Opinion: STAT readers on MAHA activists, perimenopause, and diversity in medical school

OpinionLetters to the editor STAT readers on MAHA activists, perimenopause, and diversity in medical school Keep those letters coming! Manage alerts for this article Email this article Share this article By Torie BoschMay 2, 2026 Editor, First Opinion Torie Bosch[email protected]Torie Bosch is the First Opinion editor at STAT. First Opinion is STAT’s platform for interesting, illuminating, and provocative articles about the life sciences writ large, written by biotech insiders, health care workers, researchers, and others. To encourage robust, good-faith discussion about issues raised in First Opinion essays, STAT publishes selected Letters to the Editor received in response to them. You can submit a Letter to the Editor here, or find the submission form at the end of any First Opinion essay.Advertisement The story “I’m a MAHA activist. I went into the public health lion’s den — and it changed how I think,” by Aaron Everitt The response It’s great that you had the opportunity to actually interact in a professional setting with the people in our country who have actual expertise: doctors, scientists, etc. Unfortunately, the resources don’t exist to take every flat-earther to the International Space Station to change their mind. It seems MAHA folks are being intentionally misdirected by meaningless nonsense (like concerns about red 40 dye, vaccines, and fluoridated water) to intentionally distract you, the medical/scientific communities, and our wider population, pitting us all against each other so that we aren’t focused on the real issue: the corporate interests and their corruption of our politics for their gain and the rest of our loss. Yes, I will go as far as to say that there is mainly one political party who gains from this. And it’s the same story with social media billionaires, it’s the same with unnecessary wars, disinformation in general. The billionaire class benefits, while the rest of us suffer and fight with each other. Please don’t conflate corrupt politicians and corporate interest preventing our country from having an effective health care system that protects us all with the authoritative experts, doctors, scientists, and officials who are doing their best to protect us in light of the limitations imposed on them by that corrupt system. I hope MAHA can begin to at least appreciate the irony the rest of us see: You’ve got your red dye banned, so now you can “safely” eat Cheetos and Skittles as much as you desire, while you watch our entire health care safety net being dismantled before our eyes. Was it worth it? — Doug Ray The story “Medical schools must continue to teach students about structural barriers to care,” by Uché Blackstock The response Uché Blackstock’s piece hinges on a narrow premise: that unless physicians are formally trained in matters of “equity,” they will overlook the real-world constraints their patients face. She therefore laments the Liaison Committee on Medical Education’s decision to drop its requirement that medical schools teach about equity — i.e., the non-medical social and political realities that may affect patients’ lives.Advertisement Yet Blackstock fails to account for two basic truths. First, clinicians have long done the listening she wants, without being subjected to inherently politicized equity-based training. Inquisitiveness about a patient’s unique circumstances has always been key to medicine. For generations, physicians have been taught to take a social history. Good doctors listen, adapt plans pragmatically, and focus on what they are uniquely trained to do: assess, diagnosis, and treat the patient before them. Empathy emerges from clinical competence, not ideological instruction that supplants scientific rigor. Second: How does turning physicians into amateur social workers improve clinical results? The LCME’s old standard was a vehicle for implicit bias training, antiracism frameworks, and other ideologies that framed disparities primarily through systemic oppression rather than the complex interplay of behavior, biology, and access. In practice, it crowded out core science and pressured schools to focus less on clinical education. This has resulted in students who are trained to see patients through group identity lenses — not as individuals with distinct clinical needs. As such, equity-based training is less likely to encourage what Blackstock wants most: a focus on each patient’s unique situation. The LCME’s revised standards recognize that medical education must prioritize the knowledge and skills only physicians — not social workers or policy advocates — are trained to deliver. Its pivot back toward self-directed study, critical appraisal of evidence, and professional learning aligns with medicine’s mission: producing scientifically grounded physicians capable of providing the very best in care. Merit-focused education equips physicians to serve all patients through competence, not sociological training. At the end of the day, physicians can’t solve the housing, food access, and transportation issues facing patients. We have neither the agency nor authority to do so; nor should we. Our job is much more focused — and vitally important. We seek to improve patients’ health and empower them to lead the best lives. The LCME is right to refocus medical education on medicine.Advertisement — Kurt Miceli, Do No Harm The story “The perimenopause movement sells women the lie that they are ruled by their hormones,” by Patricia Bencivenga and Adriane Fugh-Berman The response Patricia Bencivenga and Adriane Fugh-Berman raise a legitimate concern about pharmaceutical and wellness marketing of hormone therapy. But the article applies the same historical critique to dismiss current independent science, giving scientific cover to inaction that can have a significant impact on women’s cognitive health. Estrogen receptors are concentrated in the hippocampus and prefrontal cortex, governing memory, executive function, and decision-making. Neuroimaging research by Lisa Mosconi at Weill Cornell demonstrates measurable changes in brain glucose metabolism during the menopausal transition, detectable years before the final menstrual period. Mosconi calls this a bioenergetic brain crisis. Up to 60% of women experience it as confusion, difficulty concentrating, and forgetfulness that is estrogen-specific, not just aging. The authors’ primary evidence of harm is from the 2002 WHI study, which studied conjugated equine estrogen and synthetic progestin in women averaging 63 years old, more than a decade past menopause. The critical window hypothesis has emerged from re-analysis of WHI data itself, not from pharmaceutical research. The current Menopause Society position statement confirms that for healthy women under 60 or within 10 years of menopause the benefits of hormone therapy outweigh the risks for most women. The authors assert that only hot flashes and vaginal dryness are genuinely associated with menopause, citing a 1970s NIH consensus conference that predates decades of neuroimaging and cardiovascular research — an outdated position. The real-world consequences of dismissing the impacts of menopause are measurable. A Mayo Clinic study of nearly 5,000 women found more than 80% did not seek medical care for menopause symptoms despite substantial effects on daily life and work productivity. Lifestyle interventions are foundational. But exercise and estrogen share a molecular pathway. Preclinical research shows long-term estrogen deprivation epigenetically silences BDNF in the hippocampus, blunting the brain’s response to exercise over time. For some women lifestyle alone may not be enough. Current evidence, including a meta-analysis of more than 50 studies by Lisa Mosconi’s team and 14-year follow-up data from the KEEPS Continuation Study, shows that estrogen therapy initiated within 10 years of menopause is associated with significantly reduced dementia risk.Advertisement The answer to pharmaceutical and wellness overclaiming is not a counter-narrative that frames women who seek hormonal support as manipulated or anti-feminist. Understanding your neurobiology is not the same as being ruled by it. The answer is precision and clinical rigor rather than either a supplement or a shrug. — Manna Semby, Aruna Personalized Medicine and Center for Cognitive Resilience, San Diego, Calif. diversity and inclusion, education Submit a correction requestReprints Torie Bosch Editor, First Opinion Torie Bosch is the First Opinion editor at STAT. Newsletter The smartest thinkers in life sciences on what's happening — and what's to come Recommended First Opinion Podcast May 2, 2026 What do medical students think about their education? First Opinion May 1, 2026 America is worrying about fertility again. But it’s not really about families Advertisement First Opinion May 1, 2026 The psychedelic revolution is leaving behind people of color First Opinion April 30, 2026 Are international medical graduates taking residency spots from Americans? We did the math First Opinion April 30, 2026 Congress must hold RFK Jr. accountable after hearings Subscriber Picks