The Pros and Cons of Daylight Saving Time for Your Health

Updated on Sep 17, 2026 | Featured, Your Health

Photo of a woman looking out the window with her coffee in the early morning

Every March, on the second Sunday, we turn the clocks ahead one hour to begin daylight saving time, which gives us one more hour of light during the evening when the weather is warmest. And every November, on the first Sunday, we turn the clocks back to resume permanent standard time.

The disruptions to sleep patterns and the collective grogginess in the week or so afterward are discomforts that we’ve gotten used to. But does it have to stay that way?

In this Q&A, Andrew Varga, MD, PhD, a neuroscientist and physician at the Mount Sinai Respiratory Institute Integrative Sleep Center, discusses the pros and cons of keeping the clocks set permanently at daylight savings time or permanent standard time.

“The bottom line is that we can’t change the amount of daylight we get,” he says. “But we, as a community, can decide when we want those hours of daylight to occur.”

A portrait of Mount Sinai sleep specialist Andrew W. Varga, MD, PhD

Andrew W. Varga, MD, PhD

What are the health issues surrounding switching to daylight saving time?

Changing the clocks twice a year creates lots of problems, especially at the point of the time change. There are increased spikes and incidents of adverse health outcomes at those times of year in the spring and fall when we make the time change.

Twice a year, everyone is forced to make a dramatic adjustment in their circadian rhythm, which is your internal biological clock that governs key functions, such as your sleep/wake cycle, eating habits, digestion, and body temperature. It’s been documented that making the change has a number of adverse consequences, such as an increase in heart attacks and cardiovascular incidents at those times. And because people are sleepy, there’s a spike in the statistics in auto accidents, as well.

What are the alternatives?

It seems everybody is on the same page that we should stick with one thing, and not change it. But there are two camps—one is for making daylight saving time permanent, and the other is to stick with permanent standard time year-round.

The American Academy of Sleep Medicine believes we should stick with permanent standard time, which is what we observe in the fall and winter. They argue that permanent standard time is more in line with people’s natural circadian rhythms.

It’s worth remembering that we can’t change the amount of daylight in June or December, we can only decide where we want that light to be. The people who are proponents of permanent daylight saving time like the fact that in June you have light as late as 8:30 pm. If we were to change it to permanent standard time, you’d only have daylight until 7:30 pm. But you would gain it in the morning, so sunrise would be around 4:30 am instead of 5:30 am.

What would happen if we changed to permanent daylight saving time?

If we shifted to permanent daylight saving time in the winter, we would gain an hour of daylight in the afternoon but lose it in the morning. The sun would set at 5:30 pm instead of 4:30 pm, but it wouldn’t rise until 8:30 am. So most people would be getting up and commuting to work in the dark, and children would be going to school in the dark.

In addition, the further north you are, the more drastic the differences in the amount of light. For example, in Minnesota, the sun would rise about 20 minutes later than in New York City, at almost 9 am. In Miami, the sun would rise about a half hour earlier than New York—at about 8 am.

The United States did experiment during the energy crisis with switching to permanent daylight saving time. Congress passed the Emergency Daylight Saving Time Energy Conservation Act in December 1973, and at first, the public didn’t react that much. But as the consequences began to be felt over the course of the year, the public outcry was significant, and the law was repealed by the fall of 1974.

What is the argument for making standard time permanent?

Most medical authorities agree that sticking to standard time would be best from a health and safety standpoint. The American Academy of Sleep Medicine has released a position paper that says the twice-a-year time change “incurs significant public health and safety risks, including increased risk of adverse cardiovascular events, mood disorders, and motor vehicle crashes.” The paper makes an argument that standard time year-round would best align with human circadian rhythms. The time that we habitually wake up, go to bed, and do certain activities, such as commuting, is more in line with standard time.

It’s interesting to note that Arizona stays on permanent standard time and has done so since 1968. I’m not aware of any data that shows whether they are realizing any health benefits. However, they are routinely not included in national traffic accident statistics due to this fact.

Having trouble sleeping or have other medical concerns? Find a Mount Sinai primary care doctor who can help.

25 Years After 9/11, Mount Sinai Continues Its Commitment to Caring for First Responders and Safeguarding Public Health

Updated on Sep 16, 2026 | Community, Featured, School

A photo showing the September 11th "Tribute in Light" beacons shine up from lower Manhattan. New York City, NY/USA. September, 2015.

Like countless New Yorkers, Michael Crane, MD, MPH, has his own personal story about the morning of Tuesday, September 11, 2001.

A doctor and public health expert then working for Con Edison, he made his way to Ground Zero on that day. Over the next several weeks, he helped ensure that the company’s workers took proper precautions during the recovery operations. Like thousands of other responders, they were exposed to hazardous conditions, toxic agents, and extreme psychological stress.

As it turns out, safeguarding the health of workers who were at Ground Zero would continue to be a focus of his life and career 25 years later. Mount Sinai had been caring for 9/11 responders since 2001, and he went on to serve as Medical Director for the World Trade Center (WTC) Health Program Clinical Center of Excellence (CCE) at Mount Sinai after the federal WTC Health Program was formally established in 2011.

These days, Dr. Crane’s primary responsibility is overseeing Mount Sinai’s program, which monitors and cares for more than 27,000 first responders in the New York City area. Mount Sinai is the largest of eight Clinical Centers of Excellence that care for about 95,000 responders—firefighters, police, recovery, and cleanup workers and many others who participated in rescue and recovery efforts.

The other New York metropolitan area Centers of Excellence that serve responders are run by the State University of New York at Stony Brook, Rutgers University, Northwell Health, and the New York University Grossman School of Medicine, along with a Fire Department of New York center exclusively for New York City firefighters. These Centers were established to monitor, treat, and support rescue and recovery workers who responded on September 11 and in the following weeks and months.

A photo of Michael Crane, MD, MPH, Medical Director for the World Trade Center (WTC) Health Program Clinical Center of Excellence (CCE) at Mount Sinai.

“Unless we get as many responders as possible, we won’t know the full impact of what happened to these folks,” says Michael Crane, MD, MPH, Medical Director for the World Trade Center (WTC) Health Program Clinical Center of Excellence (CCE) at Mount Sinai. “We need all the data we can get. That’s the real goal when you have an exposure that is unknown.”

These Centers are part of the national WTC Health Program overseen by the U.S. Centers for Disease Control and Prevention. The WTC Health Program is authorized and funded through 2090 under the James Zadroga 9/11 Health and Compensation Act, signed into law in January 2011, and reauthorized by Congress in 2015. Mount Sinai’s World Trade Center Clinical Center of Excellence is located within the Mount Sinai Selikoff Centers for Occupational Health.

The WTC Health Program also oversees programs for survivors—those who lived, worked, or went to school in downtown Manhattan. There are now more than 145,000 people enrolled in the WTC Health Program, including about 57,000 survivors and 95,000 responders. The program also funds medical research into the physical and mental health conditions related to 9/11 exposures.

As the New York region marks another significant anniversary of the attacks, Dr. Crane says Mount Sinai’s Clinical Center of Excellence continues to see new members and encourages other responders who may not yet have sought care to enroll in the program. Staff at Mount Sinai’s Center  are available to assist with enrollment in the WTC Health Program.

In this way, Mount Sinai and the other Centers are building on the lessons of public health, which is to follow the lead of those on the ground in identifying possible concerns, gather data, provide care, and use research to understand the results, all while demonstrating a commitment to safeguarding the public  and building trust and confidence in the communities affected.

Still, Dr. Crane says he hopes more responders will decide to participate in the program.

“Unless we get as many responders as possible, we won’t know the full impact of what happened to these folks,” says Dr. Crane, who is also a Professor in the Department of Environmental Medicine at the Icahn School of Medicine at Mount Sinai. “We need all the data we can get. That’s the real goal when you have an exposure that is unknown.”

From the beginning, Dr. Crane and other health care experts knew there would likely be long-term respiratory troubles for first responders. A compounding factor would be the heroic efforts of first responders, many of whom would not stop working at the site even when they worried about possible medical issues.

One of the most striking initial symptoms among these responders was “a thunderous cough that would not stop,” which came to be known as the WTC cough.

“I had never heard anything like it,” he says. “It was a sign of healthy people having trouble clearing out their airways, and some of them getting quite distressed.”

In their monitoring of both first responders and survivors, public health officials continue to see respiratory conditions, specifically chronic rhinosinusitis (an inflammation of the sinuses), and asthma, among the top five conditions. Other leading conditions include gastroesophageal reflux disease (GERD), cancer, and post-traumatic stress disorder (PTSD). To address these and other mental health concerns, the WTC Health Program provides mental health services to eligible members.

Of note, cancer has become an increasingly important part of the program’s work, with more than 25,000 responders and 27,000 survivors nationwide being diagnosed with cancer, according to the program. Some of the most frequently covered cancer conditions treated by the program include non-melanoma skin cancer, prostate cancer, breast cancer, melanoma, and lymphoma.

The WTC Health Program covers yearly monitoring for those enrolled and treatment. Regular monitoring is important because many of these conditions may develop years after exposure, experts say. It’s also important to build relationships with clinicians who can track these patients over time and to ensure there are no obstacles to care that might discourage regular monitoring.

Another critical element of the WTC Health Program is that it generates data that has been the basis of publications by researchers. Recent findings by the Mount Sinai team indicates PTSD may accelerate brain aging in 9/11 responders, and that harmful substances, contaminated environments, and hazardous materials may contribute to conditions such as PTSD, GERD, respiratory disorders, diabetes, and chronic headaches.

For those who seek out monitoring and care, the prognosis can be promising, even for those facing more complex conditions and cancers. This care has included lung transplants, according to Dr. Crane.

“If you come to the program, I am optimistic that you will find the best care available anywhere. We will strive to optimize your lifespan and optimize the joy that you have in that life while you’re living it,” he says. He hopes doctors will continue to refer patients to the WTC Health Program.

In fact, multiple studies show the value of this ongoing treatment. For example, a study of more than 28,000 responders found that those enrolled in the WTC Health Program had a 13 percent lower risk of death. The study was published in the Annals of Epidemiology in March 2026.

Dr. Crane also expresses concern for the group of survivors who lived in downtown Manhattan and returned to live there in the weeks and months after the attacks. Health authorities believe this group of people may be as large as 400,000, and the effects of longer-term exposure to lower levels of environmental hazards that come from living many years downtown with the residual environmental effects are not known, according to Dr. Crane.

The World Trade Center Environmental Health Center at NYC Health + Hospitals and the William Street Clinic assess and treat these survivors, which includes residents, students, workers, or passersby who may be sick from  9/11-exposures.

Dr. Crane says those who lived in lower Manhattan during this period should consider applying to the WTC Health Program and get their 9/11-related symptoms monitored. He hopes increased participation in the program will help public health authorities expand the data they are now collecting on possible longer term health effects, especially for young children who were exposed for longer periods while they were growing up and their bodies were developing.

“The pollution from the collapse of the buildings was significant,” Dr. Crane says. “It’s an ongoing concern for all of us in the program given what we are seeing with the responders. These folks who lived in the community may have had somewhat lower-level but longer-duration exposure. We’re especially concerned about those young people whose bodies were changing in the presence of toxins.”

During the early years, survivor enrollment in the program had lagged significantly behind the responder enrollment, but this has been changing over the last decade. Survivors now represent more than 39 percent of the total number of program participants. Experts believe this is probably the result of greater awareness of the program, and the delayed onset of some medical conditions. About 59,000 participants are survivors, compared with about 95,000 responders.

“We hope that people will join and participate because we think there may be problems there,” Dr. Crane says. “Quite frankly, we don’t even know what they are.”

About the World Trade Center Health Program

The WTC Health Program is a limited federal health care program that provides health care for certified WTC-related health conditions at no out-of-pocket cost to those directly affected by the September 11 attacks in New York, at the Pentagon, and in Shanksville, Pennsylvania. The program was established by the James Zadroga 9/11 Health and Compensation Act of 2010. It is administered by the National Institute for Occupational Health and Safety (NIOSH) part of the Centers for Disease Control and Prevention in the U.S. Department of Health and Human Services. To learn more about the WTC Health Program, click here.

Learn more about the World Trade Center Health Program

Worried About CTE? What to Know About Risk, Symptoms, and Diagnosis

Updated on Sep 15, 2026 | Featured, Neurology, Your Health

A football player in a red helmet looks down the field at a fellow player, who is blurred in the background

You may have heard about chronic traumatic encephalopathy (CTE), a brain disease linked to repeated hits to the head. CTE has been found in some former NFL players and others who had repeated head impacts.

If you or a family member played contact sports, you may wonder about the risk of CTE. The risk depends in part on how often and for how long a person experienced repeated head impacts. Even people with extensive exposure do not always develop CTE.

In this Q&A, Kristen Dams-O’Connor, PhD, Director of the Brain Injury Research Center of Mount Sinai, explains what researchers know about CTE, what may affect your risk, and what you can do if you are concerned.

headshot of Kristen Dams-O’Connor, PhD, Director of the Brain Injury Research Center of Mount Sinai

Kristen Dams-O’Connor, PhD

How do I know if I’m at risk for CTE?

The biggest known risk factor for CTE is extensive exposure to repeated hits to the head over a long period of time. Researchers call these repetitive head impacts.

American football is the best-studied example. Repeated head impacts can also happen in other contact sports, including soccer, and possibly during military service or from domestic violence.

In football, the risk appears to increase based on how many years a person played, the level at which they played, and their position. For example, someone who played football briefly as a child or teenager would have a very different level of exposure than an NFL player who experienced repeated impacts for many years. If someone played in a position that exposed them to more impact, like a lineman, that may also carry greater risk.

Just because someone experiences repetitive head impacts does not mean they will get CTE. In fact, most people who have played football never develop CTE, and it isn’t clear yet why some do but others don’t.

Can one concussion cause CTE?

Current evidence does not suggest that one traumatic brain injury, whether it’s a mild concussion or more severe traumatic brain injury, puts you at significant risk for CTE. Researchers have found very few cases of CTE in people whose only known exposure was a single traumatic brain injury. The concern is greater when a person has repeated head impacts over time. These impacts do not have to cause diagnosed concussions, it is the extent and duration of repetitive head impacts that seems to matter most.

Can I be tested for CTE?

There is currently no test that can definitively diagnose CTE while a person is alive. CTE can only be diagnosed by examining brain tissue under a microscope after death.

Researchers are studying ways to diagnose CTE during life. These include blood tests that may detect signs of disease and specialized brain imaging. These tools are still being studied and cannot currently diagnose CTE in patients.

What symptoms should I be concerned about?

People who were found to have CTE after death have experienced symptoms such as:

  • memory changes
  • acting without thinking
  • irritability
  • trouble controlling emotions
  • poor decision-making
  • problems with planning, organizing, and completing tasks

Having these symptoms does not mean you have CTE. They are common after traumatic brain injuries and can also occur with dementia and many other conditions. At this time, researchers cannot tell from symptoms alone whether a person has the brain changes associated with CTE.

Substance use, including alcohol and drug use, can also contribute to symptoms during life, and may also contribute to the deaths of some people who are later diagnosed with CTE. But these concerns should not automatically be attributed to CTE, and many can be treated.

What can I do if I’m worried about CTE?

First, do not assume you have CTE. Problems such as memory difficulties, emotional changes, depression, or trouble controlling anger may have other causes, and some can be treated effectively. Also, fearing you have CTE may cause psychological problems. For example, research has found that some people who fear they have CTE experience depression and even suicidal thoughts and behaviors. Instead, focus on getting treatment for the symptoms you are experiencing rather than assuming CTE is causing them.

Behavioral and psychological treatments may help with some symptoms. For example, the Brain Injury Research Center of Mount Sinai offers neuropsychology and brain injury rehabilitation services that can help patients manage problems with thinking, memory, emotions, and behavior. Treatment may include psychotherapy, cognitive rehabilitation, and learning strategies for managing emotions. Medications may also be appropriate for certain symptoms.

Learn about the Brain Injury Research Center of Mount Sinai

What to Know About mFlusiva, the New mRNA Flu Vaccine

Sep 15, 2026 | Cold and Flu, Family Medicine, Featured, Infectious Diseases, Vaccines, Your Health

For the first time, adults age 50 and older in the United States can get an mRNA flu vaccine.

The U.S. Food and Drug Administration (FDA) approved mFlusiva®, the first mRNA flu vaccine, in August 2026. Moderna makes mFlusiva. It uses the same basic vaccine technology as mRNA COVID-19 vaccines. But it targets influenza.

Unlike traditional flu vaccines, mFlusiva does not contain a live or killed influenza virus, or pieces of the virus. Instead, it uses messenger RNA (mRNA). This gives temporary instructions to your immune system, your body’s natural defense system. The instructions help it learn to recognize influenza.

This new approach might even have an edge over traditional flu vaccines.

“There is some evidence that suggests mFlusiva may offer somewhat better protection against the flu than traditional flu vaccines,” says Rebecca Choudhury, MD, Assistant Professor of Medicine (Infectious Diseases), Icahn School of Medicine at Mount Sinai.

How does mFlusiva work? How well does it protect against the flu? What do we know about safety and side effects? Dr. Choudhury explains the new mRNA flu vaccine and gives advice on getting your flu shot.

Rebecca Choudhury, MD, Assistant Professor of Medicine (Infectious Diseases), Icahn School of Medicine at Mount Sinai

How does mFlusiva work, and how is it different from traditional flu vaccines?

Traditional flu vaccines show the influenza virus or parts of it to the immune system. This teaches the immune system to recognize and fight the virus later. Depending on the vaccine, that may mean a killed virus, a weakened virus, or pieces of the virus.

mFlusiva is an mRNA vaccine. It does not contain a living or dead virus. It also does not contain viral parts. The vaccine uses messenger RNA designed to produce influenza surface proteins called hemagglutinin.

An image of the mFlusiva mRNA flu vaccine. Image credit: Moderna

It’s the same basic principle used by mRNA COVID-19 vaccines. But the target is different. COVID-19 vaccines tell cells to make the coronavirus spike protein. mFlusiva tells cells to make an influenza surface protein.

“This flu vaccine is creating a different protein, but the principle of how it works is the same,” says Dr. Choudhury.

Is mFlusiva more effective than traditional flu vaccines?

In one trial in adults age 50 and older, about 2 percent of people who received mFlusiva developed influenza confirmed by lab testing within six months of vaccination. By comparison, 2.8 percent of people who received a standard-dose flu vaccine developed influenza. The mFlusiva group had a 27 percent lower rate of flu.

For adults 65 and older, there is an important caveat. People in this age group typically receive a high-dose or adjuvanted flu vaccine rather than the standard-dose vaccine used in this trial. An adjuvanted vaccine has an added ingredient that helps the vaccine work better.

Studies comparing the immune response to mFlusiva with a high-dose flu vaccine have been encouraging. Immune response means how the body reacts to a vaccine to build protection.

“However, a stronger immune response does not necessarily mean better protection against actually getting the flu,” Dr. Choudhury notes.

Another study is expected to directly compare clinical outcomes between mFlusiva and a high-dose flu vaccine in adults 65 and older.

Is mFlusiva safe? What are the side effects?

Clinical trials so far suggest mFlusiva has a safety profile similar to traditional flu vaccines for serious adverse events. These are harmful or unexpected medical problems or side effects.

In a trial comparing mFlusiva with a standard-dose flu vaccine, serious vaccine-related adverse events were very rare. They occurred at similar rates in both groups.

Researchers also looked closely at heart-related events because of concerns previously raised about mRNA COVID-19 vaccines.

One participant who received mFlusiva developed cardiomyopathy and pericarditis. These are two heart-related conditions. This happened about three months later. It was unclear whether the vaccine caused them. One participant in the traditional flu vaccine group also developed pericarditis.

Dr. Choudhury says current data do not show a higher risk of these events with mFlusiva than with traditional flu vaccines.

The main difference so far is short-term side effects. Injection-site reactions, headaches, body aches, and fatigue occurred more often with mFlusiva than with traditional flu vaccines. This was seen across multiple studies.

“These symptoms are generally relatively mild, they go away on their own without any sort of treatment,” Dr. Choudhury says.

What are the advantages of an mRNA flu vaccine?

“The advantages are less so in how the vaccine itself works, and more so in how the vaccine is made,” Dr. Choudhury says.

Each year, scientists must predict which influenza strains will circulate months before flu season. Traditional flu vaccines take several months to produce. That can make it hard to change the vaccine if the strains that circulate are different from those expected.

Because mRNA vaccines do not rely on growing influenza virus in a lab, they can be produced more quickly. Dr. Choudhury says this could give vaccine makers more flexibility. They can update an mRNA vaccine when an unexpected flu strain begins circulating.

That flexibility could help produce flu vaccines that more closely match the strains actually circulating. It could also potentially improve how well seasonal flu vaccines protect people.

Who can get mFlusiva, and who may want to consider it?

mFlusiva is approved for adults age 50 and older. Based on the evidence so far, Dr. Choudhury says adults ages 50 to 64 may have the clearest reason to consider it.

People ages 50 to 64 typically receive a standard-dose flu vaccine. That was the same type used in the clinical trial. The trial found a lower rate of influenza among mFlusiva recipients.

Dr. Choudhury says mFlusiva may be especially worth considering for adults ages 50 to 64 with long-lasting (chronic) health conditions. These conditions can raise the risk of severe influenza. They include high blood pressure (hypertension), diabetes, chronic kidney or liver disease, obesity, or chronic lung disease.

Adults 65 and older can also receive mFlusiva. However, researchers are still gathering stronger clinical evidence. The studies compare mFlusiva with the high-dose or adjuvanted flu vaccines typically recommended for this age group.

Still, choosing between vaccines should not stop you from getting vaccinated.

“Ultimately, the best flu vaccine is the flu vaccine that you can get,” Dr. Choudhury says. If mFlusiva is not easy to get, she recommends getting an appropriate flu vaccine from your doctor’s office, pharmacy, or workplace rather than going without vaccination.

Can an mRNA flu vaccine change your DNA?

No. The mRNA in mFlusiva cannot change your DNA. It also cannot become part of your genetic code.

Dr. Choudhury says this has confused some people. Some worry that mRNA could reprogram their genetic code. But that’s not how the technology works.

Like other mRNA vaccines, mFlusiva gives cells temporary instructions to make a specific protein. Here, that protein is an influenza surface protein. The mRNA is then quickly broken down by the body.

“The mRNA in mFlusiva cannot become part of your genome,” says Dr. Choudhury.

When should you get your flu shot?

Flu season typically begins around October. Infections often peak around December. But the timing can vary from year to year.

Your immune system needs about two weeks after vaccination to build protection. Dr. Choudhury recommends planning ahead. The same timing applies to mFlusiva.

“I typically get the flu vaccine myself around early October,” Dr. Choudhury says.

Getting vaccinated is important even if you don’t consider yourself at high risk for serious problems from the flu. Influenza can cause severe illness that requires a hospital stay. Even a less serious case can leave you sick in bed for a week or longer.

“Getting your flu shot is a very easy, safe and effective step you can take to reduce your risk of getting sick and reduce your risk of making others sick,” Dr. Choudhury says.

Have questions about the new vaccine? Talk with your doctor.

U.S. Premiere for Opera on a Gender-Affirmation Pioneer Is Authored by Mount Sinai Neuroradiologist

Updated on Sep 18, 2026 | Featured

A photo of Lucia Lucas as Lili Elbe in the U.S. premiere

Lucia Lucas as Lili Elbe in the U.S. premiere at the Santa Fe Opera. Photo credits: Bronwen Sharp for the Santa Fe Opera

“It’s a love story,” says Aryeh Lev Stollman, MD, a neuroradiologist at Mount Sinai and the librettist for the opera, Lili Elbe, which tells the story of one of the earliest recipients of gender-affirming surgery in 1930. The groundbreaking opera had its U.S. premiere at the Santa Fe Opera on August 1.

Lili Elbe is the true story of a successful Danish painter who was married to another painter, Gerda Wegener. Though Lili’s name and sex were legally changed, they remained in love with each other. Lili’s case drew international attention, and a semi-autographical account of her story was captured in a book, Man Into Woman: An Authentic Record of a Change of Sex.

“We based our story on historical sources,” emphasizes Dr. Stollman. “Lili Elbe was quite famous in her day, so we relied on her own writings and news accounts from the time.”

Lili Elbe discovers her true nature as a woman when her wife, Gerda, asks her to stand in for a female model who was delayed for a painting session. Gerda is entranced with the beauty of her husband, then called Einar Wegener, and it is she who bestows the name Lili. And as Lili embraces her identity, she says, “When you paint me now, I feel I have always been her.”

Lili becomes a muse to Gerda, whose paintings of Lili win acclaim. But Gerda wrestles with how much space to allow Lili in their marriage. At first, she insists that Lili transition back to Einar in the evening. But as Lili makes her true identity known among their circle of friends, Lili wants to experience all the feelings of womanhood, including marriage and motherhood, which were Lili’s ideas of what it meant to be a woman in her time. And even though their marriage is annulled and they become involved with other lovers, their love for each other endures.

The score was written by Tobias Picker, a Grammy Award-winning composer, who is married to Dr. Stollman. This is the second time Mr. Picker and Dr. Stollman have collaborated. The first was the opera Awakenings, based on the story of Oliver Sacks, MD, and his efforts to treat patients with sleeping sickness. That opera opened in June 2022 at the Opera Theatre of Saint Louis. Their third opera collaboration, Safe Haven, will premiere in June 2027 at the Opera Theatre of Saint Louis.

 

Originally commissioned by and performed at the Theater St. Gallen of Switzerland in 2023, Lili Elbe was named “Best World Premiere” at the OPER! AWARDS held at the Dutch National Opera in Amsterdam. The new production in Santa Fe is garnering applause and accolades as well.

“There was a standing ovation on both the first and second night in Sante Fe,” says Dr. Stollman. “It was quite wonderful.”

Lili Elbe is gaining favorable attention in the press as well, with the New York Times featuring the opera in its Arts and Leisure section, and the Wall Street Journal praising the premiere as “a multi-layered work” with Dr. Stollman’s “skillfully crafted libretto.” Musical America, the oldest and longest-running magazine for classical music and the performing arts in the United States said, “Picker’s score sustains this intertwined drama with assurance, at times expanding into passages of transporting lyricism.”

The opera Lili Elbe, in addition to being acclaimed for its artistry, is a significant milestone for being the first grand opera for and about a person with trans experience. It stars Lucia Lucas, a baritone, who reprises her role from the European production. Mr. Picker befriended Ms. Lucas when he cast her in Don Giovanni in a Tulsa Opera production—the first time a transgender singer had played the leading role in an American opera.

Mr. Picker, Dr. Stollman, and Ms. Lucas wanted to collaborate on an original project, and the story of Lili Elbe was chosen. “When Tobias asked me to write the libretto—or the story and lyrics—I wanted to work very closely with Lucia who served as dramaturg, a guide and advisor, to gain the insight of her experience and authenticity, and to better understand Lili who lived in different times,” says Dr. Stollman.

“We wanted Lili Elbe to have a mythic undercurrent,” Dr. Stollman says. “In Lili Elbe, the myth of Orpheus leading his lover, Eurydice, out of the underworld is a motif that reoccurs. The very first scene takes place with the main characters attending a play about Orpheus and Eurydice. In the myth, Orpheus is saying, ‘Don’t look back, you cannot return to your old life, but you are coming into a new life.’ I believe that myths have a strong emotional truth, and our characters are always moving to the future, to a new life, a new realization. And that’s the mythological underpinning.”

“Also, the opera is more than about love with a transgender person,” Dr. Stollman says. “It’s about love and transcending difficulties. It’s about a tragic heroine’s journey that starts with self-knowledge. And it’s about loss, because Gerda loses Lili. But also, because Lili dies in the end, as many tragic heroines do.”

There are significant differences between the Swiss and the American productions. “We were very happy with the production and interpretation done in St. Gallen, and the one done in Santa Fe is totally different, but we’re very happy with that too,” says Dr. Stollman. “It’s nice to see two different approaches to the same piece. It enriches the piece to have different directorial and production points of view.”

“For example, the staging and choreography of the opera in Saint Gallen were more modernistic, innovative, and witty. In the Santa Fe production, the scenery and costumes are more sumptuous and evoke the elegant, upper class European period of the 1920s and early 1930s. The director of the Sante Fe production, James Robinson, is renowned in the opera world and has directed at the Metropolitan Opera and is now the General and Artistic Director of the Seattle Opera, so we were very fortunate to work with him. The Santa Fe production is actually a co-production with the Seattle Opera, and he will be bringing Lili Elbe to Seattle in 2029.”

The creative process is different each time, according to Dr. Stollman.  “It’s always challenging to write a new opera from scratch. But I enjoy getting into the characters’ minds and emotions. I like that each character is different, and I get to learn more about different types of people and situations. What they all have in common is that they face challenges and adversity, and I’m fascinated by each of their journeys.”

“I am very fortunate that my career as a librettist continues to grow,” adds Dr. Stollman. “When I went with Tobias to the premiere of his first opera, Emmeline, in Santa Fe thirty years ago,  I never imagined that I would one day be on the stage, bowing with him—or that   I would have any part in  the opera world. I was writing award-winning novels, but I had no concept that I would be blessed with  the opportunity and great privilege to be involved in  that grand artistic tradition.”

How Much Do You Know About Prostate Cancer? Take the Quiz

Updated on Sep 9, 2026 | Featured, Your Health

Prostate cancer is one of the most common cancers among men, affecting about one in eight men in their lifetime. Knowing the facts about prostate cancer can help reduce your risk. Take the quiz below, then click “Done” to see your score and correct answers.

This quiz was developed with world-renowned urologist and prostate cancer specialist Ash Tewari, MBBS, MCh, FRCS, (Hon.), DSc (Hon.), Chair of the Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai.
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Learn more about prostate cancer screening and diagnosis at Mount Sinai