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The most important stories for you to know today
  • Heavy metal icon dies at 76
    A white man with long hair and circular glasses is laughing while he holds his left hand to his face.
    Ozzy Osbourne photographed in 2004. The heavy metal legend has died at the age of 76.

    Topline:

    Ozzy Osbourne, the influential and salt-of-the-earth singer who came to be known as the Prince of Darkness, has died in Birmingham, England, according to a statement from his family.

    Black Sabbath: Osbourne founded the iconic heavy metal group, Black Sabbath, in the late 60's. Black Sabbath's self-titled first record, was an unexpected, and runaway success, entering the U.K. charts and cracking the top 10. Black Sabbath's vaguely occultish presentation was entirely superficial, but against the backdrop of Manson murders and the disintegration of the utopianist '60s, the group's overdriven, electrified take on the blues, its blackened psychedelia and vaguely political overtures, the image clicked.

    Solo career: The four's early and rapid success was the spark that ignited a decade of dizzying excess. By the end of the '70s, the four were barely speaking. It wasn't long before he found a young American guitar virtuoso named Randy Rhoads, and started working on a solo venture. Osbourne quickly began being known for his wild, rockstar antics. Some of these stunts (biting the head off a dove) were planned. Others, (biting the head off a bat) weren't.

    The Osbournes: Osbourne entered the lives of non-heavy metal fans in 2002 with the debut of The Osbournes. The show was a hit, with cameras following Ozzy, his wife Sharon, and their children Kelly and Jack (eldest daughter Aimee refused to be filmed), in their day-to-day habitat.

    Ozzy Osbourne, the influential and salt-of-the-earth singer who came to be known as the Prince of Darkness, has died in Birmingham, England, according to a statement from his family.

    That statement, attributed to his wife, Sharon Osbourne, and his children Jack, Kelly, Aimee and Louis, reads, "It is with more sadness than mere words can convey that we have to report that our beloved Ozzy Osbourne has passed away this morning. He was with his family and surrounded by love. We ask everyone to respect our family privacy at this time."

    Ozzy Osbourne was born John Michael Osbourne on Dec. 3, 1948, the son of John "Jack" Thomas Osbourne and Lillian Osbourne (née Unitt), the fourth of six children. The Osbournes lived at 14 Lodge Road in the Aston area of Birmingham, U.K., where Ozzy would remain for some time, including while pursuing a career as a rock and roll singer.

    Once he became a star, he remained associated with the city, and returned often. He played a much-heralded final show with Black Sabbath, one of the most influential bands in hard rock and heavy music, in Birmingham just 17 days ago, on July 5.

    England's second-largest city, Birmingham was still pocked with rubble from World War II when Osbourne was growing up there; the city was a target of German bombers due to its importance as a hub of arms manufacturing.

    He was, by his own admission, a terrible student — in large part due to his dyslexia and attention-deficit/hyperactivity disorder, which would go undiagnosed until he was in his 30s — and left school at the age of 15. But not before being lightly bullied by, among others including a teacher, his future bandmate, Tony Iommi, who was a year ahead of him. Iommi "might have kicked me in the bollocks a few times and given me some s***, but nothing more than that," Osbourne wrote in his memoir, I Am Ozzy. It was around this time that he self-applied both his famed knuckle tattoo, which spelled out OZZY on the fingers of his left hand, and two smiling faces on his kneecaps, which he said brought him joy whilst sitting on the toilet.

    After his unceremonious exit from school, Osbourne seemed to have little future outside of manual labor, though it would later become clear that "rock star" may have been the only viable career path for him. The "class clown," as Iommi described him in his own memoir, was dismissed from several jobs in quick succession.

    After 18 months of working in a slaughterhouse — after failing at several other trades — Osbourne was fired for beating a coworker bloody with a metal rod. The dismissal led Osbourne towards a short-lived, star-crossed career as a criminal, during which he accidentally stole baby's clothes (it was nighttime and he couldn't see well); a television, which he had to leave behind after it fell on him mid-burgling; and finally, while pilfering some shirts, Osbourne wore gloves that didn't cover his thumb, leaving prints all over the scene and leading the police to his door. ("Not exactly Einstein, are we," he recalls them saying.) He was given a three-month prison sentence, and was sent to HM Prison Birmingham, known as Winson Green, where he spent six weeks. (Twenty-odd years later, Osbourne's "last good memory of the '80s" would be playing a gig at the same prison.)

    After his release, Osbourne's father — despite money having been tight his whole life — took out a loan in order to buy his son a PA, the only equipment required of aspiring rock singers at the time. Then Ozzy placed an ad — "OZZY ZIG NEEDS GIG" — in the window of a local music shop. "One day, I thought," Osbourne wrote, "people might write newspaper articles about my ad in the window of Ringway Music, saying it was the turning point in the life of John Michael Osbourne, ex-car horn tuner."

    The ad led guitarist and man-about-town Geezer Butler to his door, kicking off a brief attempt at forming a band — Rare Breed — that went nowhere, but gave Osbourne his first taste of performing. The pair, now friends, went their separate ways a few months later. But, fortuitously, the ad also led a former acquaintance of Osbourne's to his door: guitarist Tony Iommi, accompanied by drummer Bill Ward, both recent wash-outs from the relatively vibrant English rock touring circuit. (Iommi's previous band, Mythology, had been forced to break up due to a pot bust at their hotel during a tour, making them all-but unbookable at the the time.)

    Iommi was initially dismissive of Ozzy, but the four eventually ended up rehearsing together. Despite the theatrical malevolence they would come to be known for, the group was first called something far more innocuous: the Polka Tulk Blues Band, with singer Ozzy Osbourne, guitarist Tony Iommi, bassist Geezer Butler, drummer Bill Ward, saxophonist Alan Clark and bottleneck guitar player Jimmy Philips.

    The group's first gig was Aug. 24, 1968, at the County Hall Ballroom in Carlisle, in the northwest of the country. Immediately afterwards Clark and Philips were out, as was the band name (which Ozzy had come up with after seeing it on a bottle of his mom's talcum powder). The four were now known as, simply, Earth. But just as they were generating some momentum from touring, Iommi left to join the big-deal band Jethro Tull as its new guitarist.

    After Iommi returned to Birmingham and his bandmates, Earth redoubled its efforts, inspired by the professionalism Iommi saw during his brief detour with Jethro Tull. They also decided on a new, darker direction. The first fruits of the change would eventually come to be eponymous — but "Black Sabbath" was a song before it was a band, and a horror movie before it was a song, though Osbourne had no idea at the time (he suspected that Butler, who had come up with the song's title, had never seen seen the film).

    Booked by their first manager, Jim Simpson, the four spent pretty much all of 1969 touring — including a residency in Hamburg at the Star Club, the same place where Osbourne's beloved Beatles had honed its chops. The group, now officially Black Sabbath, signed a record deal in early 1970, to Vertigo, an imprint of Philips.

    Black Sabbath's self-titled first record, which they'd recorded by essentially playing a quick live set, was released on Feb. 13, 1970 (a Friday, of course). It was an unexpected, and runaway, success, entering the U.K. charts the following month and cracking the top 10 that July.

    Black Sabbath's vaguely occultish presentation was entirely superficial, but against the backdrop of Manson murders and the disintegration of the utopianist '60s, the group's overdriven, electrified take on the blues, its blackened psychedelia and vaguely political overtures, the image clicked. (Maybe too much; Black Sabbath would eventually be celebrated by Satanist leader Anton LeVay in a San Francisco parade. "At one point we were invited by a group of Satanists to play at Stonehenge. We told them to f*** off, so they said they'd put a curse on us," Osbourne wrote. "What a load of bollocks that was.") "The good thing about all the satanic stuff was that it gave us endless free publicity," Osbourne remembered in his book. "People couldn't get enough of it. During its first day of release, Black Sabbath sold five thousand copies, and by the end of the year it was on its way to selling a million worldwide."

    But it didn't click for everyone — the record was near-universally panned by critics ("the album has nothing to do with spiritualism, the occult, or anything much except stiff recitations of Cream clichés," Rolling Stone wrote) and was all-but ignored entirely by disc jockeys at the time (save the legendary John Peel, an acquaintance of Jim Simpson's, who booked them for one of his historical, if off-air, sessions). Regardless, that year they performed on Top of the Pops, which Osbourne had watched religiously with his family at home while growing up. He was 21 years old.

    The group had Paranoid, its indelible follow-up — which contains several canonical rock songs, like "War Pigs / Luke's Wall," its title track and "Iron Man" — written and practically in the can by the time Black Sabbath had reached its peak on the U.K. charts. Paranoid was released later in 1970; cementing the ascent of Osbourne, Iommi, Butler and Ward. After a management change the group would later come to regret — it hired Patrick Meehan, who it turned out "was taking nearly everything" and for whom they would title the album Sabotage — Black Sabbath was on its way.

    The four's early and rapid success was the spark that ignited a decade of dizzying excess — for which Osbourne was, it would become evident, genetically predisposed to endure. But by the end of the '70s, the four were barely speaking.

    Osbourne's pursuit of a solo career, aided by his future wife and manager Sharon Osbourne, still Arden at the time — the daughter of the well-known executive who had first signed Black Sabbath — began in 1980 with the release of Blizzard of Ozz. The album was largely co-written by Osbourne, guitarist Randy Rhoades and bassist Bob Daisley. Rhoades, whose short-lived career is considered wildly influential on the sound of metal, died in an airplane crash in 1982, while on tour with Osbourne. In 1986, Daisley and drummer Lee Kerslake successfully sued over songwriting credits on the album.

    Ozzy on his own

    While the rest of the band may have had more musical chops, what Osbourne brought to the table was his showmanship. "Ozzy was a wild man," said publicist and journalist Mick Wall, who wrote Black Sabbath: Symptom of the Universe. "He left it all on the stage, he put everything into it."

    He lived that way off stage, too. The band's early and rapid success was the spark that ignited a decade of dizzying excess — for which Osbourne seemed to be predisposed. His drug and alcohol use was a strain on the band, and by the end of the decade the four were barely speaking. A breaking point came when, after a days-long bender, Osbourne fell asleep in the wrong room and slept through a gig. By 1979 he was fired from Black Sabbath.

    But it wasn't long before he found a young American guitar virtuoso named Randy Rhoads, and started working on a solo venture. Their first album together was titled Blizzard of Ozz — a sort of play on The Wizard of Oz and cocaine. The album did well in England, but the band had trouble breaking through in the U.S., despite the record containing what's possibly his most recognizable solo song, "Crazy Train." Luckily, he now had a manager who knew exactly how to push the public's buttons to get the band some attention: his future wife Sharon Osbourne.

    The two were starting up a romantic relationship, and at the same time, Sharon was setting up stunts for Ozzy to get more attention.

    "At this stage, Sharon is secretly organizing protests outside his shows, because it gets all this publicity," said journalist Wall. "All this is stoking the fires, which is building album sales, and turning him into a major star."

    Osbourne quickly began being known for his wild, rockstar antics. Some of these stunts (biting the head off a dove) were planned. Others, (biting the head off a bat) weren't. But they did become part of his identity — something that, to Osbourne's annoyance, journalists would pester him about for the rest of his life.

    By 1982, Osbourne was touring the U.S. with his second solo album, Diary of a Madman. Osbourne was asleep on the tour bus when it pulled over into an airfield to fix something wrong with the air conditioning. There, the bus driver convinced Rhoades and hair and make-up artist Rachel Youngblood to go on an airplane ride with him, promising to not pull any stunts. But in an attempt to buzz the tour bus, the plane clipped the bus and crashed. The driver, Rhoades and Youngblood died.

    In his memoir, Osbourne described this moment with a mix of confusion, anger and sadness. But he and Sharon ultimately decide to continue the tour. Osbourne even kept his commitment to appear on Late Night with David Letterman, where he explained, "I'm going to continue because Randy would've wanted me to continue, and so would Rachel. And I'm not going to stop because you can't kill rock and roll."

    "The Osbournes"

    Shortly after the plane crash, Ozzy and Sharon Osbourne got married, and later they had three kids. They would later recount getting into fights, amped up by alcohol and drugs. As a father, Osbourne could be fun and lovable, until he got drunk enough that he got scary and angry. In one incident, he attempted to kill his wife in a drunken stupor.

    "He lunged on me," Sharon Osbourne told 60 Minutes Australia. "And got me down to the floor and started strangling me."

    He ended up doing a long stint in rehab, though he'd continue to have an on-again, off-again relationship with sobriety. But the family did manage to calm things down enough to start inviting cameras into their home and filming The Osbournes. The show was a hit. Premiering on MTV in 2002, and co-produced by Sharon Osbourne, it laid the groundwork for much of reality television to come (there is a fairly straight line from The Osbournes to the Kardashian empire).

    The Osbournes followed Ozzy, Sharon, Kelly and Jack (eldest daughter Aimee refused to be filmed), in their day-to-day habitat — Ozzy struggling with the T.V., Kelly and Jack bickering, Sharon attempting to keep everyone in line. The show softened Ozzy Osbourne's image enough that it wasn't a complete shock when he was invited to the 2002 White House Correspondents Dinner and received a special shout out from President George W. Bush.

    The rush of mainstream TV fame got to him. That very night at the White House Correspondents Dinner, he started drinking after a long stretch of sobriety. And seeing his image constantly forced him to confront some things about his health. He'd developed a stammer. His tremors got worse. In 2020, Osbourne revealed to Good Morning America that he had Parkinson's disease, after years of rumors about his medical condition. "To hide something inside for a while is hard," he said. "Because you never feel proper. You feel guilty."

    As the show came and went, Osbourne never lost his ties with the music world he came from. He released solo records at a consistent clip, and he (along with Sharon, of course) ran Ozzfest — an annual music festival dedicated to the types of bands that could cite Osbourne as a primary influence: Slipknot, Slayer, Tool, and more. It's a long list of bands — and, perhaps, the most concrete example of Ozzy Osbourne's legacy.

    Copyright 2025 NPR

  • Fears of legal blowback to boat strikes emerge

    Topline:

    U.S. service members — including staff officers and at least one drone pilot — are seeking advice from outside groups, fearing they could face legal consequences for any involvement in the Trump administration's lethal strikes on suspected drug boats.

    The backstory: Over the past three months, the U.S. has blown up more than 20 vessels in the Caribbean and Eastern Pacific that the administration says were running illicit narcotics. More than 80 people have been killed in the strikes. The administration says it is taking action to stop the flow of drugs into the U.S.

    Why it matters: Many legal experts, however, including former military lawyers, contend the strikes against the alleged civilian narcotraffickers are unlawful and amount to murder.

    Read on... for what organizations who work with military members are hearing.

    U.S. service members — including staff officers and at least one drone pilot — are seeking advice from outside groups, fearing they could face legal consequences for any involvement in the Trump administration's lethal strikes on suspected drug boats.

    Over the past three months, the U.S. has blown up more than 20 vessels in the Caribbean and Eastern Pacific that the administration says were running illicit narcotics. More than 80 people have been killed in the strikes.

    The administration says it is taking action to stop the flow of drugs into the U.S. It says the strikes are legal and are being conducted under the laws of war, and that President Trump ordered them under his Article II powers as commander-in-chief and in self-defense.

    Many legal experts, however, including former military lawyers, contend the strikes against the alleged civilian narcotraffickers are unlawful and amount to murder.

    The vast gulf between those two legal views has left some members of the U.S. military in the lurch, worried about potential legal blowback for themselves for taking part in the campaign.

    "It's hard to be a soldier and make determinations in any situation, but it's especially hard in a situation like this — where most people don't see an imminent threat — to be sent to do something that you're really worried about, could I go to prison for this?" said Steve Woolford, a resource counselor with Quaker House in North Carolina and the GI Rights Hotline.

    His organization — one of several that make up the GI Rights Hotline, which provides confidential counseling and information for members of the American military — has received calls from service members since the administration began blasting suspected narcotrafficking boats in September.


    Quaker House has been contacted so far by two service members who Woolford said were "very concerned" about their own involvement in the campaign.

    "Their calls were both about the legality of what they were participating in and what that might mean for them in terms of being subject to punishment for doing something that they weren't supposed to do and were supposed to know better than to do," he said. "Both of them also had moral concerns because they are people who are willing to be part of defense but they don't want to be part of doing something illegal, or I don't think they feel right killing people outside of the laws of war."

    Woolford, who is not an attorney, said in both instances the service members were put in touch with lawyers who could provide more guidance on the legal issues.

    "A lot more calls"

    Military personnel have also reached out to attorneys at the Orders Project, which is a nonpartisan group that serves as a reference for service members who have questions about lawful and unlawful orders.

    "We're receiving a lot more calls in the last three months than we did before," said Frank Rosenblatt, a former military lawyer with the Orders Project.

    He declined to provide numbers, but he said some of the individuals are staff officers with legal, intelligence or targeting expertise.

    "What we're finding out is that they're being told that there are these political appointees who really want to be able to talk about this and ... say everybody in the military who looked at this said it was 'green light, A-OK, good to go,'" said Rosenblatt, who is a former lieutenant colonel in the U.S. Army Judge Advocate General Corps.

    Pressure from above

    When some of those career officers don't sign off, instead indicating 'non-concur,' they are coming under pressure from higher-ups, he said.

    "So much pressure, in some cases, that they're giving us a call to say, 'What are my options? I want to do the right thing but I also don't want to torpedo my career unnecessarily.'"

    The Orders Project's attorneys who speak with service members are not giving "grand decrees" about whether an order is lawful or unlawful, Rosenblatt said. Instead, the guidance they provide is focused on what's in the caller's best interest.

    "Generically, the advice that we might give might vary from how you can document the pressure you are receiving, to what kind of questions you can ask or clarification you can seek," he added.

    Rosenblatt said his group has received calls from at least one drone pilot, but both he and Woolford at Quaker House said generally the service members who are reaching out are not the people pulling the trigger. Instead, they say, the callers are more on the operational planning side.

    While the number of callers may not be large at this point, the fact that service members are reaching out at all reflects the confusion and worry some of them feel about what they are being ordered to do.

    Woolford said that many people have voiced a concern that any future consequences for service members should be based on the law but they worry it may end up being driven by politics instead.

    "And then it just becomes this complicated guessing game of who's going to be in charge and what are they going to say is right as opposed to maybe the more solid foundation of 'we have accepted rules we can just go by,'" he said. "So that's just a really hard thing for people in the military to try to be guessing."

    Copyright 2025 NPR

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  • Trans patients won't be registered in 2026
    Large orange signage with a white font that reads "National Cancer Institute" sits in a plaza area with flowers in front of it and a large building in the background.
    Starting in 2026, registries funded through the National Cancer Institute and the Centers for Disease Control and Prevention will categorize cancer patients strictly as male, female, or not stated/unknown.

    Topline:

    The top authorities of U.S. cancer statistics will soon have to classify the sex of patients strictly as male, female, or unknown, a change scientists and advocates say will harm the health of transgender people, one of the nation’s most marginalized populations.

    Why it matters: Scientists said the change will affect all cancer registries, in every state and territory, because they receive federal funding. Starting in 2026, registries funded through the Centers for Disease Control and Prevention and the National Cancer Institute will categorize cancer patients as male, female, or not stated/unknown. And federal health agencies will receive data only on cancer patients classified that way.

    Why now: President Donald Trump in January issued an executive order stating that the government would recognize only male and female sexes. Cancer registry officials said the federal government directed them to revise how they collect data on cancer patients.

    Read on... for what this means for transgender people and why LGBTQ+ health advocates are worried this change.

    The top authorities of U.S. cancer statistics will soon have to classify the sex of patients strictly as male, female, or unknown, a change scientists and advocates say will harm the health of transgender people, one of the nation’s most marginalized populations.

    Scientists and advocates for trans rights say the change will make it much harder to understand cancer diagnoses and trends among the trans population. Certain studies have shown that transgender people are more likely to use tobacco products or less likely to receive routine cancer screenings — factors that could put them at higher risk of disease.

    The change is a consequence of Trump administration policies recognizing only “male” and “female” sexes, according to cancer researchers.

    Scientists said the change will affect all cancer registries, in every state and territory, because they receive federal funding. Starting in 2026, registries funded through the Centers for Disease Control and Prevention and the National Cancer Institute will categorize cancer patients as male, female, or not stated/unknown. And federal health agencies will receive data only on cancer patients classified that way.

    Registries currently specify whether a cancer patient’s sex is “male,” “female,” “other,” various options for “transsexual,” or that the patient’s sex is not stated or unknown.

    President Donald Trump in January issued an executive order stating that the government would recognize only male and female sexes. Cancer registry officials said the federal government directed them to revise how they collect data on cancer patients.

    “In the U.S., if you’re receiving federal money, then we, essentially, we weren’t given any choice,” Eric Durbin, director of the Kentucky Cancer Registry and president of the North American Association of Central Cancer Registries, told KFF Health News. NAACCR, which receives federal funds, maintains cancer reporting standards across the U.S. and Canada.

    Officials will need to classify patients’ sex as unknown when a “patient’s sex is documented as other than male or female (e.g., non-binary, transsexual), and there is no additional information about sex assigned at birth,” the new standard says.

    Missing the Big Picture

    Researchers said they do not have high-quality population-level data on cancer incidence in transgender people but had been making inroads at improving it — work now at risk of being undone.

    “When it comes to cancer and inequities around cancer, you can use the cancer registries to see where the dirtiest air pollution is, because lung cancer rates are higher in those areas. You can see the impact of nuclear waste storage because of the types of cancers that are higher in those ZIP codes, in those areas of the country,” said Shannon Kozlovich, who is on the executive committee of the California Dialogue on Cancer.

    “The more parts of our population that we are excluding from this dataset means that we are not going to know what’s happening,” she said. “And that doesn’t mean that it’s not happening.”

    For decades, cancer registries have been the most comprehensive U.S. surveillance tool for understanding cancer incidence and survival rates and identifying troubling disease trends. Each year, cancer cases are reported by hospitals, pathology labs, and other health facilities into regional and statewide cancer registries. The compiled data documents cancer and mortality rates among regions, races, sexes, and age groups.

    Two federal programs serve as the top authorities on cancer statistics, with information on tens of millions of cases. The CDC’s National Program of Cancer Registries provides funding to organizations in 46 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the U.S. Pacific Island territories. Its data represents 97% of the U.S. population. The National Cancer Institute’s Surveillance, Epidemiology, and End Results program, known as SEER, collects and publishes data from registries covering nearly half the U.S. population.

    The information published by cancer registries has led to changes in treatment and prevention, and the enactment of other policies designed to reduce diagnosis rates and mortality.

    For example, data collected by cancer registries was essential in identifying rising rates of colorectal cancer among people younger than 50. As a result, U.S. guidelines now recommend that adults start screenings at age 45 rather than 50.

    States have enacted their own measures. Lara Anton, spokesperson for the Texas Department of State Health Services, said epidemiologists with the Texas Cancer Registry in 2018 found that the state had the nation’s highest incidence rates of hepatocellular carcinoma, a liver cancer more common in men than women. The Cancer Prevention and Research Institute of Texas initiated a statewide effort aimed at reversing rising rates of liver cancer. The Texas Cancer Registry joined SEER in 2021.

    “Once a cancer patient is entered into a cancer registry, we follow those patients for the rest of their lives. Because we really need to know, do patients survive for different types of cancer and different stages of cancer?” Durbin said. “That’s incredibly important for public policies.”

    The North American Association of Central Cancer Registries maintains national standards outlining what kind of data registries collect for each diagnosis. It develops the list in partnership with the CDC, the National Cancer Institute, and other organizations.

    For any given patient, under NAACCR’s standards, Durbin said, registries collect more than 700 pieces of information, including demographics, diagnosis, treatment, and length of survival. CDC and NCI-funded registries must specify the sex of each patient.

    The NAACCR definitions and accompanying data standards are designed to ensure that registries collect case data uniformly. “Everyone essentially follows the standards” that NAACCR develops, Durbin said. Although registries can collect state-specific information, researchers said they need to follow those standards when sending cancer data to the federal government.

    In an emailed statement, Department of Health and Human Services spokesperson Andrew Nixon said, “HHS is using biological science to guide policy, not ideological agendas that the Biden administration perpetrated.”

    ‘Backwards’ Progress

    NAACCR routinely publishes updated guidelines. But the change to the “sex” category to remove transgender options in 2026 was an emergency move due to Trump administration policies, Kozlovich said. She was among a group that had pushed for changes in cancer data collection to account for sex and gender identity as separate data points.

    According to an analysis of CDC data by the Williams Institute at the UCLA School of Law, 2.8 million people age 13 and older identify as transgender.

    Scientists and trans rights advocates said in interviews that there are troubling signs that may make transgender people more likely to develop cancer or experience worse health outcomes than others.

    “Without evidence of our health disparities, you take away any impetus to fix them,” said Scout, executive director of the LGBTQIA+ Cancer Network.

    A study published in 2022 found that transgender and gender-diverse populations were two to three times as likely as cisgender people to report active use of cigarettes, e-cigarettes, or cigars. Tobacco use is a leading cause of cancer and death from cancer.

    A Canadian study concluded in 2019 that transgender patients were less likely to receive recommended screenings for breast, cervical, and colorectal cancers. And a 2023 study from researchers at Stanford Medicine found that LGBTQ+ patients were nearly three times as likely to experience breast cancer recurrence as cisgender heterosexual people.

    Scarlett Lin Gomez, an epidemiologist at the University of California-San Francisco and the director of the Greater Bay Area Cancer Registry, said that for at least 10 years the NCI had been interested in improving its ability to monitor cancer burden across patient populations with different sexual orientations and gender identities. Cancer registries are a logical place to start because that is what they’re set up to do, she said.

    There’s been “slow but good progress,” Gomez said. “But now we’ve completely, personally, I think, regressed backwards.”

    The decision not to capture transgender identity in cancer patients is just one change registries have confronted under the Trump administration, according to scientists leading surveillance efforts and state health agencies. An HHS mandate to reduce spending on contracts led to funding cuts for cancer registries in NCI’s SEER program. Scientists said CDC funds for registries haven’t been cut; however, the White House’s proposed fiscal 2026 budget aims to eliminate funding for the National Program of Cancer Registries.

    Among the Trump administration’s other actions targeting trans people are canceling research grants for studies on LGBTQ+ health, dismantling the National Institutes of Health’s office for sexual and gender minority health, and stopping specialized services for LGBTQ+ youth on the 988 national suicide prevention hotline.

    Without data, researchers can’t make a case to fund research that may help trans patients, Gomez said. “It’s erasure.”

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

  • Coastal Commission grants 5-year permit extension
    Aerial view of the Diablo Canyon Nuclear Power Plant which sits on the edge of the Pacific Ocean at Avila Beach in San Luis Obispo County, California
    Aerial view of the Diablo Canyon Nuclear Power Plant which sits on the edge of the Pacific Ocean at Avila Beach in San Luis Obispo County.
    The Diablo Canyon Power Plant, California’s last nuclear power plant, overcame a regulatory hurdle on Thursday when the California Coastal Commission voted to approve keeping the plant open for at least five years.

    About the vote: The commissioners on Thursday were not deciding whether to allow the plant to stay open but were weighing how best to lessen the environmental impacts of its operation. The decision was conditioned on a plan that would require Pacific Gas & Electric, which owns the plant, to conserve about 4,000 acres of land on its property. That would prevent it from ever being developed for commercial or residential use. The plant, located along the San Luis Obispo shoreline, now awaits federal approval for a 20-year relicensing permit.

    A history of controversy: Diablo Canyon has remained shrouded in controversy since its construction 40 years ago. Environmentalists point to the damage it causes to marine life, killing what the Coastal Commission estimates are 2 billion larval fish a year. Groups such as the Environmental Defense Center and Mothers for Peace have cited concerns about radioactive waste, which can persist for centuries, and its cost to taxpayers.

    California’s last nuclear power plant overcame a regulatory hurdle on Thursday when the California Coastal Commission voted to approve keeping the plant open for at least five years.

    It was one of the final obstacles the controversial Diablo Canyon Power Plant had to clear to continue operating amid renewed opposition. The decision was conditioned on a plan that would require Pacific Gas & Electric, which owns the plant, to conserve about 4,000 acres of land on its property. That would prevent it from ever being developed for commercial or residential use.

    The plant, located along the San Luis Obispo shoreline, now awaits federal approval for a 20-year relicensing permit.

    “I don’t think, unfortunately, that anything will be happening to Diablo Canyon soon,” due to the growing energy demands of artificial intelligence, Commissioner Jaime Lee said before voting to approve the permit. Nine of the 12 voting members approved the plan.

    The deliberations reignited decades-old concerns about the dangers of nuclear power and its place in the state’s portfolio of renewable energy sources. Diablo Canyon is the state’s single-largest energy source, providing nearly 10% of all California electricity.

    Defeated in their earlier attempts to shut the plant, critics of Diablo Canyon used months of Coastal Commission hearings as one of their last opportunities to vocalize their disdain for the facility. Some Democratic lawmakers supported the plant but pushed for PG&E to find more ways to protect the environment.

    Sen. John Laird, Democrat of San Luis Obispo County and former secretary of the California Natural Resources Agency, said on Thursday he approved of the new plan but pushed the commission to require the utility to conserve even more of its total 12,000 surrounding acres.

    “If what comes out of this is the path for preservation for 8,000 acres of land, that is a remarkable victory,” Laird said.

    Democratic Assemblymember Dawn Addis, whose district encompasses the plant, had also urged the commission in a letter to approve a permit “once it contains strong mitigation measures that reflect the values and needs of the surrounding tribal and local communities who depend on our coastal regions for environmental health, biodiversity and economic vitality.”

    A long history of controversy

    Founded in 1985, the plant’s striking concrete domes sit along the Pacific coast 200 miles north of Los Angeles. The facility draws in 2 million gallons of water from the ocean every day to cool its systems

    And it has remained shrouded in controversy since its construction 40 years ago. Environmentalists point to the damage it causes to marine life, killing what the Coastal Commission estimates are 2 billion larval fish a year.

    The commissioners on Thursday were not deciding whether to allow the plant to stay open but were weighing how best to lessen the environmental impacts of its operation. A 2022 state law forced the plant to stay open for five more years past its planned 2025 closure date, which could have led to significant political blowback against the Coastal Commission if it had rejected the permit.

    Gov. Gavin Newsom reversed a 2016 agreement made between environmental groups and worker unions to close the plant after the state faced a series of climate disasters that spurred energy blackouts. Popular sentiment toward nuclear energy has also continued to grow more supportive as states across the country consider revitalizing dormant and aging nuclear plants to fulfill ever-increasing energy demand needs.

    The 2022 law authorized a $1.4 billion loan to be paid back with federal loans or profits.

    Groups such as the Environmental Defense Center and Mothers for Peace opposed the permit outright, citing concerns about radioactive waste, which can persist for centuries, and its cost to taxpayers.

    “We maintain that any extension of Diablo is unnecessary,” and that its continued operations could slow the development of solar and wind energy, Jeremy Frankel, an attorney with the Environmental Defense Center told the commission Thursday.

    The California Public Utilities Commission last year approved $723 million in ratepayer funds toward Diablo Canyon’s operating costs this year. It was the first time rate hikes were spread to ratepayers of other utilities such as Southern California Edison and San Diego Gas & Electric and was authorized by lawmakers because the plant provides energy to the entire state.

    How the plant will be funded has also garnered scrutiny in the years since Newsom worked to keep it open. Last year, the Legislature nearly canceled a $400 million loan to help finance it.

    As much as $588 million is unlikely to come back due to insufficient federal funding and projected profits, CalMatters has reported.

    Proponents of the plant pointed to its reliability, carbon-free pollution and the thousands of jobs it has created.

    Business advocacy groups emphasized their support for the plant as boosting the economy.

    “It is an economic lifeline that helps keep our communities strong and competitive,” Dora Westerlund, president of the Fresno Area Hispanic Foundation, said at a November meeting.

    This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

  • CA schools that need foreign workers can't afford
    A person wearing a black Columbia hoodie faces away, only lit from their right side from sunlight coming through a window.
    H.R., a physical education teacher at a high school in the West Contra Costa Unified School District, on Nov. 7, 2025.

    Topline:

    The Trump administration is now requiring new H-1B visa applicants to pay $100,000. School districts that depend on hiring foreign workers to fill teacher jobs, especially in special education and bilingual education, say they can’t afford the new fee.

    Why now: In September, the Trump administration began requiring American employers to pay a $100,000 sponsorship fee for new H-1B visas, on top of already required visa application fees that amount to $9,500 to $18,800, depending on various factors. These visas allow skilled and credentialed workers in multiple job sectors to stay in the U.S.

    Why it matters: Most foreign workers on H-1Bs in California work in the tech sector. But California also relies on H-1B visas to address another issue: a nationwide teacher shortage and a high demand for staff in dual-language education and special education in K-12 districts.

    Read on... for what this means to California schools.

    There is a new cost to hiring an international worker to fill a vital but otherwise vacant position in a California classroom: $100,000.

    In September, the Trump administration began requiring American employers to pay a $100,000 sponsorship fee for new H-1B visas, on top of already required visa application fees that amount to $9,500 to $18,800, depending on various factors. These visas allow skilled and credentialed workers in multiple job sectors to stay in the U.S.

    Most foreign workers on H-1Bs in California work in the tech sector. But California also relies on H-1B visas to address another issue: a nationwide teacher shortage and a high demand for staff in dual-language education and special education in K-12 districts.

    Data from the California Department of Education shows school districts filed more than 300 visa applications for the 2023-24 school year, double the amount from just two years earlier. Educators and school officials say its overseas workers on visas are highly skilled, instrumental in multilingual education, and fill historically understaffed positions in special education.

    Now education leaders are sounding the alarm that the high additional fee for overseas workers will worsen the strain on California’s public education system.

    International employees fill a much-needed gap for school districts

    California continues to face an ongoing teacher shortage. In 2023, California K-12 schools staffed 46,982 positions with employees whose credentials did not align with their job assignments, according to data from the California Commission on Teacher Credentialing. Another 22,012 educator positions were left vacant that year. Of total misassignments and vacancies, around 28% were in English language development and 11.9% were in special education.

    California school districts have also resorted to hiring teachers who haven’t yet obtained certain credentials, according to a study by the nonprofit Learning Policy Institute. Facing a need for teachers, school districts have found that trained professionals from other countries are willing — and qualified — to take classroom jobs that would otherwise go unfilled.

    In 2023, in the Bay Area east of San Francisco, West Contra Costa Unified School District had 381 misassigned positions and 711 vacancies, according to the commission. So the district turned to foreign educators, hiring about 88 teachers on H-1B visas — a majority from the Philippines, Spain and Mexico — to teach in mostly dual-language and special education programs, said Sylvia Greenwood, the assistant superintendent for human resources at the district.

    “With our shortages in special ed, they were a good fit for our district. And so, therefore, we kept that pipeline open and brought teachers here from the Philippines to support our students and our students with special needs,” Greenwood said.

    The decline in the number of credentialed special education teachers continues to worsen. Between 2020 and 2024, the number of credentials earned to teach special education decreased by almost 600 across California, according to data from the California Commission on Teacher Credentialing. The number of temporary permits and waivers granted by the commission increased by about 300 during the same period.

    Francisco Ortiz, the president of United Teachers of Richmond and a teacher at Ford Elementary School in West Contra Costa, said the workload for teachers in the district will increase if West Contra Costa Unified is unable to bring in new international teachers.

    This would create “greater instability” for students, he said, adding, “It's going to have a great impact in special education, which is already on fire.”

    California school district officials say they are unsure they can pay the new fee to fill hiring gaps with international employees. West Contra Costa officials said they do not know yet who will be responsible for paying the new fee: the district, international teachers themselves or another party.

    “We are a district that is dealing with a structural deficit as well, and so that cost, in a lot of ways, is going to be very difficult for our district or really any school district, to be able to take that on,” said Cheryl Cotton, the superintendent for West Contra Costa.

    It’s essentially a giant ‘Keep Out’ sign.
    — Laura Flores-Perilla, an attorney with L.A.-based Justice Action Center

    Pasadena Unified, in Southern California, filed about a dozen applications for H-1B visa sponsorships in 2024. Now the district, facing a $27 million budget deficit, will require those applying for H-1B visas to pay for it themselves, according to district spokesperson Hilda Ramirez Horvath. She said foreign employees will also no longer receive other types of financial support, including legal or filing fees related to immigration processing.

    Language programs benefit from international teachers

    District officials are also worried about the cultural costs of losing international educators. Educators on H-1B visas make dual-language public schools possible, giving families in California a unique multicultural education that sticks with their children for life.

    Kelleen Peckham, a mother to two children in West Contra Costa, said she chose to transfer her daughter to Washington Elementary School in Richmond because it has a dual-language immersion program that teaches students to speak and read Spanish.

    Peckham also plans to send her son, who will start kindergarten next year, to the same school even though it takes the family an extra 15 minutes to drive there.

    “My husband's family is from Mexico, and so [their] grandmother, on one side, only speaks Spanish,” Peckham said. “It's important for [them] to be able to communicate with [their] family and extended family.”

    She said if the dual-language immersion program at Washington Elementary doesn’t survive, she would consider transferring her children back to the school in their neighborhood.

    A slightly high angle view of children, who's faces are out of frame, standing in a playground with numbers and letters on the floor.
    First-grade students walk to their classroom at the start of the day during summer session at Laurel Elementary in Oakland on June 11, 2021.
    (
    Anne Wernikoff
    /
    CalMatters
    )

    Fee spells ‘Keep Out’ to foreign workers

    Within weeks of the fee’s announcement, a coalition of international worker groups, unions and religious organizations sued the Trump administration, alleging the fee would inhibit staffing in education, medicine and ministry services.

    “It’s essentially a giant ‘Keep Out’ sign for prospective individuals looking to utilize the visa process to be able to come to the United States and fill these roles and provide these services,” said Laura Flores-Perilla, an attorney with the Justice Action Center, a Los Angeles-based immigration litigation group representing the coalition in its lawsuit.

    “It's not just going to hurt these individuals who have this pathway to do this, but it's also going to hurt employers within the United States,” Flores-Perilla said.

    Although the fee only applies to new visa applicants, many international teachers are feeling less welcomed to work and live in the states. A.F., an international elementary school teacher in the West Contra Costa Unified School District, said many teachers are still concerned the federal government will announce new policy changes that could force them to leave the U.S.

    “I feel like it's a form of discrimination to impose [a] $100,000 fee for teachers,” A.F. said.

    A close up of a person, who's head is out of frame, writing on a white large poster with a black marker.
    A.F., an elementary school teacher who works on a H-1B visa at West Contra Costa School District, writes out a list of grammar rules he will teach his students the next day.
    (
    Alina Ta
    /
    CalMatters
    )

    A.F., who is currently on an H-1B visa, asked to only give his initials because he fears speaking publicly will affect his ability to receive a green card in the future. He immigrated from the Philippines to California five years ago on a J-1 visa before transferring to an H-1B visa at the beginning of 2025. J-1 visas allow visitors to temporarily stay in the U.S. to participate in certain programs, including teaching, studying, conducting research and more, according to U.S. Citizenship and Immigration Services.

    A.F. said the district previously paid for all of his immigration costs for his H-1B visa, which amounted to more than $3,700 for processing fees and an immigration attorney.

    The future is uncertain for H-1B visa hopefuls

    H.R., a physical education teacher in West Contra Costa who works on a short-term J-1 visa, said he moved his family from Mexico to the U.S. three years ago to work at one of the district’s high schools because he felt it would be safer to raise his daughter in the U.S. H.R. requested to use only his initials because he doesn’t want to jeopardize his ability to apply for the H-1B visa in the future.

    “My biggest reason [for moving] is my daughter,” he said. “Me and my wife decided that it would be a good chance for her [and] a big opportunity to learn the language and to grow up in a different environment.”

    H.R. can’t apply for the H-1B visa because he missed the deadline and West Contra Costa Unified is now unlikely to pay for his immigration fees. After his visa expires in June 2026, H.R. will move back to Mexico with his family and reapply for the J-1 visa in hopes of returning to California.

    “Everybody says here that they need teachers in California … but they don't want to do anything to [help us stay] here,” H.R. said.

    A person sits on a bench on a gym's unexpanded seating. They are partially lit on their left side from a light from out of frame.
    H.R., a physical education teacher at a high school in the West Contra Costa Unified School District, on Nov. 7, 2025. H.R., who immigrated to the U.S. two years ago, may have to return to his home country due to a new H-1B visa fee implemented by the Trump administration.
    (
    Manuel Orbegozo
    /
    CalMatters
    )

    At the Los Angeles Unified School District, spokesperson Christy Hagen said in an email to CalMatters that the recent visa changes have not yet impacted the school’s hiring of educators on H-1B visas. Hagen said the district’s immigration experts were “still evaluating the effect of this order.”

    Maria Miranda, a representative for United Teachers Los Angeles — the union for Los Angeles Unified teachers — said the district had, as of mid-November, not provided any guidance to its educators or schools on how H-1B visa hopefuls would be supported.

    Flores-Perilla, the attorney bringing the lawsuit against the Trump administration, says no hearings have been set in their case yet. The U.S. Chamber of Commerce has now also brought a lawsuit over the $100,000 fee, arguing that the proclamation overrides provisions of the Immigration and Nationality Act and harms U.S. employers.

    For now, districts will have to wait on the results of either lawsuit to potentially see some relief in immigration costs.

    “It's absolutely unfeasible to be able to pay this fee [and] to be able to actually bring in prospective employees in their fields and industries, so it's going to hurt everyone,” Flores-Perilla said.

    Sophie Sullivan and Alina Ta are contributors with the College Journalism Network, a collaboration between CalMatters and student journalists from across California. CalMatters higher education coverage is supported by a grant from the College Futures Foundation.

    This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.