As cannabis becomes more widely accepted and legalized, a little-known but increasingly common condition is catching many families and healthcare providers off guard: Cannabinoid Hyperemesis Syndrome (CHS).In our recent publication, our research team explores this troubling syndrome, which is characterized by severe, repeated vomiting triggered by long-term and frequent cannabis use.
Though still unfamiliar to many, CHS is on the rise, particularly among youth. In fact, emergency department visits for the condition in the U.S. and Canada have doubled between 2017 and 2021. This trend reflects both the increased availability of high-potency cannabis products and the growing normalization of regular use. In fact, 18% of U.S. 12th graders reported using cannabis in the past month.
CHS does not start dramatically. In the early “prodromal” phase, young people may wake up feeling nauseated and mistakenly believe that using more cannabis helps. Over time, however, they can progress to the hyperemetic phase. This stage is marked by uncontrollable vomiting, abdominal pain, dehydration, and weight loss due to the inability to retain food or fluids. Many affected youth find only temporary relief through long, hot showers or baths, a curious but now well-documented hallmark of CHS. Recovery typically begins only after cannabis use is completely stopped. However, that is often a difficult step for those already using the drug to cope with stress or anxiety.
This issue is worsened by the fact that cannabis today is not what it used to be. THC concentrations, the main psychoactive compound in cannabis, have quadrupled in recent decades, making negative side effects more likely. High-potency cannabis use among youth has been linked to increased risk of depression, anxiety, paranoia, psychosis, and even self-harm. While occasional use doesn’t typically cause CHS, daily or weekly use over an extended period, especially with high-THC products, can be enough to trigger the syndrome.
Contrary to widespread belief, cannabis is not always calming. In some individuals, especially youth, THC can disrupt the body’s natural stress response and gastrointestinal system. Because the brain continues to develop until around age 25, frequent high potency THC exposure during this critical period can interfere with neural growth and the formation of brain circuits responsible for attention, memory, and learning.
Treatment is not straightforward either. Standard anti-nausea medications are often ineffective. Some emergency rooms have found success using topical capsaicin creamor medications like haloperidol, which target different pathways involved in CHS. However, the only reliable long-term solution is quitting cannabis use. That is often easier said than done, particularly for youth who may be using it to cope with underlying emotional challenges. For individuals who persist with cannabis use despite clear information linking it to their CHS symptoms, it may be appropriate to involve addiction specialists, substance use counselors, or rehabilitation services. This continued use could also indicate that cannabis has a higher potential for dependence than commonly believed.
So, what can we do? Addressing CHS requires a coordinated response that spans prevention, clinical care, research, public health, and policy. The first step is education. Prevention efforts should begin early, with school-based awareness programs, public health campaigns, and healthcare messaging that clearly communicate the risks of frequent cannabis use, including CHS. Parents, educators, and counselors should also be involved in recognizing early symptoms, such as morning nausea or reliance on hot showers to ease discomfort.
Public health messaging also needs to keep pace with the changing cannabis landscape. As legalization increases access and normalizes use, information about the potential harms of chronic cannabis consumption must be more visible. CHS should be included in these messages to ensure both users and healthcare providers are informed.
Early recognition by clinicians is essential. When youth present with repeated vomiting, abdominal pain, or unexplained gastrointestinal symptoms, CHS should be considered. Screening questions about cannabis use and symptom relief from hot water can be useful diagnostic tools.
There is also a clear need for more research. Studies are needed to better understand the causes of CHS, its risk factors, and the most effective treatments. Randomized controlled trials and population-based research will help inform evidence-based care.
CHS may still be underrecognized, but with coordinated action, its impact on youth health can be significantly reduced.
Dr. Jamie Seabrook is a Professor in the Department of Epidemiology and Biostatistics at Western University, with cross-appointments in the Department of Paediatrics, as well as the Brescia School of Food and Nutritional Sciences. Dr. Seabrook is also a Scientist with the Children’s Health Research Institute, Lawson Research Institute, and London Health Sciences Centre Research Institute in London, Ontario, and a Faculty Associate of the Human Environments Analysis Laboratory. Dr. Seabrook’s research focuses on the social determinants of child health disparities and youth substance use. In 2019, Dr. Seabrook received the Award for Excellence in Research at Brescia University College affiliated with Western University. You can follow them on X: @Jamie_Seabrook1
In April, the Centers for Disease Control generated headlines when it reported that autism now affects one in 31 American children, up from 36 in 2022 and a 2006 estimate of one in 110. Secretary of Health and Human Services Robert Kennedy responded by promising to track down the “environmental toxins” that have turned a supposedly “preventable disease” into an epidemic that “dwarfs” the Covid pandemic. By contrast, many medical authorities have interpreted the increase as an artifact of broader diagnostic criteria, greater public awareness, and increased screening. Others suggest the increase is real but dispute Kennedy’s claim about the magnitude and causes.[1]
The polarized response to the CDC report, however, threatens to obscure our broader understanding of the cultural, environmental, historical, and institutional factors that shape both autism’s incidence and its meaning. While the neurological differences associated with autism likely have deep biological roots, the way autism is recognized, described, evaluated, and responded to is very much a product of culture, history, and institutional frameworks.
What we now call “autism” is not just an age-old biomedical reality. It is also a cultural construct, assembled over time through layers of observation, classification, and interpretation, and filtered through the differing scientific, social, emotional and moral assumptions prevailing in various societies through the ages. Cultural context determines which traits are pathologized, which are celebrated, and which are simply ignored. In some cultures, avoiding eye contact is considered polite, while in others it is a red flag. Behaviors labeled autistic in one society may be seen as eccentricity or even giftedness in another.
What we understand as autism today is the product of evolving cultural attitudes about difference, normality, and disability. This is not to deny a real neurological base for many of these behaviors, nor to discount environmental factors. Chemical pollutants—airborne particulates, endocrine-disrupting compounds, pesticides—have all been linked to increased autism risk. Nutritional deficiencies in pregnancy and early childhood may also play a role, as may maternal metabolic conditions like obesity and gestational diabetes. These exposures, acting during critical windows of brain development, may subtly alter neural circuitry in ways that heighten sensitivity to social, sensory, and cognitive stressors. And as today’s children experience more screen time, less unstructured play and interaction with peers, and earlier academic pressure than previous generations, this may exacerbate traits that become problematic in overstimulating or inflexible environments.
In the United States, however, such contextual factors are often overlooked. The American model of diagnosis and treatment heavily favors biological explanations—rooted in genetics and brain imaging—over social, cultural, or relational ones. Clinicians are trained to identify codifiable disorders; insurers reimburse for diagnosable conditions; research grants disproportionately fund genetic studies over sociocultural ones.
This biomedical model has real benefits—it has driven research, legitimized neurodivergence, and improved access to services. But it also narrows our view. It risks over-pathologizing differences, underplaying environmental contributors, and overlooking the importance of community, culture, and support systems in shaping outcomes.
Toward a More Integrated and Human-Centered Approach to Autism
The dominant American model tends to frame autism primarily in biological, genetic, or neurological terms. While such explanations have yielded important insights, they also risk portraying autism as fixed and unchangeable—something to be managed rather than understood and accommodated. As a cultural construction, autism is not simply a universal neurobiological fact an experience shaped by how societies define normalcy, support difference, and distribute care. To move forward, we need a more integrated and humane framework—one that takes into account the neurological distinctiveness of autism while also recognizing its variability, plasticity, and responsiveness to context. This means broadening the scope of scientific inquiry to include not only genes and brain scans, but also the environments in which children grow, the relationships that shape development, and the social systems that allocate support.
Only by embracing complexity—biological, developmental, cultural, and relational—can we build a public health and educational framework that protects vulnerable developmental windows, affirms neurodiversity, and ensures that those who think and feel differently are not just “managed,” but understood, supported, and valued in a pluralistic society. Autism is not a disease to be eradicated but a way of being in the world—a developmental difference shaped by biology, environment, and experience. It comes with challenges, but also with insight, creativity, and perspective that can enrich families, communities, and cultures.
This reframing doesn’t deny the reality of suffering or romanticize neurodivergence. Rather, it recognizes that meaningful support must begin with truly listening to the experiences, voices, and needs of autistic individuals themselves. In this spirit, our institutions, policies, and practices should no longer ask: “How can we change the autistic person?” but instead, “How can we change the world to better include and uplift him or her?”
Because autism exists on a broad and diverse spectrum, no single description—or intervention—can capture the full range of experiences. One person on the spectrum may be nonverbal and require round-the-clock care, while another may hold a Ph.D. and still struggle with sensory overload, anxiety, or social nuance. This variability is a defining feature of the condition. It reflects the wide range of ways in which autistic traits—such as differences in communication, social interaction, sensory processing, and behavior—manifest across individuals and across the lifespan.
For this reason, any meaningful approach to autism must begin with individualization. Support systems must move beyond generic programming to meet people where they are, adapting interventions to reflect not only severity of need, but also personal strengths, preferences, communication styles, and cultural context.
In education, this means that two students with the same diagnosis may require very different supports—one might need assistive technology to communicate, while another benefits most from sensory-friendly classrooms and flexible schedules. In clinical care, some individuals may thrive with behavioral therapies, while others will require trauma-informed counseling, medication management, or occupational supports. In the workplace, one person may need a quiet space and modified hours, while another may benefit from mentorship and clear, structured feedback.
Moreover, to truly individualize support, autistic voices must be central in the design of care. Whether through self-advocacy, family input, or person-centered planning, those receiving support must be empowered to help shape it. Respecting autonomy, building trust, and tailoring environments are not just best practices—they are ethical imperatives.
Autism is a spectrum not just of needs, but of humanity. It demands a flexible, responsive, and deeply personal approach—one that treats autistic individuals not as diagnostic categories, but as whole people, deserving of care that reflects their uniqueness.
A society that embraces autistic people as they are—not as problems to be fixed, but as people to be known—will be a society better attuned to the full range of human possibility. In the end, perhaps the real question is not what autism is, but what kind of society we are willing to build around it.
A leading authority on the history of families, children, and the life course, Steven Mintz is professor of history at the University of Texas at Austin and the author and editor of 17 books, including the forthcoming The American Child: The Transformation of Childhood since World War II (with Peter N. Stearns). A past president of the Society for the History of Childhood and Youth and of H-Net: Humanities and Social Sciences Online, he has been a visiting scholar at Harvard, a fellow at Stanford’s Center for Advanced Study in the Behavioral Sciences, and a CCF national co-chair.
Mothers working full time and year-round make only 71 cents for every dollar paid to full-time, year-round working fathers.1 This wage gap robs these mothers of $1,667 every month, or $20,000 a year. That extra $20,000 could pay for seven months of rent,2 seven months of family groceries,3 and five months of childcare.4 The wage gap persists across all education levels and in nearly every occupation, robbing mothers of the money they need to provide for their families.
The wage gap is worse for many mothers of color. Racial inequities can compound the maternal wage gap.5 For example, Latina mothers and Native mothers working full time, year-round are paid just 51 cents for every dollar paid to white, non-Hispanic fathers. Black mothers working full time, year-round are paid only 52 cents for every dollar paid to white, non-Hispanic fathers. These losses to the wage gap add up to tens of thousands of dollars lost each year, with Latina and Native mothers typically losing $39,000, and Black mothers typically losing $38,000 annually compared to white, non-Hispanic fathers.6
Two-thirds of mothers are breadwinners or co-breadwinners for their families.7 The loss of tens of thousands of dollars to the wage gap each year means less money for food, rent, education, and other necessities, as well as less, or no, money for retirement or for financial emergencies. Larger annual losses from the intersectional discrimination of the wage gap faced by Black mothers is especially devastating, as Black mothers are even more likely to be primary breadwinners for their families than their white, non-Hispanic counterparts: 68.1% of Black mothers are primary breadwinners for their families compared to 37.2% of white mothers.8 Furthermore, in 2023, the unemployment rate for Black mothers was 5.3%, but only 3.0% for mothers overall, meaning Black mothers face additional barriers to making ends meet.9 When including part-time and part-year workers, the wage gap for mothers is even worse. Two out of every three working mothers work full time and year-round, which leaves a significant number out of our analysis if we limit it to full-time, year-round workers. When looking at workers regardless of how many hours or weeks they work, working mothers are typically paid only 63 cents for every dollar paid to all working fathers.10 And yet again, that figure is deeply compounded by race. When including all workers, regardless of the number of hours or weeks they work, Native and Latina mothers are each paid a paltry 41 cents for every dollar paid to white, non-Hispanic fathers. And Black mothers are paid 48 cents for every dollar paid to white, non-Hispanic fathers.11
Educational attainment does not close the wage gap.
Although educational attainment is one of the primary paths towards economic stability, it does not close the wage gap for mothers. To the contrary, a higher share of mothers (48%) than fathers (42%) have attained a bachelor’s degree or more. Mothers with at least a bachelor’s degree are still paid only 74 cents for every dollar paid to fathers with comparable educational attainment.12 For many mothers, additional gains in education actually widens their wage gap. For example, among parents with less than a 9th grade education, mothers working full time, year-round are paid 75 cents for every dollar paid to fathers with less than a 9th grade education. Yet, mothers with a master’s degree are paid only 70 cents for every dollar paid to fathers with a master’s degree. In fact, mothers need to earn a bachelor’s degree ($65,000) to make more than fathers who hold a high school diploma ($50,000), and they must earn a doctorate ($101,000) to make more than fathers who hold only a bachelor’s degree ($95,000).13
Occupational segregation contributes to the wage gap.14 Nearly 3.2 million mothers work in the 40 lowest paying occupations, including caregiving occupations like childcare workers, home health aides, and personal care aides, as well as service industry occupations like waitresses, hostesses, and cashiers.15 These critical jobs are perpetually undervalued, with workers often making below $16 per hour while supporting families. Nearly two-thirds of mothers working in low paid occupations (63.0%) are mothers of color, and mothers of color are overrepresented in the low-paid workforce: mothers of color make up 6.8% of the overall workforce but 9.6% of the low-paid workforce.16 This occupational segregation alone does not explain the wage gap, however, as mothers typically make less than fathers even within the same occupations. Among full-time, year-round workers in low-paid jobs overall, mothers are paid 70 cents for every dollar paid to fathers, and again these figures are worse for many mothers of color. Among full-time, year-round low-paid workers:
Latina mothers are paid just 53 cents for every dollar paid to white, non-Hispanic fathers;
Black mothers are paid just 56 cents for every dollar paid to white, non-Hispanic fathers; and
Native mothers are paid just 58 cents for every dollar paid to white, non-Hispanic fathers.17
The maternal wage gap persists because mothers continue to face a range of structural barriers that result in lower pay, including discrimination, an ongoing care crisis, increasing restrictions on access to abortion and reproductive health care, occupational segregation, and more. The racist and sexist wage gap continues to rob mothers—especially mothers of color—of tens of thousands of dollars a year, money that could have been used to build economic security for them and their families. It is long past time to start paying mothers what they are owed and to stop robbing their families of the financial security they need.
ACKNOWLEDGEMENTS The author would like to thank Gaylynn Burroughs, Sarah Javaid, Eun Kim, Erin Longbottom, Marissa Moore, Marybeth Onyeukwu, Maria Patrick, Vasu Reddy, Jordan Reynolds, Katherine Sandson, Jasmine Tucker, Arvia Walker, and Hilary Woodward for their design, review, and dissemination of this factsheet.
FOOTNOTES
1 National Women’s Law Center (NWLC) calculations using U.S. Census Bureau, 2022 American Community Survey (ACS), using IPUMS-USA, available at https://usa. ipums.org/usa/sda/. Mothers and fathers are women and men with at least one of their own children under the age of 18 at home. Respondents to the ACS selfidentify as either male or female. Employed respondents are all over the age of 16. Median earnings include all workers who earn at least $1. Full-time, year-round is defined as workers who usually work at least 35 hours per week and at least 50 weeks per year. 2 U.S. Census Bureau, 2022 American Community Survey, Table DP04: Selected Housing. Median rent in 2022 was $1,300 per month. https://data.census.gov/table/ ACSDP1Y2022.DP04?q=DP04:%20SELECTED%20HOUSING%20CHARACTERISTICS. 3 NWLC calculations using U.S. Department of Agriculture, Food and Nutrition Service, USDA Food Plans: Cost of Food Report for Low, Moderate, and Liberal Food Plans for MAY 2024, https://www.fns.usda.gov/cnpp/usda-food-plans-cost-food-monthly-reports. Figure is based on a low-cost monthly meal plan for a family of 4 including one male and one female ages 19-50, one child ages 2-3, and one child ages 4-5 for a total of $807 per month 4 NWLC calculations using Appendix I from Child Care Aware, Catalyzing Growth: Using Data to Change Child Care https://www.childcareaware.org/catalyzinggrowthusing-data-to-change-child-care-2022/. The average price of child care for one toddler in full time care in 2022 was $10,853. 5 Respondents to the ACS self-identify their race and whether they are of Hispanic, Latino, or Spanish origin. Please refer to the ACS questionnaire for further detail. 6 National Women’s Law Center (NWLC) calculations using U.S. Census Bureau, 2022 American Community Survey (ACS), using IPUMS-USA, available at https://usa. ipums.org/usa/sda/. 7 Center For American Progress, Breadwinning Mothers are Critical to Families’ Economic Security (March 2021), available at https://www.americanprogress.org/ article/breadwinning-mothers-critical-familys-economic-security/ This analysis uses a 5year data sample collected from 2015-2019. 8 Center For American Progress, Breadwinning Mothers are Critical to Families’ Economic Security (March 2021), available at https://www.americanprogress.org/ article/breadwinning-mothers-critical-familys-economic-security/ This analysis uses a 5year data sample collected from 2015-2019. 9 Unemployment rate – Women with own children under 18 ” https://beta.bls.gov/dataViewer/view/timeseries/FMUP4078853 and ”Unemployment rate – Black or African American women, With own children under 18” https://beta.bls.gov/dataViewer/view/timeseries/FMUP4092254 from the Bureau of Labor Statistics’ Marital and family labor force statistics from the Current Population Survey 10 National Women’s Law Center (NWLC) calculations using U.S. Census Bureau, 2022 American Community Survey (ACS), using IPUMS-USA, available at https://usa. ipums.org/usa/sda/. 11 National Women’s Law Center (NWLC) calculations using U.S. Census Bureau, 2022 American Community Survey (ACS), using IPUMS-USA, available at https://usa. ipums.org/usa/sda/.
12 National Women’s Law Center (NWLC) calculations using U.S. Census Bureau, 2022 American Community Survey (ACS), using IPUMS-USA, available at https://usa. ipums.org/usa/sda/.
13 National Women’s Law Center (NWLC) calculations using U.S. Census Bureau, 2022 American Community Survey (ACS), using IPUMS-USA, available at https://usa. ipums.org/usa/sda/.
15 National Women’s Law Center (NWLC) calculations using U.S. Census Bureau, 2022 American Community Survey (ACS), using IPUMS-USA, available at https://usa. ipums.org/usa/sda/
16 National Women’s Law Center (NWLC) calculations using U.S. Census Bureau, 2022 American Community Survey (ACS), using IPUMS-USA, available at https://usa. ipums.org/usa/sda/
17 National Women’s Law Center (NWLC) calculations using U.S. Census Bureau, 2022 American Community Survey (ACS), using IPUMS-USA, available at https://usa. ipums.org/usa/sda/
Untitled by Duckleap licensed by Pixaby. Couple in hot air balloon.
Have you ever wondered how much we say during sex without uttering a single word? While verbal communication often steals the spotlight, our new study dives into the quieter, subtler world of nonverbal cues and their impact on intimacy. We analyzed the sexual communication patterns of 78 participants, uncovering fascinating insights into what we share—and don’t share—during our most intimate moments.
This study builds on a growing body of research around sexual communication. While much of the existing literature focuses on what we say outside the bedroom, but we examined how we express pleasure, discomfort, and needs in the moment. Spoiler: nonverbal communication plays a starring role.
The Art of (Not) Saying It
When it comes to communicating during sex, participants revealed a preference for letting their bodies do the talking. Many shared that moans, gasps, or even subtle shifts in body position often feel safer and more effective than verbal cues. Why? For some, it’s about sparing their partner’s feelings. As one woman shared, “I’m very responsive with arching my back or moaning. I try to let him know he’s doing a good job with that instead of vocally because I’m not super good at getting what I want to say across correctly, and nonverbal signs aren’t usually miscommunicated between us.”
Others reported that nonverbal communication creates a deeper, more intuitive connection. “As one man explained, “I try to refrain from verbal communication during sex because it takes away from the moment. I’ll pay attention to her and the things that she’s enjoying, while also taking action to make myself comfortable.” Many participants felt that tuning into nonverbal cues allowed for a more seamless, instinctive connection between partners.
However, the study also highlighted a reluctance to express anything negative. One women admitted she would rather endure discomfort than risk offending their partner by saying, “That doesn’t feel good.” This echoes broader societal norms that prioritize affirming men’s sexual prowess while minimizing women’s needs.
Why We Hold Back
The reluctance to communicate isn’t just about politeness. It’s rooted in deeper social dynamics. Participants cited concerns about fragile masculinity, relationship stability, and even personal insecurities as barriers to open communication. Women, in particular, described how societal expectations of femininity often pressure them to prioritize their partner’s experience over their own comfort or pleasure. One woman explained, “I’ve told him that [my not orgasming is] not a huge deal. I don’t want him to feel like he is doing something wrong because I’m not getting off.” Her statement shows how societal expectations of femininity can pressure women to prioritize their partner’s experience over their own pleasure.
Interestingly, male participants were less likely to report withholding negative feedback. While this could reflect traditional gender norms around emotional expression, it also raises questions about how men and women perceive their roles in sexual encounters.
What This Means for Intimacy
Nonverbal cues aren’t inherently better or worse than verbal communication, but they do highlight the complexity of intimacy. The study suggests that building trust and comfort with a partner is key to fostering open communication—whether it’s spoken or silent. As one participant shared, “When I feel safe with my partner, it’s easier to say what I need or want.”
Let’s Keep the Conversation Going
The next time you’re navigating an intimate moment, remember: sometimes it’s not about the words you say, but the signals you give and how open you are to receiving them.
Our sexual experiences are shaped not just by what we do, but by how we communicate in the moment. Nonverbal cues—whether a lingering touch, a slight shift, or even shared eye contact—can deepen connection and foster understanding in ways words sometimes cannot. But that doesn’t mean silence is always golden. Building intimacy requires a willingness to bridge the gap between action and expression, creating a space where both partners feel seen, heard, and valued.
At the heart of it all is a simple but powerful truth: great sex isn’t about perfection or performance. It’s about paying attention, not just to what your partner needs, but to what you’re experiencing together in real time. By leaning into this awareness, we can cultivate intimacy that feels not only satisfying but transformative.
So, as you move forward in your relationships, consider this: what’s the balance between your verbal and nonverbal communication? Are you creating space for honesty and connection? And how can you ensure that both you and your partner feel safe to express yourselves fully, in whatever ways feel most natural?
Because when it comes to great sex, it’s not just what’s said that matters. It’s about what’s understood and felt.
Anna Gjika is Assistant Professor of Sociology at the State University of New York at New Paltz. Her research explores the relationships between gender, violence, youth, and technology, particularly as they pertain to sexual harm and sociolegal responses to gender-based violence. Her work has been published in Crime, Media, Culture,Gender & Society, the Journal of Interpersonal Violence,and Social Media & Society,among others. She is the author of the award-winning book, When Rape Goes Viral: Youth and Sexual Assault in the Digital Age (2024, University of California Press). You can find her on BlueSky: @gjikaphd.bsky.social and Twitter: @GjikaPhd Here I ask her 3 questions about her new book, When Rape Goes Viral: Youth and Sexual Assault in the Digital Age.
AMW: In your book, you critique surveillance-oriented approaches to teens’ digital activities and instead emphasize peer cultures, gender norms, and sexual ethics. How might families and educators shift from surveillance to fostering critical conversations that address these underlying issues?
AG: In my interviews for the book, young people stated that risk messages and surveillance responses from their parents and schools were often unhelpful and counterproductive, ignoring the primacy of technology for their identity and relationships. For teens, like for many of us, digital platforms are important for everyday communications, connecting with friends, developing and maintaining romantic relationships, and for the exploration and performance of gender and sexual identities. Rather than equipping youth with the skills necessary to navigate this social landscape, we are advising them – and young women, in particular – to protect themselves by limiting their digital engagement. This can contribute to reinforcing victim-blaming attitudes, and ignores common situations where individuals are coerced to share intimate images, or where images are created without the knowledge or consent of the victim. Monitoring teens’ devices and online activity can also normalize privacy invasions and even non-consent. It can send the message that love and care are expressed through surveillance, which young people may then go on to mirror in their own relationships and digital practices. Surveillance responses also generally communicate to teens that they are untrustworthy, which makes them more hesitant to reach out for help when they need it.
Perhaps most importantly, solutions that aim to restrict digital practices do not get at the causes of that behavior, which is what we need to understand to effectively support young people. They also fail to address one of the most harmful and underdiscussed effects of the digital turn, which is the way it has compromised our relationship with consent and ethics. By making the capture and sharing of information easy and routine, social media and mobile technologies have seriously eroded notions of consent in digital praxis and communication. And they have helped blunt human decency and concern for others by, instead, prioritizing and rewarding the sharing of information for likes and attention, which helps normalize abuse as a strategy for improving one’s status.
What I learned from my conversations with teens about image-based abuse is that when they are creating and/or sharing intimate images, whether consensual or not, whether real or fake, they are doing so with specific goals in mind. Sometimes their motivation is to bully or humiliate. More often, as my research shows, their digital activity is heavily driven by a desire to perform a valued identity (e.g., hetero-masculinity) and gain status and approval from their peers. I think the first step for us as parents and educators should be to identify what those motivations are in a non-judgmental way by asking young people to explain their thinking where problematic or abusive digital practices are concerned. Were they responding to pressure? Was it curiosity? A desire to show off to one’s friends? As I argue in the book, the explanations teens provide will tell us about how they understand gender, how boys and girls relate to each other, sexually, their thinking on consent, and the peer norms and power dynamics that inform their sexual and digital practices. I think from there, we can open further conversations about sexual ethics, gender inequality and harm, about consent and bodily autonomy, as well as privacy and ethical technological engagement. Such efforts would take young people’s voices and experiences seriously, while helping them consider the ethical implications of their digital activity and providing them with multiple strategies to better negotiate the digital landscape.
AMW: Your research highlights how digital cultures and platforms play a paradoxical role, both enabling image-based sexual abuse and providing crucial evidence to support survivors. Can you explain this tension and discuss how we might navigate these dual realities ethically and effectively?
AG: Image-based sexual abuse, which refers to the nonconsensual creation and/or distribution of private sexual images, including deepfake images, would not be possible at the present scale without digital technologies. We use our phones and various apps to create these images, which we then digitally distribute across social media platforms, online forums, and so on. These same platforms enable harm not only through the original violation, but also through the continuing and compounding trauma of the subsequent circulation, viewing, commenting, and downloading of images and videos they make possible. The scale and unbounded nature of social media often expose survivors to additional abuse and victimization through public shaming, intimidation, and harassment, further multiplying the harmful effects for many. That most platforms fail to regulate such behavior, and often reward perpetrators with likes and followers, also works to normalize and further sanction such abuse.
At the same time, every interaction with new technologies creates a digital trail that can be used as evidence by survivors and criminal legal actors. Smartphones and archives of one’s digital activity can provide proof of crime and corroborating evidence, which have historically been major obstacles in criminal justice responses to sexual violence and image-based abuse. For survivors not interested in engaging with the legal system, or in cases where law enforcement fails to investigate, digital platforms can also go some way in providing victims with spaces where they share their experiences and find validation and support. As I detail in the book, this potential is not always realized, and factors such as gender, race, class, sexual orientation, and age, among others, continue to inform and complicate both legal and social responses to survivors.
We have a long way to go towards navigating image-based abuse ethically or effectively. Despite improved efforts in recent years, how law enforcement treat victims and perpetrators of digital abuse remains inconsistent, especially where adolescents are concerned. We need more robust regulation of tech platforms and search engines to ensure measures such as content moderation, easy image removal, de-platforming of harmful apps, and investment in technologies that help identify abusive content (e.g., hash and watermarking). In the criminal legal system, we can redirect resources towards and improve processes for collecting digital evidence, which is often timely, invasive, and laborious, delaying justice for survivors. I also think we need to standardize practices with a focus on trauma-informed care around how digital evidence is used in investigations and proceedings, considering how such evidence might further traumatize victims. And I think we need to be much more critical about our reliance on digital evidence where sex crimes are concerned because while useful, the digital trail can also open survivors to increased scrutiny, deepening some of the system’s existing inequalities.
AMW: When Rape Goes Viral suggests that online sexual violence among teens mirrors broader societal values around gender and sexuality. Can you elaborate on how the book connects individual digital behaviors of teens to wider cultural attitudes, and what this reveals about our society’s implicit messages on gendered violence and accountability?
AG: Adolescents’ values and behaviors do not emerge in a vacuum. When young people participate in sexual violence, including digital abuse, they are telling us something about the cultural values and beliefs that shape their views and experiences of gender, sexual norms, and sexual victimization. If teens think such behavior is funny or normal, then that indicates that parents, educators, mentors, and the broader culture has provided them with specific scripts and narratives to normalize and sanction sexual harm. We know from a substantial body of research that dominant heteronormative discourses help excuse and minimize sexual violence by representing heterosexual relations as predatory, framing boys and men as natural sexual aggressors and women as gatekeepers of male sexual desire. We also know that often, we rely on victim-blaming narratives and rape myths to excuse sexual violence and perpetrator accountability – this is what is commonly referred to as rape culture.
One of my goals in speaking with young people was to tease out how many of these norms they have internalized, and the answer is most of them. In the book I offer extensive quotes from teens showing their essentialist understandings of gender, and their perception of heterosexual relations as hostile and exploitative, consisting primarily of male entitlement and female objectification. Both young men and women talked about the value of women’s bodies – and images of women’s bodies – as currency in young men’s masculinity performances and peer groups and seemed resigned to this reality. Rarely did girls frame nonconsensual image sharing as abusive. Rather, along with male participants, they fell back on traditional conceptions of gender and heterosexuality that posit boys as sexually aggressive and untrustworthy (e.g., boys will be boys), and girls as responsible for protecting themselves, to excuse sexual and image-based abuse and minimize their harm. They also often drew on victim-blaming narratives to trivialize the sexual violence, such as focusing on the victims’ intoxication and ‘irresponsible’ behavior to implicate them in their victimization.
One of my favorite sections of the book is when I compare these responses – especially the victim blaming and rape myths – with the responses of the parents, school officials, police officers, and attorneys involved in the high-profile cases discussed in the book, as well as reactions by the broader public, which I was able to document through social media postings and media interviews. The overlaps are striking, laying bare the connections between teens’ explanations and the rape-supportive attitudes expressed by parents, communities, and the media in the aftermath of the assaults. The sympathy voiced for the young offenders, juxtaposed against the vitriol and bullying directed at the young victims communicates to teens that sexual violence is trivial and normative, that we are not interested in holding perpetrators accountable, which works to further sanction such violence.
Social media has further reinforced and amplified this message, not only by providing a platform for people to voice and distribute their views and opinions to broad audiences, but also by consistently rewarding and promoting shocking and humiliating content because it drives traffic and user engagement. By commodifying attention, these platforms foster an environment where users are incentivized to create or circulate harmful or abusive material to enhance their status online. We see evidence of this in the rapidly increasing rates of gendered, racialized, and homophobic violence online, including online abuse and harassment, cyberbullying, doxing, nonconsensual and deepfake image creation and sharing, and the growth of rape and humiliation porn, among others.
Teens are learning about gender norms, sex, and digital ethics at the intersection of this culture that dismisses sexual violence while rewarding digitally abusive behavior. They see celebrities, athletes, and politicians skate free on charges of sexual abuse, violent misogynists like Andrew Tate becoming TikTok superstars, and the online abuse of women skyrocket without intervention from tech platforms, but certainly with more followers for the perpetrators in the manosphere. Why would our youth be immune to these messages? It should not surprise us if some teens espouse these values, if they think sexual and image-based abuse is funny or harmless, when so much of our culture communicates this message to them. I hope that by making these connections explicit, my book provides parents, educators, and policy makers with key insights and a framework from which they can create targeted and effective educational and prevention interventions for youth.
William Lopez is a Clinical Associate Professor at the University of Michigan School of Public Health and Faculty Associate in the Latina/o Studies Program. He is the author of Raiding the Heartland: An American Story of Deportation and Resistance, a follow-up to his award-winning first book, Separated: Family and Community in the Aftermath of an Immigration Raid. In addition to his academic research on the public health impacts of deportation, Dr. Lopez regularly contributes to the public discussions on deportation, diversity, and Latino culture in venues such as the Washington Post, CNN, San Antonio Express News, Detroit Free Press, and Truthout. He is on the Boards of Health in Partnership and The Latino Newsletter. He lives in Ann Arbor, MI, with his wife, two children, and pup. You can find him on Twitter: @lopez_wd and Instagram: @DrLopezOnImmigration. Here, I interview him about his new book, Raiding the Heartland: An American Story of Deportation and Resistance.
Cover Raiding the Heartland
AMW: The book vividly documents the emotional and logistical labor shouldered by local organizers and everyday residents in the wake of these raids. What does this reveal about who is actually doing the work of “family preservation” in America today?
WDL: In the aftermath of worksite raids–and really, any form of detention and deportation–entire communities show up to support the families of those detained. Those with professional roles often go above and beyond what they are used to, working through the night and pushing themselves to use an entirely new set of skills. After worksite raids, in which dozens to hundred of people are detained, those who respond include journalists who travel hundreds of miles to cover a breaking story, lawyers who have never done immigration work but show up at raid sites, and certainly pastors and other religious leaders who open church doors to those who are too terrified to return home.
But much of the labor after a raid goes unseen by the larger public and lasts far longer than the media is able or willing to cover. First and foremost, it’s families who support other families when someone has been removed. This work often falls to mothers, as fathers are more frequently detained in worksite raids. These mothers must counsel their children coping with the disappearance of a father, find ways to replace the income of the absent breadwinner, and figure out what to do without a driver to help with the logistics of the home.
And let’s talk about educators. One thing this research made abundantly clear is that after families, our country’s teachers will bear the brunt of mass deportation. It’s teachers who deal with half empty classes after a worksite raid, teachers who comfort the students asking where all their classmates are, teachers who explain to students that the parents who dropped them off may not pick them up. It’s principals and superintendents who have to make sure that buses don’t drop students off in empty homes, who have to figure out if they throw away all the extra food uneaten in the cafeteria because students didn’t show up or if they hand deliver it personally to students homes, which we heard about multiple times. And it’s school districts who have to figure out what to do about the enormous gap in learning between their Latino and white students that show up when deportations increase.
AMW: Much of the public conversation about immigration enforcement focuses on the border or urban areas. What does Raiding the Heartland reveal about how enforcement operates—and is resisted—in rural America?
WDL: Uneaten meals.
If there’s one thing that sticks with me, that I hear about over and over in my work, it’s how many times people mention the meals left uneaten after someone is detained. Over and over again, those left behind after an ICE arrest tell me about the violent and traumatic moment the father or the cousin or the neighbor is taken. Then they tell me about the moment after, the loud silence of the person’s absence, the work day, school day, or day of errands cut abruptly short, and the meal left uneaten.
This image of the uneaten meal has become one of best, albeit painful, ways for me to understand and describe deportation in rural areas like Michigan, Ohio, Nebraska, or Iowa: it’s violent and traumatic, sudden, and shocking, and then utterly, bitterly lonely. It’s also intimately violating, happening during tender family moments sharing food with nephews and nieces or eating birthday cake at a party. After worksite raids, so many people are detained that there’s often no one around to offer help because everyone is desperately trying to take care of their own families. And because the Latino population is so small in many rural areas, unlike in the South, there are relatively few protests and media attention.
I know this isn’t part of the question, but if there was one thing I worry about constantly, it’s that the advocacy and organizing energy built after the arrests in LA won’t transfer over to arrests and detentions in the Midwest because our Latino and immigrant populations are so much smaller.
AMW: Your book title also calls these worksite raids an “American story.” How is this an “American story,” and not an “immigrant story”?
WDL: So much thought goes into book titles that I’m glad you asked! You know, in my public health work, many of us who work on immigration issues are always making the case that these massive systems–like the deportation system–don’t just impact the health of immigrants. They shape the health of everyone in the US by changing the structure of families, economies, and even things like cross-race relationships. But our work is often seen as solely relevant to immigrants, or to Latinos, or to Spanish-speakers, or to other statistical minority groups.
But deportation, especially the mass deportation the current administration is engaged in, impacts everyone in the US. It’s not something anyone can ignore. At the very least, mass deportation is going to take the buy-in of millions and millions of Americans, who will see their kids go to half empty classrooms, families separated by borders, due process disappear, and the arrests of protestors who oppose these.
Not only that, but the scapegoating and removal of immigrants has always been part of American history. Some of the removal strategies we see now are not new, they are just being used on a larger scale.
So that this is an “American story” implies that mass deportation will affect us all. But it’s also meant to be a call out: we’ve been here before. We know how this goes. We know what strategies politicians use to spread fear about immigrants. And if mass deportation is going to happen, it’s going to take mass public consent. I like to believe the public will refuse to consent. We certainly are seeing this pushback throughout the country, most evident at the moment in LA.
When most people hear “BDSM,” they think of whips and chains, maybe a Fifty Shades reference, and then politely change the subject. What rarely gets discussed—but is central to how kink practitioners actually live—is the way BDSM communities foster connection, care, and growth in deeply intentional ways.
It’s about community and how radically different it looks when people stop pretending that happiness is a solo project.
When you’re seen as deviant, you build your own safety net
Many of the people we interviewed for the book spoke candidly about being misjudged. Friends and family didn’t always understand their desires. Therapists sometimes pathologized them. And pop culture offered little more than cartoonish stereotypes.
So, kink practitioners did what marginalized groups often do: they built community with each other. And not just social networks, but intentional, rule-governed, emotionally attuned communities, spaces where consent is explicit, identity is fluid, and power is discussed out loud.
In a world where most people fumble through relationship norms inherited from movies and childhood, BDSM practitioners are constantly customizing the script. They negotiate expectations. They check in. They reflect. And they don’t just do this with romantic or sexual partners. They do it with each other, as part of a larger social fabric.
One person we interviewed described their local scene not as a place to “play,” but as a place to be honest. “I can show up broken here,” they said. “I don’t have to pretend I’m okay to be welcome.”
What if more of us had spaces like that?
Community isn’t a bonus. It’s the point
In the vanilla world, we often treat community as an afterthought. You know, something you’ll get around to once you’ve handled your own healing, perfected your self-care, or completed your personal transformation.
But for many in the kink world, community is the container that makes growth possible. You don’t work through shame alone. You work through it with people who’ve done the same. You don’t figure out what boundaries you need in a vacuum. You learn by watching others, hearing their stories, and being offered tools.
That’s not some utopian fantasy. It’s a deeply practical, often messy, but remarkably effective way of being with others. It requires trust. It requires clear norms. And it requires a collective willingness to believe that people can change when they’re held, challenged, and supported.
It also flies in the face of how mainstream American culture talks about happiness.
The self-help model of happiness isn’t working
If you listen to the broader culture, happiness is something you earn through individual effort. Fix your mindset. Optimize your morning routine. Take time for yourself. Say no to others. Meditate more. Journal harder.
But as sociologists, we know that happiness is profoundly social. It doesn’t live inside your head, but within your relationships, your sense of belonging, your ability to be seen and accepted as you are.
The BDSM community offers a striking counter-narrative to the individualist pursuit of wellness. Instead of saying “you’re responsible for your own healing,” these communities say, we can do this together. Instead of self-help, they practice collaborative care.
One example? The practice of “aftercare,” where partners check in after an intense scene to see how everyone is feeling emotionally, physically, and relationally. Sometimes that means cuddling. Sometimes it means water, or silence, or reassurance. But the point is: you don’t just leave someone hanging after a vulnerable experience.
Imagine if we did that in other parts of life. After a hard conversation. After a breakup. After a job loss or a public embarrassment. What would it mean to live in a culture where we expect to be supported in the messy aftermath, not left to process it all alone?
Boundary work as collective responsibility
One of the most misunderstood things about BDSM is the centrality of boundaries. Not in a reactive, “you crossed a line” kind of way, but in a proactive, let’s agree on what we want and don’t want kind of way.
This kind of clear, mutual boundary-setting requires more than personal insight. It takes practice. Modeling. Community norms. And people who won’t shame you for naming what you need.
For many of our interviewees, learning to set and respect boundaries wasn’t something they figured out through therapy or reading a book. It happened in dungeons, discussion groups, and online forums. It happened by talking with others, seeing what worked, and building trust over time.
This kind of boundary literacy is a powerful skill, one that many “vanilla” people struggle with precisely because we treat boundaries as personal property rather than shared agreements.
Building better lives means building better communities
We didn’t write Bound by BDSM to recruit anyone into kink. We wrote it because we believe BDSM practitioners are doing something that matters, not just to them, but to the rest of us, if we’re willing to listen.
In a time when loneliness is epidemic, polarization is everywhere, and so many people feel disconnected, BDSM communities offer a working model of something else: intentional connection, co-created structure, and radical mutual care.
What would it look like to stop chasing happiness as a product of self-optimization and start building it together?
Andréa Becker (she/they) is a medical sociologist, sexual and reproductive health expert, and assistant professor of sociology at Hunter College-City University of New York. Their writing has been featured in The New York Times, The Nation, and Slate. You can find them on Instagram and Twitter @andreavbecker and learn more at andrea-becker.com. Here, I ask them about their new book Get it Out: On the Politics of Hysterectomy.
AMW: Why is there so much silence around the hysterectomy?
Cover of Get it Out
AB: We teach people with uteruses and ovaries to feel shame about these organs–especially when they are “malfunctioning.” Yet speaking out and forging communities around the various paths that lead to a hysterectomy–whether it’s endometriosis, fibroids, or part of gender-affirming care–can be lifesaving. We desperately need more research and attention within healthcare to these organs, and focusing on hysterectomy reveals just how much work there is to be done.
One in five people who are born with a uterus will have it removed by the time they are in their sixties—a statistic that was one in three when I began this project and one which never ceases to shock the person who asks why I study hysterectomy. And yet given the vast silence around hysterectomy, you’d never know how common it is. The reason for this silence is multifold. First, it is widely taboo to talk about nearly anything related to “women’s health” or “women’s organs”–from menstruation to vaginal infections to abortion. When it comes to hysterectomy specifically hysterectomy is understood as a devastating event that happens to you. To read about hysterectomy in the news is to read about disaster: emergency hysterectomy after a denied abortion, deadly hysterectomies during war, coerced hysterectomies on detained migrants. A hysterectomy often signals multifold systemic and legal failures, which are then forever written on the body—a body forever changed.
And yet, by hearing from one of the 100 hysterectomy seekers in my book and delving into the history of this procedure, the story of hysterectomy grows more complicated. While we rarely read about this in news headlines, many people want a hysterectomy, choose a hysterectomy, and are happy to have had a hysterectomy. As my interviewees explained, people might want a hysterectomy for a number of reasons, whether to find freedom from one of the many illnesses that affect the uterus and ovaries or to affirm their gender. In many ways, a hysterectomy can be understood as a form of self care. This is especially tha case because the modern hysterectomy is unrecognizable from its earlier forms–it’s now largely regarded as minimally invasive, typically outpatient, and leaves behind 3-5 tiny abdominal scars. Yet we continue to talk about hysterectomy, and doctors continue to approach the surgery as unilaterally devastating and to be avoided if possible.
AMW: How does the U.S. healthcare system deprive people of the ability to control their own bodies?
AB: When we talk about “the right to choose” conversations tend to be limited to abortion–to be able to exert agency in terminating a single pregnancy. Yet bodily and reproductive autonomy span far beyond the termination of a pregnancy. Full right to choose also means that a healthcare system is equipped to help you take care of your body. We refer to the uterus, ovaries, and cervix as the “reproductive system” or “reproductive organs” but people want to keep these organs healthy and pain-free beyond their use for gestating and delivering a pregnancy. We have known about endometriosis–a disease that impacts 10% of people with these organs–since the early 20th century for instance, yet still we can only diagnose it via surgery and there is no known permanent cure. As I say over and over in the book, to have a uterus in a medical system built for cis women having babies often means being pushed to want hysterectomy and then being told to wait. People with chronic pain and bleeding often choose a hysterectomy as a mode of self care and for many people it brings a lot of relief. Yet this choice is constrained. Would they choose this surgery if there was adequate attention, funding, and research devoted to promoting the health and wellbeing of the uterus, ovaries, and cervix? Would they have wanted a hysterectomy if they hadn’t spent years of their lives being told their pain was a normal part of having a uterus? It’s these broader structural and cultural conditions that ultimately render a hysterectomy constrained, even if it’s very much wanted and met with joy.
the pelvis—the way the body is externally racialized and gendered bestows distinct meanings on this particular part of the body. Looking closely at the various meanings deduced from these differently “housed” uteruses reveals the extent to which culture and politics interact with biological and structural forces to shape the experience of healthcare and of one’s own body. Race, class, and gender continue to stratify healthcare options, and ultimately the reproductive freedoms bestowed.
A hysterectomy as part of gender affirming care is also constrained, despite being recognized as essential care and one that brings joy and relief to those who want it. There is limited research on how the hormones involved gender affirming care impacts the uterus, ovaries, and cervix, and therefore conflicting information about whether someone taking hormones needs a hysterectomy. There’s long been a fear within the medical community that longterm use of HRT will lead to cancers in these organs, commonly leading doctors to suggest a hysterectomy to patients, and many trans and nonbinary patients opting into this surgery as a preventative measure even if having a uterus doesn’t necessarily bother them. At the same time, many of the transmasc people I spoke to would have liked to preserve their fertility, but the additional costs of games retrieval and cryopreservation on top of the hysterectomy was too burdensome. In many cases, their doctors didn’t even discuss fertility preservation, which is a stark contrast to women’s experiences. In a context of structural medical transphobia, limited research, and lack of funds, a hysterectomy as part of gender affirming care likewise becomes a constrained choice.
AMW: Why is there so much pushback for people who request a hysterectomy?
AB: Put simply, our medical system is obsessed with promoting women’s fertility (and with maintaining a sex/gender binary, in the case of trans and nonbinary patients). As the sociologist Miranda Waggoner aptly named it in her book, women’s bodies are construed as existing in a “zero trimester” of pregnancy, always viewed as one-day-pregnant or mothers in waiting. Given this, there is often a hesitation to permanently remove the capacity for pregnancy. This is particularly the case for white women, dozens of whom told me their doctors told them they were too young well into their late 30’s, that they would inevitably change their minds or feel grief, and in some cases, that their future husbands would be upset by their lack of uterus. We often talk about infertility as a tragedy–and for many it is–but the concept of willingly opting into infertility, even if in the service of living a happier, pain free, gender affirming life is so unfathomable to many.
Of note, my 100 interviews also revealed that hysterectomy is part of what sociologists call stratified reproduction. While white women well into their mid to late thirties were often told by their doctors that they are too young for a hysterectomy and told to try a dozen alternatives instead, many young Black and Afro-Latina I spoke to were recommended the surgery as their only choice. I was particularly struck by the contrast between two women, who I call Stacey and Luna. Both of these women were college students in east coast cities, and both had debilitating endometriosis symptoms in the form of chronic pain and incessant bleeding. Yet while Luna was brashly told she needed a hysterectomy as her only option, Stacey was told she should instead become pregnant as her cure. If she didn’t want the baby, her doctor assured her, she could always just place it for adoption after the pregnancy cured her. Medical research does not confirm that either pregnancy or hysterectomy is a full cure for this debilitating illness–yet race and class often come into play for which route a doctor chooses for their patient. While the uterus itself remains the same—a hollow, fist-sized, pear-shaped organ that lives in
A briefing paper prepared by Liana C. Sayer, University of Maryland and Joanna R. Pepin, University of Toronto for the Council on Contemporary Families online symposium The COVID-19 Pandemic and the Future of Gender Equality (PDF).
In the past, widespread economic impacts have affected gender dynamics in paid and unpaid work. For example, the concentration of job loss among men during the 2008 recession was associated with increases in married fathers’ household and care work. The COVID-19 pandemic produced an unprecedented economic crisis and it too brought about changes in parents’ employment. Job loss and reduced work hours were initially concentrated among women, particularly racial and ethnic minority women, and disproportionately affected mothers.
These employment changes alongside stay-at-home guidelines, restrictions on eating at restaurants, altered grocery shopping and cooking patterns, and public health guidance to sanitize living quarters led many scholars and pundits to speculate families were spending more of their time cooking and cleaning. Childcare closures and the shift to remote learning for schoolchildren upended parents’ expectations of the time necessary for supervising their children. Did these sharp disruptions to everyday family life affect gender inequality in unpaid work? And how are these changes associated with paid work during COVID?
Similar to what happened during the 2008 recession, initial research showed some signs that, in the early days of the pandemic, the parental gender gap in unpaid work narrowed. One study showed an 18% decrease in the number of minutes per day mothers and fathers spent with their children. In the Fall of 2019, the gender gap was about 175 minutes – nearly 3 hours – per day. By the Fall of 2020, the daily gap in time spent with children had declined to 144 minutes per day (about 2 hours 25 minutes). Another study, based on a non-probability sample of 1,025 US parents in different-gender partnerships, showed similar patterns. Although mothers continued to do more housework and childcare than fathers about one month into the pandemic, notably, fathers increased their contribution to the household labor. It wasfathers’ greater time spent in unpaid labor that narrowed the gender gap.
However, as the pandemic carried on, evidence of lasting change didn’t materialize. A follow-up study showed that the shift toward more equal sharing of housework returned to pre-pandemic levels by November 2020. As childcare facilities remained closed and schools shifted to remote learning, mothers more than fathers rearranged their daily lives to provide more supervision for children’s school-related activities and to physically care for children at home. The return to mothers doing more of this work than fathers was rationalized by parents who pointed to structural constraints – such as the motherhood earnings penalty and fatherhood premium – and cultural prescriptions about appropriate behaviors for men and women.
The premier source of daily activity data, the American Time Use Survey, is now available for the years prior to the pandemic (2019), early in the pandemic (2020), and late in the pandemic (2021). A new study1 uses this data to show how the pandemic affected gender inequality in unpaid work among parents with children ages 12 and younger. The analysis focuses on changes from 2019 to 2021 in mothers’ and fathers’ time spent on housework and three types of childcare: 1) parental childcare (time when childcare is the primary task and only focus of attention); 2) secondary childcare (time when parents are monitoring children but not directly engaged in childcare or other activities with children); and 3) total time spent with children present (e.g., watching TV with children). The findings confirm the pandemic affected gender inequality in unpaid work and reveal that it did so unevenly across types of unpaid work.
The most striking finding is the lack of change in the gender gap in parental childcare time. There were no statistically significant changes in either mothers’ or fathers’ time providing childcare between 2019 and 2021, meaning mothers continued to do about 40 minutes more childcare per day than fathers. Time parents are actively providing care consists of both physical childcare (e.g., hands-on care and supervision) and developmental childcare (e.g., education, playing, talking). Between 2019 and 2020, mothers’ physical childcare decreased slightly, but this was counterbalanced by a modest increase in time spent on developmental childcare, and levels in 2021 were similar to 2019. This lack of change in primary childcare suggests that in 2020 parents redistributed time across specific types of childcare activities (such as away from driving children to organized activities to managing and supervising children’s remote education and play) rather than making larger investments of time in childcare.
Still, the time parents are actively providing care does not reflect the whole spectrum of parental time investments in children. Some childcare is multitasked with other activities. For example, parents fortunate to work remotely may have experienced more flexibility in integrating childcare and housework into their lives by multitasking. But research on the early days of the pandemic suggests that fathers who work remotely safeguard their work time and space (and leisure) from care of and time with children. Although the ATUS data (like most international time use data) does not collect data on multitasking, it does collect data on secondary childcare – time parents are monitoring children’s activities and whereabouts while doing something else. Mothers’ secondary childcare initially increased 47 minutes/day in 2020 but then decreased 22 minutes from 2020-2021. Fathers followed a similar pattern, leading the gender gap in secondary childcare to remain constant during the early pandemic years.
Parents also do some daily activities with children present, such as taking a walk or watching TV while children are present. Mothers’ time with children did not change between 2019 and 2021 – around 6 hours and 40 minutes each day. In contrast, fathers’ time with children increased 30 minutes in 2020 and 13 minutes more by 2021. As a result, the gender gap in time with children narrowed from 2019-2021. The slight decrease in fathers’ time with children in 2021 may result from easing restrictions on public activities and social interactions, with children returning to school and childcare centers and older children spending more time outside their homes with friends.
The ATUS data also suggests the pandemic impacted unpaid work differently depending on parents’ employment circumstances1. Among employed mothers and fathers who worked only at home on the ATUS diary day, mothers spend about 30 minutes more per day than fathers providing physical care – but there is no significant gender gap in developmental care. This holds in 2019, 2020, and 2021 – suggesting the pandemic didn’t disrupt or exacerbate the gender gap in parental childcare. Additionally, fathers who worked at home on ATUS diary day reported more childcare time compared with those who worked outside the home (about 38 minutes more in 2021), and just about as much as non-employed fathers. College educated fathers are more likely to hold jobs that allow remote work and those fathers may have engaged in status safeguarding parenting behaviors during the pandemic.
Turning to housework, fathers’ time in housework increased about 10 minutes/day between 2019 and 2020 before a return to 2019 levels by 2021. Mothers continue to do about an hour more housework per day than fathers. Hence, the pandemic appears not to have led to greater gender equality in housework. Interestingly, though, housework did not increase during the pandemic even among mothers who worked remotely.
What do these findings mean for gender inequality in unpaid work in the future?
There are two possible ways to narrow the gender gap in housework and childcare: 1) decrease women’s time spent in unpaid labor or 2) increase men’s time spent in unpaid labor. Longitudinal data suggest childcare time increased among some parents, such as those who reduced paid work hours or left jobs altogether. About half of mothers’ increased childcare time during the initial phase of the pandemic can be attributed to mothers’ decline in paid work and leaving the labor market altogether. This is not surprising given that the United States only temporarily expanded the family safety net. Pundits and scholars alike believe the possibility of addressing the critical need for federal policies subsidizing childcare facilities and securing a robust care infrastructure is slim in the current political and social conflict. Still, 13 U.S. states and D.C. have passed legislation requiring paid family or parental leave, and 14 U.S. States and D.C. require employers to provide paid sick days. These workplace policies are likely to support mothers’ labor force participation, tamping down increases in mothers time spent providing childcare. Additionally, the absence of paid parental leave in the U.S. and U.K. negatively affected mothers’ mental health during COVID, in contrast to those in countries like Canada and Australia that offered paid leave during COVID.
The long historical arc of work on gender inequality in unpaid work offers only one vision for greater gender equality: it requires fathers’ daily time use to become more like mothers, particularly through the investment of fathers in housework and in childcare. Intentional efforts to bring this about at both an individual and societal level are necessary to bring about more lasting shifts toward greater equality in unpaid labor.
1Sayer, Liana C., Kelsey Drotning, and Sarah Flood. “Gender Racial, and Class Disparities in COVID-19 Impacts on Parent’s Work & Family Time.” Paper presented at the June 2022 Work and Family Research Network conference, New York, NY
About the Authors
Liana C. Sayer is Professor of Sociology and Director, Maryland Time Use Lab and Editor, Journal of Marriage and Family. She can be reached at lsayer@umd.edu. You can follow her on Mastodon sciences.social at @lsayer.
Richard J. Petts, Daniel L. Carlson, and Wen Fan on August 19, 2025
This picture was created by Gemini. Caption: “The benefits of remote vs. in-person work likely depend on which arrangement workers prefer.”
The debate about what type of work arrangement is best for worker well-being and work-life balance has raged for years. Most recently, this issue was brought to the foreground by the COVID-19 pandemic. While the mass transition to remote work during the pandemic opened the door for many workers to finally have the job flexibility they craved, essential workers who did not have that option experienced worsened mental health. Nonetheless, not all benefited from remote work during the pandemic. Indeed, the Great Resignation was fueled in part by some workers, mothers especially, who struggled substantially with the intrusion of home and family into their workday, and found themselves cutting back on work hours or leaving their positions altogether.
The pandemic demonstrated that on-site work and remote work both have costs and benefits. On-site work benefits workers by helping them maintain clear boundaries between work and family, reducing the possibility of work-family conflict. The downside, however, is that the rigidity of those boundaries makes it difficult to manage multiple roles. The benefits of remote work are in many ways the opposite. Working remotely provides employees the flexibility to manage their multiple role obligations and maintain work-life balance. Yet, flexibility can also foster role conflict by weakening the boundaries between work and family.
Though work locations may each come with their own costs and benefits, that does not mean that they come in equal measure. Research nonetheless is quite mixed, leaving the answer to whether on-site or remote work is best as elusive. One potential reason for this is that workers’ preferences often are not considered when employers make decisions about work location.
In a recent study published in Society and Mental Health, we examined work-place mismatch – the degree to which preferred and actual work locations are not aligned – and the degree to which this mismatch is associated with working parents’ well-being. To do this, we used national survey data collected in 2023, and focused on approximately 2,300 employed parents. Parents were asked how frequently they worked from home, as well as how frequently they preferred to work from home. We used this information to assess the degree to which parents’ actual work location matched their preferences.
Though disconnect between parents’ actual and preferred work location is common, the most important question is: does this matter for workers? In our study, we found consistent evidence that work-place mismatch is associated with lower well-being among working parents. Specifically, parents who experience greater work-place mismatch report higher work-family conflict, higher stress, and more depressive symptoms. In fact, our findings suggest that the disconnect between actual and preferred work location matters more for parents’ well-being than work location itself. Moreover, we found that failure to account for preferences masked the impact of work location on well-being. When looking just at work location, we found no differences in well-being between remote, hybrid, and on-site workers. Yet, when we looked at both work location and work-place mismatch together, we found that on-site working parents actually experience lower work-family conflict, stress, and depressive symptoms compared to hybrid or remote working parents.
What this demonstrates is that failure to account for workers’ preferences (and subsequent mismatch between actual and preferred work location) leads to underestimation of some intrinsic benefits to on-site work, particularly because work-place mismatch is much more pervasive among those working exclusively in-person. Put another way, while on-site work may have benefits to worker well-being, workers’ overwhelming preference (and need) for workplace flexibility diminishes any benefits that on-site work may provide.
Overall, our research suggests that there is no one “best” work location. Instead, the work location that is best for workers is the one that suits their own preferences and needs. When parents work in a location that matches their preferences, which overwhelmingly involves at least some remote work, they report less work-family conflict and higher psychological well-being compared to workers who experience mismatch between their actual and preferred work location.
Organizations are increasingly investing in workplace wellness programs, acknowledging that employee well-being is linked to positive outcomes such as organizational commitment and productivity. Our findings suggest that recognizing variations in workers’ preferences about working remotely, on-site, or in a hybrid format – and designing policies that enable workers to align their preferred and actual work locations – would promote higher well-being among workers and alleviate some of the challenges experienced by workers and organizations during the Great Resignation, including promoting employee retention and commitment.
Richard J. Petts is a Professor of Sociology and Associate Dean of the College of Sciences and Humanities at Ball State University. He also serves on the board of directors for the Council on Contemporary Families. You can read more about his research at www.richardpetts.com.
Daniel L. Carlson is an Associate Professor and Chair of the Department of Family and Consumer Studies at the University of Utah. He is a sociologist and family demographer studying the gendered division of labor. He serves on the board of directors for the Council on Contemporary Families.
Wen Fan is an Associate Professor of Sociology at Boston College. Her research focuses on the work, family, and well-being implications of alternative, new ways of working. You can read more about her research at wenfan.co.
About Council on Contemporary Families
The Council on Contemporary Families is a non-profit, non-partisan organization dedicated to providing the press and public with the latest research and best-practice findings about American families. CCF seeks to enhance the national understanding of how and why families are changing, what needs and challenges they face, and how these needs can best be met.
