Science
Contributor: Focus on the real causes of the shortage in hormone treatments
For months now, menopausal women across the U.S. have been unable to fill prescriptions for the estradiol patch, a long-established and safe hormone treatment. The news media has whipped up a frenzy over this scarcity, warning of a long-lasting nationwide shortage. The problem is real — but the explanations in the media coverage miss the mark. Real solutions depend on an accurate understanding of the causes.
Reporters, pharmaceutical companies and even some doctors have blamed women for causing the shortage, saying they were inspired by a “menopause moment” that has driven unprecedented demand. Such framing does a dangerous disservice to essential health advocacy.
In this narrative, there has been unprecedented demand, and it is explained in part by the Food and Drug Administration’s recent removal of the “black-box warning” from estradiol patches’ packaging. That inaccurate (and, quite frankly, terrifying) label had been required since a 2002 announcement overstated the link between certain menopause hormone treatments and breast cancer. Right-sizing and rewording the warning was long overdue. But the trouble with this narrative is that even after the black-box warning was removed, there has not been unprecedented demand.
Around 40% of menopausal women were prescribed hormone treatments in some form before the 2002 announcement. Use plummeted in its aftermath, dipping to less than 5% in 2020 and just 1.8% in 2024. According to the most recent data, the number has now settled back at the 5% mark. Unprecedented? Hardly. Modest at best.
Nor is estradiol a new or complex drug; the patch formulation has existed for decades, and generic versions are widely manufactured. There is no exotic ingredient, no rare supply chain dependency, no fluke that explains why women are suddenly being told their pharmacy is out of stock month after month.
The story is far more an indictment of the broken insurance industry: market concentration, perverse incentives and the consequences of allowing insurance companies to own the pharmacy benefit managers that effectively control drug access for the majority of users. Three companies — CVS Caremark, Express Scripts and OptumRx — manage 79% of all prescription drug claims in the United States. Those companies are wholly owned subsidiaries of three insurance behemoths: CVS Health, Cigna and UnitedHealth Group, respectively. This means that the same corporation that sells you your insurance plan also decides which drugs get covered, at what price, and whether your pharmacy can stock them. This is called vertical integration. In another era, we might have called it a cartel. The resulting problems are not unique to hormone treatments; they have affected widely used medications including blood thinners, inhalers and antibiotics. When a low-cost generic such as estradiol — a medication with no blockbuster profit margins and no patent protection — runs into friction in this system, the friction is not random. It is structural. Every decision in that chain is filtered through the same corporate profit motive. And when the drug in question is an off-patent estradiol patch that has negligible profit margins because of generic competition but requires logistical investment to keep consistently in stock? The math on “how much does this company care about ensuring access” is not complicated.
Unfortunately, there is little financial incentive to ensure smooth, consistent access. There is, however, significant financial incentive to steer patients toward branded alternatives, or simply to let supply tighten — because the companies aren’t losing much profit if sales of that product dwindle. This is not a conspiracy theory: The Federal Trade Commission noted this dynamic in a report that documented how pharmacy benefit managers’ practices inflate costs, reduce competition and harm patient access, particularly for independent pharmacies and for generic drugs.
Any claim that the estradiol patch shortage is meaningfully caused by more women now demanding hormone treatments is a distraction. It is also misogyny, pure and simple, to imply that the solution to the shortage is for women’s health advocates to dial it down and for women to temper their expectations. The scarcity of estradiol patches is the outcome of a broken system refusing to provide adequate supply.
Meanwhile, there are a few strategies to cope.
- Ask your prescriber about alternatives. Estradiol is available in multiple formulations, including gel, spray, cream, oral tablet, vaginal ring and weekly transdermal patch, which is a different product from the twice-weekly patch and may be more consistently available depending on manufacturer and region.
- Consider an online pharmacy. Many are doing a good job locating and filling these prescriptions from outside the pharmacy benefit manager system.
- Call ahead. Patch shortages are inconsistent across regions and distributors. A call to pharmacies in your area, or a broader geographic radius if you’re able, can locate stock that your regular pharmacy doesn’t have.
- Consider a compounding pharmacy. These sources can sometimes meet needs when commercially manufactured products are inaccessible. The hormones used are the same FDA-regulated bulk ingredients.
Beyond those Band-Aid solutions, more Americans need to fight for systemic change. The FTC report exists because Congress asked for it and committed to legislation that will address at least some of the problems. The FDA took action to change the labeling on estrogen in the face of citizen and medical experts’ pressure; it should do more now to demand transparency from patch manufacturers.
Most importantly, it is on all of us to call out the cracks in the current system. Instead of repeating “there’s a patch shortage” or a “surge in demand,” say that a shockingly small minority of menopausal women still even get hormonal treatments prescribed at all, and three drug companies control the vast majority of claims in this country. Those are the real problems that need real solutions.
Jennifer Weiss-Wolf, the executive director of the Birnbaum Women’s Leadership Center at New York University School of Law, is the author of the forthcoming book “When in Menopause: A User’s Manual & Citizen’s Guide.” Suzanne Gilberg, an obstetrician and gynecologist in Los Angeles, is the author of “Menopause Bootcamp.”
Science
A Physicist Who Thinks in Poetry from the Cosmic Edge
Much of the praise for Chanda Prescod-Weinstein’s debut book in 2021, “The Disordered Cosmos: A Journey Into Dark Matter, Spacetime, and Dreams Deferred,” lauded the way she used personal experiences in physics to discuss the social and political inequities that exist alongside scientific breakthroughs.
“It contains the narrative of dreams deferred,” Dr. Prescod-Weinstein, a physicist at the University of New Hampshire, explained in April at a bookstore in Chicago. But its very existence, she said, also “represented a dream deferred, because that was not the dream of what my first book was going to be.”
Her second book reclaims that dream. Released on April 7, “The Edge of Space-Time: Particles, Poetry, and the Cosmic Dream Boogie” is less pain and more play, a homage to the big questions that made Dr. Prescod-Weinstein want to become a physicist in the first place. She begins the book by asserting that it is humanity’s duty to uncover and share the story of our universe. Her latest offering toward that duty is a journey through physics that is tightly bound to her own cultural roots.
In the midst of a multicity book tour, Dr. Prescod-Weinstein spoke with The New York Times about guiding readers through the cosmos from her own point of view and about some of the art, poetry and literature she drew on to shape that journey. This conversation has been edited for brevity and clarity.
Why include so many references to poetry in a book about physics?
I knew poetry before I knew physics. It was part of my upbringing. I loved A.A. Milne’s “Now We Are Six” and Edward Lear’s “Nonsense Limericks.” Both of my books draw their subtitles from Langston Hughes’s “Montage of a Dream Deferred.”
Adrienne Rich’s poem “The Burning of Paper Instead of Children” became a guiding light for how my work would move in the world. It also opened up for me that I need language. That’s true among physicists. Even an equation is a sentence; even an equation is telling a story.
As physicists, we’re always working in language to connect what we learn with what we know. Poetry is one of the first places that my brain goes to draw those links. Language, as it moves in my brain, is often in Hughes and Rich and Shakespeare. Those are the lines that flicker up for me.
What if we got away from the argument that doing cosmology and particle physics is practical or materially valuable? Then we have to accept that we’re like the poets. What we do is important culturally in the same way poetry is. A piece of this book is me saying there is value in banding with the poets, and fighting for the value of being curious and trying to articulate the world with whatever tools are available to us. Not for the purposes of selling something, but for the purpose of fulfilling our humanity.
Another theme throughout the book is the story of Lewis Carroll’s Alice and her adventures in Wonderland.
Being a science adviser on future installments in The Legendborn Cycle, a fantasy series written by Tracy Deonn, is one reason Alice is in my book. It has allowed me to be open to the playful side that physics, as a Black queer person, can take from you. I wanted the book to be whimsical, because that’s who I was when I first arrived in physics, and that’s who I want to be when I die.
Part of the call of quantum physics is to change what our sense and sensibility are. When you look at the world through this framework — like the idea that particles have spin but don’t really spin — it sounds like nonsense. Except that’s literally how the universe works. Physics is our “through the looking glass.” It’s real.
Your first chapter invites readers to reflect on the metaphors used to describe the universe, like the “fabric” of space-time or electromagnetic “fields.” Why open in this way?
A lot of books about quantum physics start with its history. I wanted as much as possible not to just do that. I had actually planned to start it with the Stern-Gerlach experiment of 1922. But then I read an essay by the poet Natasha Trethewey about abiding metaphors and started to ask myself what the abiding metaphors of my physics training were.
We don’t ever take time in our classes to ask, “What do we mean when we say ‘space’? What do we mean when we say ‘space-time’?” There are these metaphysical questions that I often told myself were for the philosophers. This book was me letting myself think of them as physics.
One metaphor you invoke is the “edge” — not only the edge of the universe and of scientists’ understanding, but also existing at the edge of certain identities.
In “Disordered Cosmos,” I talked a lot about being at the margin and looking toward the center. With “The Edge of Space-Time,” I’m choosing to make the margin the center of the story. Part of that was me fully embracing what makes me the physicist I am. I’m an L.A. Dodgers fan. I love “Alice in Wonderland.” I love “Star Trek.” There’s lots of all of that in the book.
Picking a metaphor is a culturally situated decision. I wrote a line that says black holes are the best laid edges in the universe. I did, at some point, think that only some people were going to get this. But for people who don’t understand the reference to Black hairstyles, the sentence is still legible. And for those who do, it will feel like we just had an in-group moment. Anyone who thinks about laying their edges deserves to have an in-group moment in a physics book. Because we are physics, too.
Black students are often told that if you want to be a physicist, then you will make yourself as close to such-and-such mold as possible. At a young age, we have this understanding that whiteness and science are associated with each other, but we are also witnessing in ourselves that this can’t be entirely correct. There’s this narration of, “Well, sure, you can be Black in physics, but that means you have to acclimate to the ‘in physics’ part, and never that physics has to acclimate to the Black part.”
I use the example of rapper Big K.R.I.T.’s song “My Sub Pt. 3 (Big Bang),” in which someone tries to wire up subwoofers in his car but fries the wires because he doesn’t ground them properly. I don’t know if Big K.R.I.T. would think of this as a science story, but I think we should learn to read it as one. Not to contain it in science, but to say it overlaps there. This can be a rap song. It can be about the cultural significance of subwoofers and the Big Bang as a metaphor for the beat. And it can also be about cosmology and about how everybody who wires up cars or does this kind of work is a scientist, too.
How do you want readers to approach this book?
There is this feeling that you’re supposed to read a book like this and walk away an expert. That’s actually not the point of this book at all. The point is to wander through physics. Even if math terrifies you, you are entitled to spend some time with it.
And so here, I have made you a book with a bunch of tidbits on the oddities of the universe. The universe is stranger and more queer and more wonderful and more full of possibility than whatever limitations you might be experiencing right now. Physics challenges what we are told are social norms. For example, non-trinary neutrinos are fundamental to our standard model of physics.
“Non-trinary,” as in they shift between three different forms.
Non-trinary is natural. It’s such a challenge to the current anti-trans rhetoric that says people can only ever be one thing.
I don’t need my book to be the most important thing that someone reads. But I want it to be a source of hope. If it reminds you that, as my mom says, the universe is bigger than the bad things that are happening to us, then that’s all you need to remember. I’m good with that.
Science
Footage shows Central Valley dairy workers kicking young calves, pulling them with pliers
In late February, animal rights activists flew a drone over a calf ranch in the Central Valley and watched as workers kicked and punched the animals.
For the record:
7:15 p.m. May 12, 2026This article has been updated to reflect that no calves from Agresti Calf Ranch have ever gone on to be used for Clover Sonoma milk supplies, and the calf ranch opened only in 2025. In additional comments, Clover Sonoma also said in the future, no animals from Agresti Calf Ranch will be part of its supply.
Footage reviewed by The Times shows a worker pulling a calf by the nose with pliers.
It shows two workers removing the budding horns of a calf with a hot iron. While one held the frightened animal’s head, the other — wearing a sweatshirt with an image of the Virgin Mary — applied the iron to a horn. After a puff of smoke, the calf fell to its side, appearing motionless.
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Both male and female calves produce horns. To prevent injury to the animals and their handlers, these are commonly removed. Humane guidelines require anesthesia.
The footage was collected by the group Direct Action Everywhere, known for tactics including releasing beagles from medical breeding facilities and abused calves from farms. It was shot at the Agresti Calf Ranch in Ceres, near Modesto, which is certified by the American Humane Society for its ethical treatment of animals. The workers could not be reached for comment. One was subsequently terminated, the Humane Society said.
The Agresti Calf Ranch opened in 2025 and is operated by the owners of Double D Dairy, just up the road. Double D Dairy owns more than 10,000 cows across several operations.
The owner of Double D, Dominic Assali, declined to answer questions in person. A phone number for the dairy online is disconnected. In response to an email to his personal account, Assali said, “Animal welfare and safety are incredibly important to us, and we have a zero-tolerance policy for any mistreatment.
“We’ll always take immediate, thorough action to address any operational issues, as we have in this instance,” the email said.
The American Humane Society is a 150-year-old nonprofit focused on animal welfare. Among other things, it certifies animal safety on farms as well as on movie sets. In a statement, it said only 10% of animals raised on farms in the U.S. are certified as humanely treated.
Assali is the grandson of the farm’s founders, Harold and Marlene Agresti. He is a board member of Western United Dairies, the largest dairy trade group in California.
The mistreatment captured on video has also created a headache for a prominent California sustainable milk brand, Clover Sonoma, based in Sonoma County.
It gets 10% to 15% of its milk from Double D, and Assali and his family are featured on Clover Sonoma’s website. No calves from Agresti Calf Ranch have ever gone on to be used in Clover Sonoma milk supplies, the company said in a statement. It’s unclear whether the abused calves were being raised for beef or dairy.
A Clover Sonoma sign hung outside the main dairy complex on a recent visit.
Clover Sonoma markets its milk, yogurt and cheese products as humanely sourced and environmentally sound. It was the first dairy company to receive a cruelty-free certification from the American Humane Society in 2000. The website also features a “Our Promise” page, which states the company demands “the humane treatment of animals.”
“We were deeply concerned by the reported mistreatment of some cows captured on video at Agresti Calf Ranch during a separate cow operation,” the company said in an email.
“The rough handling shown at Agresti Calf Ranch is contrary and inconsistent with the humane practices we have fostered for decades and which we demand of all our suppliers.”
Clover Sonoma said it suspended business with Double D as soon as it became aware of the incidents and began “a rigorous audit,” which just ended.
“Clover and the American Humane Society have concluded that the mistreatment was an isolated issue, not systemic or reflective of Agresti Calf Ranch’s personnel. Corrections have been made, including the termination of the employee in the video. As such, we are comfortable reinstating the milk from Double D Dairy.”
After this story published, Clover went further and said a condition of Double D’s reinstatement will be that no animals from Agresti Calf Ranch will be part of Clover’s dairy supply.
A statement from the Humane Society said Clover Sonoma is working with Double D to strengthen its whistleblower policy and training, and has “reiterated its commitment to ongoing independent, third-party audits,” with both announced and unannounced visits.
Clover Sonoma mainly buys and processes milk from dairies in verdant Sonoma County, as the company’s marketing suggests. Double D Dairy is one of its few suppliers in the Central Valley, which is associated more with industrial-scale agriculture.
On a recent weekday, the calf ranch and dairy farm were visible from a public road. Holstein calves, a popular dairy breed, could be seen in cages through small trees in front of the enclosures. The sound of mooing and a pressure washer could be heard. The smell of manure and dirt wafted in the humid air.
Most dairy companies remove calves from their mothers after birth, raising them separately so they don’t take the mother’s commercially valuable milk. Some dairy farms send calves out to third-party calf ranches for rearing. Others raise them on-site. Female calves are typically raised to become milk cows. Male calves are sent away to become beef or other meat-based products, such as pet food.
A 2025 State Water Board document shows the farm houses an average of 700 calves at any one time, with a maximum 1,400.
The Direct Action Everywhere activists were recently on a public road near Double D’s main farm, flying a drone over the property. Within 30 minutes of their arrival, seven Stanislaus County sheriff’s vehicles arrived and surrounded the activists.
A heavily armed officer asked to see the drone pilot’s Federal Aviation Administration license, which he provided. After confirming it was valid, a sheriff’s deputy — one of nine at the scene — told the activists they could remain on the road but could not trespass.
Asked about the heavy response, a deputy said there had been several recent violent incidents from animal rights groups at the site, and mentioned the groups had sent in “busloads” of activists.
The Times reached out to the Sheriff’s Office to get more details about those events but did not get a response.
Temple Grandin, author and professor of livestock medicine at Colorado State University, said that punching and kicking livestock is considered abusive.
An expert in livestock welfare, she said that handlers can tap, push and nudge animals. But if the level of force goes beyond what could bend the side of a cardboard box, “it’s abuse. Period.”
She said the calves’ reaction to the hot iron indicates that pain medication, such as lidocaine, was not applied before the procedure. Double D did not respond to a question about whether medication was given before the procedure.
A pickup truck rolls by the barns at Agresti Calf Ranch at sunrise in Ceres.
(Tomas Ovalle/For The Times)
Science
A Taxidermist Gives Dead Animals a New Life
At 11, Tim Bovard undertook his first taxidermy experiment on a piece of roadkill. He had found an unlucky skunk and improvised its reanimation using an instruction book, much to the alarm of his friends’ parents.
His own parents were unfazed — his father and grandfather were both scientists and outdoorsmen — and soon it was known in their suburban community of Claremont, Calif., that, as Bovard recently recounted: “Dr. Bovard’s son was an animal nut. So when they found the abandoned birds, owls, hawks, kestrels, crows, blue jays, scrub jays, they brought them to me, and I raised them.”
By the time he was a teenager, he was sewing his own clothes, learning to tan leather and taking backpacking trips in the Sierras with his dogs while wearing a full buckskin suit of his own creation. He began apprenticing with a local taxidermist in high school, and then chose to work for him full time through college.
Bovard was always set on his life path, though when he visited friends at college parties, he asked them to stop mentioning what he did instead of going to class, noticing that it gave some people the creeps.
Bovard, still exuberant and energetic at 72, is the last full-time taxidermist at any museum in the United States. He still lives in Claremont, now with his wife, two dogs and “10 and a half cats” (the “half” cat lives mostly outdoors) and wakes most days at 4:30 a.m. to commute to the Natural History Museum of Los Angeles County, where he has worked since 1984. He is responsible for maintaining animal mounts the museum has kept in its collection for more than a century, reworking dioramas that could look more true to life and designing new exhibits.
In past generations, museums dispatched hunting expeditions to acquire their animal collections, but Bovard works only with donations from zoos or offerings from private collections. As when he was a child, roadkill is another option.
Once the skin is on and the glue is dry, he sews the pelt together, hiding his seams.
“Mammal stitching has to be pretty tight,” he said, especially for lions or zebras. “Now, a bear with long hair? It doesn’t matter so much. For birds, feathers cover it all.”
The care and keeping of these forms is a responsibility he takes both seriously and joyfully. Frequently, he skips his commute entirely and sleeps in his office, rolling out a blanket between filing cabinets that carry the records of every animal in the museum’s 111-year-old collection and the “fleshing wheel” he uses to gently remove tissue from hides.
“It wouldn’t be for everybody,” he said with a smile. “But I am known to be slightly different. That’s putting it sort of mildly.”
In fact, he has slept at work for weeks at a time, like when he was revamping the museum’s lion diorama and wanted to adjust furry skin folds and feline facial expressions every few hours during the night as the glue set.
Unlike many taxidermists, Bovard is responsible not only for the animals on display in the museum but also for very element of the dioramas, including every tree, leaf, twig, flower, dusting of snow and body of water. He’s made hundreds of thousands of leaves through a method called vacuum forming — a manufacturing technique where plastic is heated and then shaped around a mold using suction — using leaf molds he created himself from plant matter he harvested on research trips.
To do this exacting work, he has amassed an encyclopedic knowledge of the natural world. He knows, for example, that one key to designing a lifelike raptor is the hooding over the eyes. But he also knows the posture that raptor would take sitting on a tree branch, what kind of tree it would be sitting in, the patterns in which it would have preened its feathers, what kind of prey it might be looking for and how its presence would most likely affect the behavior of every other animal in its radius.
For a restaging of a lion family, he wanted two lionesses to be nuzzling foreheads, the standard greeting in big cats, to capture their sociality. He wanted to create more of a sense of dynamic movement in the scene of jaguars perched atop a box canyon in Sonora, Mexico, for example, by adding some small mammal prey, like javelinas, leaping away from the cats.
“It’s all about directing the eye,” he said, pointing toward the far corner of the painted background.
And then there are all the routine tasks, the things he’ll never stop doing, at least not until he retires, like dusting the museum’s pride of lions, vacuuming elephant ears and polishing all the glass eyes.
When asked about whether retirement is on the horizon, he laughed. He was still sleeping on his office floor as recently as New Years. There’s an orangutan he wants to mount this year, and tens of thousands more leaves to make. “No plans to retire.”
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