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America Is Too Glib About Breast Implants

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If you’ve commuted in an American city in the past decade, you’ve probably seen some kind of cheeky ad for affordable, accessible breast implants. A young woman comparing tangerines to grapefruits has greeted subway riders in New York City for the past several years. A giant close-up of cleavage promising “a gift you can both enjoy” loomed over streets in one Utah town in 2007. Almost a decade later, a California billboard reminded women that size matters.

Boob jobs have been ubiquitous in American popular culture since the 1980s, when laws changed to allow plastic surgeons to advertise and credit cards became widely available. But safety concerns have dogged the procedure since the first silicone breast enhancements were successfully implanted by Texas surgeons in 1962. In that time, the Food and Drug Administration has banned the use of silicone implants and then reinstated them on the condition that the industry closely monitor their impacts on patients.

Now, both silicone implants and the more popular, saline-filled alternative have found themselves under the agency’s lens again, this time over their potential links to a rare cancer and claims from patients that they cause pain, chronic fatigue, and autoimmune problems. On Tuesday, an FDA advisory committee completed two days of hearings on breast implants’ links to long-term complications, a forum which women’s-advocacy groups have been demanding for years. The meetings concluded with the panel recommending the FDA require manufacturers to provide simpler and clearer health warnings to all patients, but stopped short of encouraging a ban on any particular type of implants.

Decades of research suggests that breast augmentation is safe when performed and maintained as recommended. But the tens of thousands of women who attribute their health problems to their breast implants still suggest that there can be significant problems with how the procedure is recommended, performed, and maintained. No matter how the FDA moves forward, at least part of the problem faced by patients is the glib culture that can downplay the procedure’s seriousness.

Breast augmentation is the most popular cosmetic surgical procedure in America. In 2018, it was performed more than 300,000 times, according to a recent report from the American Society of Plastic Surgeons. That’s a 4 percent jump over the previous year, and part of a larger trend in plastic surgery in the U.S.: As minimally invasive facial injectables like Botox and Juvederm gain popularity, consumers are starting to move away from facial surgeries, which have traditionally been most popular, and toward bodily modifications like liposuction, butt lifts, and tummy tucks, in addition to breast augmentation.

But as Alan Matarasso, the president of the American Society of Plastic Surgeons, points out, there’s a fundamental difference between breast augmentation and other popular procedures. “Many of the most popular surgical procedures involve taking something out—a bump in the nose or some fat,” he says. “[Breast augmentation] has the same issues of having an operation, but with the limitations of a device.”

Augmentations are frequently performed on very young women, and those patients are likely to need additional procedures to maintain their health. “I tell young implant patients who are coming in for augmentation, this will not be the last surgery they have on their breasts,” says Jason Spector, a professor and plastic surgeon at Weill Cornell Medical Center in New York City. Modern implants can require replacement less than 10 years after a patient’s initial surgery. The FDA recommends that patients have follow-ups with their doctors and MRI surveillance throughout the life of the implant, something which Spector says not all doctors insist on and not all patients adhere to.

Given how casually breast augmentation is often talked about and advertised, it can seem like skipping the lifetime of follow-up is no big deal. But patients can suffer from the less-than-serious cultural attitude toward cosmetic modifications—and unscrupulous doctors can benefit. “Not everybody putting breast implants in across the country is a board-certified plastic surgeon,” says Spector. “You have variation in state laws, and if you’re doing things in your own office, all you need is a medical license.” Untrained surgeons performing cosmetic procedures in high-volume, low-cost settings can have deadly results: In February, USA Today published an investigation into a group of Miami clinics where eight women had died from surgical complications. (The owner of the clinics has denied any wrongdoing.)

Although the surgeons I spoke to said it’s likely that many patients’ breast-augmentation complications are the result of errors in their treatment, they were also clear that even a flawlessly performed augmentation carries risks. In some people, an implant can become encapsulated in scar tissue, causing pain and deformity. Recent evidence suggests that the rare cancer Anaplastic large cell lymphoma, or ALCL, is more common in patients who have had textured-surface breast implants. In a controversial 2018 study, researchers also found a link between several cancers and autoimmune diseases and silicone implants, but the study did not go so far as to demonstrate the implants were the cause of those health concerns.

In spite of the risks carried by the implantation of any kind of medical device, the benefits can win out, even for a procedure that is often dismissed as frivolous. According to Matarasso, around a quarter of all breast-implant surgeries are done in patients who have had mastectomies, which have become a popular preventive measure against breast cancer in recent years for those in high-risk populations. Breast implants can also be an important element of gender confirmation for trans women.

Even when women choose breast implants for purely aesthetic reasons, it’s expensive and invasive. There’s little reason to trivialize it, and yet there’s a constant cultural encouragement to see it as no big deal. This dismissiveness gives license to some practitioners to characterize a medical device as a fun, sexy purchase your hubby will love instead of a serious lifetime commitment to an invasive procedure that will permanently alter your body. A lot of different women get implants for a lot of different reasons, and none of them are served particularly well by a babe on a billboard.

Afternoon round-up: Today’s oral argument in partisan gerrymandering cases

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Today the Supreme Court heard oral argument in two cases, Lamone v. Benisek and Rucho v. Common Cause, which challenge the constitutionality of election maps in Maryland and North Carolina, respectively. The justices are being asked whether the states went too far in favoring one political party over the other when drawing their election maps. Amy Howe has this blog’s analysis, which was first published at Howe on the Court. She writes that after two hours of argument, “there were clear divides among some of the justices, but it was much less clear how the court is likely to rule.”

Additional early coverage comes from Richard Wolf of USA Today, Bill Mears of Fox News, Andrew Chung and Lawrence Hurley of Reuters, Greg Stohr and Kimberly Robinson of Bloomberg; Adam Liptak of the New York Times; Melissa Quinn for The Washington Examiner, Mark Sherman of the Associated Press; David Savage of The Los Angeles Times; and Robert Barnes of The Washington Post, while more coverage from The Post comes from Jennifer Barrios, who wrote about Governor Larry Hogan (R-Md.) and former Governor Arnold Schwarzenegger (R-Calif.) advocating against gerrymandering outside the court.

Early commentary comes from Rick Hasen for the Election Law Blog, Bill Blum for The Progressive, Ari Berman for Mother Jones, Mark Joseph Stern for Slate; and Ruthann Robson for the Constitutional Law Prof Blog.

The post Afternoon round-up: Today’s oral argument in partisan gerrymandering cases appeared first on SCOTUSblog.

The Original Sin of NASA Spacesuits

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The crew of the International Space Station spends most of their time inside, but sometimes they venture out. Astronauts have conducted more than 200 spacewalks in the last two decades, often to spruce up the station, and on the next one, two astronauts are scheduled to replace some old solar panel batteries. It was going to be a historic excursion: For the first time in history, both of the spacewalkers would be women.

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That was the plan. But on Monday, just days before Anne McClain and Christina Koch were supposed to float outside, NASA announced that McClain has been replaced with a male astronaut, Nick Hague. According to the space agency, the ISS doesn’t have enough spacesuits on board that would fit both women.

At first glance, this seems like a massive oversight. Shouldn’t NASA have figured out which size spacesuit their astronauts needed before they launched, and had appropriate gear waiting for them on the ISS? And how is it that the world’s premier space agency can dress two men for spacewalks without issue, as it did several times last year, but not two women?

To answer these questions, it helps to start at the beginning. Not the Big Bang—we’ll save that for another day—but the 1960s, when NASA first started launching astronauts to space.

Read: [5,200 days in space]

Back then, women weren’t wearing spacesuits, they were making them. The Apollo spacesuits were manufactured by the International Latex Corporation, the maker of Playtex bras and girdles. Seamstresses went from sewing undergarments to stitching together thin layers of high-tech fabric on their noisy Singer sewing machines. The spacesuits were custom-made for individual astronauts, all of whom were men.

After astronauts planted the American flag on the moon, NASA turned its focus toward the next phase in space travel, the Space Shuttle program. The shuttles were designed for a future of frequent flights to and from the space above Earth, with more astronauts than ever before.

Tailoring custom spacesuits for so many passengers would be too expensive and time-consuming. So in the 1970s, NASA took a Mr. Potato Head approach and developed pieces for arms, legs, and torsos that astronauts could mix and match. The spacewalking suit—known as extravehicular mobility units, or EMUs—came in five sizes: extra small, small, medium, large, and extra large.

When NASA started accepting women into its astronaut program in 1978, spacesuit engineers thought outfitting the new space travelers would be simple. “Some groups initially assumed that women could fit in the same sizes as small men—or at worst, that some of the men’s sizes would have to be scaled down proportionately to fit women,” Elizabeth Benson, a NASA design engineer, wrote in a 2009 paper on sizing considerations in spacesuit design.

This approach doesn’t account for differences in body shape of men and women. “For the same height and weight, women can have significantly wider hips and narrower shoulders than men,” Benson wrote. “If, for example, a one-piece coverall designed for a man is meant to fit at the shoulders and the hips, then one of these fit areas is likely to be compromised for a woman.”

Extra room can actually make spacewalks more difficult. “As a woman, doing spacewalks is more challenging mostly because the suits are sized bigger than the average female,” Peggy Whitson, a NASA astronaut who helped build the ISS and holds the American record for time spent in space, said in a recent documentary interview. And Whitson would know: she also holds the record for the most spacewalks for a female astronaut, 10.

In the 1990s, several years after the first American women flew to space, budget cuts forced NASA to trim its spacesuit program. Extra small was the first to go, and small followed soon after. Most astronauts fit into the mediums and larges, but not all.

“People my size are in fourth grade. Literally, I mean, some fourth graders are bigger than me,” Nancy Currie, a NASA astronaut who is five feet tall, told NPR in a 2006 interview back then.

Read: [Spacesuits for spiders]

The limited sizing affected some astronaut duties. While it didn’t impact Space Shuttle crew assignments, since crew members who didn’t spacewalk, like Currie, could do research or run the robotic arm, “it did impact assignments on the ISS where all crew members—Russian and U.S.—had to be able to conduct [spacewalks],” says Bonnie Dunbar, a former NASA astronaut who flew on the shuttle five times, and an aerospace engineering professor at Texas A&M University, where she runs a spacesuit-design lab.

The restrictions piled up after the Space Shuttles program ended in 2011, and the ISS became the only destination for astronauts. NASA was forced to judge prospective astronauts not only by their qualifications and experience, but their size, too. “Applicants had to be bigger to be selected,” Dunbar says. (The agency faced a similar situation in the 1960s, with the opposite problem: the first space capsules, tiny and cramped, required astronauts to be no taller than 5 feet 11 inches.)

Today, astronauts still use the same 40-year-old spacesuits; NASA hasn’t made any new ones since these were designed. Several have been lost over the years, including in the Challenger and Columbia disasters, and in a SpaceX cargo mission that exploded in 2015.

“We have to make do with what we have,” Dunbar says.

So what do we have, specifically on the ISS?

The station currently has six people on board. Their spacesuit wardrobe contains six spacesuit torsos, two each in medium, large, and extra large. But only some are ready for spacewalks; one medium and one extra large are spares, and require hours of work to prep for use, according to NASA spokesperson Brandi Dean. McClain trained on the ground in both the medium and large, but she wore the medium torso on a spacewalk with Hague last week. When she came back inside, she told mission control that the medium fit her better—the same size that her fellow female astronaut, Koch, planned to use.

“We do our best to anticipate the spacesuit sizes that each astronaut will need, based on the spacesuit size they wore in training on the ground, and in some cases—including Anne’s—astronauts train in multiple sizes,” Dean says. “However, individuals’ sizing needs may change when they are on orbit, in response to the changes living in microgravity can bring about in a body. In addition, no one training environment can fully simulate performing a spacewalk in microgravity, and an individual may find that their sizing preferences change in space.”

Instead of adapting the spare, NASA decided to change the spacewalk lineup. Koch will wear the medium torso on Friday’s spacewalk, and McClain will wear it again on another spacewalk, scheduled for early April.

Read:[ A brief history of fashion in outer space]

The space agency is long overdue for new spacesuits, but it has hesitated, thanks to budgetary restrictions and changing policies. Medium or large, the garments “have far outlasted their original 15-year design life,” according to a 2017 report from NASA’s inspector general. In the last decade, NASA has spent nearly $200 million on spacesuit development for future missions, including to Mars, but “the agency remains years away from having a flight-ready spacesuit capable of replacing the EMU or suitable for use on future exploration missions,” the report found.

Some of the stagnation stems from uncertainty over where NASA will send future astronauts. The moon and Mars are different worlds, with their own environmental conditions, and require different spacesuit designs to keep humans healthy and alive. And it doesn’t help that the preferred destination seems to change with each new presidential administration. “The lack of a formal plan and specific destinations for future missions has complicated spacesuit development,” the inspector general said.

NASA today is far more accommodating for female astronauts than it once was, and the agency employs more of them than before. Consider the 1980s, when engineers sheepishly asked Sally Ride whether 100 tampons were enough for her seven-day mission to orbit. But the spacesuits they wear today are a relic of that time, built with other bodies in mind. Yes, NASA has to work with what it has, but in 2019, it employs female astronauts and should anticipate more. It doesn’t seem too much to ask to have enough spacesuits to fit them, too.

The Banality of the Modern Hipster

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A young man caught my eye recently when he walked into a trendy café in Austin. It wasn’t his curling mustache but the fact that he was walking barefoot. This struck me as an odd choice given that it was overcast and drizzly outside. But I restrained my staid judgmental Britishness—this is America, after all, the land of the free, the home of the brave. I told myself to respect the local culture.

But my eye was once again caught when he joined a female companion at a table, also in her mid to late 20s, who proceeded to place her feet up against the wall at a ludicrous height. Not only did it look painful, it seemed like total posturing; as with the bare feet, what rationale did it serve—what did it all mean?

All I knew was that I was in the presence of hipsters, typically defined as those who follow the latest trends and fashions, especially ones regarded as being outside the cultural mainstream.

Americans of all hues today show a great need to emphasize tribal positions amid society’s ongoing polarization. Hence a Republican tries to be really Republican, a liberal tries to be really liberal, an evangelical tries to be really evangelical—a hipster tries to be really hipster.

But hipsters are going much further—the mustaches, beards, tattoos, going barefoot, and all the rest—to attain what they think to be their namesake while also betraying its original meaning.

In his 1957 essay “The White Negro: Superficial Reflections on the Hipster,” Norman Mailer defined the hipster as “a philosophical psychopath.” In a 2011 article about the essay for the Mailer Review, Tracy Dahlby, a professor and the Frank A. Bennack Jr. Chair in Journalism at the University of Texas at Austin, defined this individual as the quintessential American existentialist whose role was to assault society’s fear-soaked conformity by rejecting what Mailer had called “that domain of experience where security is boredom and therefore sickness.”

That sounds like my kind of hipster, exemplifying the sort of edginess to the American endeavor that had me daydreaming as a school boy on the other side of the Atlantic about what I perceived as a fabled land of rebels and nonconformity. Non-hipsters like me, representing most of the population in any country, need such individuals to wake us from our lethargy.

So what happened to Mailer’s hipster ideal? By the time I attended journalism graduate school at the University of Texas at Austin in 2010—leading to my encounter with Professor Dahlby and his enlightening ruminations on what a hipster should entail and once did—present-day hipster incarnations were already the butt of jokes among classmates and on the likes of the TV show Portlandia. But that doesn’t seem to have put off wannabe hipsters.

Perhaps that’s not surprising. Whereas the hipsters of the 1950s had to make sacrifices and uneconomic choices to live bohemian lives, now you can have a well-paid technology job, a wonderful apartment, and keep family and friends proud all while maintaining your avant-garde hipster role.

To which you could reply, where’s the harm in that? “Live your best life”—that phrase is doing the rounds these days, and while it’s uplifting on the surface, it contains many of the same problematic elements as today’s hipster lifestyle. These include the cult of self-entitlement and self-expression over all else—especially any notion of civic compromise within the public sphere. This increasingly exerts itself as today’s rightful creed.

There’s also the harm in the conceptual confusion of equating posturing with meaningful substance, and of not realizing that such feigned efforts at rebellion actually conform to a soulless orthodoxy driven by economic imperatives and media hype.

Hipsters, like many Americans, have confused the plethora of consumer-oriented diversions and incessant internet interactions with living a wholesome life.

The result has been far from wholesome, which is why I worry for the likes of Austin. Let me make clear that I have great affection for that city and its people. Graduate school there was an enormous privilege, the place where I started to put myself back together after a personal failure of a military tour in Afghanistan that affected my decision to leave the army. The city will always have a special place in my heart.

But over the past few years, Austin has become increasingly afflicted by all things hip and dreadful. Blockhouses of condos metastasize everywhere, prices are driven up by the influx of astronomically remunerated technological jobs, and old characterful stores and family-run restaurants are closing in the face of gentrification.

Downtown Austin increasingly resembles some sort of white utopian dream, full of lots of cool people all looking very pleased with themselves and their salaries and what they can buy. But there’s a thin line between utopia and dystopia when you get right into it.

So much of the narrative that underpins how we function is centered on winning, acquiring, showing off. And it’s not good for us as we become, in the cautioning words of Hunter S. Thompson, “slaves to some bogus sense of Progress that is driving us all mad.”

In a withering takedown of the American status system in his 1983 book Class, writer Paul Fussell concluded that all is not lost. There still exists a category of citizen, like Mailer’s hipster, who is free “from the constraints and anxieties of the whole class racket…[and] can enjoy something like the LIBERTY promised on the coinage.”

Fussell illustrates the characteristics of this category of citizen by quoting the venerable English novelist E.M. Forster, who describes such non-conformists as the “aristocracy of the sensitive, the considerate, and the plucky,” those who are “sensitive for others as well as themselves, considerate without being fussy.” Forster also notes that “they can take a joke,” a fact of particular significance today, given the turgid rigidness and sour-faced insistence that passes for progressive liberalism.

Modern hipsters too often can’t take a joke because they are the joke, channeling so much energy and time from a fleeting human lifespan into such vain—literally—pursuits. My advice to today’s hipsters: strive to match Mailer’s “philosophical psychopaths”— needed more than ever—but remember G.K. Chesterton’s lesson about how “two opposite passions may blaze beside each other.”

Hence, while cutting a swath through society’s conformity, also remember the words of the ancient Jewish philosopher Philo Alexandria: “Be kind. Everyone you meet is fighting a terrible battle.”

So show respect to old people, remembering what they are nearing with each passing day; offer help to or at least smile at strangers, ask their names, show that you noticed them. Maybe even offer a prayer. It doesn’t have to be to God—though perhaps there’s something to the fact that He has been a popular option for a while—it could be to the universe’s uber-soul, the shared human tragi-comedy, whatever you want it to be, so long as you acknowledge mysteries bigger and more beguiling than yourself. No one is so cool that they are above all that.

Admittedly, none of that is particularly rebellious. But these days such behavior seems far hipper and more radical than most of the “edginess” on display. And please, keep your feet off the wall.

James Jeffrey is a freelance journalist who splits his time between the Horn of Africa, the U.S., and the UK, and writes for various international media. Follow him on Twitter @jrfjeffrey.

Betsy DeVos wants to gut funding for the Special Olympics

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Education secretary Betsy DeVos would like to do America’s children a favor: gut the beloved Special Olympics program, and invest a couple million in charter schools.

“We are not doing our children any favors when we borrow from their future in order to invest in systems and policies that are not yielding better results,” DeVos said in prepared remarks to Congress discussing the Department of Education’s budget proposal, filed by President Trump earlier this year.

The proposal would eliminate the nearly $18 million previously allocated for the Special Olympics, and allocate an additional $60 million to charter school funding, according to the Detroit Free Press. Overall, her department would lose 10 percent of its budget if Trump’s proposal were taken up by Congress. DeVos has long been a proponent of school choice and charter schools.

The Special Olympics benefits both adults and children with development and physical disabilities, and held its first quadrennial games in 1968. DeVos said it would be better supported by philanthropists. Her agency suggested similar cuts last year, and DeVos donated part of her salary to the nonprofit Special Olympics.

That wasn’t the only program beneficial to those with disabilities that Trump trimmed. He suggested deep cuts to Medicaid, the health care program that benefits the poor and those with disabilities, and proposed stripping $51 million from initiatives meant to address autism and other developmental disabilities.

Athletes and advocates from the Special Olympics pleaded with Congress to maintain their funding last month, and help those with disabilities by offering free health programs. The organization has many private-sector partners, but said in a press release last month that federal dollars are critical to leveraging “additional funds from private individuals and organizations.”

The 2018 Special Olympics USA Games held in Seattle last July featured more than 4,000 athletes competing in 14 different sports, and hundreds of U.S. athletes competed in the just-wrapped international Special Olympics games in Abu Dhabi last week.

Cover: Education Secretary Betsy DeVos speaks during a House Appropriations subcommittee hearing on budget on Capitol Hill in Washington, Tuesday, March 26, 2019. (AP Photo/Andrew Harnik)

What Should Stacey Abrams Do?

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To borrow from Irving Berlin, there was nothing Beto O’Rourke did that Stacey Abrams didn’t do better in her historic campaign for governor of Georgia. She came closer than Beto, the near-miss Senate candidate from Texas, to breaking the Republican stranglehold in an equally difficult state for Democrats, falling short by just 55,000 votes, and she did it against an opponent who had previously waged an eight-year campaign of voter suppression as Georgia’s secretary of state. Yet in the aftermath of the 2018 midterms, it was Betomania that broke out, not Staceymania. And now, it’s O’Rourke who’s running for president.

Abrams ran on tangible progressive issues rather than airy liberal rhetoric. She raised record money. She came within a whisker of winning not just thanks to her own considerable charisma, but also because she’d spent years leading an unprecedented voter-registration effort, known as the New Georgia Project, and ultimately brought out 800,000 more Democratic voters in 2018 than in the 2014 midterms. She had built a movement, not just a campaign. Along the way, she broke new political ground by speaking freely about her financial debts, her brother’s incarceration and mental-health struggles, and her sky-high political ambitions. And people were riveted: Abrams was officially the most Google-searched politician in America in 2018.

Her reward? Zero presidential buzz, aside from a small boomlet of interest after she pulled off the rare feat of delivering an effective and inspiring retort to the State of the Union address in February. If Democrats were willing to embrace a candidate who had fought nobly but lost in a state that once seemed out of reach, Abrams should have been at the top of the 2020 list from the get-go. Instead, she’s being courted by two white male warhorses, Joe Biden and Chuck Schumer, to help boost their own ambitions to become, respectively, president and Senate majority leader. In recent weeks, as O’Rourke was propelling himself into the presidential race, speculation has been swirling about which lesser office Abrams ought to pursue: Veep or Senator? Helpmeet to Biden or Schumer?

In the eyes of Washington pols and pundits, Abrams’s third option—running for governor of Georgia again in 2022—sounds hopelessly minor-league, almost as ridiculous as the notion of Abrams gunning for the White House herself in 2020. Schumer encapsulated the prevailing wisdom when he told a reporter last month: “There’s no one who knows how to fight for voting rights better than Stacey Abrams. If she got to the Senate, she’d have a huge platform to do it, not just in Georgia, but nationally.”

This was a classic example of an insult masquerading as a compliment. Abrams is already the leading national voice for voting rights—a fact that was underscored again last week when Andrew Gillum, who narrowly lost his own gubernatorial race in Florida last November, announced he’d be following in the footsteps of Abrams to lead a massive voter-engagement effort aimed at transforming his own state in a lasting way. “This isn’t the sexy work, I gotta admit. I’m sure it’s probably more fun for some of those out there running for president,” Gillum said. But like Abrams before him, he’s opting to do what he deemed “the hard work of democracy.”

Transforming politics at the grassroots is exactly the “hard work” that Democrats have disastrously failed to do over the past decade and counting. By betting everything on national politics—emphasizing winning the White House and congressional majorities while ignoring state and local elections—the Democrats steadily bled seats and power throughout Barack Obama’s presidency. By 2016, Republicans controlled about two-thirds of the country’s state legislative chambers. The short-sighted emphasis on federal elections has been catastrophic for abortion rights, social welfare, criminal justice, and economic fairness. With Congress hopelessly gridlocked, the bulk of policymaking now happens in state capitals and municipalities, where the GOP is dominant.

And ironically, the emphasis on national politics has made it harder for Democrats to win nationally. They’ve given Republicans in many states free rein to gerrymander and pass restrictive voting laws that provide them with an artificial and undemocratic advantage in elections on every level.

Abrams has been the leading light for a smarter approach to moving the country in a progressive direction. Her movement, and her remarkable campaign in 2018, have already begun to remake Georgia; on her coattails, the Democrats captured 13 GOP seats in the state legislature last year, the best they’d done in 20 years, and sent a gun-control advocate, Lucy McBath, to Congress from Newt Gingrich’s old district.

While she is keeping her future options open—insisting that she’s a perfectly plausible presidential candidate in 2020, and pondering whether to heed Schumer’s call even though she’d “not thought about the Senate before”—Abrams has strongly suggested that she’s still leaning toward a gubernatorial rematch with voter-suppressing bigot Brian Kemp in 2022. (On Sunday, while promoting her book Lead from the Outside in Los Angeles, she attempted to quell rumors that she’d discussed the vice presidency with Biden during a “lovely lunch” in Washington, calling it “pure speculation.”)

“I am going to run for something. And I will tell you in April,” she said earlier this month. “But everything is on the table. I’m not being coy. This is hard. When you spend two years focusing on one thing, it’s not easy to turn to something else.” A Senate seat, she said in a recent speech at Vanderbilt University, would be “an indirect solution to some of the challenges I see.” She smilingly hinted at what she really wants next: “Revenge can be very cathartic,” she said.

By ousting Kemp, Abrams would be setting herself up—again—as the model for a revivified Democratic Party going forward. She’d be formidable in a 2022 rematch, not only because her statewide voter-engagement project has worked wonders, but also because of the state’s fast-evolving demographics—with its rapidly growing African American, Latino, and Asian populations, Georgia’s on a fast track to be majority-nonwhite in the next decade. As the first liberal governor of a Deep South state—like, ever—she could show how to bring progressive governance and reform to a state that isn’t overwhelmingly blue like California or New York. The considerable savvy she showed as House minority leader in Georgia leaves little doubt that she’d be a consequential governor. And that would put her in an even stronger position to pursue the White House in 2028 or later. She’s only 45, so there’s ample time on her side.

By eschewing national politics for now, Abrams would be taking a powerful symbolic stand against the recent drift of the Democratic Party—in stark contrast to O’Rourke and Julián Castro, who’ve given up on changing Texas to pursue long-shot presidential bids. (Castro’s twin brother, U.S. Representative Joaquin Castro, is challenging Republican Senator John Cornyn in 2020, though.) She’s already forged a new path for Democrats to compete in red states, running successfully as a full-on progressive rather than falling back on “conservative values.” And after she lost her disputed election to Kemp, she demonstrated the kind of fighting spirit that Democrats have also been sorely lacking for a long time, stubbornly refusing to go through the motions of graciously accepting defeat to an opponent who rigged his own election. “I don’t concede that I lost,” she said in March for the umpteenth time. “I feel very comfortable saying that this election was not fair, and not only was it not fair, it was not accurate.”

But rather than just complaining, or lighting out on a self-pity tour à la O’Rourke, she went to work after the election to make sure that such an injustice couldn’t happen again—to any Democrat. She turned her campaign operation into a political action group, Fair Fight, that’s working to democratize elections in Georgia and elsewhere; the group filed what could become a landmark federal lawsuit challenging the “gross mismanagement” of the state’s elections. As she’s been making the rounds on a far-flung speaking tour—wowing crowds in Las Vegas, San Francisco, New York, and Oxford University, as well as on late-night TV—she’s continued to flash the big, broad grin and ferocious brain that lit up the campaign trail in Georgia, displaying her rare talent for pursuing her ambitions while conveying that she’s not in politics just because of what she wants to be, but what she wants to do.

Stacey Abrams should run for anything she damn well pleases, anytime she wants. With all due apologies to O’Rourke, she is the next-generation Democrat who was “born to be in it.” If she sees a route to the presidency in 2020, she should go for it; if she thinks she could make a real difference in the Senate, she should give that a shot. But she’s already shown that you don’t need the rhetorical pedestal of a seat in Congress to be the country’s most influential champion for voting rights. And while vanquishing Kemp and becoming governor of Georgia in 2022 might strike establishment pundits and Democrats as sadly unsexy, it might just be the most important task she could undertake—for her party, for the progressive cause, and also for her own limitless political future.

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