In The Two-Parent Privilege, Melissa S. Kearney makes a provocative, data-driven case for marriage by showing how the institution’s decline has led to a host of economic woes—problems that have fractured American society and rendered vulnerable populations even more vulnerable. Eschewing the religious and values-based arguments that have long dominated this conversation, Kearney shows how the greatest impacts of marriage are, in fact, economic: when two adults marry, their economic and household lives improve, offering a host of benefits not only for the married adults but for their children. Studies show that these effects are today starker, and more unevenly distributed, than ever before. Kearney examines the underlying causes of the marriage decline in the US and draws lessons for how the  US can reverse this trend to ensure the country’s future prosperity. 
 
Based on more than a decade of economic research, including her original work, Kearney shows that a household that includes two married parents—holding steady among upper-class adults, increasingly rare among most everyone else—functions as an economic vehicle that advantages some children over others. As these trends of marriage and class continue, the compounding effects on inequality and opportunity grow increasingly dire. Their effects include not just children’s behavioral and educational outcomes, but a surprisingly devastating effect on adult men, whose role in the workforce and society appears intractably damaged by the emerging economics of America’s new social norms. 
 
For many, the two-parent home may be an old-fashioned symbol of the idyllic American dream. But The Two-Parent Privilege makes it clear that marriage, for all its challenges and faults, may be our best path to a more equitable future. By confronting the critical role that family makeup plays in shaping children’s lives and futures, Kearney offers a critical assessment of what a decline in marriage means for an economy and a society—and what we must do to change course.

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This study, aimed to examine how views on marriage and cohabitation changed between 2004–2009 and 2020–2023 in Austria, Czechia, Estonia, Germany, and Norway. Cross-sectional data from the first round (GGS-I) and the second round (GGS-II) of the Generations and Gender Survey were analyzed using linear regression models, with attitudes toward marriage and attitudes toward cohabitation as dependent variables. The study focused on attitudes of 48,246 individuals aged 21–45 (20,284 from GGS-I and 27,962 from GGS-II). The results revealed a substantial shift toward positive views on marriage in Czechia and Estonia, with people considering it less outdated over time. In Austria and Norway, there was a less pronounced shift toward negative and neutral views on marriage. The acceptance of cohabitation was already high in most countries in the first round and increased between rounds in Germany and Austria. Czechia remains the most traditional out of the five countries when it comes to both attitudes toward marriage and cohabitation. A weak gender difference in attitude toward marriage was found in Norway and Estonia, with women viewing marriage as an outdated institution less often than men. The study shows how attitudinal changes differ across institutional contexts and challenges the expectation of the Second Demographic Transition framework of a universal shift away from traditional family arrangements. 

Published in October, 2025 

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The Supreme Court’s recent 8-1 ruling in Chiles v. Salazar affects how states can regulate therapy for minors. It also raises a deeper question about who controls the conversation — the state, or clients and clinicians?

I submitted an amicus brief in support of Kaley Chiles, and I welcome the decision with great relief. The statute’s intent was purportedly to protect vulnerable minors from harm. In practice, its effect would be the opposite.  

The statute narrowed the scope of therapy for minors struggling with their sexual and gender identity, policing therapeutic conversation and forbidding exploration of potential fluidity and change. These restrictions, enforced by threat of legal censure, actively reduce the pool of therapists willing to work with these struggling youth.

That Colorado engaged in viewpoint discrimination was evident in that the statute did not prohibit all therapeutic discussion exploring sexual or gender identity change. Rather, the state explicitly carved out an exception for the one identity change path with the most risk and known harms: gender transition. 

I have every compassion for struggling youth and their parents. Had I been a teen in this era, I could easily have been trans-identified. As a gender non-conforming youth in the 1980s, I wore a tuxedo to my high school dance. My appearance was androgynous enough for me to often be mistaken for a boy. I used this style as a shield to guard me from the vulnerability of being female, which had, in my reasoning, exposed me to abuse. It is a familiar story: My teen self was confused and deeply depressed.  

The Dutch gender clinicians where this practice began originally urged caution due to the “high levels of psychopathology found” in adolescents with “gender identity disorder.” Twenty-five years later, abundant data and evidence show that similar patterns persist. Many young people today who present as trans-identifying also experience mental health co-morbidities or have had adverse childhood experiences. 

By forbidding all change-exploring talk therapy — except for that which affirms a change away from one’s biological sex — Colorado’s statute effectively prohibited clinicians from doing their job. They banned them from considering patients’ past, preventing exploration of both what is absent (e.g., the absence of prior childhood gender dysphoria) and what is often present, including trauma, family dysfunction, mental health issues, autism or history of sexual assault — factors that in any other circumstance would warrant deeper evaluation.  

Under Colorado’s ban, clinicians were forbidden from discussing future considerations that might override the gender identity presentation of the moment. They could not mention the long-term health harms, nor the loss of fertility, nor the evidence of shortened lifespans and increased suicidality in the long run — all of which are objective and well-documented outcomes.

According to psychiatrist and gender clinician Dr. Stephen Levine, responsible therapy takes a “wider lifecycle view.” He rightfully urges that when working with youth, “the overriding consideration is the creation of a happy, highly functional, mentally healthy person for the next 50 to 70 years of life — not merely during a transient stage of childhood or adolescent development.”  

Imagine a state legislatively restricting therapists from exploring a minor’s past, present and future if it conflicts with the client’s current identity declarations and perceptions. That is effectively what Colorado’s statute required. In so doing, the state narrowed young persons’ options and failed to guard their right to an “open future.”  

Several years ago, during testimony on a bill that sought to ban “gender-affirming” medicine for minors, a father stepped up to the microphone with his young son who now identified as a girl and described how his child had found “true happiness” in the a identity. But stories like this one become more complex when considered through a wider lifecycle view.  

At the time, I had been reading articles about emerging innovations using Tilapia fish skin grafts in sex-reassignment surgery for boys whose puberty had been blocked so early that there was not enough material to work with. I had been hearing clinicians discuss the long-term health implications, such as sexual dysfunction and infertility, that are part and parcel of this path.

I also thought of the growing number of detransitioners who wish they had been challenged more or urged to slow down, including many who wish they had chosen differently. If one path is open to exploration, the very least states can do is leave the others open for exploration as well.

Critics of decisions like this often point to historical coercive and aversive therapies as justification for restrictions. Thankfully, those types of practices have long been discontinued and are widely condemned. The real question is whether ethical talk therapy — not coerced or compelled but voluntarily sought and guided by licensed clinicians — should be constrained by the state.

This ruling comes as similar legal challenges emerge across the country. Its implications will extend beyond Colorado.

The Supreme Court reaffirmed something foundational: Therapy should be guided by clients’ values and sound clinical practice, not by government mandate. Because of this ruling, children and their therapists are safer today.

Amy Hamilton is a research fellow at Medical Institute for Sexual Health, an adjunct professor with the Nesti Center for Faith and Culture at the University of St. Thomas in Houston, and a research associate at the University of Texas.

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Russian billionaire Pavel Durov has made his frozen sperm available worldwide through his Altra Vita clinic. He claims that he is doing this to alleviate a shortage of “high-quality donor material.” And he adds that his sperm has fathered at least 100 children in at least 12 countries. Then we read of Chinese billionaires going outside of China, where domestic surrogacy is illegal, to quietly have large numbers of U.S.-born babies. Specifically, Xu Bo, a Chinese billionaire, claims to have more than 100 children born through surrogacy in the U.S. More than that, this online gaming billionaire has, for years, broadcast his ambition to build a “sprawling dynasty of children.” What does the future hold, since it sounds like he is just getting started? May I remind us that by virtue of the 14th Amendment, a baby born in the United States is a U.S. citizen?

Stop! Hold it! Does anyone speak out for all those babies, and what is going to happen to them? And what about the women, lured into being inseminated by a Russian billionaire, who believe he will leave his money to them and their babies.

Both of these stories are missing more than just outrage; they are missing moral clarity. These billionaires represent a growing global fertility marketplace that completely misses the mark by treating women as a means and children as an outcome. Where is the moral clarity necessary to support these human beings with lifelong needs?

These vulnerable women have no way of knowing that the money will be there when they need it. And of course, many of them have little to no knowledge of genetics and cannot know that just because the sperm comes from a successful man does not mean that a baby conceived with that sperm will indeed be successful. Additionally, the mother’s own genetics will also be a major determinant of “who” their child is.

An example of the futility of producing the perfect human can be found in Malcolm Gladwell’s book “Outliers.” Gladwell tells the story of Christopher Langan. Langan has an extraordinarily high IQ with unbelievable intellectual potential. Yet, Langan cannot translate his brilliance into any successful, creative, or helpful work. Gladwell tells this story to show that intelligence alone is not sufficient for success.

This story shows us that even if women have children from the sperm of a rich or successful man, and even if the children are intelligent, it does not mean that the kids will be able to do anything useful.

I am an infertility specialist. I began my practice in 1968 when all we could do for infertile women was give those who were not ovulating regularly a drug called Clomid. I finished my practice in 1995, having joined three other doctors in the mid-80s, to develop one of the first successful non-university IVF programs in the U.S.

Through all those years, I saw the guttural pain of women who could not conceive. They would do anything to become pregnant. I had patients who would go through multiple operations and multiple IVF procedures, all extremely stressful, to have a baby. This quest consumed their lives and emotions.

These billionaires and the international commercial fertility clinics are developing and preying on these vulnerable women, whom they know they can “trap” into their work. And in doing so, they are producing babies who will never know their biological father. Even more important, these babies will not have their biological father to help their mom raise them. Who knows who the substitute father will be or if there will even be one?

And the very idea of a “sprawling dynasty of children” spits in the face of the idea that children are themselves valuable. It denies the need for a “warm nest” – a home – of Mom and Dad to raise them to be average, upstanding citizens.

Who knows how many of these children will suffer from depression as they personally battle with the questions about their very identity and place in life?

This is not merely a story about wealth or nationality. It is about the value of human life. Children are not commodities to be designed, ordered, or stockpiled like products on a shelf. They are human beings with inherent dignity and worth. As medical advancements press forward, the nuclear family – a mother, father, and child – is a sacred trust and must always be preserved, valued, and protected by all of us.

The public discourse surrounding this topic is deeply lacking any serious discussion of responsibility. Who is accountable for these children as they grow up? Who ensures they are nurtured and given reliable emotional and psychological stability? Wealth can never substitute for presence, and a child needs a supportive mother and father in order to thrive.

Without limits on ethically challenged fertility clinics and their practices, we will continue to witness these heartbreaking stories. So many women naturally long for a man who cherishes them, listens to them, and respects them, and eventually becomes their husband. They hope to become a mom who nurtures their precious children. Yes, these evil men are twisting this beautiful yearning of women in ways that sabotage both the women’s future and the futures of their children. When these babies are born, their mothers will love and care for them, because that is who they are. But it will not be in the way they had dreamed of and deserved – a family rooted in love and trust.

Society must draw ethical boundaries here because without it, the most vulnerable among us – women and children – will continue to suffer the cost. Progress in any form does not take a step forward without moral restraint.

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This Thanksgiving, parents across America have much to be thankful for — their children, their health, and the simple gift of gathering around the table with people they love. We’ll share food, laughter, and stories about how quickly the kids have grown. And yet, many parents will also feel a quiet, unspoken worry about the world their children are growing up in.

Today’s kids face a culture that’s louder and more confusing than ever before. From social media to entertainment, they’re bombarded with messages about identity, relationships, and sex that can leave them adrift. They’re told to “follow your feelings” and “do what feels right.” Commitment is treated like a burden, and pornography is always one click away. It’s no wonder parents worry about how their kids will turn out — or whether they’re equipped to guide them through it all.

But amid the noise, Thanksgiving gives us a moment to pause and remember there’s still so much to be grateful for. Because despite the cultural chaos, research continues to show there is a proven path that works, one that’s as practical as it is hopeful.

It’s called the Success Sequence.

Researchers Ron Haskins and Isabel Sawhill at the Brookings Institution uncovered this refreshingly simple roadmap to stability. Finish high school. Get a full-time job. Get married. Then have children, in that order. It may sound old-fashioned, but the results are remarkable. Only about 3 to 4% of young adults who follow this path end up in poverty. What once seemed like common sense has become one of the strongest predictors of lifelong success.

And it’s not just about money. Young people who follow this path will have fewer sexual partners, fewer sexually transmitted infections, and more stable families. I’ve seen this to be true throughout my medical career. Decades of experience tell us that children who grow up with both parents in a committed home are more likely to thrive emotionally and physically.

That’s something to be thankful for, not just as researchers or clinicians, but as parents and grandparents who want to see the next generation flourish.

So this Thanksgiving, as we give thanks for food and family, let’s also give thanks for the wisdom that still lights the way forward. Let’s be grateful for the teachers, mentors, and parents who still model responsibility, hard work, and faithfulness. And let’s be grateful that even in a changing world, some truths don’t change.

The future isn’t fixed. Despite what the headlines say, our kids aren’t doomed by the world around them. The choices we encourage and the examples we set can profoundly shape their lives. The Success Sequence isn’t about restriction, it’s about freedom. It gives young people a sense of direction and the structure they need to build meaningful lives, one decision at a time.

That’s what I’m most thankful for this year, the privilege and responsibility of guiding the next generation. As parents and grandparents, we get to be the competing voice our children need. We get to show them that real joy doesn’t come from instant gratification, but from purpose, discipline, and love.

So yes, be thankful for the turkey and the laughter, but most importantly, be thankful for the family gathered around the table. Look at your children and the generations below you and be thankful for truth that still holds, for children who still turn out right, and for the grace that allows us to keep trying.

The world may change. The challenges may look different. But the truth doesn’t change, and that’s something worth celebrating every Thanksgiving.

—

Joe S. McIlhaney, Jr., MD is a board-certified obstetrician/gynecologist who resides in Plano, Texas.

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It’s homecoming season in America, but while students are celebrating, a silent and unseen epidemic is spreading among them.

For many, homecoming is innocent fun. It is a time to reconnect with old friends, dress up, and celebrate a sense of belonging. But for some, it carries an unspoken pressure: that this night marks a “coming of age,” a passage into sexual freedom.

This assumption is not only false but dangerous.

Sexual activity is a beautiful thing. It can bond two people together in a way nothing else can. It can result in the birth of a child, one of life’s greatest joys. But like anything powerful and beautiful, it must be handled with care.

Imagine a Lamborghini, one of the most beautiful cars ever designed. Handled responsibly, it’s thrilling. But recklessly managed, it not only damages the car, but it can also maim the driver. Sexual freedom is no different. Handled without thought, it carries a price tag few are willing to talk about.

That price tag is a silent epidemic of sexually transmitted diseases (STDs), an epidemic that is leaving millions with lifelong consequences, including infertility, cancer, chronic illness, and emotional pain.

Today, one in eight Americans is infected with the STD herpes simplex. Once a person contracts it, there is no cure. The virus remains in the body for life and can be transmitted during any intimate contact, even when no symptoms are visible.

And herpes is only one of more than 30 sexually transmitted diseases now identified by the Centers for Disease Control and Prevention (CDC). In just the past five years, three new STDs have emerged, a sobering reminder that these infections continue to evolve and spread.

The risk increases with the number of partners one has, and new infections often begin among people with multiple sexual relationships before spreading into the broader population of unsuspecting individuals.

Each year, there are 20 million new STD cases in the United States. About 5% of sexually active teens are infected with Chlamydia trachomatis, one of the leading causes of infertility in women. And many of these infections remain silent and undetected for months or even years, resulting in countless people spreading disease without ever realizing they are infected.

We often talk to teens about consent, emotional health, and safety, but rarely about the medical reality of what sexual activity outside a committed relationship can lead to. The silence has created a hidden epidemic that few young people truly understand.

Condoms are commonly presented as the solution, but science tells a more complicated story. A major report by a consensus panel from the CDC, NIH, and FDA found that even when condoms are used correctly and consistently, they only reduce the risk of common STDs by about 60%. That’s far from full protection.

The truth is simple: there is no mechanical safeguard that can fully protect against the consequences of sexual involvement outside of a lifelong relationship between two uninfected people.

That’s not a message of fear, it’s a message of respect. Respect for one’s own health, for one’s partner, and for the gift that sex truly is.

Our culture prizes sexual freedom. From movies to music to social media, the prevailing idea is simple: experiment, explore, and don’t let outdated restrictions hold you back. But rarely do we hear the other side of the story, the very real and costly consequences that come with this celebrated “freedom.”

Freedom without boundaries doesn’t stay free for long; it instead entraps us in lifelong consequences.

As parents, teachers, and mentors, we must remind our young people that true maturity isn’t defined by sexual experience, but by wisdom, by the ability to look beyond the moment and consider the future.

After the music fades and the lights dim, what happens after the dance matters most. The choices made in youth can help shape a lifetime of health and happiness or set up a cycle of regret that can damage and wound.

Let this homecoming season be a reminder: sex is not a rite of passage or proof of love. It is a profound act meant to be handled with care and with full understanding of its lifelong implications.

When treated casually, sex wounds. When reserved for a relationship grounded in lifelong commitment, it builds the kind of enduring love and health every person deserves.

—

Joe S. McIlhaney Jr., MD, is a board-certified obstetrician/gynecologist who resides in Plano, Texas. During his years as a practicing physician, he focused his attention on reproductive technologies. He introduced laparoscopy, gynecologic laser surgery, and microsurgery to the central Texas medical community. In 1984, along with three other physicians, Dr. McIlhaney was instrumental in founding one of the first successful non-university IVF programs in the country. He also initiated one of the first women’s health centers in Texas at St. David’s Hospital. McIlhaney’s research focused his attention on the problems rampant in the USA and around the world, including STIs, condom and contraceptive failure, and HIV/AIDS.

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Operating under the belief that forms of sexual harm are deeply interconnected, NCOSE takes a comprehensive, multi-disciplinary approach to addressing issues such as sex trafficking, child sexual abuse, image-based abuse, and pornography. Their work spans four key areas: litigation through their Law Center, corporate accountability campaigns, bipartisan legislative advocacy, and empirical research through their Research Institute. One of their most recognized initiatives is the annual “Dirty Dozen List,” which publicly names mainstream companies and platforms they identify as significant contributors to sexual exploitation, using public pressure as a tool for corporate change. Even more, since 2010, NCOSE has claimed over 100 policy victories and leads a coalition of more than 300 member organizations, with recent wins including successful litigation against major tech companies like Meta and YouTube over child exploitation and social media addiction.

NCOSE serve people in all circumstances—from survivors and concerned citizens to policymakers and journalists—offering resources, research, and action opportunities for those looking to engage with these issues.

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The statement makes a detailed ethical case for why these procedures carry a higher threshold than other surgeries performed on adolescents, citing their irreversibility, the uncertain natural history of gender dysphoria, and the lack of reliable methods to predict which young people’s distress will persist versus resolve on its own. It also pushes back on the “life-saving” framing sometimes used to justify these interventions, noting that ethical decision-making should not be driven by crisis claims.

This position statement is a valuable resource for parents, policymakers, healthcare professionals, and advocates seeking to understand where the medical conversation currently stands on gender surgeries for children and adolescents.

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The site’s central document, the Memorandum of Understanding on the Role of Puberty in Adolescent Development, affirms every child’s right to experience healthy pubertal development and opposes puberty suppression as an intervention for gender-related distress, arguing that it infringes on a child’s “right to an open future.” Visitors to the site can read and download the MoU, review a Statement of Concern addressed to policymakers and health authorities, and add their own signature to a growing list of signatories from across the globe.

The site also offers a resources section featuring articles, videos, and reports examining the evidence around puberty suppression, including analysis of the proposed NHS puberty blocker trial and testimony from individuals personally affected by gender medicine.

For those seeking an internationally-grounded perspective that is critical of the “gender-affirming” medical model for minors, Protecting Puberty serves as both an informational hub and a platform for collective professional and public advocacy.

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