Since President Donald Trump returned to office in January, federal policy has shifted to promote psychological therapy as the only treatment for transgender youth in distress.

A report issued last month by the Trump administration’s Department of Health and Human Services on care for transgender and nonbinary people analyzed 17 studies out of more than 3,400 looking into gender-affirming care — an umbrella term that can include talk therapy, puberty blockers, hormone treatments and surgeries.

They included only analyses of other studies that didn’t include any patients older than 26. Those that examined mental health generally found improvements from gender-affirming care, though with low certainty, because they didn’t include a large enough group, the effects were small, or other factors.

The report had more sweeping conclusions, however, stating that people under 19 with gender dysphoria should receive only psychological therapy, rather than being able to choose puberty blockers or hormone therapy. Gender dysphoria refers to distress when someone’s gender identity and their sex, or the way others see them, don’t match.

Major medical groups, such as the American Academy of Pediatrics, have endorsed offering the full range of affirming care to appropriate patients, and experts interviewed by The Denver Post agreed that while some patients only need therapy, others benefit from gender-affirming medical care.

The new report comes as the administration ordered providers to stop offering puberty blockers and hormone therapy to anyone under 19, threatening to take away federal funding from hospitals that didn’t comply. A federal judge blocked Trump’s executive order while a legal challenge plays out from four states, including Colorado.

The Trump administration also forbade transgender people from serving in the military, threatened federal funding for schools if they promote “gender ideology,” removed references to LGBTQ health disparities from health websites, ordered the Justice Department to take action to stop trans girls from playing on sports teams with cisgender girls, forbade the issuing of passports displaying the gender trans people identify with, and moved inmates who are trans women into men’s prisons.

Dr. Rae Narr, a nonbinary psychologist in Denver, said the administration’s actions targeting transgender people suggest the government is going to push therapy that attempts to change someone’s sexual orientation or gender identity. But, done right, therapy can also be affirming, they said.

“On their face, what they are suggesting is therapy and support for these youth,” Narr said. “When you really look at what they’re suggesting, it’s conversion therapy.”

Conversion therapy, as typically practiced today, looks for a pathological root for someone’s sexual orientation or gender identity, Narr said. For example, the practitioner might argue that another condition, such as autism, caused someone to think that they were transgender, or that they wanted to change their gender because of shame about being gay or a history of sexual trauma, they said.

Mainstream medical groups condemn the practice and Colorado banned conversion therapy for minors, though the law faces a challenge at the Supreme Court.

Affirming therapy, in contrast, starts from the position that no identity is right or wrong, Narr said. The goal isn’t to encourage young people to transition, but to help them sort through what would make them comfortable in their bodies and lives, they said.

That can involve talking about how they imagine their adult lives and practical exercises, such as trying on different clothes, Narr said. They also discuss where the young person would feel physically and emotionally safe exploring. For example, someone might go to the next town over to try out going to a store dressed differently, they said.

“I talk to kids a lot about what does it mean to you when you imagine being a boy, or a girl, or something else,” they said.

‘We listen to them’

In 2024, 46% of transgender or nonbinary young people reported seriously considering suicide, and 14% attempted it, according to the LGBTQ nonprofit The Trevor Project.

Those who reported they’d experienced bullying or physical harm because of their gender identity were more likely to report thoughts of suicide, as were those who said their schools didn’t support them.

But the odds of suicide drop when youth report that people in their lives accept them, such as by calling them by their chosen name and pronouns, Narr said.

Dr. Casey Wolf, a child and adolescent psychiatrist at WellPower in Denver, said the field hasn’t agreed to a protocol for treating gender dysphoria, but does have evidence-based therapies for the depression, anxiety or trauma that typically push people to seek help.

Sometimes, those symptoms stem from gender dysphoria or from mistreatment based on someone’s gender identity, but not always, she said.

“We listen to them. We try to understand what their symptoms are,” Wolf said.

While the public is talking about gender identity more than in the past, Wolf said she hasn’t seen an increase in young people experiencing gender dysphoria. Despite the perception that being transgender is trendy, people don’t take on marginalized identities like they change their hairstyles, she said.

Not all trans people experience gender dysphoria, and not everyone who has gender dysphoria decides to transition, said John Mikovits, an assistant professor of nursing who studies care for LGBTQ people at Moravian University in Pennsylvania. Some people may only need emotional support at some points in their life, but may decide to socially or medically transition later, he said.

What the therapist helps the patient work on may also change, Mikovits said. For example, a person who opts to transition may feel relief from gender dysphoria, but needs to learn skills to cope with increased discrimination, he said.

“The treatment is not about curing someone’s transgender or misaligned identity, it’s about affirming that identity and improving their quality of life,” he said.

‘The most basic and easiest thing to do’

Acting as a liaison between kids and parents can also be part of the job.

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Young people often struggle to tell their parents what they’re feeling, so the news they’re questioning their gender can feel like it comes out of nowhere, Narr said. Parents also don’t always do the best job explaining their feelings, so confusion or fear for their child’s future can come off as rejection, they said.

“Even if the parents are supportive, it’s reasonable to have some fear and grief” for the life they imagined for their child, they said.

While discussion about affirming care focuses on puberty blockers, hormones and surgeries, just using the right pronouns for someone can be important affirmation, Mikovits said.

“It’s the most basic and easiest thing to do, to refer to people the way they want to be referred to,” he said.

Everyone wants others to see them the way they see themselves, and if that isn’t happening, it can bring shame and hopelessness, Wolf said. When someone says they aren’t wrong or sick because of how they see themselves, that can bring back some hope that the problem is their environment, and they may be able to change it, she said.

“That’s the beginning,” she said.

There are 26 letters in the alphabet but only 21 are set aside each year for potential tropical storm and hurricane names in areas tracked by the National Hurricane Center.

The names for the 2025 Atlantic hurricane season are Andrea, Barry, Chantal, Dexter, Erin, Fernand, Gabrielle, Humberto, Imelda, Jerry, Karen, Lorenzo, Melissa, Nestor, Olga, Pablo, Rebekah, Sebastien, Tanya, Van and Wendy.

There are no names for Q, U, X, Y and Z, and each of the 21 names alternate from female to male. This year starts with a female name and next year will begin with a male name.

If some of this year’s names seem familiar, it’s because each year’s names are decided six years out by an international committee of the World Meteorological Organization. If a storm name isn’t retired after a season it recycles.

This year, for instance, the WMO Hurricane Committee retired Beryl, Helene and Milton from its Atlantic basin name list “because of the death and destruction these storms caused in 2024,” according to a WMO press release. They were replaced by Brianna, Holly and Miguel — but those won’t be used until 2030.

Hurricane Debby, though, which struck Florida’s Big Bend in August, remains on the potential storm names list for 2030. The storm was blamed for 12 deaths but was nowhere near as destructive as Helene or Milton.

So a good chunk of the storm names used in 2019 are getting reused this year. Andrea, for instance, had been used in 2019, 2013 and 2007.

The only new name in 2025 is Dexter, which replaced Dorian, a deadly and destructive Category 5 hurricane that wreaked havoc in the Bahamas in 2019.

If there are more than 21 named storms, WMO initiated a supplemental list first available in 2021 for new storm names. They are Adria, Braylen, Caridad, Deshawn, Emery, Foster, Gemma, Heath, Isla, Jacobus, Kenzie, Lucio, Makayla, Nolan, Orlanda, Pax, Ronin, Sophie, Tayshaun, Viviana and Will.

Before 2021, if there were more than 21 named storms in a year it would take on a letter from the Greek alphabet for its name: Alpha, Beta, Gamma, Delta, Epsilon and so forth.

Only twice has NHC utilized the spillover list. First in 2005 when it used six letters of the Greek alphabet, and again in 2020 when it required nine letters including Zeta, Eta, Theta and Iota. That was deemed potentially confusing and dangerous and thus begat the new augmented naming system.

The NHC began naming storms in 1963.

In addition to 2019’s Dorian and last year’s Beryl, Helene and Milton, the other retired storm names over the last decade are 2022’s Fiona and Ian; 2021’s Ida; 2020’s Laura, Eta and Iota; 2018’s Florence and Michael; 2017’s Harvey, Irma, Maria and Nate; 2016’s Matthew; and Otto and 2015’s Erika and Joaquin.

Other storms that have struck Florida whose names were retired include 2005’s Dennis, Katrina and Wilma; 2004’s Charley, Frances, Ivan and Jeanne; 1995’s Opal; and 1992’s Andrew.

By DÁNICA COTO

SAN JUAN, Puerto Rico (AP) — A record amount of sargassum piled up across the Caribbean and nearby areas in May, and more is expected this month, according to a new report.

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The brown prickly algae is suffocating shorelines from Puerto Rico to Guyana and beyond, disrupting tourism, killing wildlife and even releasing toxic gases that forced one school in the French Caribbean island of Martinique to temporarily close.

The amount — 38 million metric tons — is the biggest quantity of algae observed across the Caribbean Sea, the western and eastern Atlantic and the Gulf of Mexico since scientists began studying the Great Atlantic Sargassum Belt in 2011, said Brian Barnes, an assistant research professor at the University of South Florida who worked on the report published on Monday by the University of South Florida’s Optical Oceanography Lab.

The previous record was set in June 2022, with some 22 million metric tons.

“The peaks just seem to keep getting bigger and bigger year after year,” he said.

But scientists don’t know why yet.

“It’s the million-dollar question,” he said. “I don’t have a supremely satisfying answer.”

Three different types of sargassum exist in the Caribbean and nearby areas, reproducing asexually as they remain afloat thanks to tiny air sacs. They thrive in different ways depending on sunlight, nutrients and water temperature, factors that scientists are currently studying, Barnes said.

Sargassum covers the coast of Playa Lucía, Yabucoa, Puerto Rico, Monday, June 2, 2025. (AP Photo/Alejandro Granadillo)

Experts also have said that agricultural runoff, warming waters and changes in wind, current and rain could have an effect.

While large clumps of algae in the open ocean are what Barnes called a “healthy, happy ecosystem” for creatures ranging from tiny shrimp to endangered sea turtles, sargassum near or on shore can wreak havoc.

It can block sunlight that coral reefs need to survive, and if the algae sinks, it can smother reefs and sea grasses. Once it reaches shore, the creatures living in the algae die or are picked off by birds, Barnes said.

Huge piles of stinky seaweed also are a headache for the Caribbean, where tourism often generates big money for small islands.

“It is a challenge, but it’s certainly not affecting every single inch of the Caribbean,” said Frank Comito, special adviser to the Caribbean Hotel and Tourism Association.

In the popular tourist spot of Punta Cana in the Dominican Republic, officials have invested in barriers to prevent sargassum from reaching the shore, he said.

Sargassum gathers off the coast of Playa Lucía, Yabucoa, Puerto Rico, Monday, June 2, 2025. (AP Photo/Alejandro Granadillo)

In the Dutch Caribbean territory of St. Maarten, crews with backhoes were dispatched in late May as part of an emergency clean-up after residents complained of strong smells of ammonia and hydrogen sulfide, which can affect a person’s respiratory system.

“The smell is quite terrible,” Barnes said.

Meanwhile, in the French Caribbean, officials expect to soon use storage barges and an upgraded special vessel that can collect several tons of seaweed a day.

The sargassum “disfigures our coasts, prevents swimming and makes life impossible for local residents,” French Prime Minister François Bayrou recently told reporters.

But Comito said such vessels are “massively expensive” and not a popular option, noting that another option — using heavy equipment —- is labor-intensive.

“You have to be careful because there could be sea turtle eggs affected,” he said. “It’s not like you can go in there and massively rake and scrape the whole thing.”

A pier sits damaged as sargassum surrounds the coastline of Punta Santiago, Humacao, Puerto Rico, Monday, June 2, 2025. (AP Photo/Alejandro Granadillo)

Some Caribbean islands struggle financially, so most of the cleanup is done by hotels, with some offering guests refunds or a free shuttle to unaffected beaches.

Every year, the amount of sargassum expands in late spring, peaks around summer and starts to decline in the late fall or early winter, Barnes said.

The new record set is hardly stationary — experts said they expect even more sargassum for June.

Follow AP’s coverage of Latin America and the Caribbean at https://apnews.com/hub/latin-america

By ALEXA ST. JOHN and MATTHEW DALY

The National Oceanic and Atmospheric Administration said Monday it will hire for “mission-critical field positions” amid expert warnings that the National Weather Service has been cut too sharply just as hurricane season arrives.

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An agency spokesperson said in a statement the positions will be advertised under a temporary reprieve from the federal government’s widespread hiring pause “to further stabilize frontline operations.” NOAA also said they are filling some field office openings by reassigning staff, including some temporary hires.

The agency didn’t say how many jobs would be posted and refused to provide more details.

Elon Musk’s Department of Government Efficiency cuts gutted NWS and NOAA — which provide daily weather forecasts, up-to-the-minute severe storm warnings, climate monitoring and extreme weather tracking — earlier this year.

Hundreds of weather forecasters were fired and other federal NOAA employees were put on probationary status in February, followed by a later round of more than 1,000 cuts at the agency. By April, nearly half of NWS forecast offices had 20% vacancy rates. The Federal Emergency Management Agency has also been affected.

The new hires would be seen by the scientific community as especially imperative as the agency predicts a busy hurricane season and more tornados. In recent years, greenhouse gas emission-driven climate change has fueled more frequent, deadly, costly and increasingly nasty storms.

The weather service’s mission includes warning people in danger with enough time to evacuate or find safe shelter. The cuts forced weather forecast offices to reduce their hours or no longer staff overnight shifts in less critical periods.

Insiders and experts have warned of the consequences that a staffing shortage would mean for weather forecasting amid extreme weather and the U.S. economy.

“In 2024, NOAA was able to offer some of its most accurate weather forecasting to date for active hurricanes,” said Union of Concerned Scientists science fellow Marc Alessi. “These incredibly accurate forecasts were made possible by a fully funded NOAA.

“Despite the worsening climate and extreme weather impacts being felt across the country, the Trump administration has proceeded with its inhumane agenda that will leave people on the frontlines of disasters at greater risk,” Alessi added.

Alexa St. John is an Associated Press climate reporter. Follow her on X: @alexa_stjohn. Reach her at ast.john@ap.org.

Read more of AP’s climate coverage at http://www.apnews.com/climate-and-environment

The Associated Press’ climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.