If you’ve ever used an online patient portal to message your doctor in the middle of the night, you won’t be surprised to learn that responding to those messages takes an increasingly big bite out of clinicians’ workdays. 

So in recent years, hospitals have begun adopting an AI tool that can draft responses for them. The tool was supposed to make a time-consuming task go more quickly and smoothly, said Philip Barrison, an MD-PhD student at the University of Michigan Medical School who studies AI in healthcare.

Instead, the tool has given doctors and nurses a new to-do list. First they have to read the AI-generated response and decide if it “is actually something that they think they would say,” Barrison said. Humans are suggestible, and looking at something and deciding whether you would have thought of it on your own is a cognitively complex task.

Even if the message looks correct, the clinician still needs to “edit it to the point where they think it’s acceptable” to send to a patient, Barrison said. The AI tool introduces a totally new set of complicated judgment calls into what used to be a relatively straightforward process. As a result, many clinicians have chosen not to use it at all.

They’re fortunate to have the choice. Buoyed by expectations of cost savings and skyrocketing productivity, companies are increasingly asking (and sometimes requiring) employees to use AI to make their work more efficient. Meta, for example, last year instructed some workers to use AI to “go 5X faster by eliminating the frictions that slow us down.” The CEO of Shopify told employees they’d need to prove they “cannot get what they want done using AI” before the company would approve new hires. Some companies are even evaluating or ranking employees based on how much they use AI tools.

Workers in some sectors have found major time savings from AI. But for others, the tools just change the work rather than making it faster. Workers might be spending less time writing patient portal messages, for example, but more time editing the releases the AI tool writes. 

At best, this mismatch between employer expectations and employee reality can be an annoyance. In other cases, however, it can result in workers being laid off for failing to meet unrealistic efficiency demands. Some critics say the overzealous adoption of AI in high-stakes settings like healthcare even puts people’s lives at risk. Now workers, unions, and experts are increasingly calling for guardrails to protect employees from inflated expectations around AI — and customers, students, patients, and the general public from mistakes that can happen when managers put AI adoption above all else.

The hidden costs of AI use 

Corporations are increasingly presenting employees with a choice: Use AI to be more productive or “you’re going to be automated out of a job,” said Aiha Nguyen, director of the labor futures program at the research organization Data & Society.

But the effects of AI on productivity aren’t as straightforward as some CEOs have claimed. In one 2025 study, software developers believed AI made them faster, but in fact they took 19 percent longer to complete tasks. (The researchers tried to repeat the experiment this year but had trouble recruiting developers who would agree to work without AI.) And in a recent survey of 5,000 white-collar workers, 40 percent of rank-and-file employees said AI saved them no time at all.

Workers across heavily AI-exposed fields point to hidden timesucks that come with using the technology. Julie, an art teacher, wrote in a response to a Vox reader survey that her school’s administrators routinely suggest using AI for lesson-planning, emails, and progress report comments. She’s tried AI-generated lesson plans, but they don’t account for the fact that kids may work through an activity at different speeds.

“First, I am checking what AI suggests, then I am editing them. Why add a step I can accomplish on my own?”

Julie, an art teacher who wrote in response to a Vox reader survey

“First, I am checking what AI suggests, then I am editing them,” she said. “Why add a step I can accomplish on my own?”

For an employee at an East Coast communications agency, an internal AI tool was supposed to speed up the process of drafting press releases and other documents about the pharmaceutical industry. 

“The goal is, I think, to be able to plug and chug into this machine and be able to turn a lot of materials around a lot quicker than we already do,” said the employee, who asked to remain anonymous for fear of career repercussions.

But when the employee tried to use it for basic research, it made too many mistakes. Double-checking its work erased any time savings. When the employee tried using it for communications with clients, its people-pleasing tendencies became a problem, as the tool put a “weird happy spin” even on messages warning of bad news.

“Part of the reason we take a human speed to turn things around is because there is so much nuance behind everything that we do,” the employee told me. “AI is just not going to be able to catch it.”

It’s not just that AI makes errors. With the advent of agentic AI, workers are increasingly being asked to edit and oversee the output of multiple AI tools, a new kind of work that can have unexpected costs. 

One recent study of 1,488 workers across industries, for example, found that excessive oversight of AI agents could lead to what the researchers called “AI brain fry,” a kind of cognitive fatigue. “Participants described a ‘buzzing’ feeling or a mental fog with difficulty focusing, slower decision-making, and headaches,” the researchers wrote in Harvard Business Review. Brain fry was also associated with an increased number of errors and an increased desire to quit one’s job. 

The researchers also found that while using one or two AI tools increased productivity, adding additional tools produced diminishing returns, and after four tools, productivity actually declined. 

What workers really want from AI

Despite such findings, companies continue to pressure employees to use AI, and to cite AI investment as a rationale for layoffs, even as companies that try to link staff reductions to AI adoption tend to struggle on the stock market.

Some workers and organizations, however, are beginning to push back. National Nurses United, the country’s largest nurses’ union, has criticized the use of AI tools in hospitals to estimate staffing needs or to recommend treatment protocols for patients.

There’s no guarantee that these tools will take into account a patient’s individual profile, including underlying medical conditions, the way human clinicians can, Cathy Kennedy, the union’s president, told me. AI is supposed to “help us do our work more efficiently, but at the end of the day, it makes it even more burdensome,” she said.

Hospitals need to evaluate, with nurses at the table, whether AI tools really work as advertised, Kennedy said. “We have to stop — we have to go back and really see if this is truly doing what it needs to do,” she said.

The same is true across industries, Barrison, the healthcare researcher, told me. “Organizations need to be prepared to say when, if they were seeking a return on investment, if they were seeking value in a technology — how do you define what that value is? And if there’s not value there anymore, how do you turn it off?”

Some workers have found ways that AI actually helps them do their work — just not the ones management expected. Julie, the art teacher, likes to use Claude to learn more about topics she’s less familiar with, like kiln-firing ceramics. 

Meanwhile, researchers have found that AI can actually reduce employee burnout, if it’s used to complete tasks employees find burdensome. “Everybody in every job has a list of things that they procrastinate on,” said Julie Bedard, a managing director and partner at Boston Consulting Group who led the AI brain fry study. “Those are the places I get, unsurprisingly, a lot of enthusiasm to try AI with.”

But employers won’t find out what those burdensome tasks are unless they listen to rank-and-file employees. “Worker standards and worker rights should continue to be at the heart of all of this,” Nguyen said, “rather than just focusing too much on the AI.” 

This story was originally published in The Highlight, Vox’s member-exclusive magazine. To get access to member-exclusive stories every month, become a Vox Member today.

For years, the “Make America Healthy Again” movement was driven by moms.

Concerned about the safety of childhood vaccines and about chemicals in the food their kids were eating, they helped propel Donald Trump to the White House — and Robert F. Kennedy Jr. to the role of the nation’s top health influencer — with a message centered on fear for the next generation. 

Now, that next generation is here.

The latest MAHA advocates to gain public attention are women in their teens or early 20s. Lexi Vrachalus, 20, posts videos of her seed-oil-free, sugar-free meals, snacks, and shopping trips. In a post around Easter, she made her own Peeps with maple syrup and beef gelatin.

Her message: “You can take back health into your own hands,” she told me. “You have the power to heal your body.”

She and other influencers, like the young filmmaker Grace Price and clean-living maven Ava Noe, are creating videos with a younger sensibility than their forebears — think baking sourdough for siblings rather than talking about kids’ vaccines. And their version of MAHA (that’s Make America Healthy Again, for the uninitiated) is breaking through to American teens.

“I get questions from my younger audience like, how can I encourage my parents to eat healthy?” Vrachalus said. “Or, how can I eat healthy when all my parents do is buy junk food?”

On the surface, there’s nothing wrong with young people trying to eat healthy. But educators and misinformation experts are worried about what comes next: Among adults, MAHA influencer culture has served as a funnel for a host of beliefs and behaviors that start with skepticism, veer into suspicion of all authority, and end up with actively dangerous behavior, including a resistance to vaccines that has led to outbreaks of disease.

“There’s this focus on healthy foods and environmental concerns, but running under the surface of some of those more superficial connections is this idea that there’s this cabal,” said Whitney Phillips, a professor of information politics and media ethics at the University of Oregon. “There’s this kind of conspiratorial thinking that ‘they,’ coded as liberal, are lying to you.”

So far, polling shows that young people are less likely to identify with MAHA than Americans in their 30s and 40s. But MAHA-inflected wellness videos are reaching more teens, and there’s evidence that more young people are falling for health misinformation that they see online. 

In a 2024 survey by the News Literacy Project, 80 percent of teens said they saw conspiracy theories on social media platforms, and a majority of those teens said they were inclined to believe one or more of those theories. The second most common type of conspiracy theory mentioned by teens in the survey (after “aliens & UFOs”) was content around Covid-19 and public health issues.

The rise of young MAHA influencers has educators and other experts asking what they can do to help Gen Z and Gen Alpha Americans — a group already deeply distrustful of institutions and authorities — distinguish reality from toxic misinformation. If teachers, families, and policymakers hope to thread that needle, they’ll have to do more than just respond to false claims point-by-point — they’ll need to address the sources of discontent and disaffection that may be pushing young people toward MAHA in the first place. 

The new face of MAHA

If you had to picture the MAHA coalition, you might think about a group of millennial and Gen X moms, banding together over their opposition to vaccine mandates and food additives. Or maybe you’d call to mind someone like Andrew Huberman or Joe Rogan, male podcasters in their 50s extolling the virtues of supplements and protein to an audience of “Huberman husbands.”

And sure, that’s today’s MAHA — a recent Politico poll found that those most likely to identify with the movement were Americans in their 30s and 40s. 

But tomorrow’s MAHA is coming, and the teen girls and young women emerging as MAHA influencers show us what it might look like. 

Vrachalus, for example, has more than 170,000 followers on Instagram — not as many as established voices like Vani Hari with follower counts in the millions, but a respectable reach for a creator, especially one so young. Vrachalus recently made a video with Kennedy, the Health and Human Services secretary, to promote the new federal dietary guidelines. 

When she was diagnosed with anorexia at 13, a dietitian told her she’d have to eat “junk food” in order to get better, Vrachalus told me. Instead, “I started to research, and I realized that basically everything in the grocery store is ultraprocessed junk food,” she said. 

Today, “I heal my body using real food that God created and designed us to eat,” she said.

Ava Noe, 18, has about 26,000 followers on her Instagram account, @cleanlivingwithava. She hopes to show young people that they “don’t have to be a certain age to take their health into their own hands,” she told me. “It’s never too early to start maximizing your health.”

For Noe, that looks like anything from searching for “clean” food at the grocery store to medically controversial practices like making her younger siblings use fluoride-free toothpaste. 

Meanwhile, some older MAHA influencers feature their young children as a way to get their message out to families. Gretchen Adler, for example, a creator with over 500,000 Instagram followers, recently posted a video in which her 9-year-old daughter explains why she makes her own gummy candy from orange juice and gelatin. Storebought gummies, she says, are “pure trash.”

“I’ll always say to show this to your child,” Adler says of her daughter’s appearances on her feed. “That’s the way that we can inspire these people or these young children, is when they see another child that they can relate to.”

The anti-seed-oil to anti-vax pipeline

Young people may be an especially receptive audience for the message that they can take their health into their own hands.

Gen Z Americans “feel very disillusioned by organizations in society and institutions, including, of course, medical institutions in the wake of Covid,” said Melissa Deckman, CEO of Public Religion Research Institute and author of The Politics of Gen Z. 

They are more likely than their elders to rely on friends and family or social media for health advice, and less likely to rely on doctors. They also distrust news outlets that could give them fact-checked information about health claims.

At the same time, young people are concerned about their health, experts say. “I have seen students become more inclined towards trying to think about wellness because they need to, because they’re not doing well,” said Phillips, who has taught university students for 18 years. “College students used to be some of the most carefree people in the world, and that just isn’t what is true anymore.”

The result, some say, is a population especially primed to listen to MAHA messaging delivered by influencers their own age. “These are beautiful young people that are promoting it, and they’re thinking, old people don’t know what they’re talking about. Here’s this cute 22-year-old who’s explaining this to me,” said Bertha Vazquez, who runs Generation Skeptics, a program that trains teachers to respond to misinformation.

However, experts worry that some MAHA content could be harmful, not helpful, for young people’s health. Such content often promotes the idea that consumers need to be vigilant about their food to avoid “toxins,” or that products can be divided into “real food” and “not-real food.” 

“That black-and-white thinking is very dangerous for people that have vulnerability to eating disorders,” Zoë Bisbing, a psychotherapist specializing in disordered eating, told me. 

Vrachalus isn’t convinced that opposing processed food promotes disordered eating. “Our great-great-grandparents, they didn’t have Oreos, they didn’t have ice cream,” she said. “I just don’t think that our great-great-grandparents had eating disorders because they didn’t have fake food.”

But eating disorders aren’t the only concern experts have raised. Some fear that exposure to MAHA content could push young people toward harmful behaviors that Kennedy and other movement leaders have supported, from using beef tallow as sunscreen to avoiding vaccines or chemotherapy. 

 “When they do get a dangerous virus, or they do get cancer, or they do have a child, the big concern is that they will not get the vaccines and the standard care,” Vazquez said.

Vrachalus and Noe don’t talk as much about vaccines or avoiding modern medicine as older MAHA and MAHA-adjacent influencers do. “I’m not anti-Western medicine at all,” Vrachalus told me. “If I break my arm, I’m going to the doctor tomorrow.”

But previous generations of MAHA and wellness influencers have cast doubt on proven treatments from the measles vaccine to chemotherapy, sometimes while pushing dietary supplements that are unproven and unregulated, or foods like raw milk that can cause serious illness.

Some young people are already subscribing to this kind of thinking — 18-year-old Shelby Gwinn, who is studying to be a dietitian, recently told the New York Times that “all pills do is cover up a problem instead of getting to the root cause,” and that today she takes 30 supplements to manage her eczema. “I do think the government should step in if a food company is putting absolute trash or chemicals in their food products,” she said — “but then again, I don’t trust the government.”

There’s a long history of wellness movements shading into conspiracy theory, Phillips told me. This anti-government, anti-medicine thinking began to creep into many wellness spaces, including yoga studios, around the time of the pandemic. 

“The messaging is basically this idea that you can’t trust doctors, you can’t trust the medical establishment,” Phillips explained. “They are trying to poison you.”

Getting young people to trust science again

In a polarized political landscape in which many young people are disillusioned with traditional news sources, conspiracy theories can be especially difficult to counter. That’s doubly true since so many young people really have been failed by their doctors, their government, and their world. 

“There are so many different ways that institutions have really genuinely let people down,” Phillips said. “But being able to make those kinds of critiques is different than this kind of conspiratorial attitude towards institutions.”

Teaching young people to think critically about information, whether it comes from an authority figure or a content creator their own age, may involve separating that information from politics. 

Melanie Trecek-King, a biology professor at Massasoit Community College and founder of the website Thinking Is Power, likes to start with European witch trials. She helps her students evaluate the beliefs about witchcraft that led to these trials, the evidence presented against accused “witches,” and the harms — including torture and executions — that false beliefs caused. 

By choosing examples from the past that aren’t personal for students today, she avoids putting them on the defensive. And once they’ve learned the process of evaluating information and evidence, “then they will make the connection in the real world,” she told me.

Not everyone can take a class like Trecek-King’s. But educators say it’s crucial for science communicators to meet young people where they are, whether that means posting on platforms like Instagram and TikTok or responding to questions about health without judgment or shaming.

“We have to be going to the places where people are,” said Jessica Knurick, a science communicator and content creator who has a PhD in nutrition science. Too often, scientific and medical experts take the attitude that “you should just listen to us because we’re us, instead of talking to people on a human level and understanding where their concerns are,” Knurick said. 

Getting expert information to where teens and other young people can see it will require changing professional norms that discourage doctors and tenure-track scientists from being on social media, Knurick said. It will also require finding ways to compensate experts for their time in a social-media economy that doesn’t always reward sober fact-checking.

But more science communicators and groups that serve young people are rising to the challenge. And it’s possible that young people’s tendency to question everything can be part of the solution.

“These MAHA influencers, they’re so confident in their claims, and you’ll never see a scientist like that,” Vazquez said. “Science is never about 100 percent certainty.”

That’s something educators can teach students, Vazquez said: “If someone’s so cocksure of themselves, then that’s a red flag.”

Clavicular says he’s been taking testosterone since he was 14 years old.

For the infamous looksmaxxing influencer, the hormone supplement is part of a regimen designed to give him the hollow cheeks, square jaw, and muscular build now coveted by legions of extremely online young men. Testosterone has helped him hone his appearance to the point at which — according to him at least — he can not only attract countless women, but also brutally shame other men with the power of his masculine beauty alone. It has also, he believes, made him infertile.

Lowered sperm count, shrunken testicles, and impaired fertility are known side effects of some kinds of testosterone supplementation. Doctors can help people manage or avoid these effects with the right dosage, but the rise of direct-to-consumer medicine — and gray and black market sources — mean more men are taking testosterone without close medical monitoring. 

Some are likely unaware of the potential risks associated with the hormone. “I think a lot of men think that taking testosterone should not compromise their fertility and would probably actually improve it,” said Justin Dubin, director of men’s sexual health at Baptist Health South Florida and co-host of the Man Up podcast.

For others, however, fertility may be beside the point. Clavicular and other manosphere influencers are selling a version of masculinity that’s fundamentally divorced from procreation and even from having sex with women — it’s all about competition among men. And to “win” at this new form of masculinity, some men are willing to sacrifice not only their money, their mental health, and their relationships, but also their sperm.

What testosterone does in the body

All human bodies naturally produce at least some testosterone. The hormone helps drive male puberty, and in adult men, it plays a role in energy, as well as bone and muscle health, said Ugis Gruntmanis, a professor of medicine at the Geisel School of Medicine at Dartmouth who studies male sex hormones.

Testosterone levels can decline with age, and doctors recommend testosterone replacement therapy (TRT) if men have low levels of the hormone combined with bothersome symptoms, like low energy or sexual dysfunction, Gruntmanis said.

When taken under the direction of a doctor, testosterone is generally very safe, Dubin said. However, taking it as a medication essentially tricks the brain into thinking the body is producing enough on its own, so it signals the testicles to stop producing more. “Your testicles tend to atrophy; they tend to stop producing sperm,” Dubin said. (When trans men take testosterone as part of gender-affirming care, the fertility effects vary based on what other procedures they undergo, Gruntmanis said.)

The effect is reversible once patients stop taking testosterone, but it can take time for sperm production to return to normal, Gruntmanis said.

A doctor should counsel patients on the fertility effects of testosterone, experts say. But today, many men get testosterone from direct-to-consumer clinics that proliferated at the beginning of the Covid-19 pandemic, Dubin said. “With better access through direct-to-consumer, we started seeing more men who are younger on TRT coming with low sperm counts or zero sperm counts not being counseled appropriately,” Dubin said.

In one study, Dubin posed as a patient seeking the medication but interested in having children. Six of seven direct-to-consumer medical companies still offered him testosterone, and only half told him about the risks to fertility, he said.

Why more young men are taking testosterone

Interest in testosterone therapy has exploded in recent years. Prescriptions for the medication have increased 154 percent since 2020, with the sharpest rise in men ages 35 to 44, according to market research data provided to the New York Times. About a third of men who currently have a prescription for the medication do not meet the medical criteria for testosterone deficiency, according to the American Urological Association.

With the rise of video platforms like TikTok and Instagram Reels, young men are facing the kinds of pressures to “perfect the face and body” that women have long faced, said Jordan Foster, a sociology professor at MacEwan University in Canada who studies culture, media, and beauty. To achieve the muscular physiques prized on social media, many are turning to testosterone.

They’re taking inspiration from the many podcasters and influencers with large male followings who have spoken openly about taking the drug, including Joe Rogan and Andrew Huberman. Health Secretary Robert F. Kennedy Jr. also takes it, and a Food and Drug Administration panel last year voted to loosen some restrictions on the medication.

But it’s a complicated moment for young men to take a medication that reduces their fertility. There’s some evidence that sperm counts are declining around the world, and some of the same people boosting testosterone therapy have sounded the alarm about sperm. Kennedy recently spoke of a “fertility crisis” in America, arguing that in 1970, “Men had twice the sperm count as our teenagers do today.”

He also spoke of the Trump administration’s efforts to address the country’s declining birth rate, a major bugbear of Republicans, Silicon Valley billionaires, and manosphere and manosphere-adjacent influencers alike. Huberman has discussed declining male fertility on his show; Rogan has warned of an impending “population collapse.”

Testosterone supplementation probably hasn’t contributed meaningfully to the falling US birth rate; experts say the decline in births likely has more to do with social changes, like rising women’s education, than with changes in sperm count.

Still, the popularity of testosterone therapy has led to some bizarre collisions of priorities. Looksmaxxing influencer Felix van der Heiden, for example, discovered the impact of his testosterone usage when he tried to participate in a “sperm race” hosted by a Silicon Valley men’s fertility startup. “Everything’s dead,” he told the New York Times, of the semen sample he provided. “Just rotten inside.”

Looksmaxxers are seeking a new masculine ideal

It’s surprising to hear someone steeped in a hypermasculine online subculture casually admit that his sperm are “rotten.” After all, having lots of kids isn’t just theoretically important to manosphere influencers and their ilk; manosphere-adjacent figures like Elon Musk have walked the walk by fathering large numbers of offspring. And sperm themselves have long been a symbol of sexual potency, as anyone who’s watched Beavis and Butthead could tell you. 

But for some male-dominated subcultures, masculinity has become totally separate from reproduction, Foster, the sociology professor, said. “There’s this kind of separate conversation men are having, divorced from fatherhood, divorced from marriage, that is more about sexual conquest and virility, and that conversation is almost by default unconcerned with fertility.”

In some cases, the conversation even becomes divorced from sex. Clavicular, for example, told the Times that knowing he could have sex with a woman is in some ways better than actually doing so. “It’s a big time-saver,” he said.

For a certain segment of looksmaxxers, and manosphere adherents more broadly, there’s a sense that “we’re not doing this for women,” Foster said. “We’re doing this for men, and to show other men how powerful or competent we may be.”

There’s always been an element of male competition in male-dominated online spaces — the pickup artists of the aughts, for example, were often trying to beat one another at the game of seducing women. But there’s something especially extreme about a masculinist ethos that demands aesthetic perfection above all else — and that’s willing to destroy the very gametes that carry the Y chromosome in order to achieve it.

There are, of course, plenty of problems with traditional masculinity — I don’t mean to endorse the idea that you need to have a lot of kids, or have a high sperm count, or have sex with women, in order to be a man. But we’ve had centuries to learn about masculinity in America, and decades of practice helping boys and men navigate it in a healthy way.

Now something new is on the horizon. Young men, and everyone who interacts with them, will need new tools to deal with it.