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Aetna agrees to expand coverage of sexist surgeries

Allison Escolastico, a 30-year-old transgender woman, has wanted breast augmentation surgery for a decade. In 2019, she finally thought her insurance company, Aetna, would pay for it, only to find that she viewed the procedure as cosmetic, not medically necessary, and refused to cover it.

“I knew my case wasn’t cosmetic,” said Escolastico, who contacted a lawyer after losing her appeal last year. “I knew I had to fight for this,” she says.

Ms Escolastico’s surgery is now scheduled for February. Working with the Transgender Legal Defense and Education Fund, a non-profit organization that advocates for transgender rights, and Cohen Milstein Sellers and Toll, a large law firm that represents plaintiffs, she and a small group of trans women have persuaded Aetna to cover the procedure if they could show it must be medically necessary.

To be eligible, women would need to demonstrate that they have persistent gender dysphoria, undergo one year of feminizing hormone therapy, and be referred by a mental health professional.

Aetna’s change represents a significant shift in the way health insurers perceive the medical needs of transgender people. While some insurers offer a wide range of surgeries for trans women if deemed medically necessary, others exclude breast augmentation and other treatments as simply cosmetic.

“This has the potential to be a moment of transformation,” said Kalpana Kotagal, partner at Cohen Milstein.

Insurers have generally covered genital reassignment surgery as medically necessary. But transgender women and others say breast augmentation is also a necessary treatment for people who are diagnosed with gender dysphoria. “There’s no question from a medical point of view,” said Noah E. Lewis, director of the fund’s Trans Health project.

In addition, he said, it is illegal for a health insurer to deny health care coverage because of a person’s gender identity. “It’s a very simple discrimination issue,” he said.

Aetna, who is owned by CVS Health, had been actively reviewing the need for breast augmentation surgery for trans women, said Dr Jordan Pritzker, senior director of clinical solutions for the insurer. He said he had spoken to many doctors who perform the surgery.

“Our decision to update our Clinical Policy Bulletin is in line with many changes we have made over the years to better meet the needs of the LGBTQ community,” Dr. Pritzker said in a statement.

Aetna said she would also reimburse some transgender women who were denied coverage but had surgery. The company said it is actively reaching out to people who have applied for clearance for their surgeries and been denied.

Cora Brna was denied coverage for breast augmentation surgery two years ago when she tried to schedule it at the same time she was undergoing genital reassignment, which was covered by Aetna. “I was devastated,” she says.

“I felt like a group of people were deciding whether or not I was a woman,” said Ms Brna, 32, who works as a health care worker in Pittsburgh and was one of the women who petitioned Aetna. She had genital surgery but only had the breast augmentation procedure after being covered by a different health plan.

Aetna’s new policy also comes at a time when the federal government is reconsidering whether denying certain types of care to transgender people is discriminatory. Under the Affordable Care Act, insurers cannot discriminate against individuals on the basis of gender identity, and most insurance companies provide coverage for people who require gender reassignment surgery. But the law never mandated a specific benefit or detailed exactly what services insurers would cover, said Katie Keith, who teaches law at Georgetown University and follows this area of ​​the law closely.

“It’s almost like a parity issue,” she says.

While the Trump administration sought to overturn protections for transgender people with a rule last June, the issue is still being resolved in the courts, said Ms Keith, who also highlighted the recent court ruling. supreme that gay and transgender workers are protected. discrimination in the workplace under civil law.

The new Biden administration has already issued an executive order saying it will enforce civil rights laws that protect people from discrimination on the basis of gender identity.

The major insurance companies are uneven in their coverage. Health Care Service Corp., which offers Blue Cross plans in five states, will pay for breast augmentation and other services for trans women if they are deemed medically necessary. The insurer said it developed these policies in accordance with guidelines set by the World Professional Association for Transgender Health, a non-profit organization.

But other big insurers, including Anthem and UnitedHealthcare, continue to view surgery as cosmetic, as they typically don’t cover procedures for women without a diagnosis of gender dysphoria. They say they don’t discriminate against trans women.

Anthem states that “its medical policy is applied fairly to all members, regardless of their sex or gender identity.”

And UnitedHealthcare said in a statement that its “coverage for the treatment of gender dysphoria is comprehensive and, depending on member benefit plans, current coverage may include doctor visits, mental health services, prescription drugs and surgery to treat gender dysphoria. He added that he uses “evidence-based medicine to make coverage policy decisions,” which are updated regularly.

But lawyers for the women involved in the Aetna deal say they are looking closely at the policies of other insurers to see if they can argue that their refusal to offer coverage is discriminatory. “This is something that needs to be changed throughout the industry,” said Ms. Kotagal of Cohen Milstein.

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Aetna agrees to extend coverage for sexist surgeries

Allison Escolastico, a 30-year-old transgender woman, has wanted breast augmentation surgery for a decade. In 2019, she finally figured her insurance company, Aetna, would pay for it, only to find that she viewed the procedure as cosmetic, not medically necessary, and refused to cover it.

“I knew my case wasn’t cosmetic,” said Escolastico, who contacted a lawyer after losing her appeal last year. “I knew I had to fight for this,” she says.

Ms Escolastico’s surgery is now scheduled for February. Working with the Transgender Legal Defense and Education Fund, a non-profit organization that advocates for transgender rights, and Cohen Milstein Sellers and Toll, a large law firm that represents plaintiffs, she and a small group of trans women have persuaded Aetna to cover the procedure if they could show it must be medically necessary.

To be eligible, women would need to demonstrate that they have persistent gender dysphoria, undergo one year of feminizing hormone therapy, and be referred by a mental health professional.

Aetna’s change represents a significant shift in the way health insurers perceive the medical needs of transgender people. While some insurers offer a wide range of surgeries for trans women if they are deemed medically necessary, others exclude breast augmentation and other treatments as simply cosmetic.

“It has the potential to be a moment of transformation,” said Kalpana Kotagal, partner at Cohen Milstein.

Insurers have generally covered genital reassignment surgery as medically necessary. But transgender women and others say breast augmentation is also a necessary treatment for people diagnosed with gender dysphoria. “There’s no question from a medical point of view,” said Noah E. Lewis, director of the fund’s Trans Health project.

In addition, he said, it is illegal for a health insurer to deny health care coverage because of a person’s gender identity. “It’s a very simple discrimination issue,” he said.

Aetna, who is owned by CVS Health, had been actively reviewing the need for breast augmentation surgery for trans women, said Dr Jordan Pritzker, senior director of clinical solutions for the insurer. He said he had spoken to many doctors who perform the surgery.

“Our decision to update our Clinical Policy Bulletin is in line with many changes we have made over the years to better meet the needs of the LGBTQ community,” Dr. Pritzker said in a statement.

Aetna said she would also reimburse some transgender women who were denied coverage but had surgery. The company said it is actively reaching out to people who have applied for permission for their surgeries and been denied.

Cora Brna was denied coverage for breast augmentation surgery two years ago when she tried to schedule it at the same time she was undergoing genital reassignment, which was covered by Aetna. “I was devastated,” she says.

“I felt like a group of people were deciding whether or not I was a woman,” said Ms Brna, 32, who works as a health care worker in Pittsburgh and was one of the women. who petitioned Aetna. She had genital surgery but only had the breast augmentation procedure after being covered by a different health plan.

Aetna’s new policy also comes at a time when the federal government is reconsidering whether denying certain types of care to transgender people is discriminatory. Under the Affordable Care Act, insurers cannot discriminate against individuals on the basis of gender identity, and most insurance companies provide coverage for people who need change surgery. of sex. But the law never mandated a specific benefit or detailed exactly what services insurers would cover, said Katie Keith, who teaches law at Georgetown University and follows this area of ​​the law closely.

“It’s almost like a parity issue,” she says.

As the Trump administration sought to overturn protections for transgender people with a rule last June, the issue is still being resolved in the courts, said Ms Keith, who also highlighted the recent Supreme Court ruling. that gay and transgender workers are protected. discrimination in the workplace under civil law.

The new Biden administration has already issued an executive order saying it will enforce civil rights laws that protect people from discrimination on the basis of gender identity.

The major insurance companies are uneven in their coverage. Health Care Service Corp., which offers Blue Cross plans in five states, will pay for breast augmentation and other services for trans women if they are deemed medically necessary. The insurer said it developed these policies in accordance with guidelines set by the World Professional Association for Transgender Health, a non-profit organization.

But other major insurers, including Anthem and UnitedHealthcare, continue to view surgery as cosmetic because they typically don’t cover procedures for women without a diagnosis of gender dysphoria. They say they don’t discriminate against trans women.

Anthem states that “its medical policy is applied fairly to all members, regardless of their sex or gender identity.”

And UnitedHealthcare said in a statement that its “coverage for the treatment of gender dysphoria is comprehensive and, depending on member benefit plans, current coverage may include doctor visits, mental health services, prescription drugs and surgery to treat gender dysphoria. He added that he uses “evidence-based medicine to make coverage policy decisions,” which are updated regularly.

But lawyers for the women involved in the Aetna deal say they are looking closely at the policies of other insurers to see if they can argue that their refusal to offer coverage is discriminatory. “This is something that needs to be changed throughout the industry,” said Ms. Kotagal of Cohen Milstein.

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US border agency agrees with 2 Americans detained for speaking Spanish

Two women who were detained in a small town in Montana after a border patrol officer overheard them speaking Spanish at a convenience store settled for an undisclosed amount after filing a customs and protection lawsuit. US borders, the Montana ACLU said Tuesday.

The women, Ana Suda and Martha Hernandez, were held for approximately 40 minutes on May 16, 2018, after a border patrol officer overheard them speaking Spanish as they lined up to buy milk and eggs in a Town Pump convenience store in Le Havre, Mont., a town of nearly 10,000 people about 35 miles south of the Canadian border.

As he stood behind the two lined up women, Border Patrol Officer Paul O’Neill was greeted by Ms Hernandez. He commented on his accent and asked the women where they were from. After responding that they were from Texas and California, Mr. O’Neill asked for their ID and the two women gave him their valid state-issued driver’s licenses.

In a video of the meeting filmed by the women, one of them asked why Mr. O’Neill had asked for identification.

“The reason I asked you for your ID,” replied Mr. O’Neill, “is because I came here and saw that you speak Spanish, which is very unknown. here.

Other border patrol officers quickly arrived, along with Mr O’Neill’s supervisor, according to the lawsuit. Ms Suda asked the supervisor if she and Ms Hernandez would have been detained if they spoke French. “No,” he replied, “we don’t do that.”

Ms Suda, who was born in El Paso, Texas, and Ms Hernandez, who was born in El Centro, Calif., Both grew up speaking Spanish and were residing in Le Havre at the time of the incident.

In 2019, the ACLU filed a lawsuit on behalf of the women, alleging that a border patrol agent singled them out for speaking Spanish and relied on that as a “power of attorney for the race”. Lawyers representing Ms Suda and Ms Hernandez also said the detention violated the Fourth Amendment and women’s right to equal protection.

Since the incident, Ms. Suda and Ms. Hernandez have left Le Havre out of fear for the safety of their families and because of “local backlashes,” said Caitlin Borgmann, executive director of the ACLU Montana.

Lawyers representing O’Neill did not respond to requests for comment.

In a statement, U.S. Customs and Border Protection said the regulations did not mean he was held responsible for the incident. Border Patrol officers “are trained to apply US laws consistently and fairly, and they do not discriminate on the basis of religion, race, ethnicity or sexual orientation,” the agency said. .

“CBP is committed to fair, impartial and respectful treatment of all members of the business and the traveling public, and commemorated its commitment to non-discrimination in existing policies,” the agency said.

In a statement released by the ACLU, Ms. Suda said she hoped the meeting would prompt U.S. Customs and Border Protection to reassess her conduct.

“We have stood up to the government because speaking Spanish is no reason to be racially profiled and harassed. I am proud to be bilingual and I hope that following this affair, CBP is carefully reviewing its policies and practices, ”said Ms. Suda. “No one else should ever have to go through this again.”

This was not the first time that she and Ms Hernandez had come under suspicion of border patrol officers.

In February 2018, an agent overheard Ms Suda and Ms Hernandez speaking Spanish in a bar in Le Havre. The agent sent a picture of them to other agents in a message saying, “There are two Mexicans at the bar.” An officer receiving the message then replied that Ms Suda and Ms Hernandez were friends of his wife.

Hispanic residents make up about 4% of Le Havre’s population, while white residents make up about 80%, according to census data. In Montana, almost 4% of people speak a language other than English at home.

In a video the ACLU obtained during the investigation, a supervisor of US customs and border protection told agency investigators he saw “nothing harassing” about the incident of May 2018. Le Havre is a small town, he noted, where “nobody really has much to do”.

“If there’s someone speaking Spanish here,” the supervisor says, “all of a sudden you have five agents swarming like, ‘What’s going on? So Havre is a bit like that.

The ACLU also discovered that Mr. O’Neill was a member of the “I’m 10-15” Facebook group, which included “obscene images of Hispanic lawmakers and threats against members of Congress.”

The local Havre area office of U.S. Customs and Border Protection, which had 175 officers in fiscal 2018, has jurisdiction over 456 miles of the border area.

In 2006, the United States Court of Appeals for the Ninth Circuit ruled that agents in the Le Havre area had violated the Fourth Amendment and “lacked reasonable suspicion” when they arrested five Hispanic men in 2004.

Ms Borgmann said the 2018 incident involving Ms Suda and Ms Hernandez was not just an example of a ‘bad apple’ but also of a systemic problem within the Le Havre area.

“I hope that it is recognized as a result of this trial and the courage of these women to come forward,” she said, “that this is ingrained behavior and must be to cease.

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Army agrees to review thousands of unfavorable dismissals for veterans

In a statement Thursday, Alexander Conyers, Deputy Assistant Secretary of the Army, said: “The Agency for Military Review Boards, which acts on behalf of the Secretary of the Army, reviews and assesses cases of impartially in a fair and equitable manner. soldiers, former soldiers and the army.

“As the U.S. District Court for the District of Connecticut has yet to approve a settlement and Kennedy v. McCarthy remains in litigation,” he added, “any comment regarding a proposed settlement would be premature.”

Messages left with lawyers representing the military in the settlement agreement on Thursday were not immediately returned.

After a tour of 14 months as an infantryman in Iraq, Mr. Kennedy said he had committed a minor offense in 2009 and had been sent to a mental health clinic at Fort Bragg, North Carolina, where the doctors discovered he was suffering from depression and recommended him for separation. , saying they couldn’t provide adequate care. As a result, he received a general and not honorable discharge.

According to the legal clinic at Yale, the Army sent about 150,000 soldiers from 11 September 2001 attacks with so-called bad as Mr. Kennedy papers, many of which showed symptoms of mental disorders such as depression and post-traumatic stress, or suffered traumatic brain injury as a result of their combat service.

When a soldier, sailor, aviator, navy, or coast guard is dismissed, service is qualified as honor, general under honorable conditions, other than honorable, bad conduct, or dishonorable. Only the first, honorable, guarantees the new veteran access to the full range of benefits of the Department of Veterans Affairs.

The type of leave a service member receives after being separated for minor misconduct is subjective and may vary.

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Biden talks to more world leaders and agrees to meet with the South Korean president.

President-elect Joseph R. Biden Jr. spoke with three other foreign leaders on Wednesday in the latest show of international support for his electoral victory. He also pledged to a quick meeting with one of them: President Moon Jae-in of South Korea.

In a statement, Biden’s transition team said the president-elect participated in “congratulatory calls” with Mr. Moon, Prime Minister Scott Morrison of Australia and Prime Minister Yoshihide Suga of Japan. The calls with three of the United States’ closest allies came the day after four Mr. Biden held with Western European allies, in a return to traditional diplomatic protocol after years of random foreign interactions by the president Trump.

Mr Biden spoke to each of the leaders in the coronavirus pandemic, the global economy and “democracy building,” according to the descriptions of the transitional office calls. While the State Department typically helped facilitate such appeals to an elected president and provide him with translators if needed, a source familiar with Mr. Biden’s calls in the past two days said the Trump administration had refused to provide such assistance.

But even as Mr Trump continues to make false accusations of electoral fraud and claim to be the real winner of the election, virtually all of the world’s top leaders have now acknowledged that Mr Biden would be inaugurated in January. The few who resist include two autocratic allies of President Trump – Russian President Vladimir V. Putin and Brazilian President Jair Bolsonaro – as well as Chinese President Xi Jinping.

In one Twitter messageMr. Moon said he and Mr. Biden affirm their countries’ “strong” alliance and their desire for a “peaceful and prosperous” Korean peninsula.

During their 14-minute phone call, Mr. Moon highlighted “Mr. Biden’s long experience in the affairs of state, his excellent leadership and his clear vision,” Mr. Moon’s spokesperson said. , Kang Min-seok. Mr Biden praised South Korea’s largely successful fight against the coronavirus, comparing it to the Trump administration’s handling of the pandemic.

The two leaders agreed to meet as soon as possible after Mr. Biden’s inauguration, Mr. Kang said.

Mr. Moon’s government hopes the Biden administration will restart stalled negotiations over North Korea’s nuclear weapons program and abandon Mr. Trump’s speech on reducing the presence of US troops in South Korea, which now has 28,500 soldiers.

“As President, I will stand with South Korea, strengthening our alliance to safeguard peace in East Asia and beyond, rather than extort Seoul with reckless threats to withdraw our troops.” Mr. Biden said in a column published by South Korean Yonhap. News agency a few days before the elections.

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The polls underestimated Trump – again. No one agrees on why.

As the results rolled in on Tuesday night, a strong sense of déjà vu followed suit. The pre-election polls, it seems, have once again been misleading.

As the country awaits final results from Pennsylvania, Arizona and other key states, it is already clear – no matter who ends up winning – that the industry has not fully considered the missteps that led her to underestimate Donald J. Trump’s support four years ago. . And it begs the question whether the polling industry, which has become a national fixture in the age of data journalism and statistical forecasting, can survive another crisis of confidence.

“I want to see all the results, I want to see where those deviations are from the pre-election polls and the final margins,” Christopher Borick, director of polls at Muhlenberg College in Pennsylvania, said in an interview. “But there is plenty of evidence that there were major problems again. How deep they are, we’ll see.

In some states where polls had projected President Trump to narrowly lose – such as Ohio, Iowa and Florida – he had already been declared the winner by a comfortable margin on Tuesday night. And in states that seemed more than likely to go for Joseph R. Biden Jr., like Michigan and Nevada, the outcome was too close to call last night.

To some extent, it was clear that this process would be complicated. With a large number of ballots in the mail and the first in-person votes still not counted, the early returns in most states gave an exaggerated impression of Mr. Trump’s strength, as voters in Republican areas turned out to be revealed in greater numbers on election day – and these ballots were often the first to be compiled.

It is also possible, said Patrick Murray, the poll director at Monmouth University, that Republicans’ efforts to prevent certain populations from voting easily had a huge impact – a factor pollsters knew would be immeasurable. in their surveys.

“We need to know how many votes were rejected,” he said. “I won’t know, until someone gives me some data, what happened. And we may never know.

He added: “We will never know how many ballots were not delivered in the mail.”

But what is now clear from the ballots that were counted (and in almost every state a majority was) is that there was an overestimation of support for Mr Biden. at all levels – especially with white voters and with men, preliminary exit polls indicate.

While polls had predicted a move away from Mr. Trump among white voters 65 and over, it never fully took shape.

Partly as a result, Mr. Biden underperformed not only in polyglot states like Florida, but also in heavily white suburban areas like Macomb County, Michigan, where he was widely expected of him.

Dr Borick pointed out that while state-level polls were largely unsuccessful in 2016, they held up midway through 2018. This led him to conclude that people’s views on Mr Trump might be particularly difficult to measure.

“Ultimately, like so many things related to Trump, there may be different rules when voting with him on the ballot,” Dr Borick said. “I am a quantifiable human type; I want to see evidence. And I only have two elections with Donald Trump – but both seem to behave in a way that others don’t.

Analyzing pre-election polls alongside exit polls is like comparing apples to apples – if one lot is rotten, the other probably is too. But exit polls may still provide some clues as to what the pre-election polls might have missed.

At the top of that list is Mr. Trump’s strength among college-educated white voters, especially men. According to exit polls, candidates evenly distributed white college graduates – after an election season in which nearly every major poll across the country and battlefield states showed Mr Biden length. ahead of white diploma holders.

And while there is a tendency for the polls to under-represent Mr. Trump’s support, it doesn’t just affect college-educated voters, as “Trump-shy” theorists have often suggested. Some studies had postulated that highly skilled Trump supporters might be more likely to say they preferred his opponent because of social pressure. In many high-quality pre-election telephone polls, support for Mr. Trump spilled over into the 1950s among uneducated white voters. But exit poll results firmly established his support for this group in the mid-1960s, at about the same level as his totals in 2016.

There is also no certainty as to the share of the electorate these voters represented. Pollsters questioned this question in the wake of 2016 and came to varying conclusions; This year’s results should revive this discussion.

Regarding the coronavirus pandemic, it should also be noted that, compared to most pre-election surveys, the exit polls showed a smaller proportion of respondents favoring caution over rapid reopening. As of Wednesday afternoon, with the latest expected data adjustments, there was only a nine percentage point split between voters saying it was more important to contain the virus and those saying they cared more to rush to rebuild the economy, according to exit polls. In pre-election polls, the split was generally well in the double digits, with a sizable majority of voters across the country saying they preferred caution and restraint.

It appears the virus was also less of a motivator for voters than many polls seemed to convey. This year, exit polls – conducted as usual by Edison Research on behalf of a consortium of news organizations – faced direct competition from a new probability-based election survey: VoteCast, collected via a panel in line assembled for the Associated Press by NORC a research group at the University of Chicago. Looking at the discrepancy between the numbers from the exit polls and the responses to the VoteCast survey, we can see that there were many more voters who saw the coronavirus as a major problem in their country. saw the people who said this was the issue they were voting on.

The VoteCast survey found that more than four in 10 voters said the pandemic was the No.1 problem the country faces when presented with a list of nine choices. But in exit polls, when asked which issue had the most impact on their vote decision, respondents were less than half as likely to say it was the pandemic. The economy was much more likely; behind it was the issue of racial inequality.

Not all pollsters got bad results. Ann Selzer, long regarded as one of the nation’s top pollsters, published a poll with the Des Moines Register days before the election showing Mr. Trump opening a seven-point lead in Iowa; this appears to be consistent with the actual result so far.

In an interview, Ms Selzer said that this election season, she has gone through her usual process of avoiding assuming that the one-year electorate will look like those in previous years. “Our method is designed so that our data tells us what is going on with the electorate,” she said. “There are some who will weight their data by taking into account a lot of things – the vote in the past elections, what the turnout was, things from the past in order to project themselves into the future. I’m calling this poll backwards, and I’m not doing it.

Inevitably, Robert Cahaly and his mysterious Trafalgar Group – which projected a number of close races on the battlefields – will also receive another look from curious commentators wondering why his polls were so close to accuracy, both in 2016. and this year.

The firm was among the only pollsters to show Mr Trump’s strength in the Midwest and Pennsylvania four years ago, and while its polls this fall may end up looking a little rosy, they appear to have come close to the final. horse racing ends up in states like Michigan, Wisconsin and Nevada than other pollsters, not neglecting Mr. Trump’s strengths.

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Divided nation agrees on one thing: a lot of people want a gun

CHANTILLY, Virginia – Like many Americans, two women thousands of miles apart are each concerned about the uncertain state of the nation. Their reasons are quite different. But they found common ground and a sense of certainty in a recent purchase: a gun.

Ann-Marie Saccurato traced her purchase to the night she was dining at a sidewalk restaurant not long ago in Delray Beach, Fla., When a Black Lives Matter walk took place and her mind started to wander.

It only takes one person to start a riot when emotions run high, she recalls thinking. What if the police are under control and cannot control the crowd?

Ashley Johnson, in Austin, Texas, is worried about footage she has seen in recent weeks of armed militias showing up at rallies and making plans to kidnap governors. The election result, she believes, will be devastating for some people, regardless of who wins.

“Maybe I’m just watching the news too much, but there are hints of civil war depending on who wins,” Ms. Johnson said. “It’s a lot to deal with.”

In America, spikes in gun purchases are often motivated by fear. But in recent years, that anxiety has focused on fears that politicians will pass tighter gun controls. Mass shootings often lead to more arms sales for this reason, as do elections for the Liberal Democrats.

Many gun buyers now say they’re driven by a new, destabilizing sense that drives even people who saw themselves as anti-guns to buy guns for the first time – and those who already have to buy them. buy more.

The country is on track in 2020 to store at record rates, according to groups tracking background checks from FBI data. Across the country, Americans bought 15.1 million firearms in the seven months of this year, from March to September, a 91% jump from the same period in 2019, according to estimates by Seasonally adjusted firearms sales from The Trace, a nonprofit news organization that focuses on firearms. problems. The FBI also processed more background checks for firearms purchases in the first nine months of 2020 than in any previous full year, according to FBI data.

FBI data shows sales increased earlier this year as virus fears spread. And big increases in sales are apparently happening everywhere: The states with the smallest increase in sales in September, for example, were Alaska and North Dakota, each up about a third from September 2019. 198% from September 2019 and in New Jersey, up 180%, according to The Trace estimates.

It is difficult to know exactly who is buying guns at any given time in America. Gun shop owners, gun rights groups and gun lobbies say they are now selling more guns than usual to black buyers, and women in particular, and more guns to new gun owners in general.

Keep up with Election 2020

“The year 2020 has been just one long publicity as to why someone might want to have a gun to defend themselves,” said Douglas Jefferson, vice president of the National African American Gun Association, which has experienced the largest increase in membership this year since the group was formed in 2015.

The influx of new guns into American homes is troubling at a time when many people are under incredible job stress and spikes in coronavirus cases, said Kris Brown, president of the Brady Center to Prevent Gun Violence and who noted that suicide and domestic violence is increasing.

On the issue of gun control, the division has long been partisan. Concealed carry laws, the ban on high capacity magazines, and allowing teachers to carry guns to school have separated many Republicans from Democrats. A 2017 Pew Research Center survey found that Republicans and Independents who lean Republican were more than twice as likely as Democrats and Independents who democratically lean to own a gun.

But when it comes to gun ownership, there is something uniquely American that transcends party membership and social boundaries – letting liberals and conservatives scramble for ammunition because they want to prepare for whatever is to follow.

“It’s a giant ‘you never know’ room,” said Bert Davis, watching people flocking to a Virginia convention hall to browse guns earlier this month at the Nation’s Gun Show, the one of the biggest events of its kind.

Mr. Davis was surrounded by tables displaying AR-15 semi-automatic rifles, Bunny-shaped brass knuckles, pistols engraved with American flags and President Trump’s face, booklets with headlines like “Be Prepared For Anything.”

A human resources worker for the city of Richmond, Virginia, Mr. Davis had come to the show with his sister Toni Jackson, who had struggled to find 9-millimeter ammunition in local gun stores; they were all sold.

At the show, glittering golden circles were on sale by the thousands.

“Everyone arms up against their neighbor,” Ms. Jackson said, looking at the many other buyers, strollers and wheelchairs, one in a Black Lives Matter mask, the other in a Keep America Great mask. and a line for background checks that meandered the length of the room. “It fuels the country’s separatism.”

Ms Jackson bought her first gun about three years ago, a small .380 caliber handgun, because her property management job required her to handle large sums of money. Recently, she made a down payment on a more powerful 9 millimeter pistol which she believes will provide better protection.

“What’s going on in the country right now, I’m afraid of being alone as a black woman,” Ms. Jackson said, describing the unrest in her town of Richmond and beyond. “There are a lot of people who are not necessarily happy that Confederate monuments have been demolished.”

Other buyers said they bought a gun because they feared calls to dispel police could be heard. Some said they were afraid of the police. Some were afraid that Joseph R. Biden Jr. would become president. Others feared four more years of President Trump.

Don Woodson oversaw the Trojan Arms and Tactical array of dozens of black, pink, and Tiffany Turquoise 9-millimeter semi-automatic pistols. He estimated that 70% of his sales at the show went to new gun owners, many of whom told him they were afraid of rioters.

“People who would never have had weapons before,” he said. “Now they are looking for safety.”

Two aisles down was Larry Burns, wearing a Keep America Great mask and a Trump 2020 t-shirt. He said he would take action if he saw protesters spiraling out of control.

“If they start hurting people, I’m going to hurt my back,” said Burns, who owns two shotguns. “I have lived my life. I will sacrifice myself for my grandchildren.

The uncertainty in the gun lounge aisles is what Charrie DeRosa hears at her private shooting range in Palm Beach County, Florida.

“Every person who walks in says I don’t know what’s going on in the world,” said Ms. DeRosa, who offers gun safety training. “People are just nervous and looking for some kind of security. “

It was a feeling that weighed heavily on Ms. Saccurato’s mind when she was having dinner and the Black Lives Matter walk passed.

She had seen reports of violence in towns as demonstrators gathered. She understood why people walked and thought George Floyd’s death was horrific. But the violence that followed, the damage, the rage against the police, she said, “was even more disgusting.” Ms Saccurato, 43, who trains athletes for a living, is white and has friends in law enforcement. They are good people, she said, and they don’t get the respect they deserve.

“They are placed in situations where they cannot handle things as effectively and efficiently as they want,” Ms. Saccurato said. “And if this happens to them, where does it put me?”

Watching the protesters that evening, she decided it was time to get a permit and buy a gun. His new weapon: a Sig Sauer p365-XL 9 millimeter pistol.

Ms Johnson didn’t grow up in a house with guns. About a year ago, she moved to Austin, which she saw as a bold step for someone who had never lived outside of her family in North Carolina.

In the spring, when the virus began to spread, she found herself alone in a relatively new town while everyone was in hiding with families. And as a buyer for a grocery store, she was at the end of the havoc all panic buying wreaked on the supply chain.

“I saw it firsthand,” she says.

After Mr Floyd was killed by police in May, Ms Johnson decided to take part in protests sweeping the country. The only march she attended this summer was in broad daylight, but she was anxious.

“I wholeheartedly understand wanting to protect your business,” she said of those condemning property damage during protests. “As a black man, am I like, a broken window against a life?”

Soon after, a friend invited her to a shooting range for a gun safety class. She was nervous holding a gun for the first time. Take control, the instructor told him. Don’t let anyone rush you. She fired. She came back to the beach several times.

Then she watched the first presidential debate and heard Mr. Trump refuse to disown white supremacists.

“I just thought if he lost this election something was going to happen and I just needed protection,” she said.

On a recent Sunday afternoon, between a grocery run to fill up her new crockpot and watch football on TV, Ms Johnson walked past the gun store and purchased a Ruger SR22 semi-automatic pistol.