Science Friday - Gender-Affirming Health Care, Defining ‘Life’. April 23, 2021, Part 2

Episode Date: April 23, 2021

Proposed Legislation Threatens Trans Rights Nationwide Since the start of the 2021 legislative session, members of more than 30 state legislatures have proposed over 100 bills that would limit transgender children’s ability to play sports, or access gender-affirming medical care such as puberty blocking medications. One such proposal, restricting access to gender-affirming medical treatments for anyone under 18, passed the Arkansas State Legislature earlier this month, over the veto of Republican governor Asa Hutchinson. Ira talks to Kate Sosin, LGBTQ+ reporter for The 19th News, about the scope of bills limiting access to medical care. Sosin explains why lawmakers say they’re pushing them—and what misconceptions about both trans kids and trans adults may be fueling these proposals.  We had editing and consultation help for this segment from Jaye McAuliffe. Why Gender-Affirming Healthcare Is ‘Lifesaving Care’ State legislatures around the country are proposing bills to remove access to gender-affirming healthcare for transgender youth. Meanwhile, doctors, parents, and trans adults warn that restricting access to commonplace interventions, like puberty blocking medications, will endanger the mental health and social well-being of trans children across the country.  Learn more about the bills passing through statehouses this year. The American Academy of Pediatrics, the American Medical Association, the Pediatric Endocrine Society have all condemned bills like Arkansas’ AB1570, which passed the state legislature in early April. It prohibits healthcare providers from giving puberty blockers or gender-affirming hormones to anyone under the age of 18. The World Professional Organization For Transgender Healthcare (WPATH), which produces standards of care for transgender youth and adults, has stated that the ability to pause puberty supports the mental health of trans youth while they navigate their gender identities. Ira talks to pediatric endocrinologist Kara Connelly and family therapist Alex Iantaffi about their work with trans youth, and what gender-affirming health care provides, to young people and throughout a person’s lifespan.  We had editing and consultation help for this segment from Jaye McAuliffe. What Does It Mean To Be Alive? What is life? This question has caused headaches for humanity for centuries. But if it’s taken out of philosophy classes or past Frankenstein’s monster, this question becomes an important legal and biological discussion. If we’re searching for life on other planets, how will we know when we’ve found it? Scientists throughout history have come up with what they think the constraints of life are, whether it needs to meet certain physiological criteria, or reproduce. But despite hundreds, if not thousands of theories that have been proposed, the scientific community can’t come to a consensus about what makes something alive. The complexities of defining life are the subject of the new book, Life’s Edge: The Search For What It Means To Be Alive, by New York Times science columnist and author Carl Zimmer. He joins Ira to talk about the creatures that complicate our understanding of life, and if synthetic biology and artificial intelligence might ever be classified as alive. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Ira Flato. So far in 2021, state legislatures in more than 30 states have introduced more than 100 bills legislating the bodies and choices of transgender people. Many of these bills target youth, their ability to play sports in grade school or college. Many others target their access to medical care, whether that's hormones that help them transition or puberty blockers which pause puberty until a chance. child is ready to decide what they want to do next. Earlier this month, Arkansas was the first state to pass such a bill. The Republican state legislators behind this bill said it was necessary to protect children from what they called, quote, experimental treatments. But bills like Arkansas's have been opposed by many experts in medical care, including the Pediatric Endocrine Society, the American Academy of Pediatrics, and the World Professional Association for Transgender Health. And in hearings prior to the bill's passage,

trans adults, parents of trans youth and medical providers all argued that this restriction would harm kids. Here's a small sample of what that bill's opponents had to say in one state legislative committee hearing in Arkansas in March. I very strongly oppose this bill. It not only creates many, problems, including further marginalizing an already marginalized population, but it pretends to fix a problem that doesn't even actually exist. If this bill passes, people will die. We as pediatricians

are truly dedicating our lives to keeping children healthy and safe. And this is why I feel that alongside parents, we are most qualified to determine the best course of care for our patients. I just can't go on enough about them. They're just amazing kids, okay? And they know who they are, and they know who they are from a very young age. Let me first speak directly. to Arkansas's transgender youth with the love of a real father. You are loved. No matter what happens here today, you are loved. With me to talk about this is Kate Sossin. Kate is the LGBTQ reporter for the 19th news and one of the few trans reporters covering these bills. Welcome Kate. Thank you for having me, Ira. Nice to have you. First of all, can you walk us through this Arkansas bill? What exactly is it saying?

Yeah, the Arkansas bill is like a lot of these bills that limit gender affirming care for trans youth, and that it basically says that trans kids are not allowed to access or their physicians are not allowed to give them the kinds of care that most medical associations have agreed trans kids would need in order to navigate puberty. So most commonly, if you're a trans kid and you're experiencing gender dysphoria, A lot of times they'll tell trans kids, okay, you want to go on puberty blockers. And puberty blockers are these entirely reversible medications where they can just press a pause on puberty and decide later when they're older with their positions or parents if they want to medically transition. So a kid who's trans won't have extreme mental duress of going through puberty and gender that they don't identify. and these have been shown to reduce suicidality in trans kids. A lot of media have reported that this is actually preventing kids from medically transitioning

with hormones. That's actually a lot rarer than what we see. For the most part, it is puberty blockers, which just press pause so that kids don't have to make that decision right away or that their parents don't have to. And what is the legislator's argument for doing this? It seems to be that there's some confusion between what a puberty blocker does. and what hormones do. A lot of people who don't understand trans health care think that puberty blockers and hormones are the same thing, that this is an irreversible change, that you're transitioning

children and making irreversible decisions about their sex and gender at a really young age. Puberty blockers are actually meant to do the opposite, to give kids some breathing room to figure things out, and also to just relieve some of the mental stress of experiencing bodily changes at a time when they're really not ready. Is there any scientific research that the legislators point to to justify these restrictions? Yes, although for the most part, that scientific research is not backed up by major medical associations. They will often bring out a doctor here or there, but those physicians have largely been debunked, the science pretty much is settled on this kind of care for transgender youth, the American Medical Association, pretty much every major medical group and psychiatric group

is in line with this kind of treatment for trans kids. As I mentioned, the Arkansas bill is one of more than a hundred related to trans rights this year. It's the first one to pass. Can you talk about a few more of the bills relating specifically to medical care? So Ella Baylor, has a similar bill, and that would make it a felony for doctors to provide this kind of care. Texas also has a bill, which would classify it as child abuse for parents to allow their kids to access this kind of care. Tennessee also has a similar bill that classifies this kind of care as child abuse unless three physicians sign off on it. Louisiana, South Carolina, and Missouri also are still considering bills like this. A number of other states,

also have these bills pending, but we haven't seen a lot of movement on this. These kinds of bills are not just limited to trans kids necessarily. We've seen all kinds of medical restrictions for transgender people more largely, right? Bills that would allow physicians to turn transgender people away on the basis of what are classified as conscience protections. So if a trans person went into an emergency room and a doctor didn't want to treat them, if they had an ethical or religious objection, they could turn people away. And what about the insurance companies? Are they able to fund these procedures, these medications if the kids want them?

This is a really interesting question, right? Because we do have the Affordable Care Act. And transgender people were supposed to be protected under the Affordable Care Act. The Trump administration, of course, really made significant moves to removing those protections for transgender people. And then we have the Biden administration coming in to enforce. protections in the affordable care for trans people. And now states are going after those protections in a piecemeal way. So we're going to have a battle to see how that turns out. But yes, we do

have these bills. We have a bill in Texas that tries to ban coverage for trans kids. And so I think what we're inevitably going to see is court battles over some of this care. And it's going to boil down to what is legal in terms of what you limit. What are the rights of transgender minors? And what human rights do transgender kids have and what are insurance companies required to cover on the basis of that? Because, you know, the Affordable Care Act was watershed for transgender people. It stated that insurance companies had to cover health care for trans people as medically necessary care. That was deeply important for trans people. It opened up access for trans people in ways that had never been possible before.

You know, you bring up different administrations. I can't help think that there's politics involved here. There have been a lot of questions about why this is happening and why it's happening all at once. After the advent of marriage equality in 2015, there was a shift in focus from mainstream gay issues to transgender rights, both from progressives who wanted to see transgender issues taken up and also from opponents of LGBTQ rights.

and after that time we saw a lot of focus on bathroom bills. And then it got to kids. And the idea of protecting children is so close to our hearts. All of us want to protect kids. And it seems that at the heart of this is this idea that we want to protect kids, but we want to protect them from being transgender. That is because pop culture has made the idea of being trans so terrifying if you look at the media that we've consumed for all of our lifetimes.

But as a transgender person, like, I know that being trans is a wonderful life and that the thing that makes it actually terrifying is people legislating away your ability to move throughout the world. There's been a lot of polling that suggests that actually these bills are not particularly popular with Republican voters. A new poll came out from NewsHour that said, actually, that 50% of people knew transgender people. And that was about the number of conservatives. who supported transgender people playing sports, which shows that if you know a trans person,

it's hard for you to oppose transgender rights. And there's also this issue of, we have a six, three conservative Supreme Court. Whether or not these bills are going to pass muster in a lower court certainly is a question. But if one of these bills gets elevated to the Supreme Court, then there's a real question of changing the law of the land here. I know we'll be talking to clinicians who work with transgender kids in our next segment. But while I still have you, I'd like to ask, what misconceptions do you see people have about care for trans kids that might be fueling these bills? These bills are sort of founded on the idea that being trans is some kind of mental illness or some kind of problem that needs correcting

or is a life of pain. And the reality is that this is not something that you need to try to avoid or fix for a kid. The only problem with being trans is the way that the world treats you. This medical care is medically necessary. We have legislators who are trying to legislate away science. You know, this has been settled science for years now. There's one other thing that's been sort of hidden in all of this, which is there's been a lot of talk about these bills and their impact on kids, like even when they don't pass. We're sending a message to kids. You're not welcome in your states. but I did a story last week that reported that transgender homicides in the last year have doubled. At this time last year, we had six trans homicides reported.

And last year, by the way, was the highest number of trans homicides we'd ever seen by far. 44 trans homicides when the record had been 29 before. And this year, we have 14 in April, whereas at this point last year we had six. And I asked advocates, I said, do these bills matter at all? are they doing anything? And across the board, from advocates to black trans women who are targeted at the highest level, they said yes. They said this stigma is sending a message that the government doesn't like these people. So why should I care? The government says that we're less than human. So it's fine if we dispose of them. That is a story that's not being told.

These bills, it's not just about children, right? It's, there's an impact. on trans adults. The stigma is fueling a crisis across the community that is not just about mental health access, but it's also about the violence that the community faces. I want to thank you, Kate, for taking time to be with us and enlightening us about what's going on here. Thank you so much for having me. You're welcome. Kate Sossin, LGBTQ reporter for 19th news. Kate joined us from Los Angeles. We're going to take a break and we're going to have more talking about gender-affirming health care, what it is, what it means to the people who receive it, and what doctors have to say about the future of trans health care. This is Science Friday. I'm Ira Plato. We've been talking about the current wave of bills attacking the rights of transgender adults and children in states like Arkansas, Alabama, and more than 30 other states this year.

many of those bills address medical care and would restrict access to medical care for kids under 18 and even those under 21 in the case of North Carolina. And that's what we want to talk about next, that medical care and what gender affirming care means to the people who receive it. Here's just a short sample of what trans listeners have told us this week about their experiences. About a year and a half ago, I finally came out as not. non-binary. Three weeks ago, I had top surgery. And immediately after having the surgery, I felt totally better. My body matched my understanding of my body and my feelings about who I was

and how I presented myself. Being on the right hormones, getting the surgery I needed, it's allowed me to feel so much more comfortable in my skin and confident and less anxious in my day to day, I really feel like it's given me my life, like that my life has now started. Gender affirming care isn't simply hormones and surgery and trans-specific health care. Gender-affirming health care is being treated with respect and having the reality of my existence respected by a doctor regardless of their specialty. I've received that, but I've also definitely not. All the research essentially boils down to this. Provide a supportive, caring environment for trans kids, and they do fine.

The research shows that it's not anything inherent in being trans that causes depression, anxiety, and it's the lack of acceptance. You know, the only really regret I have is that I couldn't have access gender farming care earlier as a teenager. because to me it's like looking back on those years that I could have started living my life earlier. Thank you, listeners, DB, Alex, and Sammy, and therapist Laura Jacobs for your contributions. Here to talk with us about gender affirming health care are my guests. Dr. Alex Yantafee, Ph.D., a family therapist who works with trans adults and children, as well as their families. Dr. Yantafi is also host of the Gender Stories Podcast.

Dr. Yantafee joins us from Minneapolis. And Dr. Kara Connolly, M.D., a pediatric endocrinologist and medical director for the Gender Clinic at Oregon Health and Science University's Dornbecker Children's Hospital in Portland. Welcome to Science Friday. Thank you for having me here. Thank you so much. I'm happy to be here. What is gender affirming health care for children, Kara?

Gender affirming health care is actually a little bit hard to define in just one or two sentences. it is all-encompassing. It can mean just being affirmed and supported. It doesn't necessarily mean medications that are changing the hormones in their bodies, but it can. So for some children who are starting a puberty that they were born with, if it's not in alignment with their gender identity, and if their body is starting to change in ways that are not in alignment with their gender identity, we have medicines that can prevent those changes from happening, causing puberty,

so that their bodies don't continue to change in those ways. They suppress the puberty hormones that are produced by the pituitary gland in the brain so that there's no message being sent down to the testicles of the ovaries, telling them to make testosterone or estrogen. So these medicines will suppress those hormones so they're not causing those changes to the body that are permanent and may be really distressing to kids. Is there anything else that you need to factor into a young person's care

when they're on puberty blockers? When kids are on puberty blockers, the main thing that we think about is just the fact that we are pausing puberty hormones in the body. The main effect that puberty hormones can also have on is on the bones. So we take great care and thinking about bone health. We recognize that bones eventually do need hormones. So we support young people and making decisions about when and whether to start cross hormone

therapy. And we want to make sure. that we keep bones healthy in all other ways. So making sure that they get enough calcium and vitamin D, regular weight-bearing exercise, and then we can monitor bone density using bone-density scans. And Alex, let's talk about your line of work, about when it comes to therapy and counseling. What does gender affirmation look like in your work? The first and most basic rule of gender affirming care is to be able to see and recognize the person for who they are. So affirming their name, affirming their pronouns.

And then also it's about making sure that if there is a desire to transition, whether that transition is social. So, for example, changing name and pronouns, legal, changing name and gender marker legally or medical, such as accessing puberty blocker or cross hormones, that there is support for the young person and their families to fully understand the process and fully understand the options, they have. Some people might want to change their name and pronounce. Some people don't. Some people might want to access hormone therapy and maybe later in life, even codi modification, such as gender

affirming surgeries, and some people don't. And giving young people in their families a space to explore, the space to have challenging conversations around what do they want to do around their reproductive capacity, for example, as they get older and their contemplating cross hormones, can be really helpful. Care all these kinds of treatments, mental health, medical. There is real science behind this, is there not? Absolutely. First of all, our treatments we've been using for over 50 years. These are not new medicines. Many of the puberty blocking medicines were developed for a medical condition called central precocious puberty for children who go into puberty at like five or six years old. We can use those medicines to pause puberty for those kids. And so we have many, many

years of experience and understanding how these medicines work and what their safety and efficacy are. And we've been using as medications for kids who identify as gender diverse or transgender for over two decades, hormone replacement therapy or cross hormone therapy. Again, we've been using the exact same hormones for many, many decades, over 50 years. I also want to make it clear that nobody is giving like hormones or puberty blockers to children as young as like four or five, what is happening in terms of gender affirming care with those younger children is that they are telling us, I'm a boy, I'm a girl, I'm a boy and a girl, and they might want to play with what clothes they're wearing, how they do their hair, what name they're using,

and what pronouns people are using for them. But usually medical care doesn't come in until much later when those prebital changes start to come into the picture. One thing that people arguing for those bills keep saying, this idea that trans kids aren't ready to make decisions and they might regret the decision they do make. Kara, how do you respond to that? Yeah, I can appreciate that question. And I think one of the things that's important to recognize and remember is that these decisions are not taking lightly. We work with the whole family unit to help them make decisions and help the young person make the decision about whether this is the right thing for them and whether this is the right time for them.

But in reality, these young people know who they are, and they are looking to us to help them to achieve those long-term goals so that they are able to express who they are to the rest of the world. When we meet with young people, we always discuss the possibility that they may decide to change directions. We often refer to somebody who's pursuing medical interventions as being on a journey with many different paths that they can choose to take. And if somebody is going down one path, they may decide to change course, and we support them

in those decisions. We always bring up the possibility of them deciding that if they start a medicine, that they don't want to be on the medicine anymore. And if the changes aren't feeling affirming to them at any point of time, then we can decide to stop it or change directions. And I think that one of the things that's important to remember is that young people make decisions about their life all the time and they do make decisions about their medical care with their parents all the time. But somehow when it comes to transgender and non-binary children,

we think that they're somehow set apart from their cisgender peers. One of the studies that I think was published in 2019 clearly identified that the gender identity development trajectory for transgender and non-binary children is very similar to that for cisgender children. That means the most children know who they are in terms of their gender identity between the ages of three to five years old. And so if they are in an environment that's affirming enough and safe enough for them to announce who they are, that's usually when a child says, I'm a girl, I'm a boy, I'm a girl and a boy, or I'm not a girl and I'm not a boy. And of course, they're expressing their identity in a way that is age appropriate to them. As they get older, they develop an understanding of their gender

identity and expression, that kind of grows with them, just like all of us do. Probably most of us have a memory of being four or five and knowing what we wear, knowing what kind of toys we like to play with, what kind of clothes we like to wear. And it's really no different for transgender children. And I think that's one of the main things to remember is that trans children are children first. If I'm a parent, what's the best practice for responding to my child who is realizing they are trans. Well, as a parent and a family therapist, I think when a child discloses something like that,

the first answer needs to be, thank you so much for trusting me with that information. I'm so glad that you felt you could come to me. And then the next question needs to be, what does that mean to you? What would you like me to do differently? And let their children know that there is space here for them to explore. Because gender is a journey.

And also we can change our mind throughout our life. And that's true for all of us, trans folks or not. And so for a parent to just meet their child and know that they're listened to, that they're loved also, and I'm with you. You're not alone, right? Because children can feel so alone. And children are aware that all this anti-trans sentiments are going on because they access social media. And they need to know that their families are on their side because family support lowers suicidality, lower simsumption. lower symptoms of depression, anxiety. It's the thing that is most needed by trans youth.

So both of you, how have you seen kids respond to receiving gender-affirming care? Almost every single young person that we see in our clinic come back to clinic with their parents telling us, this is the first time that I've seen them come out of their room and interact with the family in years. They're smiling for the first time. It's just an absolutely incredible, experience to be able to witness our treatments, help them to blossom. Gender affirming care is actually life-saving because of the high rates of suicidality in trans population. And also that, you know, we see them connect with their parents better, connect with their peers better, participate in kind of everyday experience that a lot of cisgender children

and youth take for granted. But really, gender affirming care allows children to be children and to blossom rather than being weighed down with dysphoria and depression and anxiety. It's really liberating for many young people. Just a quick reminder, this is Science Friday from WNIC Studios. I'd like to talk about some issues that would be applicable for all trans people of all ages. And one listener, Kay, shared many frustrations with their ability to access health care. You know, I think these letter requirements for insurance that say that you've been diagnosed with a thing in order to qualify for a surgery, diagnosed mentally with a thing. It's bullshit honestly. A ciswoman wishing to get breast enhancements does not need to be diagnosed in a clinical like there's something wrong with you sort of way, essentially what the insurance agencies are asking for. You don't need that to make decisions about your body if you're cis. And yet you do if you're trans. I agree with Kay. And I think many of us, especially trans providers like myself, feel that there shouldn't be a mental health rubber stamp that we put on people to address medical care.

You know, as long as somebody's capable of providing their informed consent, that should be able to access the medical care that they need. I think this is a longstanding kind of struggle of the trans community and the legacy of how medicalized are. communities have been. Honestly, the way I address kind of writing a letter for a client is, first of all, affirming that I wish you didn't need this letter, because I shouldn't have to kind of prove that you need to access this medical care. But the way I approach is, let's be collaborative and let's look at this as a portal for you to access the medical care that you need. But maybe let's also use it as a moment of reflection to make sure that you've fought through everything that you need to think through, that you are prepared for the medical appointments

that are to come and that you are prepared to make an aftercare plan, for example, when it's gender affirming surgeries. And so I think there is still a role for therapists, but I would like for people not to feel forced to see me, but to choose to see me. Because I didn't become a therapist to become a gatekeeper. I want to be supportive of people rather than having to just put a rubber stamp and say, yes, you are, or you say you are. That sentiment is sort of echoed in our last question from Tessa, who sent us this via the sci-fi Vox Pop app. Affirming health care is health care that's backed by a wealth of data research and the medical

literature. And while it's been established that there aren't any major negative side effects of medical transition, which is a good thing, beyond that, there isn't even, for example, really consensus on what the full effects of hormone-referferferfer, placement therapy even are for trans people. And I would love to see that remedied. We are a criminally under-researched demographic. Kara? I agree. Well, we have a lot of research to back the care that we provide. It's a growing, rapidly growing body of evidence, but we still need more research and we need to center the voices of the community, the transgender and gender

diverse community determining what needs to be studied and how the studies need to happen. And I think that funding agencies need to hear that as well. This is very necessary and we need to make sure that we are hearing from the transgender and gender diverse populations, including the young people and their families, about what are the questions that remain that need to be answered. Absolutely. I would add, like putting my scholar hat on that we're both an under-research and over-research population. I think from the point of view of the social sciences or psychology, sometimes cisgender researchers pursue things that are of interest to them

because they're not always well-informed. And so we're often very much under-researched in areas that matter to us. But one of the biggest changes that actually researchers can make is to include transgender folks in their larger studies. So if there is a large medical study of cardiac health, include a category for transgender non-binary people. If there is a large study of bone health, include kind of trans and non-binary as an option, because then we're going to start to have those kind of larger data sets.

But as long as we assume that most of the population falls into this binary, we're not going to really have the comprehensive data that we need in order to kind of move the field forward. And that's about where we'll have to leave it. Very interesting discussion. I want to thank both of you for taking time to be with us today. Thank you so much. Thank you very much. And for you listeners, we had to leave more than half of this conversation on the cutting room floor this week. So if you'd like to hear the full version and find more resources for trans adults and youth, visit our website, ScienceFriday.com slash gender. We've got to take a break. But when we come back, we'll come back. contemplate just what does it mean to be alive with science writer Carl Zimmer. Stay with us. This is Science Friday. I'm I, Myroplatto. I've got a really simple question for you to mull over. What is life? Oh yeah, I'm sure you've never thought about that before, right? Sounds like something out of your college philosophy class. But what makes this question different at this time is that the

definition of life has left the pages of philosophy. It's gone way past Frankenstein, has become an important legal and biological discussion. I mean, we're searching for life on other planets, in other galaxies. How will we know when we found it? Does it have to meet certain physiological criteria? What about the ability to reproduce or self-sustain? And scientists still have not come to an agreement over what is alive and what isn't. If you really want to get your head around this, check out a new book by an author you are very familiar with. He joins me now. Carl Zimmer, science columnist for the New York Times, an author of the book, Life's Edge, the search for what it means to be alive. Welcome back to Science Friday, Carl. Great to be here.

Tiny little topic you chose to bite off here. Well, you know, life is short. For give the pun. There you go. Thank you for joining us. You stick very closely to the history of this concept in science for most of the book. You got to tell us what drew you to this topic from a science perspective. Well, I suppose, you know, a lot of us wondered what life is as soon as we started using the word as kids. And maybe we asked our parents and maybe our parents kind of gave us an answer that wasn't terribly satisfying. And then we thought maybe science had the definitive answer. And, you know, I went on to become a science writer and got to write about all sorts of

different kinds of life, you know, jellyfish and trees and humans and all sorts of other things. And yet, you know, if you stop and ask somebody who studies, say, snakes, well, what is life? It gets to be a little awkward, you know? they may not have a definition at the ready or they might say, well, you know, that's not really my thing. I really am a snake person, you know. And then if you dig deeper, you discover that there are hundreds of definitions of life out there and they're not converging on one. It just seems like there are more and more new definitions that come out every year. So I just find that fascinating.

I mean, what could be a bigger question for biology? And yet one that, really doesn't have an answer yet. And you know, there are so many historical theories of what life is when it begins, et cetera, that that you talk about in your book that we know now are not correct, for example, how fermentation was seen as an act of life or how a concoction of radium and beef. This was a really interesting story that you talked about, was thought to create the most primeval form of life. Do you have any favorite theories that you came across during your research that aren't quite right. Some of the, you know, ones that you really thought were fascinating. Well, you know, in a way, I find the stumbles and the mistakes in science

just as interesting as the grand successes. You know, we tend to just learn about the big victories, and we kind of forget that it's part of a much bigger process. So one example is that there was a great biologist in the 19th century, Thomas Huxley, who convinced himself that the entire ocean floor was carpeted by what some people called a living paste, the most primordial form of life. It wasn't even a cell. It was just this sort of mass of protoplasm. And he even gave it a name, a species name, he called it Bethybius. And he made all sorts of grand pronouncements about how this was kind of the well-sprous. of all life on earth. And it turned out he was totally wrong. I mean, this Bithibius, in, you know,

in the 1870s, you could open up a textbook about biology, and on page one, there was Bithibius, this weird blob-like thing. And it did not exist. It was just the result of a chemical fluke. And to Huxley's credit, when other scientists pointed out to him that Bithibius was not real, he said, hey, if anyone made a mistake, it's me. And he, and he, and he, totally copped to it. So I think it just shows you just how hard it is to really figure out, where's the line between the living and the non-living? Yeah. And as you said before, and I'm going to quote from your book, asking biologists what it means for something to be alive makes for an awkward conversation. They demure, they stammer, they offer a flimsy notion that crumbles under

scrutiny. Is this something they just don't want to talk about or is it something they're embarrassed that we don't know. I honestly just think it's something that biologists are not trained to really think about that much. You know, as a biologist, you're trained to get answers about life. And so, you know, you might be very interested in maple trees. And so you want to understand how do maple trees reproduce. And you drill down and down and down into the molecular details of that. And you publish paper after paper after paper. There is much less of a, of a, of a, of, a, of of an incentive in biology to step back and be like, okay, like, what is, what is, what is, what does all this have in common? What, what, what does it mean for all these things that we call

alive to be alive? So there are people who, who dare to tread on that very dangerous territory, but not a lot. You know, along with the history, you go through, this book traces your adventures through a lot of different labs, environments where you look at creatures and experiments that complicate our understanding of what is alive and what isn't. And it struck me that throughout the book, you get to do science yourself. I was reading some of these things saying, I wish I could do that stuff,

putting together experiments in lab with researchers, getting your hands dirty with kelp on the beach. Do you have a favorite experience of any of those that you've written about in the book? It was a really wonderful experience to be able to visit with science, travel with scientists in order to kind of explore the territory of life. And, you know, there were different hallmarks of life that everyone generally agrees on. And I wanted to kind of really get to know those hallmarks by looking at certain species.

There were really the just the exemplars of it. So, for example, you know, life has a certain kind of intelligence, a lot of scientists would argue. In other words, living things make decisions about what to do based on their environment. So, you know, I mean, we make decisions every day. What are we going to have for lunch? But I was really fascinated by scientists who study these things called slime molds, which are these bizarre science fiction-like creatures that live on the forest floor. They're everywhere.

You know, go out in the summer and you'll see them if you know what to look for. And they send out their tentacles across the forest floor looking for bacteria. here to eat. And they have to decide where to go and basically how to lay out their network. And it's amazing that they are like little mathematicians making calculations on the most efficient way to cover a certain area and to find certain kinds of food. They can solve mazes. So I have to say that was a particularly fun experience. Let's go on to some more modern theories about life because these are the kinds of things we cover all the time. And it's amazing.

how quickly the definitions change. I mean, you have a line in your book that I absolutely love. Let me quote it. We don't know when a theory of life may arrive, but we can hope that our own lives last long enough to let us see it. As long-time science journalists, we've both seen research on biology really accelerate.

Do you think we'll get more insight into this in our lifetimes? I do, actually. I mean, I think that there are a number of scientists, not just biologists, but physicists, for example, who are really working hard on developing a theory of matter that could explain life. And this would be in the same way that, you know, chemists developed a theory of matter that explained, you know, molecules and water. and then, you know, all those are inanimate substances around us. And so, you know, you need theories to really, like, to get a deep understanding and to be able to understand even more. And those theories are in the works right now, you know, and there are several different theories that are being developed, which are very exciting.

I don't think anyone really pretends that they, you know, they've got the definitive theory all worked out. But, you know, when you talk to people in this field, they sort of feel like, you know, I think we're going to sort this out. They're pretty optimistic, which is, which is nice. But it is a little frustrating that, you know, imagine, you know, living right before the theory of chemistry started to make molecules and atoms and elements make a lot more sense. That's kind of where we are now. You mean agreeing all of us on what life is? Yes. To have it. So is it criteria? I mean, we're looking for it, we're going to other planets. Do we need a set of specs to understand, hey, this is life? Well, you know, we, on the one hand, it would be nice to have a really clear

theory of life before we go searching for it. But on the other hand, we don't want to wait forever. So, you know, NASA is using kind of working definitions of life to kind of get some clues. And so, you know, honestly, like they're looking on Mars for rocks and other, other patterns that kind of look like signs of life on Earth, which is fine. But, you know, what if life on Mars or on some moon around Saturn or in another solar system doesn't play by our rules, isn't based on DNA, doesn't even use carbon? Like, we need a deeper understanding of life to really be open to all the possibilities. Let's move on to talk about cutting-edge research on synthetic organisms because it really has moved very, very quickly. Just last month, there was news that scientists created a synthetic cell that grows and divides as normal. Other cells have been created with completely synthetic genomes.

What do you think, Carl, do these synthetics ride life's edge? Yes, I think they do. Although, you know, in some cases, what we're looking at are examples where you're sort of taking life as we know it and sort of pulling pieces out of it and figuring out what's the bare minimum that you can get by and this thing that still operates in the same way that it did originally before you started pulling all the genes out. So there are other scientists who say like, well, wait a minute, like life didn't start with, you know, a complicated cell. that got stuff pulled out. Probably what happened is that there were proto cells that didn't even have DNA in them. They probably had a much simpler molecule, RNA. We have RNA in ourselves.

But sometimes just think that inside of these protocells, the first cells on Earth, you would just have RNA that was carrying genetic information and carrying out chemical reactions. So they're trying to build these proto cells as well. And that's, you know, still got a ways to go before you have a really full-blown RNA protocell that can really just thrive and grow and do all the things on its own. But, you know, they are getting there. And so, again, I wouldn't be surprised if in 10 or 20 years we're looking at these things that could be a very good model for how life began.

But, you know, there are other people who are just saying like, well, let's not fixate on RNA? What if we just look at different combinations of simple chemicals and see if they form droplets that show life-like behavior? And that sounds crazy, but they're actually, at the University of Glasgow, they're actually making some strange droplets that skitter around in petri dishes that split into kind of looks like they're reproducing. There's just some weird stuff happening there. And they're using robots to keep changing these recipes to see if they might just stumble across droplets that we might call alive. Just a quick note that I'm Iroflato, and this is Science Friday from WNYC Studios.

We're also making, as you point out in your book, little mini organs, body organs that are not fully formed brains or lungs, but they are enough to work with. Yeah, I mean, when we think about life, we often think about, you know, when life begins, you know, we think of that boundary in terms of the start of life, and that's very controversial when we think about human life in particular. And, you know, scientists are really complicating our efforts to kind of draw that line by being able to grow things from cells. So, for example, you know, I went to a lab where they can take one of your skin cells

and put it in a dish, hit it with some chemicals, and it basically, turns into a neuron, a neuron much like in a human embryo, which then will start to grow and divide and grow and divide into hundreds of thousands, millions of neurons that organize themselves on their own into a brain-like structure. And if you just keep giving it the right chemicals for food, you can keep it alive, I think we'd agree it's alive, for years. So here's this thing that even seems to be producing brain waves, but it's not inside a human body. It started out as a skin cell. So, you know, is that alive? And, you know, how do we, how do we, how do we deal ethically with this, this life? It's, we, we have no answers

to these questions. Well, what about the question about artificial intelligence? Do you think it would ever meet the criteria if we come up with some definition of life? Yeah, you know, Well, I mean, there's artificial intelligence, which, you know, is able to say, this image looks like a cat to me, but, you know, that might tick off some of the boxes that we have for what it means to be alive, but I suspect it wouldn't tick off other ones. It's not as if, you know, Google has artificial intelligence programs that are reproducing themselves, you know? So if that's your standard for life, then I don't think that we'd consider it alive. But, you know, it's interesting that we might be able to just skip all that and all those

criteria and have something we might agree is intelligent or even conscious without all the other things that go with being alive. Interesting stuff. There's so much to talk about Carl in this book, so much to contemplate. Thank you for taking time to be with us today. Thank you. It's been a pleasure. Carl Zimmer, science columnist for the New York Times, and author of the book Life's Edge, The Search for What It Means to Be Alive. One last thing before we go. If you like books, we hope you're reading along with our Spring Book Club. We're talking Lost Feast by Lenore Newman, a book about the extinction of food species, the current state of biodiversity, and what's next for agricultural systems. Plus, did sailors really turn the dodo into soup?

tough. They were fishy. There's actually documentation about how bad they were. Join our next virtual discussion on Zoom, find our online community forum, or just sign up for our newsletter, all at sciencefriday.com slash book club. If you missed any part of this program, or you would like to hear it again, subscribe to our podcasts, or ask your smart speaker to play Science Friday. We also had held this hour from Jay McAuliffe, who served as a sensitivity reader, and consultant for our discussion of gender-affirming health care. Of course, you can always say hi to us on social media, Facebook, Twitter, Instagram, email.

We're there all week. Have a great weekend. We'll see you next week. I'm Ira Flato.