24 United States The Economist January 8th 2022
sex hormones on a first visit. “We treat in
fections with antibiotics, no questions
asked—it is just exactly like that,” she says.
Affirmative care has done irreversible
harm to some young people’s bodies. This
has become especially clear from the expe
rience of “detransitioners” who regret tak
ing hormones or having their breasts or
genitals removed. Puberty blockers also
prevent bones from developing properly;
when combined with crosssex hormones
they can lead to infertility and inability to
have an orgasm. A 26yearold student at a
medical school in Florida who plans to be
come a paediatrician is shocked by what
she has not been taught about these treat
ments. “With other diseases and treat
ments we are taught in such depth about
every possible sideeffect,” she says.
Medicalschool academics suggest two
reasons for all this. One (reflected in the
fact that none wanted their names pub
lished) is fear. Some transrights activists
bully anyone who expresses concerns pub
licly. The other is ignorance. A paediatri
cian who teaches at a medical school in
Florida says once doctors have finished
their training, many pay scant attention to
new medical research but rely on the me
dia for information. In America there has
been little coverage of the dangers of block
ers or the woes of detransitioners.
Last year Marci Bowers, a surgeon (and
trans woman) who performs vaginoplas
ties and phalloplasties, said she no longer
approved of the use of puberty blockers be
cause they left surgeons with too little gen
ital material to work with and led to a loss
of sexual function. This, extraordinarily,
appeared to surprise some genderclinic
medics. Ignoring the difference between
biological sex and gender at medical
school has other risks. Several diseases
present differently in men and women or
are more common in one sex than the oth
er. A doctor who treats a trans man, say, as a
man might miss something important.
Katherine, the student in Louisiana,
worries about the effects on female pa
tients. As a black woman, she is acutely
aware that “when physicians have an im
plicit bias against black people, it leads to
poorer delivery of care”. Genderidentity
ideology, with the use of such terms as “bo
dies with vaginas” in medical journals, has
“increased bias against women by normal
ising dehumanising language and by gin
ning up hatred of women who assert their
boundaries”. She is concerned that doctors
who have absorbed these views during
training may be less likely to deliver high
quality care to female patients.
She also worries that gender ideology is
impeding the development of medical stu
dents’ critical judgment. “It’s a problem”,
she says, “when doctors start believingthat
they can simply ignore medical evidence
and scientific facts that they don’t like.”nS
eanshermanreckonsheuses 25
pounds (11 kilos) of crickets a week:
“Pretty much every table buys some.” His
restaurant, Owamni by the Sioux Chef,
opened in Minneapolis in July and serves
Native American fare. Customers can
feast on bluecorn mush and bison tar
tare. Though indigenous restaurants
remain scarce, they are spreading. Recent
openings include Wapehpah’s Kitchen in
Oakland, California, and Watecha Bowl
in Sioux Falls, South Dakota.
What counts as Native American food
remains up for debate. Mr Sherman uses
only ingredients found in North America
before Columbus arrived. Diners will
find no wheat, beef, pork or chicken at
Owamni. If rules change, they may be
able to order something furrier. Mr Sher
man has “a couple beavers'' in his freezer
but “can’t sell them to the public because
that kind of licensing doesn’t even exist”.
Lois Ellen Frank, a food historian and
caterer, takes a different tack. She says if
every society were constrained by the
ingredients available to their distant
ancestors, Italians would have no pasta
al pomodoro and Britons no chips. (Both
tomatoes and potatoes came to Europe
from the New World.) Ms Frank includes
foods introduced to the southwest by
the Spanish, such as watermelon and
wheat. On her menu are cactusleaf salad
and bluecorn gnocchi.
A fault line has emerged around fry
bread, a pillowy, deepfried flatbread that
can be served sweet or as a taco. Legend
has it that Navajo women invented itusingtherationsprovidedwhenthe
government forcibly moved their tribe
from Arizona to New Mexico in the 1860s.
Some chefs refuse to serve it, saying it
represents colonialism and modernday
health struggles. In 2017 the Miss Navajo
pageant ditched the portion of the con
test where contestants make fry bread.
Miss Navajo hopefuls now cook up other
dishes including chiilchin, a red sumac
berry pudding. Others think fry bread is a
symbol of survival and ingenuity.
Ms Frank has a middle way. She some
times offers a healthier version: “nofry
fry bread”. She uses bluecorn flour and
grills the stuff instead of frying it.
The scarcity of Native American
restaurants has much to do with history.
In the mid1800s, as the government
pushed indigenous people westward to
take their land, many of their recipes no
longer made sense in a new climate.
Until the 1970s most Native Americans
lived in rural places. By the time they
moved to cities in numbers, they were
“too late and too few” to have a booming
restaurant scene, says Krishnendu Ray of
New York University.
Indigenous eateries have opened
from time to time since the 1980s, but
have failed to catch on. This time may be
different. President Joe Biden’s stimulus
bill included a big increase in funding for
tribal governments and programmes
aimed at helping Native Americans.
America is in a racial reckoning. That
applies to food, too. Owamni has been
fully booked every night since it opened.IndigenouscuisineCrickets, blue corn and bison tartare
Native American chefs are cooking up a culinary renaissanceAbowl full of heritage