Medicine has come a long way. We are living longer than ever, we have eradicated diseases that once seemed like a certain death sentence, and new improvements  are constantly being made to our quality of life. But despite all the advances, there’s a huge gap in women’s health. “I think there’s such an interconnectedness between society, culture, medicine, and science,” Dr. Elizabeth Comen told Vox. She’s a medical oncologist who specializes in breast cancer and an associate professor at NYU Langone. She says medicine often mirrors what’s happening in society at large. “For many societies across the globe, women did not have equal agency or power over their bodies, and that’s really reflected in the history of medicine.”

It’s reflected in medicine’s present, too. The share of women with heart disease in the United States is rising, there’s a cultural backlash and skepticism surrounding birth control, and almost half Americans are turning to social media influencers (many of whom aren’t credentialed) for medical information. 

Why is there such a disconnect when it comes to health care for women? And what will it take for it to end? We find out on this week’s episode of Vox’s weekly call-in podcast, Explain It to Me.

Below is an excerpt of my conversation with Evans, edited for length and clarity. You can listen to the full episode on Apple Podcasts, Spotify, or wherever you get your podcasts. If you’d like to submit a question, send an email to askvox@vox.com or call 1-800-618-8545.

We are at this point where we know more about our bodies than we ever have before. Sometimes you go to the doctor, and it feels like they’re still catching up on some pretty basic aspects of women’s health. Why does it feel that way?

Because it’s true. It takes a long time for medical science to catch up with the glaring gaps in our healthcare system. The gaps are not just about the obvious women’s health issues. We focus a lot on breast cancer. We focus a lot on reproductive function or our gynecological needs. But the gaps exist head to toe from our neurologic care, our gastroenterology care, how our hearts function, how our immune system functions, how our joints function. The gaps are real, and the experiences are real.

Can you walk me through some of the history? What did it look like to study women’s health before the 20th century? What were we dealing with?

When we think about modern medicine today and these specialties of urology, gastroenterology, they really didn’t exist before the 1900s at all; those are relatively new concepts. For much of the history of medicine, at least in the Western world, the idea was that, at best, we were small men and, at worst, there were many ridiculous diagnoses like hysteria and a long legacy of dismissing women’s medical needs because we were largely not taken care of by women. Those women that were caregivers in the history of medicine, whether it was the midwives or other types of healers, were largely pushed out of medicine as it became codified, and the idea of medical science really came to rise in the late 19th century.

So, I’m guessing that they weren’t really talking about menopause at the time, let alone perimenopause.

Perimenopause wasn’t even discussed. That’s a relatively new term and new part of our lexicon when it comes to lay discussion and the public at large. With respect to menopause, one of the famous physicians, Roger Wilson, wrote a book [called] Feminine Forever and referred to women going through menopause as vapid cows. He was the one that advocated in the 1960s and 1970s for women to be on hormone replacement therapy. But understand that, in the 1850s, it’s not like people really were wildly aware of what estrogen, and testosterone, and progesterone did. These are all relatively new ideas — the concept of hormones and how they can travel in our body. And again, we have a long way to go.

I read that women were rarely included in clinical trials until the National Institutes of Health mandated it in 1993. I find that so surprising. Why were women missing there? 

Well, these studies were not designed with women in mind. Some of the massive cardiology studies for drugs that we use day in and day out were done on thousands of men and not women. There is so much to that history, including the animal models on which many of these drugs were developed. In order to develop a drug, often, they are developed on mouse models first. It wasn’t until 2016 that you were even required to state the sex of the mice that you were studying. In many of these instances, female mice were not even included in drug development.

Oh my gosh — even the mice? How were these hormones marketed to people when hormone replacement therapy first became a thing?

It depends on which advertisements that you look at. If you look at advertisements of women in the 1950s, ’60s and ’70s, a lot of women were being prescribed anti-anxiety medicine. “Can’t manage your household at home? Don’t want to take care of your kids? Here’s what will sedate you and at least make you able to prepare breakfast for your husband.” It’s really shocking, and yet, not that surprising. If you look at Instagram today, are we really that far off from what gets marketed to women? Women sink billions of dollars probably into sham supplements and sham treatments, because they don’t feel cared for when they go to the doctor. And what fills that space? A lot of people trying to market things that have no proven evidence.

I think it’s really interesting that, at one point, hormone replacement therapy was this big thing, because I feel like growing up in the ’90s and 2000s, hearing women who are older than me speak, they were kind of anti-hormones. How did the pendulum swing that way?

Well, the pendulum has swung in wildly different directions. At first, it was: Every woman needs to be on it. And there were wildly successful sales. Then, there was the women’s health study that exaggerated the risk of breast cancer. Understandably, women were terrified. They were told by the media and by reputable scientists that these risks were significantly high and that they could not be on it, and we didn’t leave them with any alternatives. Now, we’ve become much more granular about what we know and what we don’t know, but I still think we’re far behind on the science. There’s still a lot that we need to learn, but, fortunately, an understanding of the prior studies and what their limitations are has come to light.

There are all these gaps in trust and treatment. There’s going to be a fair amount of snake oil out there, but are there ways that this moment is actually driving better treatment for women?

I’m so grateful that we’re talking about it, but I am terrified of what I see from influencers on Instagram. People can fake their knowledge. There’s so much fake imagery and information that is out there. I wish that we could invest this in quality science, which is long and laborious and painful at times but gives us the quality answers that we need. Every day, I see the consequences of fake information online, whether it’s an incredible loss of financial resources or just wasting money so that you could buy a nice pair of shoes. That would make you feel better than the ridiculous thing online that’s over promising and under delivering. The fear mongering is out of control.

What do you think it will take to trust their doctors again, rather than turning to the treatments they’re being sold online that might be dangerous? What will it take for them to feel good about the interactions they’re having at the doctor’s office? 

I think it’s going to be really challenging. We can’t blame patients, because we’ve done them a disservice. Medicine has fragmented the care of many patients — not just women, but men as well. We have to build a health care system that allows for time to be with patients and really hold space for them. I think that’s where the trust is really going to be built, because, at the end of the day, despite all the technology that’s available, medicine is about human to human care. That is what everybody wants to be treated as: a human to be seen and heard in the ways that you can’t just reduce a body to biology.

The gerontocracy is real: The median senator is 64 years old, and 20 members of Congress are over 80. One legal scholar called it the “old-igarchy.” It seems the combination of President Donald Trump’s recent 80th birthday, the sudden death of Sen. Lindsey Graham, and the currently unknown health status of Sen. Mitch McConnell has called collective attention to the advanced age of our elected officials — and with good reason. 

So this week, I talked with Rep. Jim Clyburn of South Carolina on his 86th birthday. And I wanted to (delicately) ask a question that’s been brewing in my head since the whole fiasco with then-President Joe Biden: Why don’t the oldheads want to retire? 

Over a long interview, I asked the House Democratic leader about generational change, shifts in the electorate on corporate PAC money and artificial intelligence, and whether he thinks there are any lessons to learn from the 2024 election.

On the question of age, Clyburn told me, “I know people who are 66 years old with much less energy than I have, and none of the experience that I have.” Clyburn said he would also be open to a recently proposed law calling for members of Congress to take cognitive tests, though he dismissed the idea of term limits or an age cap. 

Here’s what else I learned: 

1. They aren’t giving up power because they don’t want to

That’s the whole thing. The reason the boomers (and Clyburn’s Silent Generation) won’t step aside isn’t that no one has asked. It’s that they don’t want to. And for Clyburn, I think the armor doubles as the blind spot. When I asked about younger generations being distrustful that older politicians can deliver, he invoked his grandparents, saying, “Don’t worry about what people call you. It’s what you answer to that’s the issue.”

And while that is wisdom, hardened over the decades, I don’t know if it works as well as a leadership philosophy. Stay the course and ignore the criticism can also be read as ignoring electoral feedback. “I don’t react to that stuff,” Clyburn said, when asked about calls for generational change.

2. Clyburn says what the establishment thinks: It’s the voters’ fault

Clyburn articulates the core view of establishment politics as cleanly as anyone: There is nothing much to change. He doesn’t believe the party made significant errors in 2024, and he doesn’t take the primary results in New York City, Colorado, and elsewhere to be anything other than a flash in the pan. Pushed on what political lesson he took from an administration built to stop Trump that ended with Trump back in office, he went to turnout: “When the white vote turned out 71 percent two years ago, and the Black vote turned out 59 percent, you tell me whose fault that is.” Asked directly whether the argument was that Black people let Kamala Harris down, he didn’t hesitate: “In many instances, absolutely.” 

At its heart, this is a philosophy that blames the voters and insulates the party establishment from reflection. 

But this is also why the next round of primaries is so important. It’s easy to file New York, Colorado, or Graham Platner’s rise in Maine as one-offs — local flukes, not an overwhelming trend. But the Michigan and Wisconsin primaries are coming, and those are the ones that decide whether this gets treated as a pattern. The temperature of the freakout is still yet to be set.

3. He defends the establishment’s alliance with the Congressional Black Caucus

The moderate wing of the Democratic Party is held up, at the grassroots, by Black voters — particularly in the South. Clyburn knows that, and he defended both the alliance and the corporate policies that tie them together. 

Clyburn holds that taking corporate dollars is necessary for minority candidates who don’t come from family wealth — “I would challenge you to find me one single vote I have ever cast that pharma supported and my constituents didn’t.” He deferred to a pro-Israel colleague, Rep. Gregory Meeks, on questions of Israel: “I’m guided by Gregory Meeks.” He made no apology for backing Andrew Cuomo over Zohran Mamdani in this year’s New York mayor’s race — the same Cuomo he’d said should resign in 2021.

I asked him what Black communities have gotten in exchange for that loyalty. His answer was an agenda: “What did we get out of our support for Obama? What did we get out of our support for Biden?” And that’s a real answer. But I think there’s also another one underneath it.

I see Clyburn’s actions through the context of changing power within the Democratic Party, just as much as what’s going on outside of it. The Black political class, specifically, is invested in holding its own position against the party’s rising coalitions, immigrant communities in particular. That’s part of what’s at the heart of Clyburn’s endorsements of Cuomo and Haley Stevens in Michigan, and even the recent fight over which states should vote first in the Democratic presidential primary. 

Find the full episode — including a bonus segment where Clyburn defends the party’s approach to Israel — wherever you get your podcasts.

Last week, House Democrats voted on an amendment that would have cut $3.3 billion in annual US military aid to Israel from a State Department funding bill. The amendment was brought to the floor by Rep. Thomas Massie, an outgoing Republican from Kentucky. It failed 314-104, but 103 Democrats — nearly half of the House Democratic caucus — supported it, signaling a significant shift in the party’s longstanding support for aid to Israel.

In 2024, a similar vote came up in the House to cut military aid to Israel. Then, just 37 House Democrats voted for the measure. Now, two years later, 103 House Democrats voted to cut funding. That shift in support was accelerated after the October 7 Hamas attacks and Israel’s subsequent military campaign in Gaza, which has killed large numbers of Palestinian civilians. The debate is also playing out in Democratic primaries across the country. In New York and Colorado, Democratic socialist candidates who have sharply criticized Israel and opposed continued US military aid recently won House primaries.

Historically, Jewish Americans have overwhelmingly identified with and voted for the Democratic Party, while Democratic lawmakers have generally supported Israel and US military assistance to the country. In 2016, the Obama administration signed a 10-year memorandum of understanding (MOU) with Israel, committing the US to seek $38 billion in military assistance for fiscal years 2019 through 2028. Congress must vote to approve this funding, so the shift in Democratic support of Israel could have real consequences.

There is still a very strong support for Israel among many House Democrats, but the shifting views are notable. House Minority Leader Hakeem Jeffries opposed the Massie amendment, arguing that it was overly broad and could jeopardize humanitarian assistance. But in a letter addressed to his House colleagues he also called for a “major reset” in US policy toward what he described as Israel’s “far-right Netanyahu government.”

Today, Explained host Sean Rameswaram spoke with Democratic Rep. Brad Schneider, who represents Illinois’s 10th Congressional District, and remains a strong supporter of Israel.

Below is an excerpt of the conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained wherever you get podcasts, including Apple Podcasts, Pandora, and Spotify. 

Can you walk us through last week’s vote? You voted against the measure to cut aid to Israel, and a lot of your colleagues obviously did not. How did that play out for you?

Growing up in the ’60s, ’70s, and for the last 65 years, I fundamentally believe that the US-Israel relationship is important. I also believe that the aspiration for peace in the Middle East, not just between Israelis and Palestinians, but broadly throughout the region, is something that is in the United States’s interest and the interest of the people in the region. So this is not a new issue to me, and it’s something I thought long and hard about. 

Tom Massie doesn’t believe any of that. His intentions with this amendment were anything but pure. It was hastily crafted and poorly written. And one of the biggest issues with it is not only does it [not] address this 10-year memorandum of understanding, something negotiated by President Obama eight years ago, but there are also two years left on the MOU. 

It was a messaging bill and nothing more, and it was a negative message. I voted no because I think if we’re going to move toward peace, we need to do so in a constructive way. A lot of my colleagues were saying we need to send a message to the Netanyahu government.

“I have to hold onto that optimism for the prospects of peace because the alternative is too dark.”

I’ve been extremely critical of this government, their failure to address the settler violence in the West Bank, the failure to plan for a day-after in Gaza following what was a horrific war. If we’re going to move towards peace, if we’re going to find a path where Israelis and Palestinians can live side by side and the region can have the peace they deserve. Because we’re not just talking about Israelis and Palestinians; there’s progress being made between Lebanon and Israel in giving Lebanon, the people of Lebanon, the liberty and freedom they all deserve. 

Can I ask you if you still take money from AIPAC? And if so, how much?

I appreciate the support I get from people who care about the issues that I advocate for. So people who are pro-Israel, pro-US-Israel relationship are likely to support me because I’m pro-US-Israel, pro-US-Israel relationship. I’m also pro-addressing gun safety and reducing gun violence in this country. So I get the support of those groups. The support I get doesn’t determine my positions. I think my positions determine who supports me. 

Has your position on Israel shifted at all since October 7th, or at any point in your political career? And if so, can you tell us how?

So my position hasn’t changed because I’ve always been committed to promoting peace between Israelis and Palestinians and finding a path where both can live together, which I believe ultimately is two states: a Jewish democratic state of Israel, and a Palestinian state living side by side. My frustration with the current Israeli government has grown and continues to grow. Every conversation I have with them, whether it’s the US ambassador to Israel, whom I’ve had the privilege of working with many times, or my meetings with Prime Minister Netanyahu. I’ve had an engagement with the prime minister going back now for almost 30 years. But in the last several years, every single conversation I have with them talks about the need to address settler violence, the need to get humanitarian aid.

One of the things that I am proud of and will say loudly and proudly is that immediately after October 7th, as the war began, my team and I worked hard to push for humanitarian aid into Gaza to do everything we could to make sure that the civilians who were always caught in the middle of any war wouldn’t suffer more than they did. And the suffering was horrific. And I did challenge Israel when they made what I’ll call ill-conceived, ill-advised, in some cases illegal decisions to deprive humanitarian relief from entering Gaza. We pushed hard, and we worked with the Egyptians to get the Rafah crossing open. We pushed the Israelis to open the Karam Shalom crossing. And to not just get aid to those crossings, but get aid into and across the territories within Gaza.

Why are you so optimistic about the situation? 

I am always going to be optimistic. I have to hold onto that optimism for the prospects of peace because the alternative is too dark. And let’s separate the issue for folks living in the region and the folks living here. And for the Israelis and Palestinians, these are two peoples who are totally traumatized — traumatized not just over the last couple of years, but for decades. So I recognize the trauma that Israelis have and are experiencing, and I recognize the trauma that the Palestinians have and are experiencing. And that’s part of what I feel is my obligation: to hold onto that optimism and speak to a better future and work to try to find ways to bring the parties on both sides of the issue together to make the hard choices and take the risk to get to a path to peace.

So the reason I’m holding onto optimism — and it’s not 24/7; I have my moments when I am down and where I feel like the hill we’re climbing is just too steep — is you take a deep breath and you dig deep, and you say, I can’t give up on hoping and working towards peace because otherwise peace is never going to happen. And I want to find people who are like-minded.

And that is not just on the Israeli side of the equation. We have to find people on the Palestinian side, and for those on the Palestinian side, we have to find Israelis. And I meet, and I spend time with them on a regular basis. They come to my office. When I’m in the region, I talk to them. We have to strengthen and empower those voices who believe that peace will only come when the Israelis see the Palestinians as a people worthy of engagement and a shared future, and the Palestinians see the Israeli as a people worthy of engagement and a shared future, and recognize that until they get there, there’s no future for either side. We’ve got to have a path where both are pointing in the same direction.

Fermented food is the hottest new trend in the halls of the White House. Members of President Donald Trump’s Cabinet are reportedly walking about with jars of sauerkraut in the hopes that it will give them glowing skin and tiny waists. 

Wall Street Journal’s Liz Essley Whyte told Today, Explained co-host Sean Rameswaram that “Health Secretary Robert F. Kennedy Jr. Commerce Secretary Howard Lutnik, Transportation Secretary Sean Duffy, and Vice President JD Vance are all on this eat-a-lot-of-steak-and-sauerkraut diet.”

So, should we all be eating jars of sauerkraut? Or are ferments just the new Florsheims?

Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained wherever you get your podcasts, including Apple Podcasts, Pandora, and Spotify.

Is there a name for this diet?

Kennedy calls it the carnivore diet. I think people mean different things when they say that, but for him, it includes a lot of yogurt, a lot of kimchi or sauerkraut, a lot of steak, a lot of eggs. Kennedy now travels with sauerkraut. His wife has said that he has asked her to carry it in her purse for him, and she has said, “I actually cannot,” which is an amazing phrase. It seems they all think their skin is glowing, and people online have commented that JD Vance is looking good.

Are we sure it’s not Wegovy?

We don’t have any public knowledge of that, but we do know that he is eating eggs, sauerkraut, pickles, blackberries, and raspberries for lunch pretty often — and beef and lamb with sauerkraut for dinner. Then, when he’s on Air Force Two, he snacks on beef jerky and maybe eats a hamburger with cheese, no bun, and a side of fermented vegetables.

Now that you’re mentioning the full spectrum of JD Vance’s diet, it’s kind of reminding me of their new food pyramid. Is this part of that?

Earlier this year, Kennedy and the other health officials like to say they flipped the food pyramid. They recommended a lot more fruits and vegetables, red meat — which was controversial — and whole grains, and whole milk, that kind of thing. They also, and for the first time in the nation’s dietary guidelines, recommended fermented foods, which was something that was actually agreed upon by a lot of people, and they thought that was a good part of this, even if they had qualms about the red meat recommendations, because those can introduce more cardiac risk and risk of bad cholesterol.

How widespread is this in the White House? Does it go up all the way to the top, to the president?

Given what we have seen of his recent public dieting, I don’t think so. At the Knicks game, he was eating pizza and french fries, and, you know, he still has his Diet Coke button on his desk where he just pushes it and a Diet Coke comes. Kennedy said, once said on a podcast about him, “I don’t know how he’s alive.” 

Does the science back this up, or is this some kind of quackery that ferments can make your skin healthier and help you lose weight?

I don’t think there are a lot of good studies that show exactly that sauerkraut can help you lose weight, but there have been a number of studies that have shown health benefits. Researchers have generally agreed that sauerkraut and other fermented foods can help with digestion and inflammation. There was a 2025 study from UC Davis that suggested fermented cabbage could protect your gut and protect against illness. Basically, they found that the intestinal cells do better with sauerkraut. They help maintain the integrity of those intestinal cells. And, in general, that has a lot of other good health effects. Mainstream scientists, dieticians, are pro-fermented veggies. This is not something that is hotly debated.

Most people in the scientific community are realizing there’s a lot of good fresh science out there about how important your gut really is in your overall health. The part of the diet that is a little more controversial is the focus on red meat. Obviously, that comes with some cardiac risk and some cholesterol risk. That is why when the new dietary guidelines came out and recommended more of that for Americans, that part, in particular, made some dietitians a little upset.

Do you think fermented foods could help people with this parasite that gives you explosive diarrhea?

I personally have not seen any studies on whether fermented foods help with explosive diarrhea, but let me know if you find one.

AI was supposed to make our lives better. Instead, it’s made many of us scared and angry. Communities are protesting against the building of new data centers — the warehouses of IT equipment powering the AI buildout — across the country, and increasingly they’re winning. And polling shows most Americans think AI is moving too fast.

So how did public opinion on AI curdle so quickly? Jasmine Sun, who reports on the industry from San Francisco, argues that the backlash treats AI less as a technology and more as a political project. “The debate was not about like, is ChatGPT useful to me?” Sun told me during a taping of Vox’s The Gray Area. “The debate was actually something more like, there are these big corporations and unaccountable billionaires…coming into my city, coming into my life and changing it without having any sort of democratic input?”

Filling in for Sean Illing, I talked to Sun about the rise of “AI populism,” the parallels with the Industrial Revolution, and how the backlash could crash into the 2028 presidential election. 

As always, there’s much more in the full podcast, which drops every Monday, so listen to and follow us on Apple Podcasts, Spotify, Pandora, or wherever you find podcasts.

You’ve been writing about a phenomenon you call AI populism. How would you define that? What is AI populism?

I define AI populism as a worldview where AI is not seen as an ordinary technology, but specifically as an elite political project to be resisted. I came to the term while thinking about the AI backlash and the reasons people are increasingly anti-AI — whether that’s LLM slop, whether that’s Waymos in their city, whether that’s a new data center project. One thing that occurred to me was that a lot of times the debate wasn’t about whether ChatGPT is useful to me, or whether Waymos are safer than a human driver. The debate was actually something more like: There are these big corporations and unaccountable billionaires who are coming into my city, coming into my life, and changing it without any democratic input.

When I talk to people who are opposing AI in various ways, they seem more concerned with this concentration-of-power, anti-elite dimension — which is where I take the word “populism” — rather than classic AI safety concerns, which are more about the technical characteristics that might introduce risk.

You wrote a piece that touched on some of this but went to a darker place — “AI populism’s warning shots” — and you wrote about actual shots. Sam Altman, the CEO of OpenAI, was targeted by a Molotov cocktail and a shooting within the span of a couple of days. There was an Indiana councilman who voted for a data center and woke up to gunshots at his home and a note reading “no data centers.” Why do you think of those incidents of violence as warning shots of something to come?

It was pretty scary. I’m no Sam Altman fanboy, but it’s terrifying that assassination attempts are showing up in response to people’s worries about AI. One factor is that we’ve been seeing a rising wave of political violence and support for political violence in the US, especially among young people, over the past few years — the UnitedHealthcare CEO shooting, the Charlie Kirk shooting. Increasingly, a lot of disaffected, maybe nihilistic young people are turning toward political violence as a way to express political beliefs they don’t feel they have other channels for. Or maybe that person is just unwell. But I do expect to see more of it, because my theory of political discontent is that if people feel they have institutional channels to bargain for their rights — if they feel the democratic process is working, or they’re part of a union and believe their union leader will go bargain about how automation shows up in the workplace — they’ll most likely go through those channels.

When it feels like the official channels aren’t working, opposition becomes much more diffuse and volatile. That’s part of why, in creative communities, you’ll see people witch-hunting each other over AI use. I think we’ll see more political violence against people seen as AI leaders, or as supporting AI leaders.

That’s really scary.

Yeah, I’m quite worried about it. But again, my sense is that it comes from a feeling of — what else is there to be done, when you have this level of concentration of wealth and power, and there’s no democratic input right now into how AI is regulated or built?

It’s like a jump straight from complaining at your community meeting about the data center to an act of violence.

I was talking to some friends about this. During the 20th century in the US, there was a wave of factory mechanization and automation, but unions were really strong — often when a company said, “We’re going to bring in these machines,” they’d sit down with the factory union leader and say, “Okay, you can bring in the machines, but we’re going to couple that with a wage increase,” or a 35-hour workweek, or earlier retirement. There was a channel to make a deal about how automation would show up in your workplace. That meant people were more likely to accept it as something lifting all boats. I don’t think that’s happening now — most of the industries affected by AI aren’t organized in labor unions, and the democratic channels are questionable at best.

It’s like when people have agency to be part of the transition, the process goes a lot smoother. Is there a historical analogy for a technological change that didn’t allow for input from the people involved? I’m thinking of the Luddites.

The Luddites are a good example. When the automated looms were introduced, there was a lot of violence against the looms. The book I’d really recommend here is Carl Benedikt Frey’s The Technology Trap. He’s an Oxford economist who studied a ton of historical examples — in Europe, in China, all over the world — including the Luddites and 20th-century automation. His central question was: In what contexts do workers successfully stop automation, and in what contexts do they allow it to be introduced? How does the political environment, or the balance of power between people and their leaders, change the outcome? He found that when automation was introduced alongside social welfare policies — a higher minimum wage, some form of redistribution — people were much more willing to accept it, which is fairly rational.

I want to talk about Silicon Valley’s understanding of this backlash more generally. You’re painting a pretty dark picture, and you’re right in the belly of the beast in San Francisco — I’m sure you talk to people involved with AI every day. Is there a moment when it clicked for them that this backlash is real and something they have to take seriously? Or has that happened yet?

I’ve definitely noticed a huge difference, over the past six months, in how seriously people in Silicon Valley take the AI backlash.

Like what?

People just talk about it more. I’d bring up AI populism to people last year, and they’d normally say, “It doesn’t matter — technology always introduces some discontent, people get annoyed but they get used to it, like the internet.” That was the standard reaction last year. Not anymore. I think part of the reason OpenAI and Anthropic have felt pressure to introduce economic policy proposals around job automation is that they’re seeing how worried people are. The data center moratoriums and the broader data center backlash have been surprising and meaningful in getting AI leaders to recognize they have both a messaging problem and an actual problem with the product and the technology they’re introducing.

A lot of the increasing opposition to AI in Washington has caused people to see this too. At first, Trump — as you mentioned — was very pro-AI. He and David Sacks were accelerationists; they wanted AI to go faster and to block attempts at regulation.

He was the AI czar.

“The moratoriums, the regulation fights, even the booing at graduations, the literal assassination attempts — people in Silicon Valley have become much more worried.”

He was the AI czar — he’s no longer the AI czar. But it turned out a lot of other constituencies, both on the left and the right, were pretty opposed. For example, Trump and David Sacks tried to introduce a big federal bill that would preempt all state-level AI regulation — no state could regulate AI for 10 years. They tried to sneak it into a big omnibus bill so no one would notice. But members of Congress realized it was happening, and — whether for kid-safety reasons or frontier-safety reasons — people said, Wait a second, the idea of preventing any state from regulating AI for ten years is crazy. A lot of people organized in Washington to successfully stop that preemption. I think that showed the scale and bipartisanship of a coalition that was very keen to make sure it stayed possible to regulate AI was underestimated. As a result of all this — the moratoriums, the regulation fights, even the booing at graduations, the literal assassination attempts — people in Silicon Valley have become much more worried.

China is our big competitor in the AI race, and it certainly has all the conditions for a populist pushback to AI — youth unemployment is really high, and AI technology is in some ways more advanced at taking over real-world jobs. I was watching a video about fully automated factories and a robot pharmacist. You’re one of the rare American tech reporters who gets to spend time in China, and you wrote a piece that surprised me — you found there wasn’t really a populist backlash to AI there. Why not?

I was really interested in this question, and I was finishing my New York Times piece while in China for a few weeks, talking to both AI people and non-AI people. The main reason there’s not a big populist backlash in China is that there isn’t a lot of social unrest or populist backlash against anything — the entire MO of the Chinese government, the No. 1 priority, is domestic social stability. Any whisper of protest gets shut down; that’s why they have such strong speech controls. So one factor is that China doesn’t have much of a culture of resistance in general, whether in workplaces or politically. I’m not saying no one dissents — but it has a cultural effect too, because people don’t see it as useful or as an option. When I ask family members of mine in China about AI, sometimes they’re annoyed about specific things, but fundamentally, the idea of opposing AI is seen as almost unimaginable.

The other thing about China is that if you’re middle-aged there, you’ve lived through so many political, economic, and technological revolutions in your lifetime. When I was a little kid visiting Shanghai in the mid-2000s, there were no high-speed trains — now China has some of the best high-speed rail systems in the world. Technology has always gone hand in hand with dramatic economic advancement, with being lifted out of poverty. The modernization process has been aggressive and disruptive, but it’s not something the party has offered opportunities to resist, and it’s something most Chinese people still see as an inevitability that was mostly good for most people — because incomes did increase by dramatic amounts alongside the technological change. So I think people have a similar attitude toward AI: It’s much less about “Can I stop the AI wave?” and more “How can I take advantage of the AI wave to get ahead economically?”

We were just talking about this deep pessimism about what technology can bring us here in the US. I think a lot of people look around and think: We don’t have a cure for cancer yet, but we’ve sure seen our lives get worse in a lot of ways because of technology, social media, whatever. That pessimism probably fuels the backlash to AI, the skepticism about whether it can ever deliver on its promises. And that experience just isn’t the same in China, or probably much of the rest of the world, where technological progress has been faster and more concrete in people’s lives.

My 90-year-old grandfather said he’d love an elder-care robot to help him do tasks around the house so he doesn’t have to rely on his kids — he wants more freedom and mobility. It’s seen more as a tool to help individual goals. Even with the robot factories or pharmacies — one thing that struck me visiting a robot pharmacy was that the PR people happily said, “Yep, we’re doing these robots because human workers take too many smoke breaks and bathroom breaks and take too long.”

You’d never say that in the US, but they’re probably thinking the same thing — they just don’t say it. The other thing they mentioned is that this lets the pharmacy operate 24/7, because a lot of people need medications in the middle of the night and want to order via the DoorDash equivalent. There was actually a labor shortage before — Chinese workers weren’t willing to work night shifts — so these pharmacies are offering real consumer surplus. A significant percentage of orders come in overnight, when no other pharmacy is open. And with the factories, part of the issue is that Chinese workers, especially young people, don’t want to do factory work anymore.

“I think the 2028 presidential primary and election is really where I expect AI to become a centerpiece of the conversation.”

That anecdote gets at the promise and peril of AI, and the role of the backlash movement — which I’m still wrestling with how I feel about. On the one hand, I want to live in a world where cancer gets cured, where we live in an era of abundance, where things are cheap and easy to make because factories can run all the time with machine workers who don’t require anything — I want the future we were promised, of flying cars and everything working well.

But I also don’t want to lose my job, or see humanity wiped out by an angry machine god. Because we don’t really know what’s going to happen yet, it’s hard to work out my own feelings about the pushback here in the States — what’s appropriate, and what’s holding us back from real advances in our lives.

Totally, I agree. I like Waymos — I think they’re safer, and I’d prefer a safer robot car driv[ing] me around instead of me driving. I’m not a good driver; no one should let me drive. So I wrestle with some of the same things.

To close out the conversation — let’s come back to the United States. AI populism is brewing as a political force. We’ve seen it show up in a couple of races so far, but it’s early. We’ve got the midterms, then the presidential election. How do you think it’s going to affect American politics this November, and in 2028?

My sense is that this November, it’s going to be more about state and local races where AI really shows up. I’m going to spend some time in Michigan and Wisconsin this summer touring some of the data center sites facing the most opposition — those states also have contested governor and Senate races where AI and data centers have become a core issue, so I’m interested to learn more there. I think the 2028 presidential primary and election is really where I expect AI to become a centerpiece of the conversation — especially if we start to see some of the employment impacts people are expecting. As soon as we see something like a 2 percent rise in unemployment, if that happens, I think people will be very upset, and we should expect a ton of focus on the issue.

The other thing I’ll note is political opportunism — you’re already seeing a bit of this, where politicians are likely to raise the salience of AI above where people might ordinarily care about it, because it’s become a convenient boogeyman. It polls so poorly, people are so anti-AI and anti-data-center, AI billionaires are so unsympathetic, that no matter what your policy program is, AI is a great reason to push it. I think a lot of politicians who are being clever about this are going to move AI to the center of the conversation, raising its salience to manufacture urgency for proposals they’re already excited about. That’s definitely something I’m watching for 2028.