Silly Rabbit, Trix Aren’t for Kids!: How General Mills’ Trix Cereal Targets Young Audience

by Divya Jagnarain, April 5, 2022

It’s 7:15 AM on a Monday morning. Your bus will arrive outside your house in fifteen minutes. Half asleep, you reach into your cabinet and grab a vibrantly colored box of General Mills’ Trix cereal. The nutrition label sticks out, but as usual, you don’t care to read it. It’s colorful, grabs your attention, is easy to prepare and tasty. Many of the cereal boxes advertised on the shelves of grocery stores are designed in such a way to grab the attention of loud, demanding children. While making parents out to be the bad guys, who can say “no” to this brightly colored box of sugar?

What is it about the color of the box and the details of the illustrations that draw children in? According to Leatrice Eiseman, director of Eiseman Center for Color Information and Training and executive director of Pantone Color Institute, “Children are inevitably fascinated by brighter colors from early infancy” (Parpis, 4). Studies have shown that the eyes of growing children will be attracted to the primary colors, red, blue, and yellow (Parpis, 4). Marketing companies, such as those of General Mills’ Trix use this to their advantage. 

Since their eyes are not fully developed yet, from an early age children have a preference for bright colors. These colors are much easier to perceive than faint shades. The bright colors typically used by companies targeting children stand out more in their field of vision (Pancare, 3). On Trix cereal boxes, one can find an abundance of reds, greens, yellows, purples, etc. The combination of these contrasting colors is inviting to a bored child strolling through the aisles of a grocery store. 

Plastered on cereal boxes all over America, the Trix Rabbit, illustrated by Joe Harris has captivated the minds of youths. The Trix Rabbit, commonly referred to as Tricks, has a way of connecting to children. “And, of course, what we feel connected to—which happens when someone, even a cartoon character, makes eyes at us—we’re more likely to buy,” states Alice G. Walton of Forbes Magazine (Walton, para 1). Having a character representing one’s brand that is inviting and entertaining bodes well to grab the attention to young minds. 

The Trix Rabbit is more than meets the eye, however. In the Journal of Popular Culture, author Thomas Green contends that Trix the Rabbit bears more than a passing resemblance to a “trickster” (Eisenberg, 118). Green writes, “Tricksters are often depicted as participating in some kind of trick, theft, or sacrifice that results in the gift of the useful technology or plant to humanity” (Eisenberg, 118). Similarly, on television commercials, Trix the Rabbit is willing to cheat or deceive to acquire the toothsome cereal from unsuspecting children. That’s where the famous slogan, “Silly rabbit, Trix are for kids,” comes into play. 

From the 1970s to the present day, this harmless rabbit has been trying to get a taste of the eye-catching cereal but has failed to do so due to “selfish children” refusing to share. Trix the Rabbit has to resort to concealing his identity in costumes in order to trick the children. From disguising himself as an astronaut to a breakdancer, Trix the Rabbit takes on the costume of whatever advertisers perceive as popular with children at that time (Eisenberg, 120). In doing so, advertisers succeed in their goal to captivate young audiences. On the contrary, Trix the Rabbit, when he is nearing his goal of acquiring the delicious fruity goodness, his ears always spring free, exposing his true identity (Taylor, para 2). This iconic, well-known television commercial has been planted in the memories of many generations. 

To understand how television companies advertise to specific consumer segments such as children, teenagers, and adults, one must assess the nutritional quality, packaging, and co-branding of the product (Berning et al., para 4). In other words, a cereal’s nutritional profile, package attributes, and co-branding correspond to television advertising targeted at specific audiences. Often, breakfast cereal packaging is “covered in brand characters, promotional opportunities, nutritional claims, and other engaging marketing strategies” (Berning et al., para 13). As mentioned beforehand, Trix the Rabbit is an identifiable character which entices young consumers. In other popular brands, children are drawn to Toucan Sam and Cap’n Crunch in the same light. 

The attractiveness of brand profiles are heightened with the addition of “games on the box, toys in the box, and other forms of brand enhancements” (Berning et al., para 14). On the rear of a General Mills’ Trix™ Cereal box, one can find an abundance of enticing activities. Such activities include “Tumblin’ in Trix,” “Name the Rabbit,” “Hurray for Fruity Shapes,” and so on and so forth. These activities can range from short, adventurous stories to mini puzzle games to full-blown challenges. By putting different activities on these boxes, it begs consumers to buy often to complete the next set. 

Furthermore, breakfast cereal packaging is used to promote product co-branding. For instance, a child walking down the cereal aisle in a grocery store would be drawn to the cereal box with a famous athlete or character from a movie. According to Qu Rao et al, “co-branding can help gain increased access to new markets and can signal reputation and quality” (Berning et al.,  para 15). Television or movie themes, athlete endorsements, or cartoon endorsements are effective ways of targeting new consumers. 

In order for the product to be picked up from the shelves, taken to the register, bagged, taken home, and consumed, advertisers must be able to win over the hearts of both the child and parent. In regards to breakfast cereals, manufacturers are aware that sugar appeals to children. According to statistics, “a third of U.S. consumers buy one box of cereal per trip, 41% buy two and 19% buy three or more” (Sherred, para 3). Chief marketing officer of Shopkick, Kristy Stromberg says “We’ve seen that people are loyal to the brands and tastes they love, and despite a movement towards incorporating healthier options, consumers will always love classic favorites” (Sherred, para 15). At the end of the day, taste is the deciding factor when it comes to choosing breakfast cereals. 

Of the millions of Americans that shop every day, only 18% of consumers look at the nutritional values before purchasing. On the side of a box of General Mills’ Trix is the “Nutrition Facts.” The nutrition facts are clearly visible with the mass and percentage of its ingredients. Many consumers overlook this nutrition label as it is hard to understand. Having it written very plain and simple, one chooses not to question the “healthiness” of the cereal. Additionally, right below the concentrations of cholesterol, sodium, potassium, carbohydrate, and proteins are the percentage of vitamins, irons and calcium listed. It’s general knowledge that these minerals are pivotal to one’s diet. Minerals help our bodies develop and function. For instance, iron is important for cell growth, development, and normal body functions. According to Robert Earl et al, “the prevalence of iron deficiency anemia among young children has been declining, and the decline is attributed to the use of iron-fortified formula and cereal, appropriate supplementation of breastfed infants, and later introduction of cow’s milk to infants’ diets than had been typical in the past” (Earl, 3). Having these minerals listed on the boxes of cereal in clear and readable font further persuades one to purchase said cereal, whether they read it or not. 

As insignificant as it seems, the font displayed on these cereal boxes do make a difference. A brand’s chosen typeface reflects the personality of the brand. Trix™ cereal utilizes fonts such as Franklin Gothic Heavy, Helvetica Regular, Helvetica Black, and other plain fonts. In accordance to UX design student Liz Fu of University of Michigan, “The typefaces were categorized according to their personality traits and typographical features such as x-height proportion, ascender and descender proportion, font weight, stroke design, and counter design, as well as the kerning of the letter pairs. These typographical features give typefaces their personality” (Fu, para 6). These fonts are characterized with the personality traits of directness, gentleness, cheerfulness, and fearfulness. Using fonts of such that have a very familiar, legible, plain, and straightforward personality is agreeable to consumers. 

How can advertisers get this sugary goodness into the household of roughly all Americans? The answer is simple: Box Tops. Popular among cereal boxes are the inclusion of “Box Tops,” which are used for educational purposes. Trix™ cereal is in participation with the “Box Tops for Education” program. Not only on Trix™ cereals, but many popular cereal brands have the words “Every valid Box Tops clip is worth 10¢ for your school” printed on their products as well. In collecting box tops to raise funds for one’s school, children are taught the importance of giving back and how small actions can impact others in a fun way. By doing so, they earn the school’s funds that can be used towards things like school supplies, books, and field trips (Hanawalt, para 2). This characteristic on cereal boxes is appealing to parents along with their children. Many parents want to contribute to their children’s education in one way, shape, or form—whether that is through the donations of box tops or staying up late at the dinner table to complete their child’s science project on time. 

By understanding how the minds of their target audience works, marketing companies are able to play to their advantage. Through the usage of vibrant colors, large fonts, simple words, and enticing games, General Mills’ Trix™ Cereal has stolen the hearts and money of Americans all across the country. Many companies recognize that children are easy targets to sell to. The demanding voices of children bodes well for their products to sell. Where nagging children go, frustrated parents follow.

Works Cited

Berning, Joshua, and Adam N. Rabinowitz. “Targeted Advertising In The Breakfast Cereal Industry.” Journal of Agricultural and Applied Economics, vol. 49, no. 3, 2017, pp. 382–399. doi:10.1017/aae.2017.1. 

Earl, Robert O., et al. Iron Deficiency Anemia Recommended Guidelines for the Prevention, Detection, and Management Among U.S. Children and Women of Childbearing Age. National Academy Press, 1993.

Fu, Liz. “How Typefaces Affect Consumer Perception of Brand Personality.” Medium, 15 Dec. 2017,

Hanawalt, Zara. “Parents Can Now ‘Clip’ Box Tops Using an App.” Motherly, 30 July 2019,

Pancare, Rachel. “How Do Bright Colors Appeal to Kids?” Sciencing, 2 Mar. 2019,

Parpis, Eleftheria. “The Color of Money: The Art, Science and Psychological Appeal of Bright colors.” Brandweek, vol. 51, no. 17, Apr. 2010.

Sherred, Kristine. “Shopkick Survey: 96% of US Consumers Buy Cereal Every Time They Shop, Sweet Brands Still #1.”, 5 Mar. 2019,

Eisenberg, Lee. Shoptimism: Why the American Consumer Will Keep on Buying No Matter What. Free Press, 2009.

Taylor, Heather. “Silly Rabbit! The Trix Rabbit Celebrates His 60th Anniversary.” POPICON, 5 Aug. 2019,

Walton, Alice G. “The Sticky Methods Of Marketing Cereal To Kids.” Forbes, 4 Apr. 2014,

From Criminals to Celebrities: How Women’s Fascination with Serial Killers Reflects Their Perception of Romance

by Ayesha Azeem, March 25, 2022

People have always been interested in learning about influential people’s lives — through both gossip and the media. Whether we’re learning about Jennifer Aniston’s new fling, Kim Kardashian’s pregnancy, or Harry Styles’s secret vacation, we often interest ourselves with other people’s lifestyles, namely celebrities, because we feel as if we personally know them through our powerful admiration and devotion. We see celebrities as heroes; people we aspire to be like. But why are we so drawn to the lives of villains as well?

Recently, women have developed a strong obsession with true crime, a literary and film genre in which the author examines an actual crime and exposes the actions committed by real people; specifically, there has been a sudden fascination with serial killer crimes. This infatuation with evil reveals our desire to uncover the secrets and truth behind those who commit the horrific acts we abhor. Perhaps it fascinates us that these famous perpetrators hold such obvious disregard for morality and societal values; we feel obligated to witness the dramatic scenes unfold as a means of “preparation” for any real-life danger. 

From Ted Bundy to Charles Manson, women often find themselves deluded into romanticizing famous serial killers. We find it hard to accept that attractive people are just as capable of committing grotesque crimes as ordinary people. Recently, the Joker movie played by Joaquin Phoenix, though fictional, has captured the attention of young girls infatuated with his depressing life story and motivation to commit heinous crimes that are similar to real killers. Though women are more likely to be victims of a major crime, for some reason they feel increasingly attracted to the vile and twisted side of history, intrigued to learn about the ways in which they can face danger.

Psychologists conducted a 2010 study at the University of Illinois to investigate the relationship between gender and the true-crime audience. Psychologist R. Chris Fraley and their team discovered that women wrote 70% of the true-crime book reviews on Amazon, while men felt a greater connection to war books, writing  82% of reviews (Yates). The researchers hypothesized why women may feel an increased inclination to read more true crime and suggested that such stories can provide useful information that may help readers avoid or escape potential attacks such as murder or rape. To investigate this claim, the psychologists reviewed the summaries of the books most often reviewed by women. Further study revealed that women were more likely to read a true crime book if the victim used a clever ‘psychological trick’ to deceive and escape from their perpetrator. Unsurprisingly, women also felt attracted to true crime books with female victims. Thus, evidence strongly suggests that women tend to read more true crime books with clever female survivors because they provide a ‘guide’ of instructions as to how to avoid deadly encounters in real life. If women consume as much violence as they can in art, maybe they can escape the true violence that unfortunately lingers in our reality. 

Recently, the producers of All Killa No Filla, a British podcast dedicated to exploring the lives of serial killers, found that roughly 85% of listeners are female (Woman’s Hour). BBC Radio 4’s Woman’s Hour considered why their listeners consisted mostly of women, and invited Dr. Gemma Flynn, a criminologist at Edinburgh University, and Rachel Fairburn, co-host of the famous podcast, to explain their theories. Dr. Flynn believes that a major explanation for female true crime listeners includes women retaining an extensive fear of crime. According to Fairburn, “women love true crime because pretty much from the time that we’re very small, we’re told to be careful, look after ourselves, watch out for bad people, make sure we get home safely” (Woman’s Hour). The host suggests that society constantly attempts to protect women from danger, instilling in their minds that as long as they’re alone, they can be attacked. Thus, women tend to leave their house with a constant target on their back and safety on their minds, attracting them to true crime out of self-preservation. With the stereotype and widely held belief that women cannot walk alone at night because of possible attacks, women feel the need to protect themselves as much as possible, consuming true crime stories at the top of their list. 

The constant fear society holds regarding women as potential victims of brutal crimes stems from the media’s infatuation with blood and murder. According to a 1992 study conducted at SUNY Oswego, mass media “serves as the primary source of information about crime for up to 95% of the general public,” with approximately 50% of news coverage devoted exclusively to crime stories (Mann). With this extensive reporting on crime and violence, Americans fall victim to their availability heuristic, a mental shortcut that relies on immediate examples that come to a person’s mind when thinking of an idea or event. Because of the increased attention presented towards crime on-air, Americans may not believe that the crime rate has actually decreased over the years since all they hear about is murder, rape, and violence when they turn on their televisions. While murder rates decreased by 20% from 1993 to 1996, reporting on murder on television rose by 721%. (Mann). This affects women especially as the constant fear perpetrated by the media regarding crime and murder may be a key reason in females’ attraction towards true crime media. 

Now that we understand why women tend to reach for books labeled with the true crime genre, the compelling question needed to be answered is why women romanticize these vile human beings. After the release of Extreme Wicked, Shockingly Evil and Vile, a film on the life of Ted Bundy based on the perspective of his girlfriend, viewers went to Twitter to express their newfound admiration for the ‘misunderstood’ villain. Ted Bundy was portrayed by attractive and talented Zac Efron, only attracting more fans to the Ted Bundy “fandom,” a group of teenage girls infatuated with the killer (Donaldson). Some tweets include: “Love that conservative masculinity #TedBundy,” and “Ted Bundy is so hot… wish he killed me” (via Twitter). The women who romanticize serial killers like Ted Bundy and Charles Manson can be described as having hybristophilia, or sexual arousal “over someone committing an offensive or violent act,” as described by Dr. Katherine Ramsland, a forensic psychology professor at DeSales University. These women admire the idea of being the ‘exception’ for a damaged person; they feel the need to ‘nurture’ and ‘protect’ their powerful and evil lovers. These women fantasize about “changing” the broken part of serial killers; they want to “fix” them; usually, women who admire such behaviors have trouble with conventional relationships due to insecurities. If she dates a serial killer in jail, at least she’ll know where he is all the time (Psychology Today). Additional research indicates that women feel attracted to masculinity and may interpret serial killers’ unchecked aggression as ‘protective’ or ‘manly.’ Women may feel that these attributes will keep them safe and secure, and thus may prefer more violent mates (Perrett).

Whatever may be the reason behind women’s fascination with serial killers, this infatuation proves fatal. When Charles Manson and Ted Bundy awaited death, thousands of female fans lined up, expecting to marry these vicious men, refusing to believe their crimes simply because of their attractiveness (Sutton). The never-ending fame of attractive serial killers depicts the true danger: our inclination as human beings to automatically trust and like attractive people, simply because of their looks. Many women fell prey to Bundy and Manson’s traps simply because they might’ve misjudged them for being kind, respectable people because of their beautiful smiles or bright eyes. Though Netflix and other entertainment providers may attempt to raise awareness of real tragedies, it is important to also consider the danger of awareness. Today’s generation may be too infatuated with Zac Efron’s looks and appearance in Extreme Wicked, Shockingly Evil and Vile to realize that his charm was what allowed many to overlook his apparent misogyny and objectification of women: “Women are possessions… Beings which are subservient, more often than not, to males. Women are merchandise” (Wyman). The tales of these serial killers should serve as a warning to many women, rather than favorable romantic heroes; we really don’t know what people are like behind closed doors. We need to remind ourselves who these serial killers actually are: vile, immoral men disguised as educated, charismatic professionals; they are not compassionate or need protection – they do not feel. We must not grieve or sympathize with men that never existed.

Works Cited

Donaldson, Kayleigh. “The Sexy Killer Fandom Wars: No, Fancying Ted Bundy Is Not the Same Thing as Fancying Venom.” SYFY WIRE, 11 Feb. 2019,

Mann, Stephen, et al. “Crime and the Media in America.” OUPblog, 3 Apr. 2018,

Perrett, David I., et al. “Effects of Sexual Dimorphism on Facial Attractiveness.” Nature, vol. 394, no. 6696, 1998, pp. 884–887. doi:10.1038/29772.

Ramsland, Katherine M. Confession of a Serial Killer: the Untold Story of Dennis Rader, the BTK Killer. ForeEdge, 2016. 

Schildkraut, Jaclyn. “Crime News in Newspapers – Oxford Research Encyclopedia of Criminology.” Oxford Research Encyclopedias, 18 Apr. 2018,

Sutton, Candace. “Inside Serial Killer Charles Manson’s Deluded Fan Club.” NewsComAu,, 9 Jan. 2017,

Tuttle, Kate. “Why Do Women Love True Crime?” The New York Times, 16 July 2019,

“Woman’s Hour – True Crime: Five Reasons Why Women Love It.” BBC Radio 4, BBC,

“Women Who Love Serial Killers.” Psychology Today, Sussex Publishers,

Whyman, Tom. “The Myth of Ted Bundy as a Charming Guy.” The Outline, The Outline, 5 Feb. 2019,

Yates, Diana. “Women, More than Men, Choose True Crime over Other Violent Nonfiction.” ILLINOIS, 15 Feb. 2010,

Islamophobia in the Digital Age: The Rise of a Global Mental Health Crisis

by Farah Hasan, March 22, 2022

My phone lies face down on the table beside me, buzzing sporadically, but insistently. I ignore it, fanning myself against the mid-July heat as I attempt to concentrate on an assignment for my summer class. I drum my fingers against the desktop and whisper the words aloud to myself, trying to make sense of the convoluted sentences of the essay as the buzzing continues. What do they want? I think exasperatedly, assuming my friends are simply spamming me with memes from Instagram and funny Tiktoks. As I finish the reading passage and move on to the multiple choice questions that accompany it, I decide to spare a glance at my phone. Expecting to see Instagram direct messages (DMs) and text messages headed by my friends’ familiar usernames and contact names, I am shocked to instead see hundreds of Instagram comment notifications from unfamiliar usernames, all beginning with the common header “[Instagram user] mentioned you in a comment.” My heart racing in anticipation, I open the Instagram app and quickly scroll through my notifications. I had left a comment criticizing France’s April 2021 ban on hijabs (headscarves worn by women for religious reasons) for Muslim women under the age of 18 on a post advertising travel to the Eiffel tower, and now I see that all these comments are in response to mine. Some of them back me up, but others range from applauding France’s actions, to blatantly calling Islam backwards and incompatible with Western civilization, to attacking me as a young Muslim woman myself. I exit the app without bothering to respond to anyone and close my eyes for a second, my heart still pounding as the hate words flash through my mind repeatedly. Like me, young Muslims everywhere are exposed to Islamophobic rhetoric on the social media sites they use most, and chronic exposure to such hate inevitably takes a toll on their mental health. Online hate is not given the same coverage or attention that street-level hate crimes get, but the effects of the former may be exponentially more profound due to the wide reach of users that are present on online platforms. Actions should be taken to limit such hate speech on public platforms like social media to preserve the mental-wellbeing of users that are targeted by these remarks, even if it means limitations on the First Amendment right to free speech. 

In a case close to home, a Muslim student recently graduated from my high school in the summer of 2021 and was chosen to deliver a speech at the commencement. In her speech, she advocated for the need for understanding and peaceful coexistence during difficult times, and briefly mentioned the ongoing conflict between Israel and Palestine. This part of the speech incited infuriated outcries from the audience, rude remarks shouting at her to “go back to Pakistan” as she walked off the stage, and the creation of a Facebook group as a space for angry parents to vent and express mildly Islamophobic sentiments. Due to the convenience and ease of access, social media is frequently defaulted to as a platform for these polarizing conversations. Certain social media sites, such as Twitter, are “better-designed,” in a sense, to perpetuate hate speech and to facilitate radicalized expression. Dr. Nigel Harriman, professor at the Harvard T.H Chan School of Public Health, and a group of researchers found that 57% of students that actively used the social media sites Youtube, Instagram, and Snapchat had come across hate speech, and 12% had encountered a stranger that tried to convince them of racist beliefs (this was especially common on Youtube). Additionally, exposure to hate messages was significantly correlated to Twitter use and Houseparty use (Harriman et al., 8531). Twitter is a particularly convenient hotbed for such rhetoric, as victims that come forward to tell their stories to Twitter are simply told to block the hating account or delete their own account. In 2014, Twitter issued a statement claiming that it “cannot stop people from saying offensive, hurtful things on the Internet or on Twitter. But we can take action when content is reported to us that breaks our rules or is illegal” (“Updating Our Rules Against Hateful Conduct”). Twitter more recently updated its rules against hateful content in December 2020:

In July 2019, we expanded our rules against hateful conduct to include language that dehumanizes others on the basis of religion or caste. In March 2020, we expanded the rule to include language that dehumanizes on the basis of age, disability, or disease. Today, we are further expanding our hateful conduct policy to prohibit language that dehumanizes people on the basis of race, ethnicity, or national origin.

(“Updating Our Rules Against Hateful Conduct”)

Although Twitter has taken some necessary steps to limit hate speech, this form of harassment nonetheless still exists on this and countless other platforms, and more action must be taken to counter this.

As someone that frequents social media sites like Instagram and Facebook, I understand how detrimental the algorithms themselves can be to one’s self-esteem, but coupled with exposure to hate speech, mental health for those targeted is more likely to plummet. Although I ultimately ignored the hate comments on Instagram under the post about France, the occurrence bothered me for several days afterward, leaving me anxious, unsettled, and dealing with mild sleep difficulties to the point where I deleted Instagram for a few months. Research by Dr. Helena Hansen at NYU Langone found that victims of online hate speech are found to have elevated levels of the stress hormone cortisol, leading them to exhibit a blunted stress response as well as higher rates of anxiety, sleep difficulties, and substance use (Hansen et al. 929). Dr. Brianna Hunt at Wilfrid Laurier University found that exposure to Islamophobic rhetoric is also a predictor of social isolation and loneliness, particularly among Muslim women in Waterloo, Canada. Furthermore, the dehumanizing aspect of hate speech also incites conflicts of identity in Muslim women of color, who feel that neither their religious nor their racial ingroups accept them fully, calling for the need to address mental health for more complex cases of intersectionality as well (Hunt et al.). 

In an effort to mitigate the destructive effects of hate speech on mental health, individuals have advocated for limiting such speech, but opponents of these limitations have expressed their concerns and dissatisfaction with this movement. In the 2017 case Matal v. Tam, the Supreme Court of the United States ruled that hate speech, like regular speech, is protected under the First Amendment under the justification that “giving offense is a viewpoint” (as long as it does not directly incite violence) (Beausoleil 829). Thus, individuals opposing limitation of hate speech on social media argue that doing so would be an infringement on their First Amendment right. There is also the danger that limitations of this sort would be a step in the direction of mass surveillance and abuse of power, ultimately resulting in a power dynamic of large digital companies﹣and potentially the government﹣in stifling any and all dissent (Beausoleil 2124). Other supporting evidence includes the notion that some exposure to counter speech is needed for the development of stable mental health and that various studies have shown that limitation of hate speech does not correlate to improved social equality (Beausoleil 2125). In fact, Dr. Stephen Newman of York University points out that expression of this sort of dialogue may be integral to human personality development, and that exposure to robust forms of speech may actually improve societal dynamics by influencing democratic policy (Newman). Lastly, there is limited existing literature proving that hate speech limitation is beneficial, as regulations of this magnitude have not been implemented anywhere yet. Thus, this argument is largely based on studies that have shown the harmful effects of hate speech. 

In a growing digital age, where social media use is a part of daily life for adolescents, young adults, and even middle aged individuals, chronic exposure to hate speech such as Islamophobic rhetoric cannot be tolerated. The longer online sites and social media platforms delay addressing such sentiments, the more widespread and normalized they will become and the more detrimental the effects will be on affected individuals’ mental health. In regards to opponents’ concerns over First Amendment compromise, the First Amendment cannot be applied perfectly to the digital age, which allows for unprecedented and unanticipated reach of communication across borders, continents, and time, as posts can always be viewed and interpreted so long as they are not deleted (Beausoleil 2127). Restrictions on the right to free speech are warranted in this case, where the mental health of countless targeted individuals on a global scale are at stake. To limit the likelihood that these companies abuse their extended powers of speech limitation, restrictions should be placed on the companies’ extent of power as well (ie. restrictions should be placed on the restrictions). Rather than immediately deleting all posts and comments including hateful rhetoric (which may be impractical), social media platforms should specifically aim to disband or deactivate groups, chat rooms, and accounts specifically devoted to or frequently posting Islamophobic﹣and other hateful﹣rhetoric. On particular posts where the comment section becomes overwhelmingly belligerent and hate-fueled, social media platforms should either delete the post, delete the inflammatory comments, or disable the comment section entirely. Lastly, these social media platforms should issue public statements against hate speech like Twitter did, include them explicitly in their terms and conditions of use, and send automated warnings to users who violate conduct rules multiple times with the intent of suspending their accounts if hateful activity continues. 

Ideally, the extent to which media companies can regulate inflammatory speech should be overseen by the federal government. However, complications may arise due to matters of jurisdiction: for example, the US government may have limited say on regulation of content posted on the social media platform TikTok, as this company was founded in China. Thus, for the time being, regulations should remain on a company-to-company basis. In the short-run, it can be expected that consumer use and feedback will let companies know how effective and acceptable their policies are. 

Though many praise the advent of cyberspaces and the beginning of the digital era as a way of bringing the world closer together with connections never known before, it is difficult to fathom how connected we really are amidst the divisive and discriminatory rhetoric that is often perpetuated on the very same platforms. Hate speech is present in several different forms, including anti-Semitism, racism, homophobia, gender discrimination, and prejudice against disabled individuals. As a Muslim woman, the recent increase in Islamophobic sentiments on social media have made me realize how pervasive their effects on young Muslims’ mental health are. Therefore, I strongly encourage social media platforms to limit hateful speech and promote civil and constructive dialogue instead using the methods outlined above, even if it means a slight compromise on First Amendment rights. By merely limiting and not completely eradicating hate speech, the extent of social media companies’ power is kept in check and the potential societal benefits of exposure to antagonistic speech mentioned previously may still be experienced. Taking actions such as deleting the Instagram post about France with the barrage of inflammatory comments would be steps in the direction of greater coexistence as the Muslim high school graduate’s speech earnestly called for and promoting the benefits of global connection that the digital era originally promised.

Works Cited

Beausoleil, Lauren. “Free, Hateful, and Posted: Rethinking First Amendment Protection of Hate Speech in a Social Media World.” Boston College Law Review, vol. 60, no. 7, 2019, pp. 2101–2144.

Hansen, Helena, et al. “Alleviating the Mental Health Burden of Structural Discrimination and Hate Crimes: The Role of Psychiatrists.” The American Journal of Psychiatry, vol. 175, no. 10, 2018, pp. 929–933, doi:10.1176/appi.ajp.2018.17080891.

Harriman, Nigel, et al. “Youth Exposure to Hate in the Online Space: An Exploratory Analysis.” International Journal of Environmental Research and Public Health, vol. 17, no. 22, 2020, 8531, doi:10.3390/ijerph17228531.

Hunt, Brianna, et al. “The Muslimah Project: A Collaborative Inquiry into Discrimination and Muslim Women’s Mental Health in a Canadian Context.” American Journal of Community Psychology, vol. 66, no. 3-4, 2020, pp. 358–369, doi:10.1002/ajcp.12450.

 Newman, Stephen L. “Finding the Harm in Hate Speech: An Argument Against Censorship.” Canadian Journal of Political Science, vol. 50, no. 3, 2017, pp. 679–697,

“Updating Our Rules Against Hateful Conduct.” N.p., n.d. Web. 26 Sept. 2021.

The Ugly Truth Behind Beauty

by Iman Shah, January 20, 2022

Women and men across the world use eye pigments, blushes, lipsticks, eyeliners, and lip liners as a way to express themselves, enhancing their natural features. From a little pop of glitter in the inner corner of the eye to make the eye look bigger to a hint of shiny blush to give the cheeks a fuller look, glitter is a fundamental ingredient in a lot of makeup products. But how does the $500 billion makeup industry manage to shine all that glitters? The answer lies in a mineral found in nearly every continent, mica. Mica is utilized in makeup, but it is also used in the automotive, medical, and defense industries, making it a widely used inexpensive ingredient. The mica industry is forecasted to be worth over $700 million by 2024, yet the workers who mine and dig as a group all day in some of the poorest states of India can only hope to collectively make two dollars per day in total (Schipper and Cowan). This contrast is possible because some of these states, namely Jharkhand and Birpur, have indigenous communities living in the outskirts of the city who sieve through mud and dirt all day in the hopes of finding as much of the shiny rock as they can, and it is their only source of income. Geographically these communities live remotely and have limited access to job opportunities, basic services, schools, and businesses. Agriculture used to be another source of income, but due to increasing infertility and drought-prone soil, the only viable option is to work for long hours, digging and mining for mica and that too without any safety equipment. The conditions have irreversible consequences on adults, yet children accompany their elders to provide a helping hand, leading to a systematic cycle of poor health and poverty. Since it is the only way to earn bread and butter, an estimated 20,000 children have to work to support the multi-billion dollar industry (Schipper and Cowan). However, the problem of child labor can be significantly improved with awareness which will then promote the proper implementation of laws, economic growth, and education. Therefore, when it comes to survival and child rights, child rights should be chosen not only because it is morally right but also because in the long run, it will prove more beneficial. 

Child labor has effects that are cyclical and long-lasting. However, one of the most effective ways to combat this issue is through awareness. Awareness through different means, especially social media, can be helpful in terms of putting pressure on governments to acknowledge issues, put light on issues, and create fundraisers and donations for important causes. Makeup gurus, some of whom have millions and even billions of followers, have the immense potential to start the change. Realizing there is an issue in the first place is what will initiate the change because as a beauty influencer remarked after finding out the truth about the deadly industry, “I’m very embarrassed to only be finding out about this now” (“The Dark Secret Behind Your Shiny Makeup”). A study on social media found out how the “Red Cross received eight million dollars in donations directly from texts” in two days, illustrating the power of social media (Gao 10). Although Makeup gurus can use their influence to raise donations for these children, they can also use it to simply show their viewers how the most important ingredient in many makeup products is supplied. Influencers hold a lot of power as proven by a survey conducted by Statista which reported how “58 percent of the brand strategists and marketers surveyed report that influencer marketing will become integrated into all of their forthcoming marketing activities” (Stubb and Colliander). Makeup products that are used every day, wasted, redesigned thousands of times, without considering how this ingredient ends up in almost every makeup product. However, by simply informing viewers of the way these things happen, people can become more conscious. 

This consciousness can then in turn help pressurize companies to trace the supply chain. A major reason why child labor and abuse that is utilized to supply Mica is virtually undetected is that traders can legally get licenses to sell the mineral (Bliss 21). The supply chain goes from miners, collectors, traders, processors, exporters (Bliss 25). Therefore, since the mineral is technically purchased legally from the exporters, the rest of the process that happens behind it goes unseen. A lot of companies report that tracing the supply chain of the mineral is hard and ambiguous, but the truth is that these companies are simply not interested in tracing the origins of the chain. However, if awareness is raised amongst people, then consumers can demand greater supply chain transparency and traceability. A local activist in Jharkhand urges consumers to “Write to them [companies] and request that they disclose the source of their mica… after all, if they manage to procure the specific grades of mica required for their various products, they should be able to find out who is extracting it” (Zuckerman). Makeup buyers can usually find out if Mica is being utilized sustainably in specific products by reading the ingredients or by searching online for the brand’s sustainable-sourcing policies. Consumer awareness can make companies realize that it is worthwhile for them to start a due diligence trajectory specifically for Mica. Tracing the whole chain is difficult since these companies are not sourcing directly from the mines, but if companies and NGOs collaborate on working to end child labor, it can drastically improve the situation. 

The supply chain of Mica poses its hardships, but there are alternate resources companies can resort to which makes the eradication of child labor more possible. L’oreal, for instance, has taken an initiative to source Mica from only “legal” and “fenced” mines (Bliss 29). Similarly, other companies have resorted to Mica mines in more developed countries such as America, which comes with a higher price but a transparent supply chain. Moreover, there is also synthetic Mica, which is developed in labs. Lush, the British cosmetics company, proudly presents itself as the leader of supplying its ingredients ethically; however, in 2016 it “discovered natural Mica in a range of mica pigments it had been told were synthetic” (Bliss 30). Therefore, the development of synthetic Mica is a field that requires further research; however, it can still prove to be worthwhile putting efforts by the billion-dollar companies as it can eliminate the need for natural mica in the first place.

Awareness is imperative because it will then bring attention and aid to all the other things that need drastic changes. People will be more conscious of their actions, and they can also donate. Furthermore, NGOs and other organizations can come to these poverty-stricken areas to better the situation. One of the ways this can be achieved is through improving the traditional ways of livelihoods, specifically the agriculture system. A sustainable agriculture system ensures food security and environmental safety; it provides livelihood by providing a source of income. Given that the farming situation in these areas has suffered due to drought and ineffective and primitive techniques, NGOs can initiate a change by teaching non-traditional farming techniques which will not jeopardize the availability of the resources for future generations and still provide an alternate source of income for the villagers. These change initiatives could include innovations on water scarcity, multiple-use schemes or other community resilience, extreme water vulnerability mapping in the area, and technical options on water demand management. These initiatives can equip farmers to effectively mitigate droughts, stop using urea and DAP fertilizers, and teach methods like crop rotation, so the same nutrients are not drained from the soil throughout the year. The revival of these lands might seem unworthy; however, a UNEP report has found out that “for 42 countries of Africa the benefit of intervening to conserve is 3-26 times greater than the cost of inaction,” and those interventions came through the help of NGOs (Kumar). NGOs are very prominent and effective in implementing sustainable agriculture programs, but, on the other hand, governments can also play their role by implementing state-led land reform programs and buying crops from the local farmers at a fair price. State-led land reforms take a big piece of land and assign sections to different farmers; this leads to greater independence and possible profits for the individual farmers, avoiding the monopoly of one person controlling the lands. Government buying crops at a certain price will ensure that despite any other inconveniences that might occur, such as price drops or crop failures, the crops the farmers were able to produce are sold at a predictable and fair price. 

Eradication of child labor cannot be achieved only through the improvement of farming techniques but also through the implementation of laws and regulations. India already has laws that forbid children under the age of eighteen years from working in mines, and it is also against the UN Child Conventions (“Act now: end child labor!”). Awareness of the abuse of children in these states will urge governments to go beyond simply stating these laws in law books and implementing this law. One law that can potentially prove beneficial in this case is the legalization of mining Mica, which was made illegal in 1980 under the Forest Act. Mica is a forest resource and in efforts to conserve the environment, this law made it illegal to extract this mineral. 24,000 people who once relied on a stable source of income were left jobless (Bliss 24). Repealing this law will not only enable to formalize something which is already happening but also regulate the sector thus addressing the issues related to working conditions, minimum wages, and protective equipment. Enforcement of this law should include setting a minimum age for the mineworkers through proper documentation processes like unique identification numbers or birth certificates. The legalization of these mines would also mean that the workers do not have to work in fear of being caught all the time and illegal operators will not be holding control of the mines. Villagers get forced to work under these operators because they depend on unlicensed lenders when they need money for medical treatments or other reasons (Zuckerman). The only way to pay off the loan is by agreeing to work in these mines; hence, people get stuck in an intergenerational cycle of poverty. Furthermore, deaths in these mines usually go unreported and people are compensated with “blood money” (Makower). Therefore, the legalization of this law could also mean that deaths will be reported as there will be less fear of pursuing illegal activities under illegal operators who assert their dominance through force and brutality. However, these resolutions can only potentially occur if the law is properly enforced. 

Eradication of child labor cannot be achieved only through the implementation of laws but also to create alternate sources of income. Besides agriculture, supporting small and medium scale enterprises (SME’s) through soft loans or micro-credits (on the model of Grameen Bank in Bangladesh), promoting local cottage industries, and local, national, and international tourism can be some examples of job creation and economic activities. Skills the indigenous people already possess can be utilized to their advantage. Research conducted found that women in Jharkhand possessed skills such as “sari-making”, painting mud houses, “sewing”, and “tailor-making” (Dagar 6). However, Suyamukhi, one of the indigenous women, remarked “These items don’t sell for much” (Dagar 7). This is where awareness can be used so these products are sold on a national and international scale. Furthermore, NGOs and the government can provide further assistance to this marginalized group by teaching ways for starting a business, applying for microcredits, and navigating the market. Supporting such potential small local businesses will lead to gradual independence from the dependence these people have on mining Mica as their only source of income.

In addition, the government also needs to play its role by providing facilities to these citizens. Citizens and governments have social contracts whereby each has roles and responsibilities. If it is expected that citizens will abide by the law, then the government is responsible for providing them not only safety and security but also sources of income and provision of social services. Besides health and education, water supply and sanitation, infrastructure development particularly farm-to-market roads and broader connectivity with other parts of the state and country are important ingredients in fostering this vertical social cohesion. It would be highly recommendable that the government look into this with a different lens i.e. not only provide these services but also use it as means to create jobs for youth and unemployed persons from various strata and skills sets. Consumers and the international community can play their role by urging the government to abide by their side of the social contract so villagers then do not need to resort to unlicensed lenders or other such resources. 

Education is another imperative aspect that would again need the government’s attention and involvement to truly support the eradication of child labor. Besides traditional education, vocational and technical education needs not only to be promoted but also attractive. This can include incentivizing through free education, free books, and perhaps stipends for the students who attend and perform in their respective educational areas. However, Dr. Kumar, who researched education in Jharkhand, concluded that “doling out some incentives does not do much” (9). It is true that only providing incentives will not eradicate the overall issue of lack of education; on the other hand, there have been instances that have illustrated the effectiveness of incentives. Anjali Sinha, a researcher who has been to Jharkhand sites to collect data, witnessed in 2014 how some of the villagers willingly converted to Christianity for incentives such as certain amounts of food per month (Sinha). It is important to note though that this conversion is not only because of the incentive but also because these people want to escape India’s brutal caste system. Additionally, research in Nicaragua on poverty eradication illustrated how “school breakfasts were implemented to attract children,” which after three weeks resulted in “all eligible children” attending “school” (Blandon et al. 5). Therefore, incentives can become a channel that makes children less desperate to leave education and earn money instead. Simply providing children with a school will not solve the problem, children need to be taught in their mother tongue, at least in the primary years, in efforts to keep dropout rates low. Respectful and sensitive teachers, who are patient towards the first-generation learners, are needed. Awareness needs to be raised amongst the villagers to assure parents why sending children to school, especially girls, is beneficial for them and it will become a chief way to break the cycle of poverty. It is both in the government’s and villagers’ interest to pay attention to this aspect as education has proven to be “essential to a country’s development” (Kiross et al. 10). Many studies have proven how literacy has “been a major determinant in the rise or fall in other indicators” such as “growth rate, birth rate, death rate, and infant mortality rate”(Kiross et al. 10).

Awareness of the child labor situation in these mines has the potential to create a platform which in turn will result in consumer awareness, urging companies to either resort to alternative resources or trace the supply chain; additionally, consciousness regarding this matter can also urge government and NGOs to provide these people with different sources of income, by, for example, improving the agricultural state, and overall the government should be pressurized to play its role by providing proper facilities. However, these are all long-term initiatives that require enforcement and solving the problem from the very root. The main concern that can arise against such potential implementations is that the eradication of child labor “could increase the cost of commodities, harming the economic “comparative advantage of countries with cheap labor” which will eventually negatively impact the “poor people” (D’Avolio). Nevertheless, it is important to realize that the overall problem of child abuse in this area is complicated and deeply rooted; hence, it is going to take time and in the short term it might seem futile to pursue these actions. On the contrary, not initiating a change will keep these neglected groups of people fixated on a meager lifestyle. 

Child labor is so easily utilized in India because poor children are vulnerable and easily exploited. Children cannot form unions, go on strikes, demand breaks, and set minimum wages because children are not meant for such pursuits. They are meant for school, for playing. They are not meant to worry about whether they will be able to see tomorrow or will there be enough food on the table tomorrow. India and the global community have a responsibility to give this oppressed group of people and their children their basic rights, facilities, and resources; furthermore, the international community should not lose sight of this cause till these goals are fulfilled. The situation of this problem is difficult, deeply rooted, and complex; however, through awareness, the right resources and resolutions can be passed so the rights of the children can be chosen without hindrance by this neglected group of indigenous people.

Works Cited

“Act now: end child labor!” World Day Against Child Labour, United Nations, 2021,

Blandón, Elmer Zelaya, et al. “Breaking the Cycles of Poverty: Strategies, Achievements, and Lessons Learned in Los Cuatro Santos, Nicaragua, 1990–2014.” Global Health Action, vol. 10, no. 1, Jan. 2017, p. N.PAG. EBSCOhost, doi:10.1080/16549716.2017.1272884.

Bliss, Susan. “Child Labour in India’s Mica Mines: The Global Beauty Industry.” Geography Bulletin, vol. 49, no. 3, 2017,

Dagar, Preeti. “Vocational education and training for indigenous women in India: Toward a participatory planning approach.” International Journal of Training Research, Aug. 2021. doi:10.1080/14480220.2021.1959379.

“The Dark Secret Behind Your Shiny Makeup | Undercover Asia.” YouTube, uploaded by CNA Insider, 1 May 2021,

D’Avolio, Michele. “Child Labor and Cultural Relativism: From 19th Century America to 21st Century Nepal.” Pace International Law Review, vol. 16, no. 1, 2004. 

Gao, Huiji, et al. “Harnessing the Crowdsourcing Power of Social Media for Disaster Relief.” IEEE Intelligent Systems, vol. 26, no. 3, 2011, pp. 10–14. doi:10.1109/MIS.2011.52.

Kiross, Girmay Tsegay, et al. “The Effect of Maternal Education on Infant Mortality in Ethiopia: A Systematic Review and Meta-Analysis.” PloS One, vol. 14, no. 7, 2019, e0220076. doi:10.1371%2Fjournal.pone.0220076.

Kumar, Anant. “Universal Primary Education among Tribals in Jharkhand: A Situational Analysis.” Xavier Institute of Social Service, 25 Mar. 2008,

Kumar, Pushpam. “Restoring Natural Capital Can Help Reduce Extreme Poverty.” United Nations Environment Programme, 5 Aug. 2016,

Makower, Joel. “Inside Beautycounter’s quest to transform its mica supply chain.” Greenbiz, 5 Oct. 2020,

Schipper, Irene, and Roberta Cowan. Global Mica Mining and the Impact on Children’s Rights: Executive Summary. The Centre for Research on Multinational Corporations [SOMO], Mar. 2018, 

Sinha, Anjali. Personal Interview. 25 Sep.2021.

Stubb, Carolina, and Jonas Colliander. “‘This Is Not Sponsored Content’ – The Effects of Impartiality Disclosure and e-Commerce Landing Pages on Consumer Responses to Social Media Influencer Posts.” Computers in Human Behavior, vol. 98, Sept. 2019, pp. 210–222. doi:10.1016/j.chb.2019.04.024.

Zuckerman, Jocelyn C. “Is Your Makeup the Result of Child Labor?” Marie Claire, 17 Oct. 2018,


by Zarya Shaikh, December 31, 2021

Spending time between Pakistan and the United States as a child, I have learned about different receptions to the LGBTQ+ community in two cultures. I thought that the first time I met a transgender individual was as a 14-year-old in America. After reading Jeffrey Gettleman’s article “The Peculiar Position of India’s Third Gender,” I realized I have met transgender individuals as early as age 8 (and possibly even earlier) in Pakistan. Similar to the Fa’afafine in Samoan culture, Hijras are individuals in Pakistan’s and India’s Muslim history who do not subscribe to a single identity as male or female.1 “Hijra” in Hindi translates to eunuchs, who are sexless individuals. They are castrated to eliminate the desire for love or lust and are meant to be sexless beings who are sexually receptive to men.1 It is important to note that not all transgender individuals in India identify as Hijras. Hijras are an entity that exists under the umbrella identity of transgender.1 During my visits to Pakistan, my family would donate money to Hijras whenever they stopped by our home or knocked on car windows. Gettleman finds that the identity of Hijras stems from a Hindu myth that Lord Rama, a Hindu god. Gettleman describes that Lord Rama “was exiled from Ayodhya and his entire kingdom began to follow him into the forest.” Lord Rama told men and women to leave him and regroup in Ayodhya.1 Hijras were known for their loyalty as they awaited Lord Rama’s return for 14 years in a folktale.1 Scholars of Hindu mythology discount the anecdote, claiming it is not in early versions of ancient Hindu texts. Regardless, the devotion of the Hijras demonstrated by the folktale is a significant characteristic of the Hijra identity.1 Before Britain’s colonization of India, Hijras were “revered as demigods.”1 Britain stripped Hijras of their identity upon colonization and enforced the binary gender system of female and male by suggesting they existed against the “order of nature” and thus criminalized “carnal intercourse.”1

In the modern-day, Hijras dress in sparkly saris and makeup while dancing and offering blessings in the streets. Indians perceive Hijras as beings with the power to bestow blessings or curses on those they meet. Radhika, a 24-year-old Hijra, shared that they were uncomfortable with resigning to a single-gender while in school. Her mother condemned these thoughts and told Radhika to “stick to” the gender binary.1 Soon after this interaction, Radhika’s parents split and her mother died. With no one else to turn to, 8-year-old Radhika met an older sex worker who made her a sex worker in a park.1. Radhika continues sex work today, as there is no other source of income. Hijras are still essential to the hierarchy of harems, which often operate like street gangs. They rely on gurus, also Hijras, who “fulfill the hybrid role of den mother, godfather, spiritual leader and pimp.”1,3 Beneath Hijras in the pyramid are chelas (disciplines) who are used to increase cash flow to the guru. For Hijras, there is not much social mobility due to restrictions placed on education and employment.2 Their rights as humans are often violated; these factors contribute to the cycle of being exploited through sex work and facing humiliation through castrations and social isolation.1 For a majority of the time following colonization, there were no modes of medical care that are easy to access. Countless deaths occurred as a result of the castrations by unqualified individuals.1 In recent years, however, India has recognized being transgender as another gender. Hijras can now undergo gender-affirming surgeries in some hospitals and access government benefits including welfare.1,2 Although this is a step in the right direction, Hijras are still considered inferior oddities who are not respected. The attitudes of society on their roles as sex workers have yet to change.


1 Hylton, S., Gettleman, J., & Lyons, E. (2018, February 17). The peculiar position of India’s third gender. The New York Times. Retrieved from 

2 UK Essays. (2021, August 12). The khawaja sara and hijra: Gender and sexual identities formation in post-colonial Pakistan. UK Essays. Retrieved from 

3 Stief, M. (2016, November 22). The sexual orientation and gender presentation of Hijra, kothi, and Panthi in Mumbai, India – Archives of Sexual Behavior. SpringerLink. Retrieved from,networks%20that%20are%20hierarchically%20organized

Physician Insecurity and Patient Expectations Drive Medical Excess

by Ean Tam, December 8, 2021

In 2008, a seven-year-old boy complained that his stomach was in such pain that he could not sleep. The boy’s parents took him to see his pediatrician. In due time, the boy found himself in a hospital in Long Island. He was missing an entire school day, which would have otherwise been a happy occasion if it were not for the IV in his arm and the impending endoscopy—a procedure in which a small camera is inserted down his esophagus and into the stomach to check for gastrointestinal issues. The doctors could not find any explanation for the stomach pain. 

Eventually, the boy’s parents brought him to a specialist in Manhattan, who did his own tests. When all the tests seemed to be futile, the specialist asked if lactose intolerance had been considered as a possible cause. After a few days of avoiding milk, the boy’s stomach pain went away. In the end, he had no gastrointestinal issues, no infections, no serious complications; he simply could not digest dairy. Silly, right? I know. The boy was me.

Lactose intolerance is not only very common, but it also runs in my family. All my signs and symptoms indicated lactose intolerance. The evidence was there. As the saying goes, “When you hear hoof beats, think horses, not zebras.” It should not have taken three doctors and a camera down my throat to reach the proper diagnosis. So why did it?

Did my parents’ urgency for their child create a dramatic flare for the doctors? Was there a desire to take action so quickly and intensely? Maybe the doctors thought a simple answer was not satisfactory enough for my concerned parents? Maybe the multiple lab tests and procedures done on me were just the doctors’ gesture that they were trying their hardest to get an answer, no matter how convoluted and unnecessary the gesture. While this may seem ridiculous that a doctor would  offer excessive medical services just to make patients happy, it is not unheard of. In fact, it is quite common. To the detriment of the medical profession, the interpersonal dynamics of the clinic can become tangled with a physician’s fear of lawsuits.

The Power of Patient Expectations

“[W]e overprescribe antibiotics, but my own view is that I don’t really care… your goals at the end of the conversation is for both you and the mother and the baby to be satisfied.”

Anonymous doctor 
(qtd. in Butler et al. 639)

Some doctors find symbolism in providing medical services they know are unnecessary. The doctors see their actions as doing everything they can for their patient (Rowe et al. 5). To them, the issue of overtesting and overprescribing their patients can be overlooked. Doctors have even reported that if their patient left an appointment without some kind of prescription, the doctors felt as if they had not done their job (Butler et al. 639). 

More often than not, patient expectations for their medical care are communicated to doctors implicitly rather than explicitly (Stivers 1127). Since patients are not always making their wishes clear, doctors decide to follow their gut instinct on what they believe their patients want. University of Newcastle researchers Jill Cockburn and Sabrina Pit found that if a doctor perceived their patient to be expecting medications, then the patient was ten times more likely to get a prescription (Cockburn and Pit 521). 

Now, one may say, ‘Maybe the doctor is correct. Maybe the doctor is just really perceptive, and they can tell what the patient wants without the patient saying it.’ Unfortunately, doctors are frequently wrong on this occasion. A study published in Patient Education Counseling observed that when doctors predicted a patient’s expectation for medication, the doctors were correct only 53% of the time (Jenkins et al. 276). Medications can have harmful side effects and high costs. Lab tests also bear negative consequences, especially if the tests involve radiation or high risks of false-positives. Medical services should not be given on gut instinct just to make patients happy.

However, the demand to meet patient expectations is both compelling and draining for doctors. In the short term, doctors may receive some relief in believing their patient walked away feeling fulfilled, but in the long term, the reality of not complying with standards of their medical training may kick in. In interviews with Dr. Theresa Rowe et al. of Northwestern University, doctors spoke about prescribing unnecessary antibiotics because they felt the patients desired them. One doctor remarked, “You spend 15 minutes trying to educate [patients], when they will go out disillusioned, come back the next day and see someone else, making you feel 5 minutes would be better spent just giving them a prescription and getting rid of them.” Another doctor admitted, “I do feel as though I’ve been slightly used. Sometimes slightly abused as well” (639). 

When doctors put an emphasis on patient expectations, they lose the motivation to limit medical excess, preferring to cater to customer satisfaction. Ironically, the physician makes the medical profession more mentally taxing for themselves. Now, they must walk a fine line between customer service and patient wellness. And to keep customers coming back for business, sometimes it pays to think of zebras, not horses.

Looking for Liability

“Malpractice attorneys like to say they save more lives than physicians.”

Eric Katz, MD, MBA (329)

When we think of the healthcare we receive, we hope physicians run their medical practice faithfully, not defensively. However, an unfortunate reality is that the threat of malpractice lawsuits and mentalities such as “more is better” have made doctors weary of acting according to their medical training. Doctors would prefer to safeguard themselves with defensive medicine, ordering multiple tests or procedures that do not always make the patient feel better, but will definitely make the doctor feel better. Doctors can use tests or prescriptions as evidence that they did their job correctly and were extensive in their examination of a patient. 

At times, some of these numerous tests may alert doctors to a hidden, life-threatening illness. If we think in terms of “more is better” or “earlier is better,” then maybe the cost of defensive medicine is acceptable. However, if we prioritize the moral integrity of the medical profession, then we should not accept that some doctors direct our medical care by threat of lawsuit. Then our treatment plans are not designed exclusively for patients. Rather, doctors will begin to merge the clinic with the court, and legal opinion with patient outcome. As Johan Bester, director of bioethics at the University of Nevada Las Vegas, writes, “[Defensive medicine] represents an egregious breach of professionalism and of ethical obligations to the patient and to society” (418-419).

We should hold doctors liable for their mistakes, but we should be mindful of where the threat of liability is steering doctors’ decisions. Current trajectory suggests more defensive medicine. It would be ironic if the tool we use to hold doctors responsible for isolated incidents encourages doctors to have an irresponsible approach to treating every patient.


If we would like to have patient-oriented medicine, we should consider the realities in which doctors exist today. There is no magical wand to stop doctors from engaging in defensive medicine. This is more than just a patient-doctor issue. It is one that affects our economy and healthcare system: from longer wait times to more expensive medical bills. Bill Clinton said he wanted to get rid of defensive medicine in 1992. So did George Bush in 2004. And Barack Obama in 2009.

But there are realistic steps that we can take to clarify the line between patient and customer. We should be more upfront with our doctors: let them know what we expect, what our presumptions are, and what we would like done. We should not be worried about sounding stupid or wasting the doctor’s time with questions. Doctors undergo many years of medical training to give you an answer. So ask away and be frank. We cannot risk our doctors making an inaccurate assumption of our needs and then treating us accordingly. Not all of us are doctors, but all of us at some point will be patients. We do not need to be over-tested nor overprescribed. We should take up our side of the effort to prevent medical excess and preserve our doctors’ attention to us.

Works Cited

Bester, Johan C. “Defensive Practice is Indefensible: How Defensive Medicine Runs Counter to the Ethical and Professional Obligations of Clinicians.” Medicine, Health Care and Philosophy, vol. 23, no. 3, 2020, pp. 413-420.

Butler, Christopher C., et al. “Understanding the Culture of Prescribing: Qualitative Study of General Practitioners’ and Patients’ Perceptions of Antibiotics for Sore Throats.” BMJ, vol. 317, 1998, pp. 637-642.

Cockburn, Jill and Sabrina Pit. “Prescribing Behaviour in Clinical Practice: Patients’ Expectations and Doctors’ Perceptions of Patients’ Expectations—a Questionnaire Study.” BMJ, vol. 315, no. 7107, 1997, pp. 520-523.

Jenkins, Linda, et al. “Developing and Using Quantitative Instruments for Measuring Doctor–Patient Communication About Drugs.” Patient Education Counseling, vol. 50, no. 3, 2003, pp. 273-278.

Katz, Eric D. “Defensive Medicine: A Case and Review of Its Status and Possible Solutions.” Clinical Practice and Cases in Emergency Medicine, vol. 3, no. 4, 2019, pp. 329-332.

Rowe, Tiffany A., et al. “Examining Primary Care Physician Rationale for Not Following Geriatric Choosing Wisely Recommendations.” BMC Family Practice, vol. 22, no. 95, 2021, pp. 1-6.

Stivers, Tanya. “Participating in Decisions about Treatment: Overt Parent Pressure for Antibiotic Medication in Pediatric Encounters.” Social Science & Medicine, vol. 54, no. 7, 2002, pp. 1111-1130.

One reason that is probably destroying Gen-Z

by Aliaksandra “Sasha” Kiniova, December 3, 2021

Special thanks to Brian Bulag to contributing to some parts of this paper.

As a fellow Gen-Z person, I feel as if it is very appropriate for me to judge this generation of souls. Whenever I look at criticisms or judgements of Gen-Z people, it often comes from older generations and to be frank, they may not understand the different and unique experiences that this upcoming generation is facing. There are many economic issues such as college rates, loan management and the increasing wealth gap in the United States. I will be focusing on some of the more social issues affecting the U.S. Gen-Z  population, however it is likely that my observations can be generalized to Gen-Z populations in different regions of the world. 

One of the biggest changes that Gen-Z experienced that no other generation in history had experienced was the exponential increase of social technology such as social media, applications and the Internet. In many ways it has helped progress our society in professional ways, but I cannot say the same for social reasons. One of the difficulties of this adaptation is that no one has experienced this type of change. So all the generations were trying to learn. Unfortunately for Gen-Z, is that all this technology coincided with a very developmentally challenging and complicated time, puberty and adolescence. 

During this time, it is hard for a person to find their own identity and they are learning how to react to situations that are more complicated than most typical childhoods. Many professionals in the psychology field back this claim up by saying that “adolescence is a transition period characterized by major changes in terms of biological, cognitive and social development” (Assuncao et. al, 2017) Also during this time there is a big shift in not only how friendships and relationships are formed but also how they are maintained. In Gen-Z, the biggest issue socially seems to be making and retaining friendships and relationships with people. There are many reasons why, however I believe the rise of individualism, mobility, consumerism and vulnerability may contribute to this problem. 

Individualism is a philosophy or belief that the person themselves and their wants and needs are above all else in life. This definition seems very harsh but milder versions of individualism is just thinking about oneself more often than about others. Due to the rise in business and career growth, people have started becoming too focused on themselves. Friendships and relationships are becoming deemed as unnecessary, when in reality a person’s support group is one of the most important things in the world.

With many Gen-Z feeling like they cannot reach out to make new friends or cannot get a reply from a person they met, this can be because of individualism. People often do not go out to meet with friends or check up on them because they say ‘they do not have the time’. The reality is that if someone really cares or wants to talk or be with someone, you or that person will find or make time for them however this takes effort on our part. But it also can be our fault. When was the last time that we texted an acquaintance or old friend to genuinely talk and not just talk about superficial things? I find that I struggle to make friends, however I have been trying more and more to reach out first since I do not want to become one of those people who does not have time for friendships and possibly pass up on many interesting people that could be amazing friends. 

One of the less visible reasons that Gen-Z could have trouble making meaningful relationships is because this new generation is always up and moving. People always move, however with the increase of transportation technology in Gen-Z, many people are moving. This will naturally cause any relationship to become less close. Even though we have social media and other ways of communicating, this cannot replace proximal relationships oftentimes and seeing people in person is integral to being human. Gen-Z also had to go through the Covid-19 pandemic through their adolescence which does not help the fact that we often need to see people to continue our friendships with them. 

There also has been a shift in how Gen-Z treats friends in general and this adds to my idea of how consumerism is affecting relationships. With the rise of hookup culture in the Gen-Z era, we see that people often treat each other as people who can be ‘replaced’ or that relationships can easily be ‘thrown away’ if that person starts becoming a burden. Oftentimes with consumerism or materialism, we associate ourselves with materials. However this can easily be translated to people. When we want to drink some water, is it easier to buy a plastic bottle of water or remember to fill our water at home and bring it? Of course the plastic bottle of water. After we buy the plastic bottle is it easier to throw it away or to keep it, wash it and reuse it for a different time? It is easier to throw it away! And this scenario I showed can easily be applied to how our generation is starting to treat people.

Lastly, it has become harder for us to be vulnerable with people, which may also explain why Gen-Z is struggling mentally as a whole. Let us first reflect on our own friendships and relationships with people. How often do we genuinely talk about how we feel and how often do we actually listen to how a person feels and do not dismiss the fact that they said something that is worse than ‘good’. With the rise of social media and technology, I think that it is harder for us to look eye to eye with someone. We are always more comfortable to do this anonymously. However when we are friends with people, we cannot just talk about superficial things and only check up when something life-changing is happening to someone. We need to learn and understand that opening up is important because not opening up about how we feel can lead to many mental health issues such as depression and anxiety. The rise of these mental health issues are often disregarded by older generations as ‘our generation being too sensitive’. However I believe a major contributing factor is that our friendships as a whole are becoming less meaningful. We open up less to others and are not very receptive to others. 

These are just some reasons and some issues of how I think Gen-Z is one of the most confusing and unique generations that is shifting society in a different direction, in good and bad ways. In the psychology field, many professionals have proposed that there is “a model of “problematic Internet use”, identifying several specific cognitive and behavioral constructs associated with negative outcomes of the Internet use such as preference for online social interaction, mood alteration, cognitive preoccupation or compulsive behavior”(Assuncao et. al, 2017). I hope to write a longer version of my analysis and it will encompass all my reasons and with a more detailed look at Generation Z by a person who is Gen-Z and therefore understands the Gen-Z/internet culture better.


Assuncao, R., Costa, P., Tagliabue, S., & Mena Matos, P. (2017). Problematic Facebook use in adolescents: Associations with parental attachment and alienation to peers. J Child Fam Stud, 26(11), 2990–2998.

The Silent Cruelty of Calorie Counting

by Sara Giarnieri, November 24, 2021

***Content warning: This essay discusses eating disorders***

The first time I was exposed to a calorie counting app was in high school during the start of the COVID-19 pandemic. A gym teacher required us to download the app, My Fitness Pal, in order for us to complete assignments that involved tracking our food intake and exercise. Even after the end of my senior year, I continued to use the app with the mindset of losing weight. The app did as advertised. It certainly helped me to keep track of how many calories I burned versus how many calories I was absorbing… however, I was not happy. Anytime I went out to eat with a friend, I anxiously searched for the lowest calorie options on the menu. I constantly looked at myself in the mirror to bodycheck. I was trapped. Looking back on this time, I realize how much calorie counting made me feel miserable. Rather than being a healthy tool, it was an obsession. My experience made me ponder: Can fitness apps with calorie counting be harmful to some of its users? 

A study conducted by Courtney C. Simpson and Suzanne E. Mazzeo titled “Calorie counting and fitness tracking technology: Associations with eating disorder symptomatology” focused on whether the use of health tracking apps correlated with eating disorder (ED) symptomatology. After conducting the study, it was concluded that their findings “corroborate media reports documenting a relation between calorie tracking technology and ED attitudes, and indicate that monitoring consumption might enhance rigidity and anxiety regarding calorie intake” (Simpson and Mazzeo). This study is showing us that calorie tracking apps have a correlation with behaviors regarding eating disorders (Simpson and Mazzeo). This fact is extremely dangerous because someone who downloads a fitness app with healthy intentions in mind could possibly slip into a harmful situation. It could also be dangerous for those diagnosed with a mental illness like anxiety, since this study has proven that these fitness apps intensify anxiety around calorie counting. This could be potentially triggering.  

On a more personal note, an article titled “Hunger Games” by Alice Gregory highlights the obsession that users with fitness apps can develop over calorie counting. According to the article, a woman named Rebecca Gerson felt herself become more strict with what kind of foods she ate because they all “counted” (Gregory). She felt her social, academic, and personal life decline to the point that she received eating disorder treatment (Gregory). Rebecca’s experience gives us some insight on how an obsession with calorie counting may feel, and more importantly how it leads to negative consequences. Calorie counting forces you to look at every food you eat along with its portion size. It may make an individual afraid to touch certain foods, healthy or not, because of the fear of increasing calorie intake. Unfortunately, the fixation on calorie counting can lead to serious consequences that involve eating disorders, both shown by the study and Rebecca’s experience. 

Keeping this information in mind, how do we approach this situation surrounding calorie counting apps? One of the most important things to do first is to spread awareness of the potential harm of these apps. We need more academic studies, articles, and journals about them. We need fitness influencers who promote these apps to share statements of discretion; share warnings. The most significant thing is for the apps themselves to have clear and concise warnings for users that want to download the app. A discrete message hidden in terms and conditions will not help the problem. For example, some medications have black box warning labels to indicate serious, adverse side effects the medication could cause. Fitness apps should do the same, as they are tools that can deeply change a person’s life. Like medication, it does not work for everyone. 

Another way to approach this issue is to promote body positivity. Users should be encouraged to stay active and nourish themselves with nutrients, but there shouldn’t be a pressure to look a certain way. These apps are for health, not to change our genetic code. We all have different body types, and that is okay. There are many influences outside the app that must be changed in order to encourage body positivity. It will take a long time for such a culturally ingrained thing to change. However, we must start to break the cycle. 

There is certainly a lot to be done in order to prevent the harmful consequences of calorie tracking apps to continue. Becoming more mindful of these consequences can help us as a whole to combat them.

Helpful Resources

Eating Disorder Hotline & Treatment Information:

National Suicide Prevention Lifeline Information:

Works Cited

Gregory, Alice. “Hunger Games: Is our tech obsession making anorexia worse?” New Republic, vol. 245, no. 1, 18 Dec. 2013, pp. 7–9. Retrieved from

Simpson, Courtney C., and Suzanne E. Mazzeo. “Calorie Counting and Fitness Tracking Technology: Associations with Eating Disorder Symptomatology.” Eating Behaviors, vol. 26, Aug. 2017, pp. 89–92. doi:10.1016/j.eatbeh.2017.02.002.

The United States is Overdue for a Film Like Pixote (1980)

by Cassandra Skolnick, November 22, 2021

Press the “channel up” button on your television remote several times. Every channel you stop on features colonial concepts of gender and power, concealing relevant truths about actual lived experiences. This is how those in the status quo maintain systems of oppression; unchanged, unchallenged, and uninterrupted. We need an escape from political ideology in film and television, centering our focus on social problems, like the film Pixote (1980) did in Brazil, under the direction of Héctor Babenco. I intend to examine how Pixote created an uncompromised and devastating view of the lived experiences of street children in São Paulo, forcing people out of their comfort zones and to finally address social problems; supporting my argument that a film like Pixote is long overdue in the United States.

Set in the 1980s, Pixote brings attention to the social problems experienced by abandoned children living on the streets of São Paulo and falls under an artistic genre known as social realism. Héctor Babenco originally set out to produce a documentary, but after nearly a dozen visits to the juvenile reformatories he reported that “…the authorities closed the door on me” (Csicsery 3). Instead, he created a fictional film based on the experiences of the children he interviewed. Concerned that it would not be genuine enough, Babenco hired non-actors from the low-income regions of São Paulo. The boys were not given a script or screenplay and were encouraged to speak in their own language (Csicsery 3). They were only told about the situations in workshops and improvised genuine responses. The result is a film that highlights “…the dark side of life for abandoned children in Brazil” (Shaw 149). 

Beyond extreme poverty, street children experience abuse and exploitation at juvenile reformatories by the men in power, demonstrating an overarching depiction of toxic masculinity that filters down to the boys. Our first glimpse of this transference of toxic masculinity occurs when a few older boys at the reformatory violently gang rape a younger and weaker boy (Pixote, 09:29). The abuse waged against the boys by the men at the reformatory is also responsible for enabling a primitive survival instinct in them. The boys frequently showcase their strength to one another, as well as to the men running the reformatory. This survival instinct is clearly present when one of the boys is framed for murder, and he grabs a knife in the cafeteria and threatens the guards (Pixote, 52:48). The will to survive drives the boys to turn to drugs and criminal behavior as an escape mechanism.

Pixote is the central character, and the point of view in the film is often deployed through his eyes as he encounters an accelerated coming-of-age transformation from childlike innocence to deviant delinquent. Following an escape from the reformatory, Pixote and a few friends form a familial pact and engage in criminal activities to support themselves. This begins with thievery, stealing purses, briefcases, and wallets from pedestrians (Pixote, 01:05:44), and ultimately leads to involvement in drug trafficking (Pixote, 01:14:32), prostitution (Pixote, 01:34:13), and murder (Pixote, 01:30:52; Pixote, 01:57:20). 

The themes of strength and survival showcased by the boys influence a third theme, sexuality, which is explored in an uncensored and often uncomfortable way throughout the film. The character Lilica, a transgender woman, is abused and sexually assaulted by the boys; rarely does she enter a sexual encounter on romantic terms. Sueli is a prostitute who sells her body for her male pimp, giving up her autonomy to support herself and her addiction. At one point, Sueli admits to Pixote that she got pregnant from one of her sexual encounters and gave herself an abortion (Pixote, 01:35:27). Pixote sees the aborted fetus discarded in the bathroom trash can. The boys also explore their sexuality, entering non-heteronormative sexual encounters. Dito, a boy who escaped the juvenile reformatory with Pixote and serves as a patriarchal leader of the group, engages in both romantic and sexual relations with Lilica and Sueli, exploring his sexuality and desire in the process. Pixote, on the other hand, never engages directly in sexual relations but learns about sexuality and desire through his observations of the other boys.  

The purpose of social realism is to illustrate real-life conditions and experiences of people living and surviving in society. Pixote accomplishes this by refusing to hold back on the life experiences of abandoned children in Brazil. In the United States, we have become accustomed to censored television and filmmaking, maintaining dominant concepts of heteronormativity, the nuclear family, and positive views of capitalism. However, I argue that a film rooted in social realism in the United States would challenge these concepts. Pixote showed how a group of boys can become family, incorporating common familial traits like shared responsibilities, unconditional love, financial support, and opportunities for learning and growth. This non-traditional nature challenges the dominance of nuclear families and also challenges concepts introduced in capitalist ideology, ideas that propose “…childhood as a separate and protected space of play and of learning” (Reimer 2011). The children are forced into accelerated coming-of-age transformations, leaving no opportunities for them to experience childhood.   We need films like Pixote to force Americans out of their comfort zone, to see the dark side of lived experiences in the United States. There has been some progress with filmmaking moving in a direction of social realism; Moonlight (2016), introduced us to the intersections of race, toxic masculinity, and sexuality in the lived experiences of Chiron, a queer Black boy living in Miami, Florida. The film was able to challenge the concept of the nuclear family, raising the question, “what is family?” Chiron finds himself supported and unconditionally loved by Juan, a drug-dealer, and his girlfriend Teresa; important traits than he rarely experienced from his birth mother. The film addresses poverty within Black communities, and Chiron’s transition to drug dealing for survival challenges capitalist failures in the United States. While this is a meaningful step in the right direction, we need more filmmakers to take the risk that films like Pixote and Moonlight took to challenge dominant societal norms.

Works Cited

Babenco, Héctor, director. Pixote. Embrafilme, 1980. 

Csicsery, George, and Héctor Babenco. “Individual Solutions: An Interview with Héctor Babenco.” Film Quarterly, vol. 36, no. 1, 1982, pp. 2–15,

Jenkins, Barry, director. Moonlight. A24, 2016. 

Reimer, Mavis. “On Location: The Home and the Street in Recent Films About Street Children.” International Research in Children’s Literature, vol. 5, no. 1, 2012, pp. 1–21.,

Shaw, Deborah. “National Identity and the Family: Pixote by Hector Babenco and Central Station by Walter Salles.” Contemporary Cinema of Latin America: Ten Key Films, Continuum, New York, 2003, pp. 142–179. 

Social Determinants of Mental Health in First Responders: Paid versus Volunteer Status and Related Implications

by Farah Hasan, November 18, 2021

First responders are celebrated for their selfless devotion to aiding civilians in traumatic events. However, as the first ones to arrive on scene, these responders often face the brunt of the immediate danger. Volunteer first responders may experience their work differently from the way occupational first responders do in regards to workplace culture and environment. As a result of these subtle differences, the mental health implications of responding to emergencies on volunteers differ from the mental health implications on paid responders. The experiences of both paid and volunteer responders must be improved and standardized to ensure that both types of responders are sufficiently prepared for high-stress work and are equipped to deal with common psychological outcomes.

Although career and volunteer first responders perform similar work, they face significant differences in terms of time commitment, recruitment/hiring processes, and training. Paid responders often devote anywhere between 56-72 hours per week to their work, while volunteer responders often dedicate their free time to providing service, resulting in them offering about half the amount of hours that paid responders give. Volunteer first responders are usually recruited on the basis of their completion of basic training (ie. EMT-B training for volunteer EMTs and training through probationary schools for volunteer firefighters), as well as hazardous materials (“Haz-Mat”) awareness training, AED-CPR training, and National Incident Management System (NIMS) training. Career first responders, on the other hand, may go through competitive interview processes and receive extensive training in addition to the basic requirements, including rigorous written and physical tests, as well as close to 200 hours of lectures, labs, and clinical experience (Ventura et al., 2021). Training and on-boarding processes may differ slightly from state to state. It is also important to note that while behavioral health and mental health programs for first responders are available, they are not a standard part of the majority of training processes for both volunteer and career responders. 

Due to the high-stress nature of their work, the prevalence of mental health disorders is significant among these trained heroes. First responders may experience irregular sleeping patterns, autonomic hyperarousal, and hypervigilance as a result of responding to traumatic and/or high-risk emergencies (Stanley et al., 2017; Skogstad et al., 2016). The severity of these symptoms and other aspects of mental health may be influenced by career or volunteer status. Distinctions between career and volunteer first responders arise in terms of cumulative time spent exposed to traumatic events, competing responsibilities (i.e. volunteers may have a separate job), and areas served (Stanley et al., 2017). In a study with a hybrid sample of firefighters (n=204 volunteer, n=321 career), career firefighters reported higher levels of substance use, particularly problematic alcohol use in comparison to volunteer firefighters (Stanley et al., 2017). On the other hand, volunteer firefighters reported elevated levels of posttraumatic stress, depression, and suicidal ideations compared to career firefighters (Stanley et al., 2017). After the 2003 Bam earthquake in Iran, the 2001 World Trade Center terrorist attack, and a 2011 vehicular bus accident in Norway, volunteer first responders were much more likely to exhibit symptoms of posttraumatic stress disorder (PTSD) than career and professional responders (Skogstad et al., 2016). Volunteers are also more likely to report higher perceived personal threat during an emergency situation (Skogstad et al., 2016).

In comparison to career departments, volunteer first responder programs may not provide adequate access to critical incident stress management (CISM), employee assistance programs (EAPs), or general stress reduction therapeutic programs. This may be due to inadequate funding and/or a belief that volunteer first responders do not require extensive resources, as their services may not entail work that is “serious” enough to necessitate them. This serves as a potential structural barrier to treatment for volunteer first responders and may contribute to increased risk of or exacerbated psychiatric symptoms (Skogstad et al., 2016; Stanley et al., 2017). 

Lack of prior training and exposure is another issue that confronts volunteer first responders. Nontraditional responders, such as construction and utility workers, electricians, and transportation workers, who assisted at the terror attack on the World Trade Center (WTC) on September 11, 2001 were in a similar situation in regards to lack of relevant training. Nontraditional responders at the WTC were twice as likely to develop PTSD compared to the police that were present (Bromet et al., 2015). Partial PTSD was also more prevalent among nontraditional responders than among the police (Bromet et al., 2015). This would suggest that lack of training is a contributing factor to the development of PTSD in volunteer first responders, who do not receive as extensive training as paid or professional first responders do. 

Other factors that may contribute to volunteer first responders’ increased risk for psychiatric disorders include lack of role clarity, perceived obstruction of services provided (Skogstad et al., 2016), and education level (DePierro et al., 2021). Role clarity pertains to the idea that volunteers may not fully understand what their task or role(s) are in an emergency, as delegation of roles may not be as efficient and definitively assigned to them as they are to paid professional responders. Perceived obstruction of services provided may arise when volunteers feel that their work is hindered or overshadowed, thereby feeling remorse over perceived inability to provide adequate service in a time of need. Additionally, first responders with a high school diploma are more likely to endorse symptoms of both PTSD and partial PTSD, compared to first responders with graduate or postgraduate degrees (Motreff et al., 2020). Lower education levels can be compared to lack of exposure/training for volunteer first responders, who are also more likely to endorse stigma surrounding psychiatric disorders, thus leading them to attempt to cope with their mental health stressors on their own (DePierro et al., 2021). Despite perceiving a greater stigma around psychiatric disorders and mental health resources, interestingly enough, DePierro et al. also found that nontraditional responders and volunteers were more likely to endorse higher perceived need for mental health resources (DePierro et al., 2021). Lack of education and lack of training both constitute a potential barrier to gaining a deeper understanding of mental health and realizing the importance of seeking professional help when needed.

As both volunteer and paid first responders are typically on the front lines during emergencies, it is important to ensure that the mental health of both types of responders are addressed. Volunteer first responders should be trained to provide the greatest role clarity possible and provided with CISM services as often as possible. For both volunteer and paid first responders, the importance of getting help from mental health professionals when necessary should be emphasized, and the contact information for such services (if they are not already provided by the corps) should be explicitly provided. Research by Jeff Thompson and Jacqueline Drew at Columbia University Irving Medical Center’s Department of Psychiatry show that resilience programs such as warr;or21, which incorporate practices such as controlled breathing and showing gratitude, have potential in alleviating mental health outcomes for first responders (Thompson & Drew, 2020). Additionally, reducing the stigma around mental health using training such as the Road to Mental Readiness (R2MR) program and reforming the workplace culture in this manner will encourage healthy dialogue (Szeto et al., 2019). These steps will pave the way for healthier and better-informed volunteer and paid first responders, which will ultimately enhance the quality of their work and services.


Bromet, E. J. et al. (2016). DSM-IV post-traumatic stress disorder among World Trade Center responders 11-13 years after the disaster of 11 September 2001 (9/11). Psychological Medicine, 46(4), pp. 771–783.

DePierro, J. et al. (2021). Mental health stigma and barriers to care in World Trade Center responders: Results from a large, population-based health monitoring cohort. American Journal of Industrial Medicine, 64(3), pp. 208–216.

Motreff, Y. et al. (2020) Factors associated with PTSD and partial PTSD among first responders following the Paris terror attacks in November 2015. Journal of Psychiatric Research, 121, pp. 143–150.

Skogstad, L. et al. (2016) Post-traumatic stress among rescue workers after terror attacks inNorway. Occupational Medicine (Oxford, England), 66(7), pp. 528–535.

Stanley, I. H. et al. (2017) Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters. Psychiatry Research, 247, pp. 236–242.

Szeto, A., Dobson, K. S., & Knaak, S. (2019). The Road to mental readiness for first responders: A meta-analysis of program outcomes. Canadian Journal of Psychiatry, 64(1_suppl), 18S–29S.

Thompson, J. & Drew, J. M. (2020). Warr;or21: A 21-day program to enhance first responder resilience and mental health. Frontiers in Psychology, 11, 2078–2078.

Ventura, Denton, E., Court, E. V., & Nava-Parada, P. (2021). The emergency medical responder: Training and succeeding as an EMT/EMR. Springer.