Health

Superficially, abortion rights had a good run at the Supreme Court this term. Two weeks ago, the justices unanimously let an abortion pill remain widely available. On Thursday, the court dismissed a case about Idaho’s strict abortion ban, which had the effect of letting emergency rooms in the state perform the procedure when the patient’s health is at risk.

But the two rulings were so technical as to be ephemeral. They seemed designed for avoidance and delay, for kicking a volatile subject down the road — or at least past Election Day.

Some supporters of abortion rights called the rulings Pyrrhic victories, ones they feared would set the stage for more restrictions, whether from the courts or from a second Trump administration.

In Dobbs v. Jackson Women’s Health Organization, the 2022 decision that overturned Roe v. Wade, the Supreme Court signaled that it sought to get out of the abortion business. “The authority to regulate abortion must be returned to the people and their elected representatives,” Justice Samuel A. Alito Jr. wrote for the majority.

The two recent rulings were generally consistent with that sentiment, though Justice Alito himself was eager to address Thursday’s case. “Apparently,” he wrote, “the court has simply lost the will to decide the easy but emotional and highly politicized question that the case presents. That is regrettable.”

The majority took a different view, but its strategy of evasion cannot last, said Mary Ziegler, a law professor at the University of California, Davis.

“What is clear, both in this term and in what is likely to come next, is that the abortion struggle is not being left to the states,” she said. “The executive branch and the Supreme Court are still very much going to have their say.”

David S. Cohen, a law professor at Drexel University, said the end of Roe was the beginning of a war in which each side seeks total victory. That means, he said, that the Supreme Court will not be able to duck hard issues in the long term.

“In both of these cases,” he said of this month’s decisions, “the court avoided tackling the morass created by overturning Roe v. Wade. Without a national right to abortion care, contentious cases like these are going to come back to the court again and again. The court won’t be able to sidestep its self-imposed mess forever.”

He added: “Neither side in this debate is going to stop fighting for their preferred outcome — a national rule applicable everywhere. So there is no doubt that we’re going to see more and more cases like this bubbling up to the Supreme Court in the coming years.”

The two rulings resolved almost nothing.

The first said merely that the particular doctors and groups challenging the Food and Drug Administration’s approval of an abortion pill had not suffered the sort of injury that gave them standing to sue. The court did not rule on whether the agency’s action was lawful.

Other challengers, notably three states that have already intervened in the case in the trial court — Idaho, Kansas and Missouri — will continue to fight. Their challenge could reach the Supreme Court fairly quickly.

The Idaho case was even more of a nonevent. The court, which had taken the unusual step of agreeing to review a trial judge’s ruling before an appeals court had acted, thought better of getting involved at such an early stage

The court dismissed the case as “improvidently granted,” the judicial equivalent of saying “never mind.” After the appeals court, the U.S. Court of Appeals for the Ninth Circuit, rules, the Supreme Court may return to the case.

Or it might hear an appeal involving a broadly similar Texas law, which has been sustained by the Fifth Circuit. The Biden administration has already filed a petition seeking review of that ruling.

“Both decisions strike me as Pyrrhic victories for the Biden administration,” Professor Ziegler said. In the abortion-pill case, Food and Drug Administration v. Alliance for Hippocratic Medicine, she said, the court interpreted conscience protections for doctors opposed to abortion far more broadly than it had in earlier decisions.

In the case on emergency abortions, Moyle v. United States, Professor Ziegler said, Justice Amy Coney Barrett “likewise hinted at the importance of conscience protections and expressed suspicion of mental health justifications for abortion — both of which could be consequential in the future.”

Rachel Rebouché, dean of Temple University Beasley School of Law, said that “these decisions can’t be described as pure wins for abortion supporters.”

“The issues at the heart of both cases are sure to come before the court again,” she said. “The court didn’t rule on the merits in either decision, and there are already cases in the pipeline to test the legality of mailed medication abortion and to uphold state abortion laws that make no exception for avoiding serious injury or threat to health.”

The coming election may have played a role in the Supreme Court’s failures to act. After all, the Dobbs decision, issued months before the 2022 midterm elections, was a political windfall for Democrats.

Greer Donley, a law professor at the University of Pittsburgh, said that the court’s conservative majority may have wanted to avoid “an unpopular merits-based abortion decision in an election year.”

Professor Ziegler said she was not sure how the election figured in the court’s calculations.

“It would have been extraordinary for the court to issue two major rulings in an election year, and it’s fair to assume that the court’s most institutionalist justices were looking for a way to avoid that outcome,” she said. “At the same time, there were real reasons to postpone ruling on the merits in either case.”

She added: “That means there isn’t a smoking gun pointing to this being an election-year about-face — after all, why take these cases in an election year in the first place? — but it seems quite likely that the upcoming election made it even more attractive to kick the can down the road.”

If Mr. Trump wins, much of what was at issue in the two cases may be resolved by executive action. His administration could withdraw the guidance on emergency room care at issue in the Idaho and Texas cases, and it could interpret an old law, the Comstock Act, to try to ban the mailing of abortion pills.

Still, whatever may be said about the direction of the Supreme Court’s abortion jurisprudence, Professor Cohen said, it is important not to lose sight of who won and who lost in the two recent decisions.

“The antiabortion movement took big swings with these cases and missed in both,” Professor Cohen said. “They couldn’t stop abortion pills, nor could they stop federal law from trumping a state abortion ban. That may change in the future, but right now, they’re 0 for 2 post-Dobbs.”

The Biden administration said this week that it opposed gender-affirming surgery for minors, the most explicit statement to date on the subject from a president who has been a staunch supporter of transgender rights.

The White House announcement was sent to The New York Times on Wednesday in response to an article reporting that staff in the office of Adm. Rachel Levine, an assistant secretary at the Department of Health and Human Services, had urged an influential international transgender health organization to remove age minimums for surgery from its treatment guidelines for minors.

The draft guidelines would have lowered the age minimums to 14 for hormonal treatments, 15 for mastectomies, 16 for breast augmentation or facial surgeries, and 17 for genital surgeries or hysterectomies. The final guidelines, released in 2022, removed the age-based recommendations altogether.

“Adm. Levine shared her view with her staff that publishing the proposed lower ages for gender transition surgeries was not supported by science or research, and could lead to an onslaught of attacks on the transgender community,” an H.H.S. spokesman said in a statement on Friday evening.

Federal officials did not elaborate further on the administration’s position regarding the scientific research or on Adm. Levine’s role in having the age minimums removed.

The administration, which has been supportive of gender-affirming care for transgender youth, expressed opposition only to surgeries for minors, not other treatments. The procedures are usually irreversible, critics have said.

Medical care for transgender adolescents has become a hot-button issue in many states, particularly in conservative political circles. The Texas Supreme Court on Friday upheld a state law banning all gender-affirming medical treatment for minors.

The Supreme Court agreed on Monday to hear a challenge — brought in part by the Biden administration — to a Tennessee law that bans treatments including puberty blockers, hormone therapy and surgery for transgender minors. This will be first time the justices will decide on the constitutionality of such statewide bans.

The Biden administration’s previous statements on gender-affirming care for minors have not in the past explicitly opposed surgery.

A two-page explainer on gender-affirming care that is frequently cited by federal officials stated that gender-affirming surgeries were “typically used in adulthood or case-by-case in adolescence,” leaving the door open to surgery for minors in some instances.

Other gender-affirming treatments such as puberty blockers are used during puberty, the explainer noted. Hormone treatments with estrogen or testosterone, which are partly irreversible, are used in “early adolescence and onwards,” it said.

Despite the outsize attention the issue has drawn, it is rare for minors in the United States to undergo gender-affirming surgeries.

The procedures include “top” surgeries to remove or augment the breasts, “bottom” surgeries on genitals and reproductive organs, and other operations to modify facial features.

Breast reductions or mastectomies for transgender men and nonbinary individuals are the procedures done most frequently. Some doctors have argued that minors should have access to breast surgery before age 18 because breast development takes place early in puberty and the breasts are so visible that transitioning teens go to great lengths to conceal them, often binding their chests.

But even as the number of minors having these operations has risen in recent years, they continue to be extremely uncommon.

The number of annual chest procedures for minors covered by insurance in the United States is estimated to be in the hundreds. While there are no official statistics, a national analysis of hospital data from 2016 through 2020 identified about 3,600 patients from the ages of 12 to 18 who had gender-affirming surgery.

A vast majority were chest-related, an increasingly common procedure among transgender teens.

An analysis of one hospital’s data found that the number of gender-affirming mastectomies in insured teenagers increased from five cases in 2013 to 70 in 2019. But genital surgeries among minors are “exceedingly rare,” doctors have reported.

The administration has been a strong supporter of transgender people, affirming individual rights to gender-affirming care, highlighting federal provisions protecting transgender Americans against discrimination, and emphasizing the importance of mental health services for transgender youth.

The Biden administration has condemned state legislation targeting transgender people. It has allowed passport holders to use an “X” to describe their gender, and taken steps to combat violence against transgender individuals.

After Florida proposed a number of laws targeting transgender residents in 2023, including measures that would ban gender-affirming care for minors and restrict transgender athletes from joining certain sports teams, Mr. Biden said he found the efforts “terrible.”

He did not specify the particular policies with which he disagreed. In contrast, Donald J. Trump, the presumptive Republican nominee for president, announced a plan in a video posted in 2023 on Truth Social to pass a federal law banning all gender-affirming care for minors, which he described as “child sexual mutilation.”

He also said any hospitals that perform the treatment would be ineligible for Medicaid and Medicare funds under this policy.

“Hey, buddy, how are you doing?” a man wearing a Boba Fett costume said as he leaned over the bed of a young boy in a hospital gown.

It was a Sunday afternoon in the emergency room at Maimonides Medical Center in Brooklyn, where Dr. Alex Arroyo, the hospital’s director of pediatric emergency medicine, often dons one of more than 20 costumes when he visits patients. His favorite is Boba Fett, the famed bounty hunter from the “Star Wars” films.

“I love what I do, but it’s sure hot in there!” said Dr. Arroyo, 48, who has worked at the hospital since 2006. He started wearing costumes in 2021.

A die-hard “Star Wars” fan who grew up watching the original trilogy with his parents, Dr. Arroyo has passed that love on to his two youngest children, Grayson, 8, and Karra, 6. For New York Comic Con each year, the whole family dresses up, including his wife, Dr. Sharon Yellin, 44, a fellow pediatric emergency medicine physician who works at NewYork-Presbyterian Brooklyn Methodist Hospital. One year they went as the family from “Encanto.”

“I was the big, strong sister with the donkey,” Dr. Arroyo said, referring to the character Luisa.

Dr. Arroyo, who also has a 21-year-old son, Colin, from a previous marriage, was born in the Borough Park neighborhood of South Brooklyn — at Maimonides, in fact. Now he lives less than a mile from the house where he grew up, in a four-bedroom, three-story 1920s brownstone. He uses one of the spare bedrooms as his office and rents out the third floor.

“It’s a frightening place to be inside of because I’m also an active-duty comic collector,” he said of his office. “It’s filled wall to wall with toys. It’s my sanctuary away from the world.”

READY TO ROCK I wake up at 7:30 or 8. I probably don’t need my iPhone alarm, but I set it just in case. It’s “Sabotage” by the Beastie Boys. It puts me in the mood for the day.

The first thing I do is make a cup of coffee. I brew as much as I can in the Keurig. I’m not a coffee snob — I’ll have whatever’s available.

CHEF HOUR While my children run downstairs to steal some iPad or TV time, I get breakfast going. My go-tos are pancakes, waffles and quail eggs — I bought them at the grocery store around the corner as a joke one day, thinking my kids would find them hilarious because they’re so tiny, but they’ve gotten to really enjoy them. They’re extremely difficult to open, though; there’s usually shells everywhere. Somehow, I’ve become the default cook for the house. My wife refers to my cooking style as “‘Iron Chef’ on steroids.” I cook the way I work — extremely fast and really efficient, but it’s really messy.

TECH FIX I check my email first, and then the WhatsApp groups from the hospital to see if anything happened overnight or if anyone needs anything. Then I’ll run over to Instagram, scroll through X to catch up on what happened when I was sleeping. I’m something of a social media addict. Then my wife and I face off in our daily Wordle, Connections and mini New York Times Crossword challenges. We text each other our results to see who beat who today.

FIGHT CLUB Around 10 or 11 a.m., I head to jujitsu class at Windsor Terrace Martial Arts. I try to go as often as possible, sometimes as much as 10 times per week. I’ve been doing it for about 17 months. I’ll usually do a private lesson on Sunday. I generate a lot of joy by strangling people who I consider my friends. It’s an amazing outlet for the horrors of the world I see on a daily basis.

SPLIT TRACK When it comes to work, my Sundays vary. I could be working one of three 12-hour emergency room shifts — which start at 7 a.m., or 1 p.m., or 7 p.m. — or I could be off. Today, I have a 1 p.m. shift.

I run the department, so my time in the E.R. is limited to about 12 hours per week. My other time is occupied with being in the office and trying to manage the day-to-day craziness that is running an E.R. in New York City.

HEADING IN I take a shower, then head to the hospital. On a good day with no traffic, it’s a six-minute drive. Usually parking is a challenge, but not on the weekend, which is nice. I get a cup of iced coffee from Dunkin’ Donuts around the corner from the hospital.

SUITING UP I’m starting my shift by visiting kids as Boba Fett, so I head to my office to change into my costume. It takes me about 20 minutes to put on, and I need help. I wanted it to be as close to movie accurate as possible, so it has at least 20 different pieces I have to put on. Good luck sitting down or walking through doors!

BOBA FETT WILL SEE YOU NOW I put aside an hour at the beginning of my shift to walk around in costume, because I don’t actually work while wearing it. Even on Halloween, we discourage wearing any costumes — the last thing you want is SpongeBob SquarePants handling your child’s cardiac arrest.

I have at least four “Star Wars” costumes, including two Jedis and a fighter pilot. “Star Wars” is good because it’s a ubiquitous thing that reaches across generations — when kids recognize a character, they light up and their eyes kind of pop out of their head.

THE REAL WORK BEGINS The 1 p.m. to 1 a.m. shift is the busiest of the three — I’m seeing patients pretty much nonstop. On a good day, I can sit down for five minutes at some point to eat and pee, but sometimes that’s not possible because I’m running around like a maniac.

I see lots of fevers — which, in a weeks-old baby, is one of the biggest emergencies we can see in pediatric emergency medicine. I liken that to an adult with chest pain, because it’s usually indicative of something very serious and we have to also rule out all the bad things. In the spring and summer, when the weather is nicer, I also see lots of broken bones, especially broken arms. Kids fall down at the park, especially off the monkey bars.

SUNDAY FUNDAY When I’m not working — or when I’m working the late shift — I’ll do something fun with my kids. They’re big foodies, so I’ll take them to Smorgasburg, the open-air food market in Prospect Park. The French fry place is my favorite. My kids love the rainbow grilled cheese, but it looks disgusting.

Or we might take a trip to grandma’s house and do brunch. Then we might see a movie at Nitehawk Cinema — Prospect Park, which is great because it has food.

HOT DOG NIGHT When I’m home, around 5 or 5:30, I’ll make dinner for my kids. Their palates aren’t as refined as those of many Brooklyn children. They’re big on chicken, pizza, hot dogs, pasta … and my son loves sushi.

After my wife and I put the kids to bed around 7:30 or 8, we’ll eat dinner around 8:30 — usually something more adventurous than a hot dog and mac and cheese.

TV TIME My wife and I will watch pretty much everything — dramas, comedies, period pieces. We recently finished “The Crown.” We’re big fans of “Cobra Kai,” “Yellowstone” and murder mystery documentaries.

DOOMSCROLLING Around midnight, I head upstairs to bed, where I spend 30 minutes doomscrolling whatever social media app to lull myself to sleep.

The nice thing about working in emergency medicine is that I don’t get the “Sunday Scaries.” My schedule flips and turns constantly, so I’m in this perpetual cycle of “whatever comes, comes.”

Watermelon is the fruit of summer. In the United States, it’s more popular than cantaloupe, honeydew and all other melons combined.

It’s good for your body, too, especially on a hot day. Here’s a rundown of watermelon’s healthiest qualities, plus some cool and delicious recipes from New York Times Cooking.

It’s hydrating.

“Watermelon” is a fitting name, because it’s more than 91 percent water. When you eat an average-size wedge (10 ounces or so), you’re effectively drinking a full cup of water.

Hydration keeps the body functioning as it should, from promoting blood flow to bowel regularity. The water in watermelon helps keep you hydrated, which can be extra beneficial in hot weather, when you lose more fluids through sweat.

“Our bodies recognize and utilize water molecules regardless of the source,” said Dr. Tamara Hew-Butler, a sports medicine scientist at Wayne State University. “Moist foods like fruit, vegetables and soups are considered water sources.”

Older people, in particular, may find it easier and more enjoyable to get some of their fluids through fruit, said Amy Ellis, a dietitian and associate professor of nutrition at the University of Alabama. They tend to feel less thirsty and therefore drink less — one of the reasons they’re at a higher risk for dehydration and heat-related illness during a heat wave.

It’s not as sugary as you might think.

Because watermelon is mostly water, it’s also low in calories — a one-cup serving has just 46.

“Some people think it’s sky-high in sugar because it tastes so sweet, but really it’s very moderate,” Dr. Ellis said. One cup of diced watermelon contains about 9.5 grams of sugar, which is less than the 13 grams in a cup of chopped apples or the nearly 15 grams in a cup of blueberries.

That’s little enough that the fruit likely won’t cause spikes in blood sugar, added Joanne Slavin, a dietitian and professor of food science and nutrition at the University of Minnesota.

Calories are energy, though, so watermelon alone won’t sufficiently fuel your body, said Samantha Dieras, a dietitian and the director of ambulatory nutrition services at Mount Sinai Hospital. But when you eat watermelon as part of a balanced diet, the water content and sweet flavor could help you feel satiated.

It’s heart healthy, to some degree.

Watermelon is fat- and sodium-free, which is good for your heart. But the jury is still out as to whether watermelon plays an active role in lowering heart disease risk, Dr. Slavin said.

Dr. Slavin, Dr. Ellis and Dr. Dieras all suggested that the amino acid L-citrulline and the micronutrient lycopene — both abundant in watermelon — could improve heart health. There’s a rationale for these ideas, Dr. Slavin said.

Scientists know that the kidneys convert L-citrulline into nitric oxide, which can relax your artery walls and lower blood pressure. And lycopene, a chemical found in certain plants, can reduce inflammation, which is linked to heart disease. People tend to associate lycopene with tomatoes, but watermelon has more.

Still, independently funded human studies directly examining watermelon’s effect on heart health have not shown measurable improvements. “Watermelon is not a magic bullet,” said Dr. Ellis, who led one of the studies. “It’s not going to displace blood pressure medication or anything like that. But if it’s incorporated into a diet with nutrient-dense foods, it may be a good thing for vascular health.”

Here’s how to make the most of it.

Watermelon doesn’t lend itself well to canning, drying or freezing, Dr. Slavin said, so it’s harder to enjoy out of season. She thinks this is one reason the fruit is so loved.

“Watermelon is summer and happiness,” she said. “When someone cuts open a fresh watermelon and hands you a hunk, that’s when it’s best.”

It’s also delicious in a dinner salad, soup or fizzy drink. Here are some recipes from NYT Cooking to get you started.

Recipe: Farro and Watermelon Salad

In this satisfying grain bowl, watermelon is paired with farro, cheese, herbs and red onion. You can substitute quicker-cooking rice or quinoa for the farro.

Recipe: Tomato-Watermelon Gazpacho With Avocado

Keep a pitcher of this chilled soup in the refrigerator for an instant meal on sweltering days. Watermelon tempers the sweetness of overripe summer tomatoes in the blended mix.

Recipe: Country Panzanella With Watermelon Dressing

Juicy with chunks of watermelon, tomatoes and cucumber, this ultimate summer salad becomes even more refreshing with a watermelon dressing. Toasted ciabatta and crumbled feta make it filling enough to be a meal.

Recipe: Watermelon Chaat

This savory fruit dish tossed with spicy cumin-citrus dressing could work with any fruit, but is especially good with watermelon. It’s tasty as a stand-alone snack or as a side dish.

Recipe: Watermelon Ginger Beer

Blitzing watermelon into juice is a brilliant move all summer long. Topping it off with fizzy ginger beer for a nonalcoholic spritz? Genius.