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Commentary: A candid take on mortality and the power of friendship

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Commentary: A candid take on mortality and the power of friendship

They gather several times a week in the parking lot of a Vons supermarket in Mar Vista, and no subject is off-limits. Not even the grim medical prognosis for 70-year-old David Mays, one of the founding members of the coffee klatch.

“It’s one of our major topics of conversation,” said Paul Morgan, 45, a klatch regular.

Mays is a cancer survivor with a full package of maladies, including diabetes, a faltering heart and failing kidneys. But since I met him almost two years ago, he has told me repeatedly that he doesn’t want dialysis treatment, even though it might extend his life.

“I get it, because it’s a lot of hours out of your day,” said Morgan, a schoolteacher who lives nearby. “People think you go in for dialysis for 15 minutes before you go straight to work. But really, it’s a part-time job.”

Steve Lopez

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Steve Lopez is a California native who has been a Los Angeles Times columnist since 2001. He has won more than a dozen national journalism awards and is a four-time Pulitzer finalist.

His treatment would require that he visit a dialysis center three times a week, for four hours each time, Mays said.

“For the rest of my life.”

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“I don’t think I could do it,” said klatcher Kit Bradley, 70, who lives in a van near the supermarket with his dog, Lea.

I met Mays in October 2023, when he was living in his Chevy Malibu in a downtown garage that was part of the Safe Parking L.A. program. Mays later moved into an apartment in East Hollywood and still lives there, but his health has continued to deteriorate.

“He is Stage 5,” said Dr. Thet Thet Aung, Mays’ nephrologist at Kaiser Permanente West Los Angeles.

A man sitting in a car talks to two men standing outside flanking him, one holding the open car door

David Mays, center, enjoys a morning get-together with Paul Morgan, left, and Kit Bradley in a Vons parking lot in West Los Angeles on June 25, 2025.

(Genaro Molina / Los Angeles Times)

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For such patients, Aung said, death can be imminent. She told me she’s had many conversations with Mays about his treatment options, including dialysis in a clinic or self-administered at home. But not everyone does well on dialysis, she added, and when a patient makes an informed choice, “we respect their wishes.”

Mays has a refreshingly healthy attitude about mortality. Multibillion-dollar industries cater to those who want to look younger and live longer, and about 25% of Medicare’s massive outlay is spent on patients in the last year of life, many of whom choose life-extending medical procedures.

Mays, in the time I’ve known him, has been realistic rather than fatalistic. He has told me he doesn’t think bravery, faith or spirituality has anything to do with his desire to let nature take its course.

“It transcends those things,” he said.

He’s at peace with his fate, he explained, because he’s got friends, love and support.

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On a recent day at his apartment, I watched Mays load medication from more than 20 vials into a weekly pill organizer.

“I could almost do this in my sleep,” he said as he arranged meds that resembled miniature jelly beans. This one for his kidneys, that one for his heart, his blood pressure, and on and on.

Bottles of medicine and a photo of a group of people and another of two women sit on a table

Bottles of medication and photos of close friends rest on David Mays’ table at his apartment in East Hollywood.

(Genaro Molina / Los Angeles Times)

There were 18 pills in each compartment. And none of that will cure any of what ails him, he said.

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“You just have to keep doing it, and doing it, just to stay at a sustained level,” he said. “It’s not like … I feel great because I took this stuff.”

Two women in Mays’ life are heartbroken about his condition but respectful of his refusal to try dialysis.

“I don’t want him to suffer for the sake of placating other people,” said Mays’ daughter Jennifer Nutt, 47, of Merced.

Her parents divorced when she and her brother were young, and Nutt had no relationship with Mays until recently. She’s had her own trials, Nutt said, including homelessness.

Father and daughter began connecting in the fall of 2024.

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“We spend hours every day talking. It’s like a nonstop festival of catching up,” and they’ve discovered they have the same cheeky sense of humor and pragmatism, and similar traits and interests.

“We like big words and thick books,” Nutt said.

The other woman is Helena Bake, of Perth, Australia, a registered nurse Mays affectionately refers to as “Precious.” They met in 1985, when Mays was visiting London, and Bake, 18 at the time, was working in a restaurant he visited with friends. After Bake moved to Australia, Mays visited her many times and became close to her entire family.

“He was lovely,” said Bake, who is not surprised by Mays’ attitude about his deteriorating health. “He’s always very positive and so pragmatic. He has this wonderful view of the world and the people in his life. It’s such a gift that he has.”

Mays, who gets by on Social Security payments, has set up a GoFundMe page to help pay for his cremation and send his ashes to Bake, to be scattered in his favorite places in Australia.

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Lately, medical appointments with his several doctors, and the occasional ER visit, have gotten in the way of one of Mays’ favorite activities — the gatherings in the Vons parking lot.

A man with a gray mustache, in a dark cap

David Mays is “always very positive and so pragmatic. He has this wonderful view of the world and the people in his life. It’s such a gift that he has,” a longtime friend says.

(Genaro Molina / Los Angeles Times)

Mays worked for many years in the Mar Vista area as a live-in elder care provider, and he’d bump into Bradley at a park, or Morgan in the strip mall that includes the grocery store. Several years ago, they made a habit of grabbing coffee around 7 a.m. and hanging out near Mays’ car. Bradley’s dog often hops into the vehicle, a Vons employee named Elvis comes out for a smoke break, and others come and go.

“I had a cousin who had diabetes, and he called my mom one day and said, ‘I’m not doing it anymore,’ ” Morgan was saying the other day. His mother wasn’t supportive at first, he told the klatch, but she listened to her nephew’s explanation and came around. “Who could judge someone for the choices they make in that situation?”

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“There’s a waiting list for kidneys of two to eight years,” Mays said. “Let’s say [in] four or five years, there was a kidney available. Your body can reject it … and then you’re back to the drawing board…. I told Precious about this like a year and a half ago … and she said, ‘I have to hang up now because I have to process this.’ And the next time I talked with her, she said, ‘I get it.’ ”

Mays said he doesn’t want to be “a prisoner to a process, like a machine or something.”

“And you have to do this indefinitely. It’s not like you’re on it for two or three years…,” he said. “It is. The. Rest. Of. Your. Life.”

“I’ve seen people that were on dialysis,” said Bradley, a former musician. “I think I’d rather be just, if I gotta go, I gotta go.”

Morgan said his father, who died last year, had kidney problems in the end and resisted extreme measures to extend his life.

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“It’s not like he was at all suicidal, just like David’s not,” Morgan said. “The thing about David is, he’s always been so resolute about it. We’ve never had a discussion where I felt like we could waver him, or like he was on the fence.”

When he first resisted dialysis, Mays said, doctors set him up in a room with a video that explained the process.

“I watched the whole thing, and that was the clincher,” Mays said. “By the time I got through looking at that, I’m just going, ‘Oh HELL no.’”

It’s not that he wants to die, Mays said. It’s that he wants to live on his terms.

“The irony of the whole thing is, it’s all the people that I have around me — they’re the reason I’m willing to go like this. What I get from them in the way of being … uplifted and loved, well, when you have all that, you can deal with anything.”

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He has his klatch buddies, he has Precious, he has his daughter in his life again.

“With people around that give a damn about you, care about you, you can deal … with death, you can deal with dying…. And I told my doctors I would rather live a shorter period of time, but with what I feel to be some decent quality of life, than live a longer period of time and be miserable. And I would be miserable on dialysis,” Mays said.

“Plus, I’m 70. It ain’t like I’m 30 and there’s so much life to live. I am the age that I am, and I would like to go further, sure, but it has to close out soon. And I’m fine with that, because I have lived.”

steve.lopez@latimes.com

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Southern California mountain lions recommended for threatened status

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Southern California mountain lions recommended for threatened status

The California Department of Fish and Wildlife has recommended granting threatened species status to roughly 1,400 mountain lions roaming the Central Coast and Southern California, pointing to grave threats posed by freeways, rat poison and fierce wildfires.

The determination, released Wednesday, is not the final say but signals a possibility that several clans of the iconic cougars will be listed under the California Endangered Species Act.

It’s a move that supporters say would give the vulnerable animals a chance at recovery, but detractors have argued would make it harder to get rid of lions that pose a safety risk to people and livestock.

The recommendation was “overdue,” Charlton Bonham, director of the state wildlife department, said during a California Fish and Game Commission meeting.

It arrives about six years after the Center for Biological Diversity and Mountain Lion Foundation petitioned the commission to consider listing a half-dozen isolated lion populations that have suffered from being hit by cars, poisoned by rodenticides and trapped by development.

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The following year, in 2020 the Commission found the request might be warranted, giving the lions temporary endangered species protections as “candidates” for listing. It also prompted the state wildlife department to put together a report to inform the commission’s final decision.

The next step is for state wildlife commissioners to to vote on the protections, possibly in February.

Brendan Cummings, conservation director for Center for Biological Diversity, hailed the moment as “a good day, not just for mountain lions, but for Californians.”

If the commissioners adopt the recommendation, as he believes they will, then the “final listing of the species removes any uncertainty about the state’s commitment to conserving and recovering these ecologically important, charismatic and well-loved species that are so much a part of California.”

The report recommends listing lions “in an area largely coinciding” with what the petitioners requested, which includes the Santa Ana, San Gabriel, San Bernardino, Santa Monica, Santa Cruz and Tehachapi mountains.

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It trims off portions along the northern and eastern borders of what was proposed, including agricultural lands in the Bay Area and a southeastern portion of desert — areas where state experts had no records of lions, according to Cummings.

Officials in the report note that most of the lion groups proposed for listing are contending with a lack of gene flow because urban barriers keep them from reaching one another.

In Southern California, lions have shown deformities from inbreeding, including kinked tails and malformed sperm. There’s an almost 1 in 4 chance, according to research, that mountain lions could become extinct in the Santa Monica and Santa Ana mountains within 50 years.

The late P-22 — a celebrity mountain lion that inhabited Griffith Park – personified the tribulations facing his kind. Rat poison and car collisions battered him from the inside out. He was captured and euthanized in late 2022, deemed too sick to return to the wild because of injuries and infection.

For some species, protections come in the form of stopping chainsaws or bulldozers. But imperiled lions, Cummings said, need their habitats stitched together in the form of wildlife crossings — such as the gargantuan one being built over the 101 Freeway in Agoura Hills. He added that developments that could restrict their movement should get more scrutiny under the proposed protections.

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Critics of the effort to list lion populations have said that it will stymie residential and commercial projects.

California is home to roughly 4,170 mountain lions, according to the recent report, but not all are equal in their struggle.

Many lion populations, particularly in northwest coastal forests, are hearty and healthy.

Protections are not being sought for those cats. Some, in fact, would like to see their numbers reduced amid some high-profile conflicts.

Bonham, the director of the state Department of Fish and Wildlife, spoke to concerns about public safety at the recent meeting, alluding to the tragic death of young man who was mauled by a cougar last year in Northern California.

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“These are really delicate issues and the conversation I know in the coming years is going to have to grapple with all that,” said Bonham, who will be stepping down this month after nearly 15 years in his role.

California’s lions already enjoy certain protections. In 1990, voters approved a measure that designated them a “specially protected species” and banned hunting them for sport.

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California’s last nuclear plant clears major hurdle to power on

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California’s last nuclear plant clears major hurdle to power on

California environmental regulators on Thursday struck a landmark deal with Pacific Gas & Electric to extend the life of the state’s last remaining nuclear power plant in exchange for thousands of acres of new land conservation in San Luis Obispo County.

PG&E’s agreement with the California Coastal Commission is a key hurdle for the Diablo Canyon nuclear plant to remain online until at least 2030. The plant was slated to close this year, largely due to concerns over seismic safety, but state officials pushed to delay it — saying the plant remains essential for the reliable operation of California’s electrical grid. Diablo Canyon provides nearly 9% of the electricity generated in the state, making it the state’s single largest source.

The Coastal Commission voted 9-3 to approve the plan, settling the fate of some 12,000 acres that surround the power plant as a means of compensation for environmental harm caused by its continued operation.

Nuclear power does not emit greenhouse gases. But Diablo Canyon uses an estimated 2.5 billion gallons of ocean water each day to absorb heat in a process known as “once-through cooling,” which kills an estimated two billion or more marine organisms each year.

Some stakeholders in the region celebrated the conservation deal, while others were disappointed by the decision to trade land for marine impacts — including a Native tribe that had hoped the land would be returned to them. Diablo Canyon sits along one of the most rugged and ecologically rich stretches of the California coast.

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Under the agreement, PG&E will immediately transfer a 4,500-acre parcel on the north side of the property known as the “North Ranch” into a conservation easement and pursue transfer of its ownership to a public agency such as the California Department of Parks and Recreation, a nonprofit land conservation organization or tribe. A purchase by State Parks would result in a more than 50% expansion of the existing Montaña de Oro State Park.

PG&E will also offer a 2,200-acre parcel on the southern part of the property known as “Wild Cherry Canyon” for purchase by a government agency, nonprofit land conservation organization or tribe. In addition, the utility will provide $10 million to plan and manage roughly 25 miles of new public access trails across the entire property.

“It’s going to be something that changes lives on the Central Coast in perpetuity,” Commissioner Christopher Lopez said at the meeting. “This matters to generations that have yet to exist on this planet … this is going to be a place that so many people mark in their minds as a place that transforms their lives as they visit and recreate and love it in a way most of us can’t even imagine today.”

Critically, the plan could see Diablo Canyon remain operational much longer than the five years dictated by Thursday’s agreement. While the state Legislature only authorized the plant to operate through 2030, PG&E’s federal license renewal would cover 20 years of operations, potentially keeping it online until 2045.

Should that happen, the utility would need to make additional land concessions, including expanding an existing conservation area on the southern part of the property known as the “South Ranch” to 2,500 acres. The plan also includes rights of first refusal for a government agency or a land conservation group to purchase the entirety of the South Ranch, 5,000 acres, along with Wild Cherry Canyon — after 2030.

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Pelicans along the concrete breakwater at Pacific Gas and Electric's Diablo Canyon Power Plant

Pelicans along the concrete breakwater at Pacific Gas and Electric’s Diablo Canyon Power Plant

(Brian van der Brug/Los Angeles Times)

Many stakeholders were frustrated by the carve-out for the South Ranch, but still saw the agreement as an overall victory for Californians.

“It is a once in a lifetime opportunity,” Sen. John Laird (D-Santa Cruz) said in a phone call ahead of Thursday’s vote. “I have not been out there where it has not been breathtakingly beautiful, where it is not this incredible, unique location, where you’re not seeing, for much of it, a human structure anywhere. It is just one of those last unique opportunities to protect very special land near the California coast.”

Others, however, described the deal as disappointing and inadequate.

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That includes many of the region’s Native Americans who said they felt sidelined by the agreement. The deal does not preclude tribal groups from purchasing the land in the future, but it doesn’t guarantee that or give them priority.

The yak titʸu titʸu yak tiłhini Northern Chumash Tribe of San Luis Obispo County and Region, which met with the Coastal Commission several times in the lead-up to Thursday’s vote, had hoped to see the land returned to them.

Scott Lanthrop is a member of the tribe’s board and has worked on the issue for several years.

“The sad part is our group is not being recognized as the ultimate conservationist,” he told The Times. “Any normal person, if you ask the question, would you rather have a tribal group that is totally connected to earth and wind and water, or would you like to have some state agency or gigantic NGO manage this land, I think the answer would be, ‘Hey, you probably should give it back to the tribe.’”

Tribe chair Mona Tucker said she fears that free public access to the land could end up harming it instead of helping it, as the Coastal Commission intends.

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“In my mind, I’m not understanding how taking the land … is mitigation for marine life,” Tucker said. “It doesn’t change anything as far as impacts to the water. It changes a lot as far as impacts to the land.”

Montaña de Oro State Park.

Montaña de Oro State Park.

(Christopher Reynolds / Los Angeles Times)

The deal has been complicated by jurisdictional questions, including who can determine what happens to the land. While PG&E owns the North Ranch parcel that could be transferred to State Parks, the South Ranch and Wild Cherry Canyon are owned by its subsidiary, Eureka Energy Company.

What’s more, the California Public Utilities Commission, which regulates utilities such as PG&E, has a Tribal Land Transfer Policy that calls for investor-owned power companies to transfer land they no longer want to Native American tribes.

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In the case of Diablo Canyon, the Coastal Commission became the decision maker because it has the job of compensating for environmental harm from the facility’s continued operation. Since the commission determined Diablo’s use of ocean water can’t be avoided, it looked at land conservation as the next best method.

This “out-of-kind” trade-off is a rare, but not unheard of way of making up for the loss of marine life. It’s an approach that is “feasible and more likely to succeed” than several other methods considered, according to the commission’s staff report.

“This plan supports the continued operation of a major source of reliable electricity for California, and is in alignment with our state’s clean energy goals and focus on coastal protection,” Paula Gerfen, Diablo Canyon’s senior vice president and chief nuclear officer, said in a statement.

But Assemblymember Dawn Addis (D-Morro Bay) said the deal was “not the best we can do” — particularly because the fate of the South Ranch now depends on the plant staying in operation beyond 2030.

“I believe the time really is now for the immediate full conservation of the 12,000 [acres], and to bring accountability and trust back for the voters of San Luis Obispo County,” Addis said during the meeting.

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There are also concerns about the safety of continuing to operate a nuclear plant in California, with its radioactive waste stored in concrete casks on the site. Diablo Canyon is subject to ground shaking and earthquake hazards, including from the nearby Hosgri Fault and the Shorline Fault, about 2.5 miles and 1 mile from the facility, respectively.

PG&E says the plant has been built to withstand hazards. It completed a seismic hazard assessment in 2024, and determined Diablo Canyon is safe to continue operation through 2030. The Coastal Commission, however, found if the plant operates longer, it would warrant further seismic study.

A key development for continuing Diablo Canyon’s operation came in 2022 with Senate Bill 846, which delayed closure by up to five additional years. At the time, California was plagued by rolling blackouts driven extreme heat waves, and state officials were growing wary about taking such a major source of power offline.

But California has made great gains in the last several years — including massive investments in solar energy and battery storage — and some questioned whether the facility is still needed at all.

Others said conserving thousands of acres of land still won’t make up for the harms to the ocean.

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“It is unmitigatable,” said David Weisman, executive director of the nonprofit Alliance for Nuclear Responsibility. He noted that the Coastal Commission’s staff report says it would take about 99 years to balance the loss of marine life with the benefits provided by 4,500 acres of land conservation. Twenty more years of operation would take about 305 years to strike that same balance.

But some pointed out that neither the commission nor fisheries data find Diablo’s operations cause declines in marine life. Ocean harm may be overestimated, said Seaver Wang, an oceanographer and the climate and energy director at the Breakthrough Institute, a Berkeley-based research center.

In California’s push to transition to clean energy, every option comes with downsides, Wang said. In the case of nuclear power — which produces no greenhouse gas emissions — it’s all part of the trade off, he said.

“There’s no such thing as impacts-free energy,” he said.

The Coastal Commission’s vote is one of the last remaining obstacles to keeping the plant online. PG&E will also need a final nod from the Regional Water Quality Control Board, which decides on a pollution discharge permit in February.

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The federal Nuclear Regulatory Commission will also have to sign off on Diablo’s extension.

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In search for autism’s causes, look at genes, not vaccines, researchers say

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In search for autism’s causes, look at genes, not vaccines, researchers say

Earlier this year, Health and Human Services Secretary Robert F. Kennedy Jr. pledged that the search for autism’s cause — a question that has kept researchers busy for the better part of six decades — would be over in just five months.

“By September, we will know what has caused the autism epidemic, and we’ll be able to eliminate those exposures,” Kennedy told President Trump during a Cabinet meeting in April.

That ambitious deadline has come and gone. But researchers and advocates say that Kennedy’s continued fixation on autism’s origins — and his frequent, inaccurate claims that childhood vaccines are somehow involved — is built on fundamental misunderstandings of the complex neurodevelopmental condition.

Even after more than half a century of research, no one yet knows exactly why some people have autistic traits and others do not, or why autism spectrum disorder looks so different across the people who have it. But a few key themes have emerged.

Researchers believe that autism is most likely the result of a complex set of interactions between genes and the environment that unfold while a child is in the womb. It can be passed down through families, or originate with a spontaneous gene mutation.

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Environmental influences may indeed play a role in some autism cases, but their effect is heavily influenced by a person’s genes. There is no evidence for a single trigger that causes autism, and certainly not one a child encounters after birth: not a vaccine, a parenting style or a post-circumcision Tylenol.

“The real reason why it’s complicated, the more fundamental one, is that there’s not a single cause,” said Irva Hertz-Picciotto, a professor of public health science and director of the Environmental Health Sciences Center at UC Davis. “It’s not a single cause from one person to the next, and not a single cause within any one person.”

Kennedy, an attorney who has no medical or scientific training, has called research into autism’s genetics a “dead end.” Autism researchers counter that it’s the only logical place to start.

“If we know nothing else, we know that autism is primarily genetic,” said Joe Buxbaum, a molecular neuroscientist who directs the Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai. “And you don’t have to actually have the exact genes [identified] to know that something is genetic.”

Some neurodevelopment disorders arise from a difference in a single gene or chromosome. People with Down syndrome have an extra copy of chromosome 21, for example, and Fragile X syndrome results when the FMR1 gene isn’t expressed.

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Autism in most cases is polygenetic, which means that multiple genes are involved, with each contributing a little bit to the overall picture.

Researchers have found hundreds of genes that could be associated with autism; there may be many more among the roughly 20,000 in the human genome.

In the meantime, the strongest evidence that autism is genetic comes from studies of twins and other sibling groups, Buxbaum and other researchers said.

The rate of autism in the U.S. general population is about 2.8%, according to a study published last year in the journal Pediatrics. Among children with at least one autistic sibling, it’s 20.2% — about seven times higher than the general population, the study found.

Twin studies reinforce the point. Both identical and fraternal twins develop in the same womb and are usually raised in similar circumstances in the same household. The difference is genetic: identical twins share 100% of their genetic information, while fraternal twins share about 50% (the same as nontwin siblings).

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If one fraternal twin is autistic, the chance that the other twin is also autistic is about 20%, or about the same as it would be for a nontwin sibling.

But if one in a pair of identical twins is autistic, the chance that the other twin is also autistic is significantly higher. Studies have pegged the identical twin concurrence rate anywhere from 60% to 90%, though the intensity of the twins’ autistic traits may differ significantly.

Molecular genetic studies, which look at the genetic information shared between siblings and other blood relatives, have found similar rates of genetic influence on autism, said Dr. John Constantino, a professor of pediatrics, psychiatry and behavioral sciences at the Emory University School of Medicine and chief of behavioral and mental health at Children’s Healthcare of Atlanta.

Together, he said, “those studies have indicated that a vast share of the causation of autism can be traced to the effects of genetic influences. That is a fact.”

Buxbaum compares the heritability of autism to the heritability of height, another polygenic trait.

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“There’s not one gene that’s making you taller or shorter,” Buxbaum said. Hundreds of genes play a role in where you land on the height distribution curve. A lot of those genes run in families — it’s not unusual for very tall people, for example, to have very tall relatives.

But parents pass on a random mix of their genes to their children, and height distribution across a group of same-sex siblings can vary widely. Genetic mutations can change the picture. Marfan syndrome, a condition caused by mutations in the FBN1 gene, typically makes people grow taller than average. Hundreds of genetic mutations are associated with dwarfism, which causes shorter stature.

Then once a child is born, external factors such as malnutrition or disease can affect the likelihood that they reach their full height potential.

So genes are important. But the environment — which in developmental science means pretty much anything that isn’t genetics, including parental age, nutrition, air pollution and viruses — can play a major role in how those genes are expressed.

“Genetics does not operate in a vacuum, and at the same time, the impact of the environment on people is going to depend on a person’s individual genetics,” said Brian K. Lee, a professor of epidemiology and biostatistics at Drexel University who studies the genetics of developmental disorders.

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Unlike the childhood circumstances that can affect height, the environmental exposures associated with autism for the most part take place in utero.

Researchers have identified multiple factors linked to increased risks of the disorder, including older parental age, infant prematurity and parental exposure to air pollution and industrial solvents.

Investigations into some of these linkages were among the more than 50 autism-related studies whose funding Kennedy has cut since taking office, a ProPublica investigation found. In contrast, no credible study has found links between vaccines and autism — and there have been many.

One move from the Department of Health and Human Services has been met with cautious optimism: even as Kennedy slashed funding to other research projects, the department in September announced a $50-million initiative to explore the interactions of genes and environmental factors in autism, which has been divided among 13 different research groups at U.S. universities, including UCLA and UC San Diego.

The department’s selection of well-established, legitimate research teams was met with relief by many autism scientists.

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But many say they fear that such decisions will be an anomaly under Kennedy, who has repeatedly rejected facts that don’t conform to his preferred hypotheses, elevated shoddy science and muddied public health messaging on autism with inaccurate information.

Disagreements are an essential part of scientific inquiry. But the productive ones take place in a universe of shared facts and build on established evidence.

And when determining how to spend limited resources, researchers say, making evidence-based decisions is vital.

“There are two aspects of these decisions: Is it a reasonable expenditure based on what we already know? And if you spend money here, will you be taking money away from HHS that people are in desperate need of?” Constantino said. “If you’re going to be spending money, you want to do that in a way that is not discarding what we already know.”

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