Calif. city plans to provide transgender surgeries

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SAN FRANCISCO (AP) — San Francisco is preparing to become the first U.S. city to provide and cover the cost of sex reassignment surgeries for uninsured transgender residents.

The city's Health Commission voted Tuesday to create a comprehensive program for treating transgender people experiencing mental distress because of the mismatch between their bodies and their gender identities. San Francisco already provides transgender residents with hormones, counseling and routine health services, but has stopped short of offering surgical interventions, Public Health Director Barbara Garcia said Thursday after the vote was announced.

The idea for a new program that included surgeries came out of conversations between public health officials and transgender rights advocates who wanted mastectomies, genital reconstructions and other surgeries that are recommended for some transgender people covered under San Francisco's 5-year-old universal health care plan.

At the urging of the San Francisco Board of Supervisors and the San Francisco-based Transgender Law Center, the commission agreed this week to drop sex reassignment surgery from the list of procedures specifically excluded from the Healthy San Francisco plan.

But Garcia described the move as "a symbolic process" for now because the city currently does not have the expertise, capacity or protocols in place to provide the surgeries through its clinics and public hospital.

"The community felt the exclusion on Healthy San Francisco was discriminatory and we wanted to change that as the first step," she said.

Instead of expanding the existing plan, the Health Commission approved the establishment of a separate program that covers all aspects of transgender health, including gender transition. Garcia hopes to have it running by late next year, but said her department first needs to study how many people it would serve, how much it would cost, who would perform the surgeries and where they would be performed.

"Sex reassignment surgery is not the end all. It's one service that some transgender people want and some don't," she said. "We can probably manage this over the next three years without much of a budget increase because we already have these (other) services covered."

San Francisco in 2001 became the first city in the country to cover sex reassignment surgeries for government employees. Last year, Portland, Ore. did the same. The number of major U.S. companies covering the cost of gender reassignment surgery for transgender workers also doubled last year, reflecting a decades-long push by transgender activists to get insurance companies to treat such surgeries as medically necessary instead of elective procedures.

Kathryn Steuerman, a member of a transgender health advocacy group in San Francisco, said the city's latest move would help residents avoid going into debt to finance operations related to gender transition, as she did.

"I am filled with hope and gratitude that we are achieving this level of support for the well-being of the transgender community," Steuerman said.

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How did America become so polarized?

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WASHINGTON (AP) — The election laid bare a dual — and dueling — nation, politically speaking, jaggedly split down the middle on the presidency and torn over much else. It seems you can please only half of the people nearly all of the time.

Americans retained the fractious balance of power in re-electing President Barack Obama, a Republican House and a Democratic Senate, altogether serving as guarantors of the gridlock that voters say they despise. Slender percentages separated winner and loser from battleground to battleground, and people in exit polls said yea and nay in roughly equal measure to some of the big issues of the day.

Democracy doesn't care if you win big, only that you win. Tuesday was a day of decision as firmly as if Obama had run away with the race. Democrats are ebullient and, after a campaign notable for its raw smackdowns, words of conciliation are coming from leaders on both sides, starting with the plea from defeated Republican rival Mitt Romney that his crestfallen supporters pray for the president.

But after the most ideologically polarized election in years, Obama's assertion Wednesday morning that America is "more than a collection of red states and blue states" was more of an aspiration than a snapshot of where the country stands.

"It's going to take a while for this thing to heal," said Ron Bella, 59, a Cincinnati lawyer who lives in Alexandria, Ky. He is relieved Obama won, but some of his co-workers are in a "sour mood" about it.

"They feel like the vast majority of the country wanted Romney, and the East and the West coasts wanted Obama," he said. "I'm not sure exactly why that is, but there just seems to be such hatred for Obama out there."

Compromise was a popular notion in the hours after Obama's victory and an unavoidable one, given the reality of divided government. But the familiar contours of partisan Washington were also in evidence, especially the notion that compromise means you do things my way.

As Democratic Rep. Steve Israel of New York put it, "If you refuse to compromise, we are going to beat you." Israel, chairman of the Democratic Congressional Campaign Committee, said the election showed "if you are an extremist tea party Republican, you are going to lose."

Senate Republican Leader Mitch McConnell of Kentucky said pointedly that Republicans will meet Obama halfway "to the extent he wants to move to the political center" and propose solutions "that actually have a chance of passing."

In New York's bustling Times Square, hope, skepticism and the usual polarities were all to be found when people talked about the president. "He may not have done a great job in my mind but I kinda trust him," said Jerry Shul. "I have faith he will get with the Republicans and get something done."

A less-flattering George Dallemand called this "a moment of truth" for the country. "I guess we have to wish for the best now, but I still think he is socialism."

In Miami, Karen Fitzgerald, 55, wore a black dress and said she was in mourning over Romney's defeat.

"It's an upsetting day," she said. But she took some comfort from her Democratic friends on Facebook, who have stopped chiding the other side in their posts. "Now they're all saying we need to work together and be united," she said. "Maybe we can."

In Springfield, Ohio, an "elated" Frank Hocker, 67, hoped Republicans would get the message to get out of Obama's way. "There was a backlash," he said. "For this obstructionist House and those tea party people, I hope they learned their lesson. I hope they learned their lesson: Don't stop the progress of this country."

In Chicago, Obama supporter Scherita Parrish, 56, predicted the president will reach out to Republicans but may not get much back.

"But the people have spoken," she said. "They need to lick their wounds, get on with it and start working with the president."

Unity is a challenge not just for Obama but for the Republicans, who won less than 30 percent of the growing Hispanic vote and not even one in 10 black voters. Obama built a strong Electoral College majority, if only a narrow advantage in the popular vote, despite losing every age group of non-Hispanic white voters.

Surveys of voters found Obama's health care law to be as divisive as ever, with just under 50 percent wanting it repealed in whole or part, and 44 percent liking it as is or wanting more of it.

But democracy doesn't care about exit polls, either, and the election almost certainly means Republicans can forget about trying to roll it back now.

In reaffirming divided government, though, Americans all but ensured colossal fights are ahead over the shape of government and Obama's agenda. He is out to break a wall of Republican opposition to tax increases on the wealthy — a move that about half the voters in exit polls thought was a good idea. And extraordinarily difficult negotiations are imminent as the president and Congress try to make a deal to avoid the "fiscal cliff" — steep spending cuts and a variety of tax increases in January.

In the end, voters split about equally on whether Obama or Romney would be better at handling the economy.

Then again, they were divided down the middle on whether Obama or his predecessor, George W. Bush, deserves most of the blame for the economy's problems.

So it goes in the 50-50 nation, give or take.

___

Associated Press writers Christine Armario in Miami, Michael Tarm in Chicago, David Martin in New York, Amanda Myers in Cincinnati and Ann Sanner in Columbus, Ohio, contributed to this report.

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Apple slides to five-month low, uncertainty grows

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Read More..

Apple slides to five-month low, uncertainty grows

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Rihanna a rock star on Victoria's Secret catwalk

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NEW YORK (AP) — Rihanna rocked the lingerie look at Wednesday night's Victoria's Secret fashion show in New York, providing the highlight of the live-music soundtrack and holding her own on the catwalk with some of the world's top models.

And those models even had props, including Adriana Lima's ringmaster wand, Doutzen Kroes' body cage and several pairs of the oversized wings that the retailer has made its signature. It would be a close contest who got the biggest wings: Toni Garrn's giant poppy pair or Miranda Kerr's swan-style feathered pouf. Only Lily Aldridge could boast star-spangled wings that shot out silver sparkles.

Alessandra Ambrosio's orchid-petal wings might have lacked a little grandeur, but she made up for it with a $2.5 million jeweled "floral fantasy bra."

Still, wearing a sheer pink mini that gave glimpses of her bra, Rihanna sang "Fresh Out the Runway" at the end of the corset-and-garter parade and she was the one to grab the audience's biggest applause.

The fashion show has become a pre-holiday season tradition for the retailer. CBS will turn it into a one-hour special, which also had performances from Justin Bieber and Bruno Mars, to be shown on Dec. 4.

This year's event had a slight twist. It started with an announcer noting that Victoria's Secret and CBS had each made a donation to relief efforts for Superstorm Sandy, and a thank you to the National Guard members who are based out of the Lexington Avenue Armory that has for years been home to the show.

Mostly, though, models are encouraged to smile, ham it up and show off the extra time at the gym that most admit to in the weeks beforehand. "It's highly televised, and you take that into consideration," said model Joan Smalls ahead of the show. "This is kind of not the same as other runways. You have to prepare your body: No. 1 is the wings are heavy, and No. 2 is you have to be comfortable with your body because the camera will pick up on it if you're not comfortable and confident."

There's an emphasis on glitz, skin and dramatic production here, not wearable undergarment trends for typical Victoria's Secret shoppers. It was divided into six sections: Circus, complete with acrobats, contortionists and a sword eater; Dangerous Liaisons; Pink Is Us; Silver Screen Angels; Angels in Bloom; and Calendar Girls, which allowed Bruno Mars to serenade a model for each month of the year.

For his first song, "Beauty and the Beat," Bieber, wearing low-slung white pants and a white leather studded vest, sat alone with his guitarist in the mellowest part of the show. For "As Long As You Love Me," however, he brought in backup dancers and interacted with the models while moving around a giant makeshift pinball machine.

"It's like a dream come true," said Bieber on the pink carpet before the show. "I would rather be here than anywhere in the world."

___

AP reporter John Carucci contributed to this report.

___

Samantha Critchell tweets fashion at http://www.twitter.com/AP_Fashion

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Experts raise concerns over superhuman workplace

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LONDON (AP) — Performance-boosting drugs, powered prostheses and wearable computers are coming to an office near you — but experts warned in a new report Wednesday that too little thought has been given to the implications of a superhuman workplace.

Academics from Britain's leading institutions say attention needs to be focused on the consequences of technology which may one day allow — or compel — humans to work better, longer and harder. Here's their list of upgrades that might make their way to campuses and cubicles in the next decade:

BRAIN BOOSTERS

Barbara Sahakian, a Cambridge neuropsychology professor, cited research suggesting that 16 percent of U.S. students already use "cognitive enhancers" such as Ritalin to help them handle their course loads. Pilots have long used amphetamines to stay alert. And at least one study has suggested that the drug modafinil could help reduce the number of accidents experienced by shift workers.

But bioethicist Jackie Leach Scully of northern England's Newcastle University worries that the use of such drugs might focus on worker productivity over personal well-being.

"Being more alert for longer doesn't mean that you'll be less stressed by the job," she said. "It means that you'll be exposed to that stress for longer and be more awake while doing it."

WEARABLE COMPUTERS

The researchers also noted so-called "life-logging" devices like Nike Inc.'s distance-tracking shoes or wearable computers such as the eyeglasses being developed by Google Inc. The shoes can record your every step; the eyeglasses everything you see. Nigel Shadbolt, an expert in artificial Intelligence at southern England's University of Southampton, said such devices were as little as 15 years away from being able to record every sight, noise and movement over an entire human life.

So do you accept if your boss gives you one?

"What does that mean for employee accountability?" Shadbolt asked.

BIONIC LIMBS — AND BEYOND

The report also noted bionic limbs like the one used this week by amputee Zac Vawter to climb Chicago's Willis Tower or exoskeletons like the one used earlier this year by partially paralyzed London Marathon participant Claire Lomas. It also touched on the development of therapies aimed at sharpening eyesight or cochlear implants meant to enhance hearing.

Scully said any technology that could help disabled people re-enter the workforce should be welcomed but society needs to keep an eye out for unintended consequences.

"One of the things that we know about technology hitting society is that most of the consequences were not predicted ahead of time and a lot of things that we worry about ahead of time turn out not to be problems at all," she said. "We have very little idea of how these technologies will pan out."

THE PRESSURIZED WORKPLACE

The report was drawn up by scientists from The Academy of Medical Sciences, the British Academy, the Royal Academy of Engineering and the Royal Society.

"We're not talking science fiction here," said Genevra Richardson, the King's College law professor who oversaw the report. "These technologies could influence our ability to learn or perform tasks, they could influence our motivation, they could enable us to work in more extreme conditions or in old age, or they could facilitate our return to work after illness or disability .... Their use at work also raises serious ethical, political and economic questions."

Scully said workers may come under pressure to try a new memory-boosting drug or buy the latest wearable computer.

"In the context of a highly pressurized work environment, how free is the choice not to adopt such technologies?" she said.

Union representatives appeared taken aback by some of the experts' predictions. One expressed particular disquiet at the possibility raised by the report that long-distance truck drivers might be asked to take alertness drugs for safety reasons.

"We would be very, very against anything like that," said James Bower, a spokesman for Britain's United Road Transport Union. "We can't have a situation where a driver is told by his boss that he needs to put something in his body."

___

Online:

The report: http://royalsociety.org/policy/projects/human-enhancement

Raphael Satter can be reached on: http://raphae.li/twitter

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Four more years for Obama

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Supporters cheer after networks project an Obama victory. (Chip Somodevilla/Getty Images)


President Barack Obama handily defeated Gov. Mitt Romney and won himself a second term Tuesday after a bitter and historically expensive race that was primarily fought in just a handful of battleground states. Obama beat Romney after nabbing almost every one of the 12 crucial battleground states.


In a sweeping victory speech early Wednesday morning, Obama thanked every American who voted, and said he plans to work with leaders from both parties in the next four years to tackle looming challenges.


"Our economy is recovering, a decade of war is ending, a long campaign is now over," he told a crowd of cheering supporters in Chicago. "And whether I earned your vote or not, I have listened to you, I have learned from you and you have made me a better president." Obama added he has "never been more hopeful about America" as he returns to the White House.


Romney conceded in Boston in an earlier speech around 1:00 AM ET. "Like so many of you, Paul [Ryan] and I have left everything on the field. We have given our all to this campaign," Romney said. "I so wish that I had been able to fulfill your hopes to lead your ocuntry in another direction. But the nation chose another leader." Romney congratulated the president and his campaign on their victory.


The Romney campaign's last-ditch attempt to put blue-leaning Midwestern swing states in play failed as Obama's Midwestern firewall sent the president back to the White House for four more years. Obama picked up the swing states of New Hampshire, Michigan, New Mexico, Iowa, Virginia, Wisconsin, Colorado, Nevada, Pennsylvania, Minnesota, and Ohio. Of the swing states, Romney only picked up North Carolina. Florida is still too close to call, but even if Romney won the state, Obama still handily beats him in the Electoral College vote. The popular vote will most likely be much narrower than the president's decisive Electoral College victory.


The Obama victory marks an end to a years-long campaign that saw historic advertisement spending levels, countless rallies and speeches, and three much-watched debates.


The Romney campaign cast the election as a referendum on Obama's economic policies, frequently comparing him to former President Jimmy Carter and asking voters the Reagan-esque question of whether they are better off than they were four years ago. But the Obama campaign pushed back on the referendum framing, blanketing key states such as Ohio early on with ads painting him as a multimillionaire more concerned with profits than people. The Obama campaign also aggressively attacked Romney on reproductive rights issues, tying Romney to a handful of Republican candidates who made controversial comments about rape and abortion.


These ads were one reason Romney faced a steep likeability problem for most of the race, until his expert performance at the first presidential debate in Denver in October. After that debate, and a near universal panning of Obama's performance, Romney caught up with Obama in national polls, and almost closed his favoribility gap with the president. In polls, voters consistently gave him an edge over Obama on who would handle the economy better and create more jobs, even as they rated Obama higher on caring about the middle class.


But the president's Midwestern firewall--and the campaign's impressive grassroots operation--carried him through. Ohio tends to vote a bit more Republican than the nation as a whole, but Obama was able to stave off that trend and hold an edge there over Romney, perhaps due to the president's support of the auto bailout three years ago. Romney and his running mate Paul Ryan all but moved to Ohio in the last weeks of the campaign, trying and ultimately failing to erase Obama's lead there.


A shrinking electoral battleground this year meant that only 14 states were really seen as in play, and both candidates spent most of their time and money there. Though national polls showed the two candidates in a dead heat, Obama consistently held a lead in the states that mattered. That, and his campaign's much-touted get out the vote efforts and overall ground game, may be what pushed Obama over the finish line.


Now, Obama heads back to office facing what will most likely be bitterly partisan negotiations over whether the Bush tax cuts should expire. The House will still be majority Republican, with Democrats maintaining their majority in the Senate.


The loss may provoke some soul searching in the Republican Party. This election was seen as a prime opportunity to unseat Obama, as polls showed Americans were unhappy with a sluggish economy, sky-high unemployment, and a health care reform bill that remained widely unpopular. Romney took hardline positions on immigration, federal spending, and taxes during the long Republican primary when he faced multiple challenges from the right. He later shifted to the center in tone on many of those issues, but it's possible the primary painted him into a too-conservative corner to appeal to moderates during the general election. The candidate also at times seemed unable to effectively counter Democratic attacks on his business experience and personal wealth.
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Exclusive - Amazon to win EU e-book pricing tussle with Apple

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Exclusive - Amazon to win EU e-book pricing tussle with Apple

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The Civil Wars cancel tour using divorce language

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NASHVILLE, Tenn. (AP) — Grammy-winning duo The Civil Wars have canceled their upcoming tour dates, citing irreconcilable differences.

The folk-pop duo Joy Williams and John Paul White released a statement Tuesday announcing that because of "internal discord and irreconcilable differences of ambition" they were unable to "continue as a touring entity at this time."

Although they used the language of divorce, the duo added, "Our sincere hope is to have new music for you in 2013."

Williams and White are both married, but to other people. Williams had a baby this summer with husband Nate Yetton, the duo's manager.

Earlier this year the pair canceled part of their European tour.

The duo found unexpected success with their 2011 debut album, "Barton Hollow." With backgrounds in gospel and rock, they met when they were both asked to contribute to a country project and found chemistry.

Back then, the pair framed their partnership in terms of courting. White told The Associated Press that after two songwriting sessions, "I finally got up the nerve to ask her out, as it were."

"In a musical way," Williams said.

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