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Big Think Interview With Kwame Anthony Appiah
Kwame Anthony Appiah is a philosopher, novelist, and professor of philosophy at Princeton University. Appiah was born in London but moved as an infant to Ghana, where he grew up. His father, Joseph Emmanuel Appiah, a lawyer and politician, was also, at various times, a Member of Parliament, an Ambassador, and a President of the Ghana Bar Association. His mother, Peggy Appiah, whose family was English, was a novelist, children’s writer, and social activist. In 1970, Appiah's great-uncle, Otumfuo Sir Osei Agyeman Prempeh II, was succeeded by his uncle, Otumfuo Nana Poku Ware II, as king of Ashanti.
Appiah was educated abroad in England, ultimately graduating from Clare College, Cambridge University, in England, where he took both B.A. and Ph.D. degrees in the philosophy department. Since Cambridge, he has taught at Princeton, Yale, Cornell, Duke, and Harvard universities and lectured at many other institutions in the United States, Germany, Ghana and South Africa, as well as at the École des Hautes Études en Sciences Sociales in Paris.
Appiah is the author of several books including "The Ethics of Identity," "Cosmopolitanism: Ethics in a World of Strangers," "Experiment in Ethics," and "The Honor Code: How Moral Revolutions Happen." He has also written three novels and reviews regularly for the New York Review of Books.
He currently serves as President of the PEN American Center. He has homes in New York city and near Pennington, in New Jersey, which he shares with his partner, Henry Finder, Editorial Director of the New Yorker magazine.
Question: How do you define honor?
Kwame Anthony Appiah: Okay, well I think the sort of 10 second version of what honor is, is: honor is an entitlement to respect that’s governed by some code or other. That’s my short answer to the question, what’s honor. And to have a sense of honor is to care about whether you are entitled to respect under the code.
Question: How can honor influence moral revolution?
Kwame Anthony Appiah: The main way in which honor I think matters for what I’m calling “moral revolutions,” which are kind of big changes in moral life over a relatively short period, is by mobilizing people through a concern for how they look, how they appear, whether they’re living up to some standard. So in the book I discuss in some detail a couple of moral revolutions, three or four. One is the change that brought an end to dueling in Britain. And there, one of the things that brought dueling to an end was a shift in honor which took honor from being something that men had to defend through dueling to something that it was ridiculous to challenge someone to a duel for.
So at the end of the process, honor required not to challenge people for duels, and at the beginning of the process it required you to challenge them, so there was a big shift there. And in that shift what happened was that people who were concerned that they were entitled to respect and be treated with respect realized that, from a time when it was a case that you had to duel in order to maintain your honor in certain circumstance, you moved to a time when you had not to.
When the Chinese gave up foot binding it was because the Literati, the ruling class that was created by a system of national exams that ran the empire for a millennia, because they realized it was wrong, but they also realized that because it was wrong, it was leading to a dishonor to China. It was leading to a contempt for the Chinese.
That case allows me to make what I think is a very important point here, which is a concern for honor isn’t just a concern that you will be respected; it’s a concern that you be entitled to respect. And that the difference is, you can get respect by cheating, right. That’s Bernie Madoff’s life. Bernie Madoff’s life consisted of getting to be on the boards of lots of charities by giving money which he didn’t have. So he got lots of respect, but he wasn’t entitled to it.
The Chinese literati didn’t just want the world to think well of them, they wanted to world to think well of them because they had done the right thing. And so in those cases and in the case of slavery, which I discuss in more detail, anti-slavery. In all of these cases, what you have is a concern to be entitled to respect, mobilizing communities of people whose honor is at stake because they belong to some collectivity that has an honor stake.
Question: How do you change an immoral practice if a culture upholds that practice as honorable?
Kwame Anthony Appiah: So what many of the great moral debates in the world today, a lot of which are around agenda, have to do with the fact that different societies have different notions of what entitles men and women to respect. I mean, one of the key things about honor is that what the code says depends on who you are. The code for men is different from the code for women very often. The code for gentlemen are different from the code for ordinary people, and so on.
But these codes are often local. And so if you’re going to change the behavior that you don’t approve of, you’re going to change female genital cutting or veiling or some other gender practice that you think of as a bad one, the first debate you have to have, the first discussion you have to have is about persuading people there is something wrong with the way their code is now.
And here, this is I think another point about honor. Here I can draw attention to the fact that honor sometimes lead people to do what morality requires. But very often it doesn’t. Morality forbids killing people over small disputes about whether you are lying, but the honor code in 18th Century England required gentlemen to threaten to kill one another or try to kill one another if one accused another of lying.
Morality is obviously against slavery, but the honor codes of 18th Century colonial America assigned honor and dishonor to people on the basis of race in a way that it made it possible to enslave black people, and that was clearly against morality. Morality had to be brought to bear against this system.
So when we’re trying to persuade people in other societies, the first thing we have to do... if we think their honor codes require is wrong, the first thing we have to do is to see if we can have a conversation with them and see if we can get them to see what is wrong about it.
What’s interesting, I think, and again these historical examples confirm this, is that usually they already know that it’s wrong. It’s not as if people didn’t realize it was crazy to duel. If you read the Wills written by gentlemen the night before duals in which they thought they might die, if you read accounts of the time, everybody agrees that there’s something crazy about dueling.
Boswell asked Dr. Johnson what he thought about dueling and they had a long conversation at the end of which Dr. Johnson told Boswell: “I agree. I can’t explain the rationality of dueling, though I still think we should do it.” So they realized problems already. Dueling was illegal in England from the time of Queen Elizabeth. It was against canon law; the Popes banned dueling in the 9th Century A.D. long before it really developed. And so it’s illegal, it’s immoral, it’s irrational, but people do it anyway.
So very often, when you want to begin these conversations; you already got something on your side. It’s already clear, for example that female genital cutting causes pain to girls and that that, all things being equal, is a bad thing. Nobody in these societies thinks that causing pain to children is a good thing. It turns out that certain forms of female genital cutting reduce fertility. This is a society in which people care about having children. It turns out that it often produces infections. It’s not like they think infections are great. So you have to begin the conversation by getting them—and it has to be a respectful conversation otherwise they won’t listen to you and they won’t learn anything and you won’t learn anything about them. In that respectful conversation, you can get them to see something that often they already know, which is at some level that it is wrong. Then you have to figure out how to get honor to concede to morality. And my thought is: don’t abandon honor, reshape it.
Question: How do you define morality?
Kwame Anthony Appiah: Well I think if, for a purposes usually end up because we care about distinctions using words in slightly offbeat ways. So I use the words “ethics,” “morality” and “honor,” in ways that I... I don’t say they’re the dictionary ways of using them, but they are ways—I try to use them consistently in these ways to mark an important set of distinctions.
So “morality” consists of the norms about how we ought to treat one another. “Ethics” is about the norms about how we ought to live, which of course includes the norms about how we ought to treat one another, but it goes beyond them. We ought to pursue our own dreams and respect our own individuality, which isn’t about how you treat other people. And “honor,” as I say, is this system of codes for assigning respect.
So, both... “honor” can be important both to morality in my sense, about how we should treat one another, and to ethics, a sense of how one should live one’s life. It can be important to morality because many moral norms are held central to honor codes. Most honor codes, for example make lying dishonorable and lying is immoral. You ought not in general to lie to people. So, there is a case where honor lines up with morality normally.
Question: How might your research be leveraged to end the practice of honor killing?
Kwame Anthony Appiah: Well, there’s a case, which I discuss in the book – a very important and I think an interesting case of an honor killing in Pakistan. And it’s important because it draws attention to the fact that this is not a practice only engaged in by kind of rural peasants. The woman in the case I discuss who was killed by her family, by somebody for her family, was a law student, her mother was a gynecologist, her father was the most... was the head of the Better Business Bureau, as it were in his hometown. Her husband, from whom she was trying... to divorce, which is why she was killed, was an M.D. They were successful modern, highly educated Pakistanis.
She was killed in the office of her lawyer because her mother came with this man and he took out a gun and shot her in front of the lawyer. Now, that makes it clear that in that context... and this you know, was a decade ago. It makes it clear that in that context, these people, these respectable people just didn’t think it was dishonorable to murder your daughter in front of your lawyer, or rather, in front of her lawyer.
The practice that she was, that the lawyer was in was a very distinguished practice in Pakistan. It was headed by two sister, women, lawyers, one of whom was the head of the national human rights organization and she said immediately upon this exactly the right thing. Her name is [...]. She said, “What kind of honor is it to kill an unarmed woman?” Right? She didn’t say, “Who cares about honor?” She got the point, which I don’t think would work. I don’t think in a society that’s full of people who care about honor or “hirate” as they call it, that we could hope for any significant change by just attacking honor head on.
What she said was... and that’s a good question. I mean, how is it that a man who organizes the murder of his own daughter gets to be entitled to respect? Well, there’s a complicated thing about the way things work in that particular honor system. An honor system, but the way, that was quite common around the world. You could find it in Italy a hundred years ago; there was very much the same thing. That honor system needs shifting. If you’re going to shift it, you have first to insist on the wrongness of what it requires, but that’s not hard to do; murder is already illegal. The Koran prohibits it already and Pakistan is a Muslim state, and so there are lots of reasons you can give why you shouldn’t do it. But you also have to shift the honor system. And that’s what they are doing by banging on the point, the correct point, that it just doesn’t make sense to think of it as honorable for a man to kill an unarmed woman.
And there’s a Web site organized by some... It’s called Arabs and Muslims Against Honor Killing, and at that Web site their slogan is: “No honor in honor killing.” And I think that’s absolutely right. So what’s going on already is a shift. There are already people who see this, already people who say: "Honor requires us not to murder these women." And I think as the dialogue goes on and provided it’s conducted respectfully across societies and within that society where there are many people who agree with you and me about the wrongness of honor killing—as that dialogue goes on there will be a shift. And as more and more people come to identify this activity, not with honor, but dishonor—as in China with foot binding—there’ll be a moment, a kind of tipping point when it goes from being something you do in order to defend your honor to something which, if you do it, brings you shame.
And that’s, you know, I’m famously in all my work more optimistic than many people. I’m a bit of a Pollyanna, but I think that’s what’s happening already. I think there’s a shift going on. I think they’re making the right arguments that it’s wrong, it’s illegal, it’s un-Muslim, and that it’s dishonorable.
Question: Can individuals spark a moral revolution?
Kwame Anthony Appiah: So a moral revolution, like a scientific revolution, and I was actually thinking about the analogy between ethics and science and thinking about Thomas Kuhn's "Structure of Scientific Revolutions" that got me into this in the first place. Moral revolutions, like scientific revolutions, take longer than political revolutions, they take a generation usually. And in many of them, there are small groups, not usually just one person, but small groups of people who are crucial in setting the process in motion.
We think rightly of William Wilberforce as a crucial figure in abolitionism in Europe, in Britain, in beginning to articulate clearly and forcefully the arguments against the wickedness of the slave trade. Those people do their work in part by creating organizations; organizations of people who commit themselves to the new norm. The anti-foot-binding societies in China are very important in this. They commit themselves to the new norm. When you joined one of those societies, you said, “I won’t bind the feet of my daughters and I won’t let me sons marry women whose feet are bound.” You sort of double deal. And if you are a woman, you said, “I will unbind my own feet.” You commit yourself to the new practice.
Abolitionists joined societies where they committed themselves not just to not having slaves, but, for example, in the case of Britain, to not consuming sugar because sugar was produced through slave plantations and hundreds of thousands of people in England in the late 18th Century stopped using sugar, which was just beginning to be an important consumer product, because they associated it with slavery.
So if you create organizations which commit themselves to implementing the norm, not just as a norm of morality, but as a norm, as a convention of everyday life, as it were, as something you are going to live by, then you can be one of the key figures in... if you create such institutions, you can begin one of these revolutions. And I think that in all of these sorts of cases—there was an anti-dueling society in England—in all of these cases it is very important to get people organized around the new norm and it’s kind of exciting to be in those societies because of the thing I said earlier, which is that you can see that you’re on the right side because other people, the people who are engaging in the old norm, the norm you’re challenging, already know in their hearts, in part of their hearts at least, that what they’re doing is objectionable in some way, that it’s causing unnecessary pain, that It’d denying people things they are entitled to, that it’s crazy in the case of dueling; it’s just irrational because of course, in a duel, who wins doesn’t depend on who’s right.
Well it’s crazy to have a practice that’s supposed to put something to right where who wins doesn’t depend on who’s right. Everybody knew this was crazy, and yet, nevertheless, they went ahead with it anyway.
So, you can begin one of these processes, you can help to begin one of these processes I think by articulating clearly the sort of arguments and getting them connected with dishonor as opposed with honor and by organizing groups of people who are committed to the new norm. And if we think about people who are important in these processes, like Kang Youwei, who was a important figure in the Chinese anti-foot binding movement, or like Wilberforce is an important figure in abolition, or like the Duke of Wellington who joined the anti-dueling society, these people are partly important because of their role in these organizations.
Question: Are you dismayed by the fact that TV and celebrity culture honor people for being immoral?
Kwame Anthony Appiah: I think that it’s... it would be terrible to limit the rewards of honor simply to morality, simply to moral behavior. As I think of it, honor is important as one of the mechanisms for rewarding academic excellence. Excellence in my own field... I think honorary degrees are a useful institution for helping to motivate people to do these things and to show what we value in the academy. What kinds of work we value. So these... honor here sustains things even though writing a great novel or a great work of social science is not a moral achievement. And indeed, it’s perfectly consistent with being a bad person morally. Still we should reward, I believe such behavior with honor. So, I don’t want to limit... I don’t think we should limit honor to moral excellence. I think we should use it to reward all kinds of excellence.
But we certainly shouldn’t use honor to reward the opposite of excellence in any domain. It would be weird to honor each year the person who comes last in the U.S. Open. And I think it’s weird to honor the people who perform in shows, like the “Jersey Shore,” who have achieved nothing of any really human significance except the kind of fame which one should probably better call notoriety.
So, now is that new? Absolutely not. There have been lots of forms of notoriety in the past which led to a kind of respect. A negative respect for doing something spectacularly bad. For example. Dick Turpin, who was an English, basically highwayman and robber. He was a famous fellow. And people were sort of... people would have been excited to shake his hand now if they knew the were shaking it when he wasn’t pointing a pistol at them and asking them for their wallets.
So, yeah we human beings are like that, there’s a kind of frissant that comes from hanging out with spectacularly bad people or even sort of spectacularly tacky people, which is really what the "Jersey Shore" is about. And I should say though that I think that it’s clear that while those people are getting a certain amount of notoriety and some money, no doubt, from what they’re doing, a lot of the response to them is in fact, condescension and they are... some people take pleasure, as a kind of schadenfreude of taking pleasure in people making fools of themselves while apparently not realizing it. Or making fools of themselves in order to achieve something that’s not really worth the price of making a fool of themselves. And in that sense I think that it’s kind of manipulative and unpleasant to be doing that to those people. And the sin is not so much theirs as the sin of those who are doing it to them and those who are taking their nasty pleasure in watching it.
Question: In 100 years what cultural phenomena will we look back on and ask, “what were we thinking?"
Kwame Anthony Appiah: That’s a very important question because if you think that we are at the beginning of some moral revolution, or that we should be at the beginning of some moral revolution, then my thought is that we can think already about how to mobilize the systems of honor in order to get it going and to do the job of being the people who organize the societies and the organizations that bring the arguments to bear and get honor shifted.
I just give... let me give just two examples which I think are very important. One, is the way in... this is an American example, it is a very local American example, it’s the way in which we have allowed our prison system to become quite appalling. We have a quarter of the world’s prisoners, incarcerated people in this country, and we have 4% of the world’s population.
We have more people in prison by far than China, which has a far larger population; four times, five times our population. And it’s not just that we have a terrible prison population, for an advanced society, the conditions in our prisons are quite appalling. You go into an American prison increases your chance of getting HIV/AIDS. Going to an American prison increases your chance of getting tuberculosis. Going to an American prison increases your chance of being raped, whether you are a man or a woman, and increases your chances of raped either by a prison staff or by other prisoners, and so on. I mean, it’s just appalling what goes on in our prisons.
I think it’s completely uncontroversial that things are appalling. You are not sentenced to AIDS, you are not sentenced to rape; you are sentenced to incarceration. And so no decent person can defend what’s going on, but it’s one of those cases where we haven’t organized ourselves yet and we haven’t looked ourselves in the face and said, "You know, we really can’t regard ourselves as decent people if we don’t do something to reform conditions in our prisons," where, by the way, just in case people don’t know this, the vast majority of these people are in there for non-violent drug offenses. They’re not people who are... pose a very great threat to anyone else directly. We don’t need them in there to protect ourselves from this. It’s just gotten out of control and we are not looking. We are not attending properly. Just as many people in the 18th century in Britain didn’t think properly about what was really going on in the hulls of those slave ships.
Let me just mention one more because I think this is a revolution that is underway, but it’s interesting. And that’s the revolutionary attitudes to lesbian and gay people. I’m in my mid-50s; I came to this country in my late 20s. When I came to this country, if I had said to the immigration official as I came in, by the way, I’m.. I suppose I would have said, I’m a homosexual. He would have been legally obliged to deny me entry. And fortunately he didn’t ask, I don’t know what I would have said.
But now, in the generation of people from the ages of 18 to 25, a very significant majority, not only don’t think that there’s anything wrong with gay sex, they believe that gay people ought to be allowed to be married. Again, 30 years ago, if I had come to this country and looked around for a bit and you’d said to me, “So, I see where Americans are going to have gay marriage soon,” I’d have told you, you were out of your tree. I’d have told you you’re completely crazy.
And notice that in that case, part of what’s happened. There’s two sort of honor things that have happened. One is, that the process of coming out and the process of self public identification as gay has made something that used to be shameful, not. In fact, we have gay pride rallies. That’s one thing. But more importantly because this has to do with the attitudes of other people to lesbian and gay people, it’s not in the younger generation embarrassing to be caught in a homophobic moment. Right? It’s not just that it’s wrong to be homophobic, it’s not cool. It’s trashy, it’s tacky. And that means that our system of assigning respect to people has gone from making it perfectly normal to be respectable if you say something rude about queers, to it’s being unrespectable and people making sure that they don’t want to be caught out being found in a homophobic moment.
Now, it’s not over and these percentages for the young are not yet, obviously duplicated in percentages for older people, but of course, the young are the ones who are going to inherit the kingdom. They’re going to inherit this country and by the time they do, by the time the people who are now 18 to 25 are my age, it’s very likely that the vast majority of the population will share these attitudes. And it came... it’s a revolution. It happened relatively fast. Stonewall happened when I was a teenager. And so I’ve seen it happen. I was... I mean, I wasn’t at Stonewall, I was in the United States, but I mean, I was alive when you could still be arrested in New York for holding hands if you were two men or two women. And now you can’t. And furthermore, people aren’t embarrassed... I mean, some people are, but most people aren’t embarrassed to see men holding hands or embracing one another, or women doing the same.
So I think there is another case where, that’s not one that happening in the future, I think it’s sort of happened. The big shift has happened, the big norm shift has occurred. Young people... because in the next generation of young people simple don’t get it.
Question: What was your experience like coming out of the closet in an evangelical family in Ghana?
Kwame Anthony Appiah: Well, I would say that, sexuality when I was growing up in Ghana wasn’t a form of identity—gay sexuality—because there just wasn’t a public discourse, there weren’t words for this. I went to an English boarding school, a boys school, so I pretty quickly acquired the words. And so I had a sort of language for talking to myself and maybe to some friends in England about my... the discovery that my sexual orientation was that my own sexual desires were directed toward my own sex and not towards women. But that wasn’t something that—I mean, if I had sort of as it were worn a t-shirt saying I was gay when I was 15 in Ghana, people would have not idea what I was talking about. That’s changed. I mean, there is now, there are now gay organizations and the gay movements in Ghana and while the government hasn’t as a whole moved in a bad direction in response to that, I would say there isn’t a huge sort of social consensus on the badness of homosexuality. There’s still just a lot of people who haven’t thought about it very much and so they will take a view if you give them a view. If you give them the evangelical view they’ll take that but it’s not because they’re deeply committed to it.
My father is famous in my family that when my father was asked about this, he said, “Well, I can see why you would have sex with a man because sex is pleasurable. What I can’t see is why you wouldn’t want to have sex with women.” So, again, this is a different way, this is a different sort of cultural contest for thinking about sexuality. For many people in Ghana today, I think gay men are men who don’t want to have sex with women, it’s not what they do want to do that interests them, it’s what they don’t want to do. Though there is a significant evangelical Christian influence from the United States in particular that’s pushing a more American style form of what I regard as homophobia.
As far as my own sort of dealing with these things are concerned, I was raised in a Christian family. We went to Sunday school, it wasn’t the kind of Sunday school that talked much about that. I don’t think anyone ever mentioned homosexuality or gayness in church so far as I can recall the whole time during my childhood. This wasn’t one of the things that people were preoccupied with. My mother was British and... I know one of my sister’s godparents was a gay man, so I assumed she, and it was obvious to me even when I was eight that he was gay, so even though I didn’t have a very well developed sense of what that was. So I assumed that my parents didn’t think that that was an obstacle. But my own dealing with it really came from the kind of Protestantism, evangelical—but in this case I would say progressive—evangelical Protestantism, which meant that you took the key thought of the gospels to be that God loved us. And it seemed to me as I was looking as my sort of own relationship to my sexuality that if I was like this and God loved me, you now, the church might not think it was okay, but it couldn’t be the case that God didn’t.
So I actually didn’t have too hard a time with this and I think I was reconciled with my sexuality as a Christian before I eventually stopped being a Christian. But this is sort of lucky story turned out well, I think that for people of my generation in Ghana, men and women who discover as they grow up that they have sexual desires for their own sex, it would have been difficult. And many of them would have left. I mean, there’s I think a million Ghanaians outside of Ghana, in Amsterdam and New York and London and Manchester and cities like that around – Frankfurt, and cities around Europe and the United States. And you know, I suspect that a good number of them are gay people who fled to those cities in the way rural gay American fly to cities because in cities you can find other gay people and also perhaps more tolerance of gay people.
But I think Ghana will figure this out. People in Ghana like sex too much to think that in the end it’s a bad thing. So my hope is that things will move in the right direction.
Question: Was it difficult to reconcile the conflicting dimensions of your identity?
Kwame Anthony Appiah: I think reconciling different dimensions of identity is actually something that people are quite good at. People know how to be gay Mormons. I mean, the Mormon Church isn’t so happy that they know how to be gay Mormons, and maybe some gay people don’t like the fact that there are gay Mormons, but gay Mormons know how to be gay Mormons. And they know how to be gay Mormon men. They know how to reconcile their gender, their sexuality, and their religion.
My father knew how to be a Methodist, a Ghanaian, a Pan-Africanist, a loyal son to the kingdom of Ashanti, a father... And you know, all of those are things were things that can pull you in certain moments in different directions. Being a loyal Ghanaian meant that you had to go to Parliament and leave the family and not spend as much time with us when we were growing up as he might have, being a cosmopolitan supporter of the United Nations meant that sometime he had to support... he had to be on the side of governments that were opposed to our own government because there are international norms that our own government wasn’t respecting and so on.
So, you know, people have complex identities but it’s one of the things human beings know how to handle. It’s usually other people that make it difficult for you. It’s the homophobes that make it difficult for the gay Mormons or the anti-Mormons who make it difficult for the gay Mormons. And while I don’t want to underestimate the struggling that goes on in the process of dealing with one’s religious identity or one’s sexual orientation as one grows up, these can be – these are challenging difficulties for young people. Usually the big problems are derived from either what other people do think or what they think other people will think. Which brings up back to our main topic because at the heart of this is a concern to be respected and to be entitled to respect and to be respected as what one is. To be respected in spite of being a gay person or in spite of being a Mormon or in spite of being a Catholic or a Jew, but as a Catholic or a Jew or a Mormon or a gay person. And one of the things we need to figure out in many of our honor codes is to make them more friendly to all kinds of people who are currently excluded by them and that’s the task I think, not abandoning the honor, but reshaping it to make it supportive of human flourishing, both by using collective honor to get people to engage in the moral revolutions that are necessary and by using individual honor to sustain excellence in human lives.
Recorded September 13, 2010
Interviewed by Max Miller
A conversation with the philosopher.
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Gender and sexual minority populations are experiencing rising anxiety and depression rates during the pandemic.
- Anxiety and depression rates are spiking in the LGBTQ+ community, and especially in individuals who hadn't struggled with those issues in the past.
- Overall, depression increased by an average PHQ-9 score of 1.21 and anxiety increased by an average GAD-7 score of 3.11.
- The researchers recommended that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders—even among those with no prior history of anxiety or depression.
Study findings<p>For the study, <a href="https://link.springer.com/article/10.1007/s11606-020-05970-4" target="_blank">published in the Journal of General Internal Medicine</a><em>, </em>Flentje and her team evaluated survey responses from nearly 2,300 individuals who identified as being in the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Most of the participants were white, while nearly 19 percent identified as a racial or ethnic minority. Multiple genders were represented with cisgender women (27.2 percent) and men (24.6 percent) making up a majority of the participants. Sixty-three percent had been assigned female at birth. For the most part, participants identified their sexual orientations as queer (40.3 percent), gay (36.5 percent), and bisexual (30.3 percent).</p><p>The JGIM study participants were recruited from the 18,000-participant <a href="https://pridestudy.org/" target="_blank">PRIDE Study</a> (Population Research in Identity and Disparities for Equality), which is the first large-scale, long-term national study focusing on American adults who identify as LGBTQ+. It conducts annual questionnaires to understand factors related to health and disease in this population. </p><p>Participants filled out an annual questionnaire (starting in June 2019) and a COVID-19 impact survey this past spring. Flentje noted that on an individual level, some people may not have experienced a big change in anxiety or depression levels, but for others there was. Overall, depression increased by a <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ-9 score</a> of 1.21, putting it at 8.31 on average. Anxiety went up by a <a href="https://www.mdcalc.com/gad-7-general-anxiety-disorder-7" target="_blank">GAD-7</a> score of 3.11 to an average of 8.89. Interestingly, the average PHQ-9 scores for those who screened positive for depression at the first 2019 survey decreased by 1.08. Those who screened negative for depression saw their PHQ-9 scores increase by 2.17 on average. As for anxiety, researchers detected no GAD-7 change among the study participants who screened positive for anxiety in the first survey, but did see an overall increase of 3.93 among those who had initially been evaluated as negative for the disorder. </p>
Risks among gender and sexual minorities<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fc3fd1ae68b77bbbf58a6995638d6d65"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/EnUqDjCqg0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The LGBTQ+ community is a vulnerable population to mental health concerns because of their fear of stigmatization and previous discriminatory experiences.</p> <p>Previous research by the Human Rights Campaign has found "that LGBTQ Americans are more likely than the <a href="https://medicalxpress.com/tags/general+population/" target="_blank">general population</a> to live in poverty and lack access to adequate medical care, paid <a href="https://medicalxpress.com/tags/medical+leave/" target="_blank">medical leave</a>, and basic necessities during the pandemic," said researcher Tari Hanneman, director of the health and aging program at the campaign.</p> <p>"Therefore, it is not surprising to see this increase in anxiety and depression among this population," Hanneman said in the release. "This study highlights the need for <a href="https://medicalxpress.com/tags/health+care+professionals/" target="_blank">health care professionals</a> to support, affirm and provide <a href="https://medicalxpress.com/tags/critical+care/" target="_blank">critical care</a> for the LGBTQ community to manage and maintain their mental health, as well as their physical health, during this pandemic."</p>
What should health care providers do?<p>The authors of the study recommend that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders in members of that community—even among those with no prior history of anxiety or depression.</p><p>As cases of COVID-19 continue to mount, the sustained social distancing, potential isolation, economic precariousness, and personal illness, grief, and loss are bound to have increased and varied impacts on mental health. Effective treatments may include individual therapy and medications as well as more large-scale coronavirus support programs like peer-led groups and mindfulness practices. </p><p>"It will be important to find out what happens over time and to identify who is most at risk, so we can be sure to roll out public health interventions to support the mental health of our communities in the best and most effective ways," said Flentje.</p>
What we know about black holes is both fascinating and scary.
- When it comes to black holes, science simultaneously knows so much and so little, which is why they are so fascinating. Focusing on what we do know, this group of astronomers, educators, and physicists share some of the most incredible facts about the powerful and mysterious objects.
- A black hole is so massive that light (and anything else it swallows) can't escape, says Bill Nye. You can't see a black hole, theoretical physicists Michio Kaku and Christophe Galfard explain, because it is too dark. What you can see, however, is the distortion of light around it caused by its extreme gravity.
- Explaining one unsettling concept from astrophysics called spaghettification, astronomer Michelle Thaller says that "If you got close to a black hole there would be tides over your body that small that would rip you apart into basically a strand of spaghetti that would fall down the black hole."
The team caught a glimpse of a process that takes 18,000,000,000,000,000,000,000 years.
- In Italy, a team of scientists is using a highly sophisticated detector to hunt for dark matter.
- The team observed an ultra-rare particle interaction that reveals the half-life of a xenon-124 atom to be 18 sextillion years.
- The half-life of a process is how long it takes for half of the radioactive nuclei present in a sample to decay.
A new study looks at what would happen to human language on a long journey to other star systems.
- A new study proposes that language could change dramatically on long space voyages.
- Spacefaring people might lose the ability to understand the people of Earth.
- This scenario is of particular concern for potential "generation ships".