The National Health and Medical Research Council will conduct the review.

Yesterday, The Australian published an open letter to Prime Minister Anthony Albanese calling for a federal inquiry, and a nationwide pause on puberty blockers and hormone therapy for minors.

This followed Queensland Health Minister Tim Nicholls earlier this week announcing an immediate pause on access to puberty blockers and hormone therapies for new patients under 18 in the state’s public health system, pending a review.

In the United States, President Donald Trump signed an executive order this week directing federal agencies to restrict access to gender-affirming care for anyone under 19.

This recent wave of political attention might imply gender-affirming care for young people is risky, controversial, perhaps even new.

But Australian courts have already extensively tested questions about its legitimacy, the conditions under which it can be provided, and the scope and limits of parental powers to authorise it.

What are puberty blockers?

Puberty blockers suppress the release of oestrogen and testosterone, which are primarily responsible for the physical changes associated with puberty. They are generally safe and used in paediatric medicine for various conditions, including precocious (early) puberty, hormone disorders and some hormone-sensitive cancers.

International and domestic standards of care state that puberty blockers are reversible, non-harmful, and can prevent young people from experiencing the distress of undergoing a puberty that does not align with their gender identity. They also give young people time to develop the maturity needed to make informed decisions about more permanent medical interventions further down the line.

Puberty blockers are one type of gender-affirming care. This care includes medical, psychological and social interventions to support transgender, gender-diverse and, in some cases, intersex people.

Young people in Australia need a medical diagnosis of gender dysphoria to receive this care. Gender dysphoria is defined as the psychological distress that can arise when a person’s gender identity does not align with their sex assigned at birth. This diagnosis is only granted after an exhaustive and often onerous medical assessment.

After a diagnosis, treatment may involve hormones such as oestrogen or testosterone and/or puberty-blocking medications.

Hormone therapies involving oestrogen and testosterone are only prescribed in Australia once a young person has been deemed capable of giving informed consent, usually around the age of 16. For puberty blockers, parents can consent at a younger age.

In the United States, President Donald Trump signed an executive order this week directing federal agencies to restrict access to gender-affirming care for anyone under 19.

This recent wave of political attention might imply gender-affirming care for young people is risky, controversial, perhaps even new.

But Australian courts have already extensively tested questions about its legitimacy, the conditions under which it can be provided, and the scope and limits of parental powers to authorise it.

What are puberty blockers?

Puberty blockers suppress the release of oestrogen and testosterone, which are primarily responsible for the physical changes associated with puberty. They are generally safe and used in paediatric medicine for various conditions, including precocious (early) puberty, hormone disorders and some hormone-sensitive cancers.

International and domestic standards of care state that puberty blockers are reversible, non-harmful, and can prevent young people from experiencing the distress of undergoing a puberty that does not align with their gender identity. They also give young people time to develop the maturity needed to make informed decisions about more permanent medical interventions further down the line.

Puberty blockers are one type of gender-affirming care. This care includes medical, psychological and social interventions to support transgender, gender-diverse and, in some cases, intersex people.

Young people in Australia need a medical diagnosis of gender dysphoria to receive this care. Gender dysphoria is defined as the psychological distress that can arise when a person’s gender identity does not align with their sex assigned at birth. This diagnosis is only granted after an exhaustive and often onerous medical assessment.

After a diagnosis, treatment may involve hormones such as oestrogen or testosterone and/or puberty-blocking medications.

Hormone therapies involving oestrogen and testosterone are only prescribed in Australia once a young person has been deemed capable of giving informed consent, usually around the age of 16. For puberty blockers, parents can consent at a younger age.

Can a child legally access puberty blockers?

Gender-affirming care has been the subject of extensive debate in the Family Court of Australia (now the Federal Circuit and Family Court).

Between 2004 and 2017, every minor who wanted to access gender-affirming care had to apply for a judge to approve it. However, medical professionals, human rights organisations and some judges condemned this process.

In research for my forthcoming book, I found the Family Court has heard at least 99 cases about a young person’s gender-affirming care since 2004. Across these cases, the court examined the potential risks of gender-affirming treatment and considered whether parents should have the authority to consent on their child’s behalf.

When determining whether parents can consent to a particular medical procedure for their child, the court must consider whether the treatment is “therapeutic” and whether there is a significant risk of a wrong decision being made.

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CLIMATEWIRE | Clean energy has gotten steadily cheaper for years thanks to a global network of research facilities and factories.

That’s over now.

President Donald Trump’s decision on Saturday to slap steep tariffs on Canada, Mexico and China signals the birth of a new global trade regime: one focused on nationalist protections, with potentially expensive repercussions for Americans. And although clean energy is a bit player in the president’s trade war, the tariffs could hit the solar, battery, wind, and electric vehicle industries particularly hard.

“It probably slows down the energy transition because it drives up cost, especially the tariffs on China, and creates chaos” in supply chains, said David Victor, a professor of innovation and public policy at the University of California, San Diego. It “probably also introduces a large amount of uncertainty about the credibility of international rules on trade investment, insofar as those seem to matter at all anymore.”

Trump’s order — which is scheduled to go into effect Tuesday — places a 25 percent tariff on goods from Canada and Mexico and a 10 percent tariff on Chinese imports. It imposes a lower levy of 10 percent on Canadian oil imports.

A White House fact sheet posted Saturday night called tariffs “a powerful, proven source of leverage” for stemming the flow of immigration and drugs like fentanyl. The order could significantly increase prices for goods, with organizations like the U.S. Chamber of Commerce and American Petroleum Institute raising concerns over the impact on the U.S. economy.

“Energy markets are highly integrated, and free and fair trade across our borders is critical for delivering affordable, reliable energy to U.S. consumers,” API President and CEO Mike Sommers said in a statement.

The tariffs come as clean energy industries race to curb costs in a bid to displace fossil fuels, the main drivers of climate change.

Trade has been a key reason behind the global decline in clean energy costs in recent decades. The average lifetime cost of utility-scale storage fell 83 percent between 2009 and 2024, even after accounting for a post-Covid bump in solar costs, according to Lazard, an investment bank. Onshore wind costs were down 65 percent over that time.

Tariffs threaten those gains. The American Clean Power Association, a trade group, said it was “concerned that increasing the costs of energy production inputs will put upward pressure on consumer energy costs and diminish our capacity to unleash energy abundance.”

“While the fuel relied upon by wind and solar energy — complemented by battery storage — is free, some parts for these machines that harness these renewable resources are manufactured in Canada and Mexico,” the group added.

Roughly three-quarters of the world’s lithium-ion batteries are made in China, according to the International Energy Agency.

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I was born with nystagmus, a neurological condition that affects my vision, and until I was in my 30s, I’d only met one person that shared it. At a holiday party with my parents when I was probably 8 or 9, my mom pointed out a boy across the room. “He has nystagmus like you,” she said. “But not exactly. Your eyes bop all over your head and his just move back and forth. He also has albinism, which is why his eyes do that. We don’t know what causes yours.” I regarded the ice blond teen across the room. I don’t think we spoke. What would I have said to him? My vision was a point of shame and something I tried to hide. If kids pointed it out, I usually ended up in tears.

My son inherited my nystagmus. It’s given me the unusual opportunity to watch how people react to his vision as a window into how the world reacts to me. Being able to watch my child closely — the flickering of his eyes as he nursed, the tilt of his head as he searched for me among the waiting moms (yes, they were always all moms) at school pickup, as he struggled to read the routes on the approaching buses just like I did — these were moments of familiarity but also of novelty, as I observed how the world observed him. The social stigma of appearing disabled trained out of me many of the behaviors that mark him as “different,” movement patterns that I have no personal recollection of, but can pick up from the family photos in which I always was tilting my head, my eyes struggling like his do to make contact with the aperture of the lens.

In some ways, it has given me the opportunity to revisit my own childhood experience of disability. And one of my main regrets, if I have any, is that I never learned braille. According to the National Federation of the Blind, only about 10% of blind and low-vision children in the U.S. are learning braille. Much of this is due to our bias toward learning through sight, and so children who have any vision are pushed toward text magnification as a replacement. But like me, every person I’ve asked who is blind or low-vision wishes they’d been taught braille as a child or, if they’d been introduced to it, wish they’d been pushed to gain true fluency. Access to language is power. That’s why I’m determined to make sure my kid learns it.

In middle school, I learned to hate public speaking. I was in every sense an “overachiever,” so I remember preparing fastidiously for my first presentation in English class, where we had to present instructions about how to perform a skill or task for our classmates. I had rainbow pastel index cards where I’d written my presentation talking points.

Then I got my grade. It wasn’t perfect. I’d been marked down because I held the note cards in front of my face and I’d failed to make eye contact with my classmates. It wasn’t so much the grade that bothered me, but the awareness that when I spoke publicly, my disability was super visible. In my attempt to assimilate and be “normal,” I feared that visibility more than anything else. From that point on, any kind of speaking in front of other people made me extremely nervous. I dreaded when other people had to watch me talk and avoided it as much as I could.

There are moments where my throat catches as I watch my kid encountering situations l can remember from my own childhood.

It wasn’t until my mid-30s when I started to work with other disabled people and from their comfort with themselves and speaking publicly, I pushed myself to get through my shame. But even with this new confidence, public speaking is still a struggle for me. The more stressed I get, the more my eyes move and so I stumble over words and easily lose my place.

To compensate, I stopped using written notes for my presentations. Instead of reading from my book at author’s events, I used slides with images to prompt me through the outline of my presentation.

Then I watched as a blind advocate read a proclamation at a public hearing using braille. Her presentation was flawless — the kind of flawlessness I’d been dreaming of since my stumbles in middle school. I wanted that skill. But braille, like any language, is difficult to learn in adulthood. If I worked really hard at it, maybe someday I’d be able to read it fluently enough to crib notes for a talk, but I’d never have the speed of someone who learned it as a child.

In the 1820s, braille was created by and embraced by students at the National Institute for the Blind in Paris. But soon their sighted educators tried to stop its adoption, at one point burning all the braille books. These educators preferred a language that they too had access to, like raised letter shapes embossed on the page. Braille was harder for sighted educators to read and it threatened their control and their careers.

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