“Patient zero” is a popular term that epidemiologists seldom use in its popular sense. It names a first case, but in the public mind it also names a cause and a culprit. This paper traces the vocabulary of first cases (index case, primary case, carrier, superspreader), examines two historical figures who became public symbols of blame, Mary Mallon (“Typhoid Mary”) and Gaëtan Dugas, and considers what the habit of seeking a single source costs public health. It closes with a reading of Taylor Swift’s 2026 song “Patient Zero,” which uses the term as a relationship metaphor and, on one reading, inverts its meaning.
1. The Vocabulary of First Cases
Outbreak investigation distinguishes several roles that popular speech merges:
Index case: the first case that comes to the attention of investigators. It is defined by when it was detected, not by when infection began.
Primary case: the individual who first brought a disease into a given population. This person is often impossible to identify and may never be known.
Source case or reservoir: the person, animal, or environment from which the infection originated.
Carrier: a person who harbors and can transmit a pathogen, with or without symptoms. The asymptomatic carrier is the most socially troublesome category.
Superspreader: a case responsible for an unusually large number of secondary infections, a statistical pattern rather than a moral one.
These categories can come apart. The first person noticed is rarely the first person infected, and the first person infected is rarely the source of the whole outbreak. “Patient zero” collapses all three into a single named individual, which is why it persuades so easily and misleads so often.
2. Mary Mallon: The Carrier as Villain
Mary Mallon, an Irish immigrant cook in New York, was identified in 1906–1907 by the sanitary engineer George Soper as the common thread in a series of typhoid outbreaks in the households where she had worked. She was among the first healthy carriers of typhoid identified in the United States. She felt well, saw no reason to believe she was dangerous, and rejected the claim.
The authorities detained her on North Brother Island in 1907. She lost a legal challenge in 1909 and was released in 1910 on condition that she stop working as a cook. She later returned to cooking under an assumed name, and a 1915 outbreak at a New York maternity hospital led to her second and final confinement, which lasted until her death in 1938. Public health records attribute a few dozen cases and a small number of deaths to her, though the real total is unknowable.
Three features of her case recur in later episodes:
The label outlived the science. “Typhoid Mary” entered the language as a general term of reproach for anyone who spreads harm, losing contact with a real woman and the medical facts.
Selective enforcement. Other healthy carriers were identified in the same period and treated far more leniently. Mallon was a poor, foreign, unmarried woman in domestic service, and class, ethnicity, and gender shaped how she was treated and remembered.
The tension between public safety and individual liberty. She was confined indefinitely without a conventional trial, and defenders of the policy and its critics have argued over it for over a century.
3. Gaëtan Dugas: A Label Made from a Letter
Gaëtan Dugas was a French-Canadian flight attendant who died of AIDS-related illness in 1984. In an early CDC cluster study, his case was tagged “Patient O” because he lived outside California, and the reporting noted this. A labeling error then turned the letter O into the numeral zero, and a note of geography became a claim about origin. The investigator who ran the study, William Darrow, has said that he never labeled Dugas “Patient Zero.”
The numeral reached the public through Randy Shilts’s 1987 book And the Band Played On. Shilts later said the phrase struck him as catchy. The New York Post ran a headline calling Dugas “The Man Who Gave Us AIDS,” and a 1993 television adaptation cemented the image. One historian has described Dugas as a villain the culture was prepared to accept: gay, unashamed, attractive, and foreign.
A 2016 study in Nature, led by Michael Worobey, recovered genetic sequences from stored blood samples. It found no biological evidence that Dugas was the primary cause of the North American epidemic, and placed the epidemic’s start in New York in the early 1970s. On the virus’s family tree, Dugas sat in the middle rather than at the beginning. Related reporting traces the lineage to Haiti in the early 1970s. Worobey also pointed to an ascertainment bias: Dugas could be placed at the center of a cluster because he had supplied investigators with far more names of partners than other participants. The cluster looked centered on him because of how it was measured.
The record also shows that Dugas cooperated with investigators. He flew to the CDC in Atlanta to give blood samples and supplied a long list of contacts. The man later cast as a villain was one of the people who helped scientists understand the disease.
4. Why the Single-Source Story Fails
Epidemiologically, the story is almost always wrong. Early cases are usually undetected, and new diseases travel through many people before anyone is looking. The 2016 findings showed that the virus had spread in New York “under the radar for a decade or so.”
Methodologically, the first person identified is a product of who was interviewed, who was willing to talk, and who was tested. Cooperative patients with many contacts are overrepresented as apparent hubs.
Institutionally, a named culprit discourages the work that matters, such as surveillance, testing access, and trust between patients and health departments. A person who expects to be blamed has reason to avoid being found.
Morally, the term assigns blame for an event that nobody chose. Transmission of a new pathogen before it is known to exist is not an act in the ordinary sense. Worobey himself cautioned that tracing origins should not be used to assign blame, a point echoed in the STAT coverage of the 2016 paper.
The pattern continues in later outbreaks. Public narratives about the Ebola outbreak of 2013–2016 centered on a toddler in a Guinean village as the presumed first case. Early COVID-19 discourse sought a single market or laboratory. Searching for origins is legitimate science, but a person at the end of a chain of inference can become a target before the evidence is in.
5. Public Health Implications
Prefer role-specific terms. Reports should say “index case” when only detection order is known, and avoid “patient zero” unless the primary case is established.
Protect identities. Case investigation depends on voluntary disclosure of contacts. Publicly naming individuals, as happened to Dugas and Mallon, damages that cooperation for later outbreaks.
Separate carrier status from culpability. Asymptomatic carriers should be offered support, such as income replacement and alternative work, so that isolation is not a punishment for being unknowingly contagious.
Treat origin claims as hypotheses. Press and officials should state the evidence behind any claim of a first case and flag its limits.
Watch for scapegoat selection. Blame tends to settle on those already marginalized by class, nationality, sexuality, or religion, as the Mallon and Dugas cases both illustrate.
6. The Popular Afterlife: Swift’s “Patient Zero”
Taylor Swift released “Patient Zero” on September 25, 2026 as part of The Life of a Showgirl: The Encore, an expanded edition of her 2025 album. Coverage describes the song as addressed to the girlfriend of an unnamed ex. In the song, the narrator calls herself “patient zero” because she experienced a man’s harmful side before another woman did. Swift’s own account, as reported, centers on an unexpected phone call between two women connected to the same man, and she has not tied the song to any named ex.
Read against the history above, the metaphor works in one respect and fails in another.
Where it works. The narrator functions as an index case in the real sense, the first one to notice the problem. Her warning to the next woman resembles a sentinel report: the pathogen is here, and this is what it does. This is an honorable use of an index case, since it is how surveillance operates in practice.
Where it inverts the term. In epidemiology and in popular usage, “patient zero” means the person from whom the spread began, and it carries blame. The song’s narrator is the first victim of a harmful man, and in the metaphor he is the pathogen or the carrier. By the term’s own logic she would be the first infected, not the source. A closer fit would be “index case” or “first exposure,” and the man would be the carrier or reservoir, the Typhoid Mary role in the metaphor.
What the metaphor misses. Two lessons from Dugas apply to the song:
Being first does not establish that the other party is the source. Dugas was first to be labeled and not first to be infected. The narrator’s claim to precedence among the man’s partners is a claim about her own ordering in a sequence, which establishes nothing about where the harm came from or whether it began with him.
Ascertainment bias applies to relationships too. The people who compare notes are the ones who find each other. The two women’s phone call reveals a cluster by the same mechanism that made Dugas look like a hub, and it leaves out partners who never spoke.
A counterargument. A BMJ Group piece asks whether the song may have helped defang the toxicity of the term by changing its meaning. The case for this reading is that the song reassigns the phrase from a source of blame to a position of knowledge and solidarity: the first one affected looks after the next. That is a gentler and arguably healthier use than the Dugas version. The case against is that it keeps the contagion framing, in which a person is cast as a toxin, which carries the same dehumanizing logic that harmed Mallon and Dugas.
7. Conclusion
“Patient zero” persists because it supplies a story with a beginning, a culprit, and a moral. The history of Mallon and Dugas shows that the story usually mistakes detection for origin and visibility for guilt, and that the people named bear the cost. Public health practice is better served by precise terms and by protecting the privacy and dignity of cases. Pop-culture uses of the term, including Swift’s, show how far the phrase has moved from its technical meaning and how readily it is turned toward blame, and the Dugas case shows how costly that habit can be.
Contemporary scholarship on the coded languages of concealed love focuses mostly on homosexual communities, especially British Polari, South African Gayle, Filipino Swardspeak, and Turkish Lubunca. This literature is valuable, but it often treats such languages as a distinct phenomenon rather than as one branch of a much older and broader family. That family includes the thieves’ cant of Tudor England, the Rotwelsch of German vagrants, the argot of French criminal fraternities, the trade jargons of itinerant peddlers and showmen, the private ciphers of adulterous lovers, and the symbolic systems of courtship. All of them follow one principle. When a deed cannot be openly admitted, the people who do it develop a language in which it can be spoken without being confessed.
This paper places the languages of secret love within that larger context. It traces the shared mechanisms and the historical lineages that connect them, and it offers a broad typology of underground speech organized by what is concealed, how it is concealed, why, and how such languages rise and fall. It also argues, from a biblicist perspective, that the existence of a concealment language is itself morally diagnostic. Concealment does not settle the question of whether a deed is righteous or wicked. It does show that a community has judged its own conduct unfit for daylight, or has been forced into hiding by those who judge it so.
1. The Problem of a Narrowed Field
The modern study of secret love-languages grew mainly out of gay and lesbian studies and the subfield sometimes called “lavender linguistics.”[1] Paul Baker’s work on Polari established the template: a recovered lexicon, a community under legal threat, and a language that declined once that threat was lifted.[2] Comparable studies followed for Gayle in South Africa, Lubunca in Istanbul, and Swardspeak in Manila.[3]
These studies are careful within their scope. The difficulty is framing. When the language of concealed homosexuality is studied in isolation, three distortions follow.
First, the historical lineage is obscured. Polari did not arise from nothing. Baker himself documents its descent from Parlyaree, the jargon of traveling showmen, Punch-and-Judy operators, and circus folk, which drew in turn on Italian, Romani, Yiddish, and the older English cant of thieves and beggars.[4] The eighteenth-century “molly” subculture of London used a cant recorded alongside, and overlapping with, the cant of the criminal underworld.[5] The language of the concealed lover and the language of the concealed thief were often the same language, spoken in the same taverns by people sharing the same exposure to the magistrate.
Second, concealed heterosexual conduct drops out of view. Adultery, fornication, clandestine courtship against parental will, and commercial vice generated their own codes, from Ovid’s instructions on invisible ink to Victorian lovers’ ciphers in the personal columns of The Times.[6] A field that omits these cannot explain the general phenomenon, because the general phenomenon is not about any one form of desire. It is about the relation between conduct and the possibility of open speech.
Third, the moral and sociological logic of concealment goes unexamined. If underground languages are treated as identity markers alone, the question of why they exist at all, and what their existence reveals, is set aside. Halliday’s concept of the “anti-language,” developed with reference to criminal argots, supplies a more general framework: an anti-language is the speech of an anti-society, built by relexicalizing the areas of life where the group’s activity sets it apart from, and against, the surrounding order.[7]
This paper takes up that general framework.
2. The Governing Principle: What Cannot Be Admitted Must Be Encoded
Scripture states the principle with precision: “For every one that doeth evil hateth the light, neither cometh to the light, lest his deeds should be reproved” (John 3:20, KJV). Job describes the adulterer who “waiteth for the twilight, saying, No eye shall see me: and disguiseth his face,” and places him among the murderer and the thief, all of whom “know not the light” (Job 24:13–17). Proverbs gives the voice of folly itself: “Stolen waters are sweet, and bread eaten in secret is pleasant” (Proverbs 9:17).
These passages group the thief and the adulterer together. Biblical anthropology does not separate secret love from secret theft. Both are hidden deeds, both flee the light, and both require concealment. Language is the most portable form of concealment there is. A locked room conceals a deed only while the door is shut, but a coded vocabulary lets the deed be planned, discussed, boasted of, and coordinated in public, in front of the very people from whom it is hidden.
Three pressures determine how elaborate an underground language becomes:
Risk of exposure. The greater the legal or social penalty, the stronger the incentive to encode. The decline of Polari after England’s Sexual Offences Act of 1967 and the decline of much thieves’ cant after police forces and newspapers absorbed its vocabulary both show the reverse case.[8]
Density of the community. A pair of lovers needs only a private code, while a fraternity of thieves needs a shared lexicon that can be taught to recruits. The more people must coordinate, the more the code becomes a language.
Duration of the concealed activity. A single clandestine affair may use an improvised cipher. A centuries-old trade of vagrancy, fencing, or confidence work builds generational vocabulary, with apprenticeship, grammar, and lore.
The difference between private codes and communal languages is one of the most important distinctions in the field, and it is the one most often blurred when secret love-languages are studied apart from secret trade-languages.
3. Historical Strands
3.1 Thieves’ Cant and the Canting Crew
English thieves’ cant is known almost entirely through its exposers. Thomas Harman, a Kentish magistrate, published A Caveat or Warening for Commen Cursetors in 1567, cataloguing the ranks of vagabonds (the “upright man,” the “abram man,” the “counterfeit crank”) and appending a glossary of their “pelting speech.”[9] Robert Greene’s coney-catching pamphlets of the early 1590s exposed the vocabulary of card-sharpers and cutpurses.[10] Richard Head’s The Canting Academy (1673), the anonymous B. E.’s New Dictionary of the Terms Ancient and Modern of the Canting Crew (c. 1698), and Francis Grose’s Classical Dictionary of the Vulgar Tongue (1785) carried the tradition forward.[11] Julie Coleman’s history of these dictionaries shows how much copying, embellishment, and invention went on among them. Some “cant” was probably the lexicographer’s own work.[12]
This creates a lasting paradox: an underground language enters the historical record mainly at the moment it fails. The canting dictionary is the informer’s report, the magistrate’s file, and the moralist’s warning. Students of Polari face the same problem, because much of what is known comes from the BBC radio comedy Round the Horne, which brought the language to a mass audience and thereby helped destroy its use as a concealment tool.[13]
3.2 Rotwelsch, Bargoens, and Continental Cants
The German Liber Vagatorum (c. 1510) catalogued the tricks and vocabulary of beggars. Martin Luther republished it in 1528 with a preface warning princes and towns against false beggars, and noted how much of the vocabulary came from Hebrew.[14] Rotwelsch and its Dutch relative Bargoens drew heavily on Yiddish and Hebrew, while English cant and Parlyaree drew on Romani and Italian. Underground languages commonly borrow from the tongues of other marginal peoples, partly for opacity and partly because the margins of society were places where those peoples met.
French argot reached literary standing early. François Villon wrote ballads in the jargon of the Coquillards, a fifteenth-century criminal fraternity, and Victor Hugo devoted a whole book of Les Misérables to argot, which he called the language of darkness and misery.[15] Hugo’s treatment is valuable because he recognized that argot was not just vocabulary but a moral and social world. Its words for prison, the police, the gallows, and the victim encoded an entire stance toward the lawful order.
Comparable systems include Russian Ofenya, the speech of itinerant peddlers; Argentine Lunfardo, which began in the port underworld of Buenos Aires and later passed into the tango; and Verlan, the French inversion slang of the twentieth-century banlieues.[16]
3.3 Secret Professions That Were Not Crimes
Not every trade-language concealed a crime. Itinerant tinkers, peddlers, horse-dealers, showmen, and butchers built private vocabularies to bargain in front of customers, protect trade secrets, and mark insiders. Shelta (or Gammon, or Cant), spoken by Irish Travellers, was identified as a distinct language in the late nineteenth century, and Kuno Meyer showed its deep roots in Irish.[17] Victorian costermongers and butchers used backslang, reversing words so that customers could not follow price discussions; Henry Mayhew recorded examples in London Labour and the London Poor.[18] Cockney rhyming slang served similar functions in market and street life.
The medieval guilds point to the same principle at a respectable level. The Middle English word “mystery,” meaning a craft or trade, comes from a root for service or office but became tangled with mysterium, the hidden thing. A guild’s “mystery” was its body of protected knowledge, passed on under oath. Private vocabulary in this setting concealed competitive advantage rather than wrongdoing.
This category matters for the typology, because it shows that underground language is not necessarily evidence of wicked deeds. It is evidence of something a group believes outsiders should not hear, and the reason may be guilt, danger, or simple competition.
3.4 The Private Codes of Lovers
Lovers’ codes are usually private between two people rather than communal. Ovid’s Ars Amatoria advises writing secret messages in fresh milk, which can be made legible with coal dust.[19] The Kama Sutra lists mlecchita-vikalpa, secret writing, among the sixty-four arts a cultivated person should know, plainly with clandestine correspondence in mind.[20] In Victorian London, couples kept apart by family or circumstance exchanged ciphered messages in the personal “agony column” of The Times. Charles Wheatstone and Lyon Playfair amused themselves by breaking them, and at least once Wheatstone published a reply in the couple’s own cipher.[21]
Symbolic courtship systems sit between private code and public convention. The Victorian “language of flowers,” codified in floral dictionaries and popularized by Kate Greenaway’s 1884 edition, assigned meanings to blossoms so that sentiments too forward for speech could be sent in a bouquet.[22] The so-called “language of the fan” was apparently promoted, perhaps invented, by fan sellers. That serves as a reminder that some “secret languages” are commercial romance rather than recovered practice.[23]
The handkerchief codes and dress signals of twentieth-century homosexual subcultures, the use of women’s names as code words in Gayle and Swardspeak, and the coded personal advertisements of the mid-century press all belong to this same family of devices. They are not a separate invention.
3.5 Persecuted Faith and Conscience
A strand of underground language arises not from hidden wrongdoing but from the persecution of open righteousness. The fish symbol traditionally linked to early Christians, the coded hymnody of enslaved believers in the American South, and the private vocabularies of dissenters under hostile regimes all show that concealment can be forced on the innocent.[24] Scripture records God’s people speaking guardedly under threat. Jesus Christ taught in parables that concealed meaning from those unwilling to hear while revealing it to disciples (Matthew 13:10–13). This strand must stay in view so that the analysis does not slide into treating all concealment as guilt.
4. A Broad Typology of Underground Language
Underground languages can be classified along four axes. Any given language occupies a position on each.
Axis A: What Is Concealed
Category
Representative Examples
Illicit or forbidden love
Ovid’s milk-ink letters; Times agony-column ciphers; molly-house cant; Polari; Gayle; Swardspeak; Lubunca; courtesan and brothel vocabularies
Property crime and fraud
English thieves’ cant; coney-catching jargon; Rotwelsch; French argot; American confidence-man jargon (Maurer’s The Big Con); pickpocket and fence vocabularies
Vagrancy and begging
Harman’s canting ranks; Liber Vagatorum; American hobo signs
Organized violence and criminal hierarchy
Mafia codes of silence and indirection; prison argots; gang lexicons
Early Christian symbols; coded spirituals; dissident vocabularies under authoritarian rule
Axis B: Mechanism of Concealment
Relexicalization. New words for existing things, concentrated in the domains of the hidden activity. Halliday observed that anti-languages often have many synonyms for the same concept, such as police, victims, stolen goods, or sexual partners, because those concepts are central to the anti-society.[25]
Borrowing from marginal tongues. Romani, Yiddish, Hebrew, Italian, and Irish supply vocabulary unknown to the dominant population.
Inversion and transformation. Backslang, Verlan, pig-Latin types, and syllable insertion.
Rhyme and ellipsis. Cockney rhyming slang, in which the rhyming word itself is often dropped, deepens opacity.
Metaphor and euphemism. Ordinary words given hidden meanings, so that a sentence sounds innocent to outsiders. This is the most deniable mechanism and therefore the most common in dangerous settings.
Names as code. Personal names, especially women’s names in Gayle and Swardspeak, standing for acts, places, or categories of people.
Iconic and object codes. Flowers, fans, handkerchiefs, clothing, chalked hobo signs, and marks on doorposts.
Cipher and steganography. Invisible inks, substitution ciphers, and messages hidden in apparently innocent text.
Gesture and kinesics. Hand signals, glances, and postures, used especially where speech itself is dangerous.
Axis C: Function
Concealment. Speaking in front of outsiders without being understood.
Recognition. Identifying fellow insiders. The biblical shibboleth (Judges 12:5–6) is the archetype: a single word distinguished friend from enemy, with fatal consequences.
Solidarity and identity. Binding members together and marking a shared world.
Performance and play. Wit, theatricality, and display, very prominent in Polari and Parlyaree, and present in thieves’ cant as bravado.
Moral anesthesia. Renaming a deed so that it no longer sounds like what it is. Shakespeare’s Pistol captures this exactly: “‘Convey,’ the wise it call. ‘Steal!’ foh!”[26] Thieves “lift,” “nick,” or “convey”; adulterers “see someone”; the confidence man “takes” a “mark.” The euphemism eases the conscience as much as it deceives the listener. Isaiah’s woe falls on this function: “Woe unto them that call evil good, and good evil; that put darkness for light, and light for darkness” (Isaiah 5:20).
Commercial advantage. Bargaining in front of customers and protecting trade secrets.
The fifth function deserves more attention than it receives. Underground language does not only hide deeds from others. It hides them from the speaker. A community that has a dozen affectionate words for its victims and none for its guilt has built a linguistic shelter against conviction.
Axis D: Lifecycle
Emergence. Under pressure of risk, a community develops private terms.
Elaboration. With density and duration, the terms become a lexicon with teachable rules.
Exposure and codification. Informers, magistrates, journalists, moralists, and lexicographers record the language. This is usually how history learns of it, and it often marks the start of its decline as a concealment tool.
Leakage. Terms pass into general slang. A large share of English slang (“nab,” “fence,” “con,” “grass,” “bona,” “naff”) has underground origins.
Obsolescence. The language fades when the concealed activity becomes lawful or socially open, when the community disperses, or when exposure makes the code useless.
Heritage revival. Later generations recover the language as cultural memory, sometimes romanticizing what had once been the speech of fear, shame, or crime.
5. Analytical Observations
5.1 Secret love-languages and secret trade-languages share structure, ancestry, and social space. The overlap between the molly cant and thieves’ cant of eighteenth-century London, and Polari’s descent from showmen’s Parlyaree, are not curiosities. They show that underground languages form where outlawed people meet. The tavern, the fair, the theater, the port, and the prison were shared spaces, and their languages mixed.
5.2 Dyadic codes and communal languages differ in kind. Two lovers hiding an affair need only a cipher, a signal, or a private nickname. A community hiding a way of life needs a language. Studies that treat a lovers’ cipher and Polari as the same kind of thing miss the difference between concealing an act and sustaining a subculture.
5.3 The record is written by the exposer. Nearly every historical underground language comes down through hostile, comic, or commercial intermediaries. Harman wrote to warn magistrates, Greene to sell pamphlets, and Round the Horne to make people laugh. Any reconstruction must allow for exaggeration, invention, and moral framing by the recorders.
5.4 Decline tracks openness, not virtue. An underground language fades when its deed can be spoken openly, whether because the deed has been legalized, because enforcement has collapsed, or because public norms have changed. The death of a secret language therefore tells something about the surrounding society’s standards, not necessarily about the morality of the deed itself.
5.5 The persecuted and the guilty use the same tools. Metaphor, recognition signs, borrowed words, and gesture serve the hunted believer and the hunted thief alike. Mechanism cannot settle moral evaluation; only the deed concealed can.
6. A Biblicist Evaluation
Scripture neither condemns all hidden speech nor excuses it. Several distinctions follow from the text.
Concealment as testimony against the deed. “For it is a shame even to speak of those things which are done of them in secret” (Ephesians 5:12). When a community must invent a language to discuss what it does, the invention is a form of self-judgment. The adulterer who waits for twilight, the thief who “conveys,” and the false beggar whom Luther warned against all bear witness in their speech that their deeds cannot stand the light. Their language is evidence of a conscience that knows the verdict, even while it seeks to dull it.
Exposure is certain. “For there is nothing covered, that shall not be revealed; neither hid, that shall not be known. Therefore whatsoever ye have spoken in darkness shall be heard in the light” (Luke 12:2–3; cf. Ecclesiastes 12:14). Human history illustrates this pattern on a small scale: every successful underground language is eventually catalogued, published, and turned into comedy or curiosity. Elisha told the king of Israel “the words that thou speakest in thy bedchamber” (2 Kings 6:12) to the king of Syria. No secret counsel is secret before God. “Woe unto them that seek deep to hide their counsel from the LORD, and their works are in the dark, and they say, Who seeth us? and who knoweth us?” (Isaiah 29:15; cf. Ezekiel 8:12).
Legitimate privacy is not concealment of wrong. The Song of Solomon is full of veiled imagery between bride and bridegroom: gardens, fountains, and vineyards. This is the private poetry of covenant love, not the cipher of an illicit affair, and its existence shows that intimate language between husband and wife is honorable. Samson’s riddle and his figurative rebuke, “If ye had not plowed with my heifer” (Judges 14:18), show that veiled speech in itself is not sinful. Trade discretion is not theft, and a guild’s protected craft knowledge is not a crime.
The persecuted righteous may speak guardedly. Where faithfulness is criminalized, guarded speech is prudence, not guilt. Jesus Christ’s parables both hid and revealed, and believers under hostile rulers have always needed discretion.
The biblicist position, then, is that underground language is a diagnostic sign, not a verdict. It reveals that something is being hidden. Whether the hiding reflects guilt, persecution, or legitimate privacy depends on the deed itself, judged by the standard of Scripture rather than by the standard of whichever authority happens to enforce or relax concealment at a given time. This is exactly why the field cannot be narrowed to any one category of secret love. The question that underground language raises is not about the identity of the speakers but about the relation between their conduct and the light.
7. Recommendations for Further Research
Comparative lexicography across categories. Studies of Polari, thieves’ cant, Parlyaree, and Shelta should be read together, with attention to shared vocabulary, shared venues, and shared speakers.
Attention to heterosexual concealment codes. The language of adultery, clandestine courtship, and commercial vice deserves systematic study comparable to that given to homosexual argots.
The moral-anesthesia function. Research should examine how euphemism within underground languages shapes speakers’ own perception of their deeds, drawing on both sociolinguistics and moral theology.
Source criticism. Every reconstruction should assess how the hostile or commercial interests of recorders shaped what survives.
The persecuted-righteous strand. Coded speech of persecuted believers should be studied alongside criminal and illicit codes, so that analysis can tell apart concealment forced by injustice from concealment chosen to hide wrong.
Notes
[1] On “lavender linguistics” and the study of gay men’s speech, see Leap (1996).
[2] Baker (2002) is the standard scholarly account; Baker (2019) offers a broader narrative history.
[3] On Gayle, see Cage (2003); on Lubunca, see Kontovas (2012). Swardspeak has received less sustained treatment in English-language scholarship.
[4] Baker (2002) traces Polari’s sources in Parlyaree, Italian, Romani, Yiddish, backslang, and older English cant.
[5] Norton (1992) discusses the molly houses and their vocabulary, noting overlap with underworld cant.
[6] On Ovid, see note 19; on the Times ciphers, see note 21.
[7] Halliday (1976) is the foundational article; his examples include Elizabethan cant and the argots of Calcutta’s underworld and Polish prisons.
[8] On Polari’s decline after 1967, see Baker (2002). On the general leakage of cant into public speech, see Coleman (2004) and Partridge (1937).
[9] Harman (1567). Harman’s pamphlet was plagiarized extensively by later writers.
[10] Greene (1591).
[11] Head (1673); B. E. (c. 1698); Grose (1785).
[12] Coleman (2004) is essential for source criticism of the canting dictionaries.
[13] Baker (2002) discusses Round the Horne and its double effect of popularizing Polari and ending its usefulness for concealment.
[14] Hotten’s 1860 English edition (Hotten, 1860) includes Luther’s preface. Luther’s comments on the Hebrew element in the vocabulary appear there.
[15] Hugo (1862), Part 4, Book 7.
[16] On Lunfardo, see Conde (1998); on Verlan, see Lefkowitz (1991).
[17] Meyer (1891).
[18] Mayhew (1851) records costermongers’ backslang.
[19] Ovid, Ars Amatoria, Book 3. The advice is given to women seeking to evade watchful guardians.
[20] Kahn (1967) discusses mlecchita-vikalpa in his account of early cryptography.
[21] Kahn (1967) recounts Wheatstone and Playfair’s reading of Times personal-column ciphers.
[22] Greenaway (1884); for history and source criticism, see Seaton (1995).
[23] The fan maker Duvelleroy is commonly associated with promoting a printed “language of the fan” in the nineteenth century; documentary evidence that the code was widely used is weak.
[24] The meaning of particular spirituals as coded escape messages is debated, and some popular claims exceed the evidence. The general pattern of guarded religious speech under persecution is well established.
[25] Halliday (1976).
[26] Shakespeare, The Merry Wives of Windsor, 1.3.
References
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Baker, P. (2002). Polari: The lost language of gay men. Routledge.
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Every compiled book shows choices about order. Readers rarely notice these choices because sequence feels natural once it becomes familiar. Yet the order of materials in a book is never neutral. It records what the compiler believed about the materials: which parts carry the most authority, how the parts relate to each other, how the book will be used, and what the reader should understand first and last.
The Bible is the clearest case. The same body of Scripture has been arranged in different sequences by different communities. Each sequence expresses a different understanding of how the books fit together. This paper sets out a typology of the main logics by which books are organized, illustrates each with biblical and non-biblical examples, and proposes a method for inferring a compiler’s logic from the structure of a finished book. It closes with observations on what this means for readers of Scripture who want to receive the text as God gave it rather than only as later hands arranged it.
1. The Problem: Order as an Interpretive Act
A compiler who gathers independent units into one volume faces a decision that the original authors did not face. Moses did not decide where Ruth would sit. Paul did not decide whether Romans or 1 Thessalonians would come first in a collection of his letters. Those decisions belong to the people who collected, copied, and bound the materials.
Because order shapes reading, it also shapes interpretation. A book placed after another book reads as a continuation, a response, or a fulfillment. A book placed last reads as a conclusion. A book placed in a group reads as a member of a category. Arrangement therefore functions as a silent commentary. It cannot add words to the text, but it does tell readers how to hold the words in relation to one another.
The practical consequence is that the structure of a book serves as evidence. An analyst who studies how materials are ordered can often reconstruct the assumptions, priorities, and purposes of the people who did the ordering, even when those people left no explanation.
2. A Typology of Organizing Logics
The following categories describe the main principles by which compilers arrange materials. Most real books combine several of them, often at different levels of the structure.
2.1 Authority or Precedence
Materials are ordered by their weight or foundational status. What comes first is what everything else depends on.
Biblical example. The Hebrew arrangement of Scripture opens with the Torah, the five books of Moses, followed by the Prophets and then the Writings. The Torah stands first because the rest of Scripture assumes it. The prophets call Israel back to the covenant given through Moses, and the Writings reflect on life lived under that covenant. Jesus Christ referred to this threefold division when He spoke of what was written “in the law of Moses, and in the prophets, and in the psalms” concerning Himself (Luke 24:44).
Other examples. National legal codes place constitutional or foundational provisions before subordinate regulations. Corporate policy manuals often open with mission and governance before operating procedures.
Diagnostic signal. When a book opens with material that later sections cite, quote, or presuppose, precedence is likely the governing logic.
2.2 Genre or Form
Materials are grouped by literary type: law with law, history with history, poetry with poetry, prophecy with prophecy.
Biblical example. The arrangement used in most English Bibles derives from Greek and Latin traditions and groups the Old Testament into law, historical books, poetic and wisdom books, and prophets. Under this logic, Ruth moves from the Writings to sit beside Judges, since both are narratives set in the same era. Daniel moves from the Writings into the Prophets. Chronicles moves from the end of the canon to sit after Kings, because both are histories of the monarchy.
Other examples. Collected works of an author are often divided into fiction, poetry, essays, and letters. Libraries shelve by subject class.
Diagnostic signal. When books of differing dates and authors sit together because they share a form, genre is the governing logic. Genre-based orders often split materials that another logic would join.
2.3 Chronology
Materials are ordered by the time of the events they describe or by the time of their composition. These are two different chronologies, and a compiler must choose between them.
Biblical example. The historical books from Genesis through Kings follow the chronology of events. Modern “chronological Bibles” extend this logic across the whole canon, inserting Job near Genesis, placing psalms beside the episodes in David’s life they reflect, and interleaving the prophets with the reigns of the kings under whom they spoke. Some arrangements of the Minor Prophets also reflect a rough chronology, with prophets of the Assyrian period preceding those of the Babylonian and Persian periods.
Other examples. Histories, biographies, diaries, and archival series commonly follow chronology.
Diagnostic signal. Look for whether the sequence tracks events or authorship. A chronological Bible that places Job early is following the setting of the narrative, not the date of writing, and that choice reveals a compiler more interested in the story of redemption than in literary history.
2.4 Use or Occasion (Liturgical Logic)
Materials are ordered according to when or how they are read, sung, or performed.
Biblical example. Within the Writings, the five short scrolls known as the Megillot are, in many Hebrew printed editions, arranged in the order of the occasions at which they are read: the Song of Solomon at Passover, Ruth at the Feast of Weeks, Lamentations on the ninth of Av, Ecclesiastes at the Feast of Tabernacles, and Esther at Purim. Here the order of the calendar, not genre or date, determines the sequence of books.
Other examples. Hymnals are frequently arranged by the calendar of worship or by the parts of a service. Lectionaries are organized entirely by occasion. A songleader’s binder arranged by service order follows the same principle.
Diagnostic signal. When the sequence of a book mirrors a calendar, a ceremony, or a routine, the compiler expected it to be used in time rather than read straight through.
2.5 Magnitude (Length or Size)
Materials are ordered from longest to shortest, or occasionally the reverse.
Biblical example. The letters of Paul in the New Testament are arranged in two groups: letters to congregations, then letters to individuals. Within each group, the letters run roughly from longest to shortest. Romans stands first not because it was written first (it was not) but because it is the longest. Philemon stands last among Paul’s letters as the shortest letter to an individual. The arrangement says nothing about date, and readers who assume it does will misread Paul’s development.
Other examples. The Mishnah’s tractates within several of its orders are arranged roughly by number of chapters. Some anthologies place major works before minor ones.
Diagnostic signal. When a sequence correlates with length but not with date, theme, or authority, magnitude is likely the rule. Magnitude is a mechanical logic, often chosen precisely because it avoids contested judgments about importance or date.
2.6 Authorship or Source
Materials are grouped by who wrote them or by which collection they came from.
Biblical example. The Pauline letters form a block. So do the letters of John. The Book of Psalms contains clusters attributed to David, to Asaph, and to the sons of Korah. Proverbs is divided by headings naming Solomon, the men of Hezekiah who copied Solomon’s proverbs, Agur, and Lemuel.
The case of Hebrews. The placement of Hebrews shows how authorship logic interacts with other rules. In some ancient manuscripts, Hebrews appears among Paul’s letters to congregations, after 2 Thessalonians. In the order familiar to English readers, it stands after Philemon, at the head of the general letters. Its position at the seam between groups records the uncertainty of compilers about whether to count it as Paul’s. Placement became a way of expressing a judgment about authorship without stating one.
Diagnostic signal. Headings, attributions, and blocks of material sharing a name point to source-based logic. Items sitting at the boundary of an author group often mark disputed attribution.
2.7 Narrative or Argumentative Progression
Materials are ordered so that the sequence itself tells a story or builds a case.
Biblical example. The New Testament as commonly arranged moves from the Gospels (the life, death, and resurrection of Jesus Christ), to Acts (the spread of the church), to the letters (instruction to the churches), to Revelation (the consummation of all things). Whatever the dates of the individual books, the arrangement reads as a movement from foundation to fulfillment. The Old Testament in its English order similarly closes with Malachi, whose final words about the coming of Elijah lead directly into the opening of the Gospels.
Other examples. Textbooks build from foundational concepts to advanced applications. Legal briefs arrange arguments from strongest to supporting. Many cookbooks follow the order of a meal.
Diagnostic signal. When the end of one unit sets up the beginning of the next, or when the first and last units form a deliberate frame, the compiler intended a reading experience and not only a filing system.
2.8 Framing and Inclusio
The compiler deliberately pairs the opening and closing units so that they bracket everything between them.
Biblical example. In the Hebrew arrangement, the canon opens with Genesis and closes with Chronicles. Chronicles begins its genealogy with Adam and ends with the decree of Cyrus inviting the exiles to go up to Jerusalem. The whole canon thus runs from creation to the call to return. Jesus Christ spoke of the blood of the righteous “from the blood of righteous Abel unto the blood of Zacharias” (Matthew 23:35; compare Luke 11:51), naming the first murder in Genesis and a murder recorded in 2 Chronicles 24. Many interpreters understand this as a reference to the span of Scripture from its first book to its last, which would indicate that the canon He knew ended with Chronicles.
Other examples. Poetry collections often open and close with poems that answer each other. Albums sometimes open and close with related tracks.
Diagnostic signal. A thematic echo between first and last units is rarely accidental. It indicates a compiler thinking of the whole as a single shaped work.
2.9 Catchword and Linkage
Adjacent units are joined because they share a word, image, or theme, so that each unit hooks into the next.
Biblical example. Within the Book of Psalms and within the Book of the Twelve, many adjacent units share key words or themes at their junction. The Psalter is also divided into five books, each closing with a doxology, a division that many readers have connected to the five books of Moses.
Other examples. Oral traditions and memorized collections often use catchwords as memory aids. Anthologies of sayings frequently cluster by keyword.
Diagnostic signal. When the reason for an adjacency cannot be explained by genre, date, length, or author but the end of one unit and the start of the next share vocabulary, catchword linkage is likely.
2.10 Alphabetical and Formal Patterning
Materials are arranged by an external formal system, most often an alphabet.
Biblical example. Within individual books, acrostic structure appears in Psalm 119, Proverbs 31:10–31, and the first four chapters of Lamentations. Here alphabetical order governs the arrangement of verses or stanzas, expressing completeness: the subject is treated from first letter to last.
Other examples. Dictionaries, encyclopedias, indexes, and directories.
Diagnostic signal. Alphabetical order in a reference work signals random-access use; the reader is expected to look things up rather than read through. Alphabetical order in poetry signals totality and often aids memorization.
2.11 Accession or Accretion
Materials appear in the order in which they were acquired, composed, or added to a collection.
Biblical example. The appended headings in Proverbs, such as the note that certain proverbs were copied out by the men of Hezekiah (Proverbs 25:1), show a collection that grew in stages, with later material added after earlier material.
Other examples. Archival collections, legislative session laws, and serial publications often preserve the order of acquisition. Appendices and supplements accumulate at the back of a book.
Diagnostic signal. Repeated headings, colophons, and sections that seem to restart the collection indicate growth over time rather than a single act of arrangement.
3. Nested and Competing Logics
Real books seldom follow a single logic. More often, different logics govern different levels of structure.
The New Testament letters provide a clean example. At the top level, the logic is source: Pauline letters before general letters. At the next level, the logic is audience: letters to congregations before letters to individuals. At the lowest level, the logic is magnitude: longer letters before shorter. Three distinct principles operate in a single sequence.
Different communities have weighted these levels differently. In the arrangement that prevails in many Eastern manuscripts, the general letters (James through Jude) follow directly after Acts and precede Paul’s letters, which places the writings of the apostles at Jerusalem ahead of the apostle to the Gentiles. Martin Luther, in his German New Testament, moved Hebrews, James, Jude, and Revelation to the end, a placement that expressed his own judgment about their standing relative to the other books.
These variations demonstrate that order can carry theological judgment. When a compiler moves a book, the move often records an opinion about authorship, authority, or doctrine that the compiler might not have stated directly.
Competing logics also create anomalies, and anomalies are among the most useful evidence. Ephesians is often noted as slightly longer than Galatians in the Greek text, yet Galatians usually precedes it. Such small departures from the dominant rule suggest either a different counting method, an inherited sequence older than the length rule, or a secondary consideration. In the Hebrew order of the latter prophets, an old rabbinic listing places Jeremiah and Ezekiel before Isaiah, while later printed editions put Isaiah first, a shift from one principle to another that is visible only because the two orders can be compared.
4. Reading Structure as Evidence: A Diagnostic Method
The following steps allow an analyst to infer a compiler’s logic from the finished arrangement of a book.
Step 1: Identify the units. Determine what the compiler treated as the basic pieces: books, chapters, letters, poems, entries. Headings, colophons, doxologies, and blank spaces mark these boundaries.
Step 2: Identify the groups. Look for clusters of units that sit together. Ask what the members of each cluster share: form, author, period, audience, length, use.
Step 3: Test each candidate logic. For each cluster and for the sequence as a whole, check whether the order tracks authority, genre, chronology of events, chronology of composition, occasion, length, author, narrative progression, linkage, or alphabet. The logic that explains the most with the fewest exceptions is likely the governing one.
Step 4: Examine the first and last positions. Openings and conclusions are the most deliberate placements in any arrangement. Ask what the opening establishes and what the conclusion resolves. Look for framing between them.
Step 5: Study the anomalies. Find the units that break the dominant pattern. These often reveal a secondary logic, an inherited order, or a disputed judgment. Units at the boundary between groups deserve particular attention.
Step 6: Compare with alternative arrangements. When the same materials survive in more than one order, the differences isolate the choices each compiler made. A single arrangement shows what was done; two arrangements show what was chosen.
Step 7: Infer the intended use. Ask whether the arrangement assumes reading straight through, reading on occasions, studying by topic, or looking up particular items. The answer reveals the audience and purpose the compiler had in view.
5. Application Beyond the Bible
The same method applies to any compiled work.
A hymnal arranged by topic expects a songleader to select hymns for a sermon theme. One arranged by the order of service expects a fixed liturgy. One arranged alphabetically expects users who already know what they want. The arrangement shows the compiler’s model of how worship is planned.
A legal code arranged by subject title reflects a codifier’s view of how law divides into domains. Session laws arranged in order of enactment reflect a record of legislative activity rather than a system of law.
A cookbook arranged by course assumes a meal as the unit of use. One arranged by ingredient assumes a cook starting from what is in the pantry. One arranged by season assumes a cook working with what is available.
A collection of essays arranged chronologically invites readers to trace an author’s development. The same essays arranged by theme invite readers to see a body of thought. The same essays arranged as an argument invite readers to accept a conclusion.
An album arranged as a deliberate sequence of tracks expresses an artistic arc, while a compilation arranged by release date or by popularity expresses an archival or commercial logic.
In each case, the structure speaks for the compiler even when no preface explains it.
6. Implications for Readers of Scripture
For readers who hold the text of Scripture as inspired, the study of arrangement yields several practical conclusions.
First, the order of books is an arrangement of inspired texts, and it deserves careful attention without being confused with the texts themselves. The words of Scripture are given by God. The sequence of books in a given printed edition reflects the decisions of those who collected and transmitted them. Some arrangements carry strong scriptural warrant, as the references of Jesus Christ to the law, the prophets, and the psalms, and to the span from Abel to Zechariah, indicate for the Hebrew order of the Old Testament. Others reflect later conventions of genre, length, or theology.
Second, unfamiliar arrangements can expose assumptions that familiar ones hide. A reader who has only known the English order may assume that Ruth belongs with Judges or that Daniel belongs with the major prophets. Reading Scripture in the Hebrew order, where Ruth sits among the Writings and Chronicles closes the canon, reveals connections that the genre-based order obscures, such as the way Chronicles gathers up the whole history of Israel from Adam to the return from exile.
Third, the logic of an arrangement should not be mistaken for a claim about the text. Romans stands first among Paul’s letters because of its length, not because it is the earliest or because it outranks the others. Hebrews stands where it does because of compilers’ uncertainty about its author, not because of any judgment within Scripture itself. Readers who know the logic behind an arrangement can avoid drawing conclusions the arrangement does not support.
Fourth, the study of arrangement guards against the subtle authority of habit. Communities tend to treat familiar orders as given. Knowing that orders differ, and knowing why, allows readers to weigh which arrangement best reflects the testimony of Scripture about itself.
7. Conclusion
The order of materials in any compiled book records the mind of its compiler. Authority, genre, chronology, occasion, length, authorship, progression, framing, linkage, formal patterning, and accretion are the main principles by which materials are arranged, and most books combine several of them at different levels. By identifying units and groups, testing candidate logics, attending to first and last positions, studying anomalies, and comparing alternative arrangements, an analyst can reconstruct the reasoning behind a structure that its makers may never have explained.
The Bible offers the richest field for this kind of study because its books have been arranged in several orders by communities with differing purposes. Each order is a reading of the whole. Recognizing the logic behind each arrangement allows readers to see which connections belong to the text and which belong to its compilers, and to give the greater weight to the arrangement that Scripture itself attests.
On 2 November 2026 the Home Secretary set out the final form of the “earned settlement” policy. The right to live in the UK permanently will no longer be granted almost automatically after five years, and will instead depend on contribution and character. The standard wait for indefinite leave to remain (ILR) rises from five years to ten for most migrants, with faster routes for high earners and certain public service workers and slower routes for those with immigration breaches or benefit claims. Refugees are sorted by manner of arrival.
This paper makes three arguments:
The policy is a response to a stock problem, namely a large cohort admitted in 2021–2024 now approaching settlement eligibility. It is not a response to current inflows, which have already fallen sharply.
Applying new conditions to people already in the pipeline is lawful in the UK, but lawfulness is a lower bar than justice. The government has recognised this in part through transitional protections, but those protections are narrow.
The UK is following a wider European and Anglosphere movement from rights-accrual toward conditionality. It is distinctive in how openly it ties settlement to income.
The paper relies on government publications and press coverage from the day of the announcement. The detailed Immigration Rules text and the impact assessments have not yet been published, so some conclusions are provisional.
1. What Has Changed
1.1 The September statement of changes
A smaller Statement of Changes (HC 584) was published on 3 September 2026. It introduced updates across work, family, student and EU Settlement Scheme routes, and the commentary on it described it as not a significant statement. Among its more notable provisions, it strengthens the rules on those who have previously frustrated immigration control, and it supports Skilled Workers who are recognised victims of modern slavery. These are incremental. The earned settlement announcement is the major development.
1.2 The earned settlement model
The Home Secretary stated that the changes will begin to be laid in the December Immigration Rules and will be implemented over the course of 2027, with impact assessments to follow as they roll out. The tiers, as published, are as follows.
Qualifying period
Who
Principal conditions
3 years
Exceptional economic contribution
Earnings above £125,141 for three years, or entry through the Highest Talent Group
5 years
Strong contribution
Earnings above £50,271 for 3 of the last 5 years; eligible public service occupations (doctors, nurses, teachers); British connection
10 years
Default
Earnings of at least £12,571 for 5 of the previous 7 years; all mandatory requirements met
20 years
Breach or benefit history
Same as 10-year path, but with a qualifying immigration breach or public funds access
Source for table: government consultation response as reproduced by the Electronic Immigration Network.
All applicants, whatever their date of arrival, must meet four conditions: a clean criminal record (tightened from the current threshold of a 12-month suspended sentence), spoken English at a high standard, no debt to the taxpayer, and a record of sustained National Insurance contributions. Those who have claimed benefits must have had five continuous years off public funds before applying.
1.3 Refugees
Refugee settlement now depends on the route of arrival. Refugees admitted through designated safe and legal routes can settle after five years. Those granted protection in the UK who move into sustained work or study face ten years. Those who remain on “core protection” face twenty. An additional ten years applies to people who entered illegally, for example by small boat, producing a maximum of thirty years, except where Article 31 of the Refugee Convention applies.
1.4 Groups retaining their current routes
Family members of British citizens, Hong Kong BN(O) holders and members of the armed forces keep their current pathways, and settled status is never removed from anyone who already holds it. Windrush-related legacy routes are also preserved.
1.5 Care workers and the transitional arrangements
The most contested group was social care workers. Between 2022 and 2025, 250,000 people and their dependants arrived on or switched into the route. The final policy divides them:
Care workers who met their visa conditions, including earning at least £25,000, keep their five-year route.
The roughly quarter who did not qualify will be offered a new five-year visa, after which they may apply for settlement. This visa is not tied to their previous employer.
Similar arrangements apply to certain public sector workers in healthcare and education, such as auxiliary nurses.
These concessions apply only to people who joined the relevant routes before the Immigration White Paper of May 2025.
The Home Office estimates that over 500,000 people will wait longer than five years to settle, and states that no one will be forced to leave.
2. The Domestic Context: Why This Policy, and Why Now
2.1 The flow has already fallen; the stock has not yet settled
Net migration peaked at 649,000 in the year to June 2024 on the earlier estimate. It fell to 204,000 in the year to June 2025, a 69% drop. A later estimate put net migration at 171,000 for 2025, down 48% on the previous year. The Office for Budget Responsibility forecasts that net migration in 2026 will fall to its lowest level since 1997.
The fall in inflow explains why the settlement reform is aimed elsewhere. As reported before the announcement, the Home Secretary set out the delay to settlement amid concerns over the wave of legal arrivals approaching eligibility after the record post-Brexit net migration under the previous government. The measure addresses the cohort admitted during the 2021–2024 surge, whose five-year clocks are now running out. In effect, the state is managing the long tail of a past policy rather than the present arrival rate. This distinction matters for evaluating the policy. Public frustration about migration is largely tied to the peak years, while the fiscal and demographic effects of that peak are still arriving.
2.2 The concerns the policy answers
Public concern about migration is a mix of several distinct worries, and the policy speaks to each differently:
Control and legitimacy. The Prime Minister framed the policy around a system “based on control, contribution,” that rewards those who play by the rules.
Fiscal burden. The Home Secretary emphasised that settlement confers access to free education, the NHS and welfare, and the government states that its Department for Work and Pensions expects savings of billions of pounds.
Abuse of sponsorship. The care route is the clearest case. 1,800 exploitative employers have been stripped of their sponsorship licences. The Home Secretary’s Commons statement gave a lower figure of around 1,400, so the number should be treated as unsettled until the formal documents are consulted.
Irregular entry. The refugee tiers are designed to make route of arrival decisive.
2.3 Political reception
The announcement is politically contested from both sides. The Shadow Home Secretary described the expected changes as a U-turn on ILR. Advocacy groups call the reform the biggest restriction on settlement rights in decades, and campaigners object that it was launched without an impact assessment. The government’s reply is that impact assessments will accompany implementation. The consultation closed in February 2026 after drawing very large numbers of responses, and the government’s final tally was 204,667. Parliamentary committees raised concerns: the House of Commons Home Affairs Committee urged the government to get the changes right rather than rush them, and the House of Lords Justice and Home Affairs Committee opposed both the ten-year baseline and any retrospective effect.
3. The Justice Question: Changing the Rules for Those Already in the System
3.1 The legal position
UK law permits the change. The Home Secretary’s stated principle is that settlement rules are determined when the decision is made, not when someone arrives, a position she described as long established and tested in the courts. The controlling authority is generally understood to be Odelola v Secretary of State for the Home Department [2009] UKHL 25, which held that applications are decided under the rules in force at the date of decision unless the rules provide otherwise. This figure and case citation come from general legal knowledge rather than today’s sources, and a lawyer should verify them before the paper is published.
3.2 The arguments for the change as just
The strongest case rests on four points:
Settlement is a new status, not a continuation. Temporary leave promises temporary residence. Permanence has never been a contractual entitlement. Parliament retains authority over who may remain permanently.
Public consent underwrites the welfare state. The Home Secretary argued that citizens will only support shared taxation and universal services if everyone is seen to contribute.
Past policy was itself a mistake. If the 2021–2024 admissions were made on terms the state would not now choose, correcting course is a legitimate act of government.
Transitional relief shows proportionality. Care workers who met their conditions keep their route, and the rest get a second chance.
3.3 The arguments against
The objections are weightier than the legal position suggests:
Reliance. Migrants made life-altering decisions on the stated terms: selling property, relocating families, enrolling children in schools, and leaving careers. Doubling the wait is a cost imposed after the commitment was made.
Asymmetry. The state may change the rules, but the migrant cannot renegotiate the commitments already made. One party bears the risk of the other’s policy shift.
The cutoff is arbitrary at the edges. Transitional protections apply only to those who joined before May 2025. The government justifies this by saying the ten-year position was widely understood after the White Paper. That reasoning is plausible for new arrivals, but it implies that someone who arrived in April 2025 is treated very differently from someone who arrived in June 2025, even though both arrived under the five-year rule.
Penalties compound. A benefit claim triggers a twenty-year path. A breach does the same. Some critics argue these can fall on people who fell ill, lost work or were exploited by sponsors. Campaigners, whose figures should be treated as partisan, have pointed to waits of up to thirty years or more in particular combinations.
Evidence. Because the full impact assessment is not yet published, the fiscal case of “billions” cannot yet be independently tested.
3.4 Scriptural considerations
For a reader approaching this question from Scripture alone, several principles bear on the justice question. This section is separable from the rest of the paper.
The stranger is protected. Leviticus 19:33–34 and Exodus 22:21 forbid oppressing the sojourner, and Numbers 15:15–16 states that one law applies to the native and the sojourner. That principle favours equal treatment under whatever standard is set.
Changing terms after the fact is condemned. Jacob’s complaint against Laban was that his wages were changed ten times (Genesis 31:7, 41). Psalm 15:4 commends the one who swears to his own hurt and does not change. Proverbs 20:10 and Deuteronomy 25:13–16 condemn unequal weights and measures. These texts weigh against altering terms for those who have already relied on them.
Authority to set terms is not denied. Scripture does not require open borders or automatic permanence. Deuteronomy 23:7–8 describes graded conditions for admission to the assembly by generation, and Romans 13 recognises the civil magistrate’s role in ordering the community. A graded, earned path to permanence is not in itself unscriptural.
Taken together, these texts favour a state that sets reasonable and equal terms and keeps its promises to those who relied on them. They do not condemn the principle of a longer path. They weigh most heavily against retroactive worsening of the terms for people already in the pipeline.
4. The Global Context
4.1 The European pattern
The UK change belongs to a wider movement. A Nordic research report found that Sweden and other Nordic countries have tightened migration and integration frameworks in recent years, shifting from a rights-based approach to one centred on migrants’ obligations and individual responsibility.
Sweden. Sweden tightened its citizenship rules on 6 June 2026, requiring eight years of residence, higher income and mandatory language and civic knowledge, and abolished permanent residency for new refugees on 9 June 2026. A Swedish government plan also sought to retroactively remove residency from over 100,000 people, which makes retroactivity an active question beyond the UK.
Denmark. Denmark’s approach has been shaped by a “zero refugee” stance since 2019, and Denmark recorded a historic low of 839 asylum approvals by the end of November 2025. Denmark also raised fees and salary thresholds for foreign workers from January 2026. Commentary on the 2025 UK asylum plan describes it as based on the immigration model in Denmark.
Germany. Germany is described in one comparison as offering one of the most straightforward mixes of lower salary thresholds and relatively quick settlement inside the EU. It is therefore a partial counter-example, although it too has been reducing some fast-track provisions.
4.2 The Anglosphere and other competitors
A comparison of six systems in April 2026 concluded that the UK is stretching settlement timelines, Canada is leaning harder on categories and provinces, Australia is redesigning employer sponsorship, and New Zealand is embedding wage thresholds into residence planning. Australia has also issued a new priority processing order that favours law enforcement, defence, construction, healthcare and teaching occupations. The common thread is selection by occupation and wage, a stricter filter on who may stay permanently, and growing use of income as a proxy for contribution. I have less recent verified detail on the United States, so this paper does not characterise US policy.
4.3 What is distinctive about the UK
Three features distinguish the UK approach from its peers:
Explicit income tiering. Few comparable systems tie the length of the settlement path so directly to specified salary bands. The result is that a hospital porter and a hedge-fund analyst face different lengths of probation for the same rights.
Route-of-arrival penalties. Penalising refugees for how they arrived, while granting a short path to those on approved routes, adds a deterrence logic to the settlement system. This is in tension with the Refugee Convention’s Article 31 principle on irregular entry, which the policy partly acknowledges through an exception.
Competitive positioning alongside restriction. The government pairs restriction with a pitch to be the most business-friendly migration system in Europe for highly skilled workers. The aim is a sharper contrast between wanted and unwanted migrants, rather than a uniform reduction.
4.4 The risk of competition
If peer countries tighten at the same time, the effect on the global market for skilled workers is ambiguous. Tightening everywhere reduces the cost of tightening in any one country. But if the UK sets a longer settlement path than Canada, Australia or Germany for mid-range earners, it risks losing workers in sectors where it needs them, including social care, teaching support and hospitality.
5. Assessment
What the policy gets right. It identifies a real problem: a cohort admitted on policy that the government no longer endorses. It offers a coherent principle, that permanence should follow contribution and conduct. It also concedes ground to care workers who kept the terms of their visas.
Where it is exposed.
The date-of-arrival cutoff will generate hard cases at the margin and likely litigation under legitimate expectation and Article 8 ECHR arguments, even though the legal baseline favours the government.
The income proxy confuses contribution with earnings. Carers, teaching assistants and agricultural workers contribute without crossing £50,000.
The stacking of penalties can produce waits that exceed a working career, and the consequences of administrative error or sponsor misconduct falling on the individual are severe.
The absence of published impact assessments leaves the fiscal claims unverified.
Recommendations for a fair implementation.
Publish the full impact assessment before the rules take effect, with sensitivity ranges.
Extend transitional protection to everyone who arrived on the five-year terms, or at least add a hardship and sponsor-fault exception.
Cap cumulative penalties so that no combination produces a wait beyond a defined maximum.
Treat public funds claims arising from sickness, disability or sponsor failure differently from voluntary reliance.
Review the income thresholds annually against wages and the real cost of care and public services.
Caveats
This paper was prepared on the day of the announcement. The detailed Immigration Rules text, the final Home Office impact assessment and the official Hansard transcript were not yet available. The Statement of Changes figures and some press-reported numbers, such as the number of sponsor licences revoked, differ between sources. The Odelola citation and the scriptural references are given from general knowledge and should be checked before publication.
Sir Patrick Stewart, who died at his home in Los Angeles following what his spokesperson called a “brief and poignant journey” with Alzheimer’s disease and Lewy body dementia, spent more than six decades in front of audiences. To most of the world he was Captain Jean-Luc Picard and Professor Charles Xavier. To the Royal Shakespeare Company, he was one of the great classical actors of his generation. To a smaller but no less important audience of domestic abuse survivors, combat veterans, and animal rescuers, he was something else: a public figure who spoke about his own family’s wounds so that other families would not have to suffer in silence. This essay traces both halves of that life, the long climb from a poor Yorkshire mill town to international stardom, and the way Stewart turned what he witnessed as a boy into a lasting commitment to people and creatures that society had misjudged or failed.
A Childhood in Mirfield
Stewart was born on July 13, 1940, in Mirfield, West Yorkshire, England, the youngest of three children. His father was a regular soldier and his mother was a weaver. The household was poor, and it was also violent. His father, Alfred, was violent towards Patrick’s mother, Gladys, and Stewart later recalled that the family sometimes had to call an ambulance. He and his brothers sometimes attempted to place themselves between their parents to stop their father from hitting their mother. The actor later explained that his father never physically abused the children. The violence was directed at Gladys.
What made the experience worse was the response of the authorities. The police and ambulance drivers would often tell his mother that she must have done something to provoke the violence, or that it takes two to have an argument. The child who watched those scenes learned two lessons that would shape his public life: that violence in the home is often hidden by the very institutions meant to stop it, and that blame is easily shifted onto the person who suffers it.
Performance offered an early way out. Stewart credited an English teacher at school with sparking his interest in performing, and he was a member of various local drama groups from about age 12. One account of his life observes that acting initially gave him somewhere to escape, and eventually his fame gave him a platform to make sure other women and children knew they were not alone.
The Stage Years
Stewart’s reputation was first built in the theater rather than on screen. He joined the Royal Shakespeare Company in 1966 and remained a core member until 1982, appearing in numerous Shakespeare productions, including “Macbeth,” “The Merchant of Venice” and “Henry IV.” Those sixteen years gave him the discipline, vocal command, and authority that would later make his science fiction roles believable to audiences who might otherwise have dismissed the genre. During this period he also took small screen work; he made his TV debut as a fire officer on the British soap opera “Coronation Street” and appeared in films like “Hedda,” the David Lynch-directed “Dune,” and “Excalibur.”
Even after Hollywood fame, he never abandoned the stage. Over his career he won three Laurence Olivier Awards for his theater work and received a Tony Award nomination. Upon his death, the RSC remembered him, in a phrase worth quoting, as “a colossus of both stage and screen”.
Picard, Xavier, and Global Fame
Stewart’s breakthrough came unusually late. In 1987 at age 47, Stewart landed his breakthrough role as Captain Jean-Luc Picard on “Star Trek: The Next Generation.” He played the role for all seven seasons and later reprised it for four Star Trek films in the 1990s and 2000s, plus the Paramount+ series “Star Trek: Picard.” Picard was a captain who led by reason, diplomacy, and moral seriousness rather than bravado, and Stewart’s Shakespearean training gave the character a gravity that made him a model of principled leadership for a generation of viewers.
A second defining role followed with the X-Men films, which began in 2000. As Charles Xavier, Stewart became a beloved figure in the franchise, especially opposite fellow iconic actor Ian McKellen as rival Magneto. He holds a Guinness World record for longest tenure in a Marvel-based role, having played Professor X for two decades across several films. His career extended to the very end: his final film role was voicing Sir Richfield in the comedy The Sheep Detectives, released in 2026, and he also reprised his role as Professor X in Avengers: Doomsday, scheduled to premiere on December 18, 2026.
Honors followed his work. He was knighted by Queen Elizabeth II in 2010 for his contribution to dramatic art. He kept close ties to the place that formed him, serving as Chancellor of the University of Huddersfield from 2004 to 2015 and continuing his association as Emeritus Chancellor. His friend Ian McKellen said that Stewart “never forsook his origins”, counting the chancellorship as his proudest achievement. Late in life he published his memoir, Making It So, in which he describes growing up poor in Mirfield, how he became an actor, and the highs and lows of his career from British theater to Star Trek and beyond. The memoir was also candid about his own failings; he revealed that he had an affair with his Star Trek: The Next Generation costar Jennifer Hetrick during his marriage to Sheila Falconer, which led to their divorce and his estrangement from their children. That honesty about his own wrongdoing gives his advocacy a certain credibility: he did not present himself as a hero untouched by moral failure.
Refuge: Speaking for His Mother
Stewart’s most personal cause was the fight against domestic violence. He described how his father’s drinking and violence towards his mother when he was young led him to become a patron of Refuge, which supports domestic abuse victims, most of them women and children. In a 2019 piece for HELLO!, he wrote openly that as a child he witnessed repeated violence against his mother, and he pressed readers on the scale of the problem and the need for funding.
His position on responsibility was firm. Even after learning about his father’s war trauma, he insisted that it did not excuse the abuse: in his words, “Violence is always a choice a man makes and he alone is responsible for it.” He also refused to treat domestic violence as a matter for survivors alone to solve; during a Refuge event, he described it as a problem that men needed to confront because men were overwhelmingly responsible for committing the violence.
The most widely remembered moment of this advocacy came unplanned, at a 2013 fan convention in Houston. Asked a question by a young woman, he explained that “The work that I do in campaigns about violence towards women, particularly domestic violence, grew out of my own childhood experience.” When she revealed that she had endured similar circumstances, Stewart left the stage to embrace her, and the video of that exchange circulated far beyond the audience of science fiction fans.
Combat Stress: Understanding His Father
The second cause grew out of a discovery made late in life. While filming the BBC genealogy series Who Do You Think You Are?, he discovered that his father had returned from action in the Second World War suffering from severe shell shock. Alfred Stewart had served with the King’s Own Yorkshire Light Infantry, and as the KOYLIs retreated, Alfred saw the horrors of mechanised war and the way the Nazis targeted civilian refugees. A local newspaper report from the time recounted some of his experiences during the evacuation from France in 1940 and stated that this gave him shell shock from which he still suffered. An expert told Stewart that servicemen are often more profoundly affected by witnessing ill-treatment of civilians than by their own combat experiences.
The discovery changed how he understood his father without changing his judgment of the violence. While stating his discoveries had not changed his attitude to domestic violence, his view of his father was transformed. He reflected that his mother likely knew things about his father that he had only just discovered, which explained why she loved him and never stopped loving him. This led him to become an ambassador for Combat Stress, the mental health charity that helps military veterans.
Stewart saw the old stigma around shell shock as part of the problem. As he told the Houston audience, in 1940 soldiers were basically being told to pull themselves together and “be a man.” He drew a direct line from his father’s untreated trauma to soldiers then returning from Iraq and Afghanistan, and he summed up his twin commitments simply: he worked for Refuge for his mother and for Combat Stress for his father, in equal measure. That balance is perhaps the most striking feature of his advocacy. He held justice and compassion together, refusing either to excuse his father or to write him off.
Pit Bulls: Challenging a Stereotype
Stewart’s third cause, the destigmatization of pit bull type dogs, came much later and in a lighter key. It is worth stating plainly that Stewart himself did not describe this cause as springing from his childhood the way Refuge and Combat Stress did; the connection is a matter of pattern rather than a stated motive (see Note 3). His conversion began with a neighbor’s dog. Of meeting her, he admitted that pit bulls had meant only one thing to him: “aggression, hostility, violence.”
That changed when, in the course of working on an anti-dogfighting campaign with the ASPCA, he decided he wanted to foster a pit bull. In 2017, Patrick and his wife Sunny fostered a pit bull named Ginger, an act documented in a popular video that helped people understand the valuable love and companionship pit bulls can offer families. Ginger’s history mattered to the story: she had been a breeding dog at a dog fighting ring. Stewart could not bring her home permanently because of British law, and he criticized that law publicly, arguing that legislation on dangerous dogs should do more to target the owners rather than the animals.
The advocacy continued. Patrick and Sunny fostered several more pit bulls in their home, and Patrick insisted on featuring a pit bull on Star Trek: Picard. In 2021 the ASPCA honored him with the Pit Bull Advocate & Protector Award for his deep commitment to improving the public’s perception of pit bulls and protecting them from cruelty.
A Common Thread
Read side by side, these three causes share a recognizable shape. In each case Stewart defended someone whom the surrounding society had misjudged: an abused wife told she had provoked her beating, a traumatized soldier told to toughen up, and a dog presumed dangerous because of its breed and the cruelty of its handlers. His argument about breed-specific laws, that responsibility belongs with the owner rather than the animal, echoes his insistence that responsibility for domestic violence belongs with the abuser rather than the victim. In each case he also used his own changed mind as testimony, whether it was his revised understanding of his father or his admitted prejudice against pit bulls. The moral clarity that audiences admired in Picard was, in Stewart’s public life, something he worked out through painful honesty about his family and himself.
Conclusion
Patrick Stewart’s career was a long demonstration that late success can be lasting success, and that classical training can lend dignity to any genre. Yet his legacy is not only a list of roles. The boy who stepped between his parents in Mirfield grew into a man who used a famous voice to speak for women in danger, for veterans carrying invisible wounds, and for animals bred for cruelty. He did not pretend that his father’s suffering canceled his father’s sins, nor did he pretend that understanding was unnecessary. That combination of firmness and mercy is perhaps the most enduring part of what he made so.
Notes
Dates of death and announcement: Stewart died on Wednesday, October 28, 2026; his representatives announced the death on Thursday, October 29, 2026. Some outlets report the date of announcement rather than the date of death, so the two dates appear in coverage.
The Who Do You Think You Are? episode aired in 2012. Some later secondary accounts give slightly different dates for when Stewart learned of his father’s shell shock; the 2012 broadcast is the most reliable anchor.
On the pit bull advocacy: Stewart explicitly tied his work with Refuge and Combat Stress to his childhood, but the sources consulted do not show him attributing his pit bull advocacy to that trauma. He described it as growing out of an ASPCA anti-dogfighting campaign and his own overturned prejudice. The essay’s connection between this cause and the others is an interpretive observation about a shared pattern, not a claim about his stated motives.
The 2013 convention exchange took place at Comicpalooza in Houston, Texas. Quotations from it are drawn from a published transcript of the event video.
Stewart’s statement that violence is “always a choice” appeared in his own commentary piece for HELLO! in February 2019 and is quoted from that magazine’s report.
Greenwood, A. (2017). Wags to riches: Patrick Stewart and his foster pit bull terrier. Best Friends Animal Society. https://bestfriends.org/node/298154
A common claim among patients and families holds that repeated major surgeries under anesthesia, such as successive knee or hip replacements, carry serious mental consequences that are well known, yet that these procedures are often scheduled close together. The claim also holds that nurses and pharmacists may understand these risks better than surgeons do. The research literature supports part of this claim, complicates part of it, and does not yet answer the rest.
Three points stand out. First, short-term cognitive disturbance after major surgery in older adults is common, well documented, and clinically important. Second, the evidence that anesthesia itself, as opposed to surgery, inflammation, and the drugs given around the operation, causes lasting cognitive harm is mixed. Studies of cumulative exposure reach conflicting conclusions. Third, the clearest weaknesses lie in how knowledge moves through the system: who screens patients, who notices symptoms, who reviews medications, and who follows the patient after discharge.
1. Terminology
Older literature used “postoperative cognitive dysfunction” (POCD) loosely. In 2018 an international working group proposed a shared vocabulary. It recommended “perioperative neurocognitive disorders” as an umbrella term covering impairment found before surgery, acute postoperative delirium, cognitive decline found up to 30 days after the procedure (delayed neurocognitive recovery), and decline up to 12 months (postoperative neurocognitive disorder). The terms were tied to DSM-5 criteria. Critics noted at the time that the recommendations might be useful but were not yet complete, and that some terms were used imprecisely. This matters because studies using different definitions report very different rates. Comparison across the literature is therefore difficult.
Two conditions need to be kept apart:
Postoperative delirium: an acute, fluctuating disturbance of attention and awareness, usually in the first days after surgery. It can be hyperactive (agitated), hypoactive (quiet and withdrawn), or mixed.
Delayed neurocognitive recovery / postoperative neurocognitive disorder: subtler declines in memory, attention, or executive function, detected by testing over weeks to months.
2. What Is Known
2.1 Short-term cognitive changes are common in older surgical patients
The foundational study is ISPOCD1, published in The Lancet in 1998. It tested 1,218 patients aged 60 or older before major non-cardiac surgery and again at one week and three months afterward. Cognitive dysfunction appeared in about 26% at one week and about 10% at three months, compared with roughly 3% in matched controls. One finding bears directly on repeated surgery: longer anesthesia, less education, a second operation, postoperative infections, and respiratory complications were risk factors for early dysfunction, but only age predicted dysfunction at three months.
Later summaries put the incidence of perioperative neurocognitive disorders in older non-cardiac surgical patients at approximately 30% at one week, 10% at three months, and 1% at one year. Most patients recover. The ISPOCD group found no difference between surgical patients and controls at one to two years, and most patients with dysfunction at one week had recovered after several months.
Recovery is not universal, and the minority who do not recover face real consequences. A Danish follow-up of ISPOCD patients found that cognitive dysfunction at three months, though not at one week, was associated with increased mortality, and that postoperative dysfunction was linked to leaving the workforce early and depending on social payments.
2.2 Delirium is a recognized complication of joint replacement
For joint replacement specifically, researchers describe postoperative delirium as a serious and common complication in older adults, associated with higher risk of other postoperative complications, mortality, and longer hospital stays. Reported rates vary widely. A 2025 meta-analysis attributes this to differences in study populations, surgical procedures, diagnostic criteria for delirium, and perioperative management protocols.
The strongest predictor is the patient’s condition before surgery. Baseline cognitive deficit was the main risk factor for cognitive disorders after hip arthroplasty, and postoperative delirium predicted early postoperative cognitive dysfunction. The ASA Brain Health Initiative’s clinical summary likewise identifies pre-existing cognitive impairment as a significant risk factor for perioperative neurocognitive disorders.
2.3 Anesthesia type matters less than once believed
A long-standing assumption held that regional (spinal) anesthesia protects the brain better than general anesthesia. Two large randomized trials in hip fracture patients tested this.
The REGAIN trial enrolled 1,600 patients across 46 hospitals in the United States and Canada. Delirium occurred in 20.5% of the spinal group versus 19.7% of the general group. A secondary analysis of patients who already had cognitive impairment found that anesthesia type was not associated with differences in delirium or functional recovery, whether or not preoperative impairment was present.
The RAGA trial in China went further by avoiding all sedation in the regional arm. Delirium occurred in 6.2% of the regional group and 5.1% of the general group, with similar severity and type. An editorial on the trial concluded that its results support the view that avoiding sedative-hypnotic medications does not prevent postoperative delirium, while raising the possibility that excessively deep anesthesia, rather than general anesthesia as such, may be harmful.
These trials involved emergency hip fracture repair, not elective joint replacement. Still, they shift attention away from the anesthetic agent alone and toward the whole surgical event: tissue injury, inflammation, pain, sleep disruption, hospitalization, and the many other drugs a patient receives.
2.4 Medications around surgery are a known, modifiable risk
The best-established precipitating factors are drugs given before, during, and after the operation. The American Geriatrics Society Beers Criteria list medications to avoid in older adults. A University of California, San Francisco quality improvement study notes that drugs commonly used around surgery that contribute to delirium in older patients include anticholinergic drugs such as diphenhydramine and scopolamine, benzodiazepines, and meperidine. A case report illustrates how easily these accumulate: a geriatric patient undergoing an uncomplicated procedure received multiple potentially inappropriate medications, including midazolam, metoclopramide, glycopyrrolate, and dexamethasone.
Interventions targeting these drugs work. The UCSF program found that a perioperative delirium prevention intervention was associated with reduced administration of Beers-listed medications to older adults. At a large university hospital, an educational video followed by an electronic health record alert advising over 300 anesthesia practitioners to reduce or omit Beers medications in patients 70 and older produced a significant reduction in their use.
2.5 Cumulative exposure: the evidence conflicts
The central question raised by the original claim, whether multiple surgeries compound harm over time, has no settled answer. The studies split.
Studies finding no association:
A Mayo Clinic population study found no significant association between cumulative surgical anesthesia exposure after age 40 and mild cognitive impairment, whether measured by number of exposures or total cumulative duration.
A prospective Group Health study concluded that anesthesia exposure was not associated with increased risk of dementia or Alzheimer’s disease in older adults. However, it also found that high-risk surgery with general anesthesia, compared directly with other surgery under general anesthesia, carried a higher hazard for both dementia and Alzheimer’s, and called for further study.
Studies finding an association:
A nationwide cohort of about 219,000 people published in the Journal of Alzheimer’s Disease in 2018 reported that dementia risk was increased after general anesthesia, and that the number of anesthetic agents, the number of exposures, cumulative exposure time, and the organ category of surgery were all associated with dementia risk.
The 12-year Maastricht Aging Study, reported in 2025, found that greater time under general anesthesia at baseline correlated with significant decline in three of four cognitive domains, though to a lesser extent than aging and comorbidities.
The disagreement likely reflects a basic problem with observational data. People who need many surgeries are, on average, sicker, older, and more frail than those who need few. Separating the effect of anesthesia from the effect of the underlying illness that required surgery is very difficult without randomized trials, and randomizing people to repeated surgery is not possible.
3. Who Holds the Knowledge
The original claim suggests that knowledge is unevenly distributed among professions. The evidence partly bears this out, but the picture is more complicated than “surgeons know less, nurses and pharmacists know more.”
Anesthesiologists. It is worth noting that surgeons do not administer anesthesia; anesthesiologists and nurse anesthetists do. The anesthesia profession has led organized attention to this problem. The American Society of Anesthesiologists created its Perioperative Brain Health Initiative in partnership with AARP and other stakeholders, including the American College of Surgeons. A working group under that initiative organized its best-practice recommendations around preprocedure consent, preoperative cognitive assessment, intraoperative management, and postoperative follow-up.
Surgeons. Orthopedic decision-making about staging tends to focus on mechanical and medical complications. A 2025 meta-analysis concluded that simultaneous bilateral knee replacement lowers reoperation and cost at the expense of higher complications and mortality. Earlier reviews found that simultaneous procedures carry higher rates of mortality, pulmonary embolism, and transfusion, but lower rates of deep infection and revision. Cognitive outcomes rarely appear among the measured endpoints in this literature. Some cohorts exclude cognitively impaired patients outright: one study states that individuals with cognitive impairment, psychological illness, or a history of addiction or balance disorders were not included. That exclusion removes from the evidence base precisely the patients most at risk.
Nurses. Nurses hold a structural advantage: they have a far higher rate of patient interaction than any other healthcare professional. Yet research consistently shows that this proximity does not automatically produce recognition. In a landmark study by Inouye and colleagues, nurses identified delirium in only 31% of affected patients compared with researchers, and hypoactive delirium raised the odds of under-recognition about sevenfold. A Cleveland Clinic study found that in one cohort, an advanced practice nurse found 24 patients positive for delirium, while ward nurses identified only four. Nurses report barriers of their own: inadequate time with patients, and the importance of nurse-physician communication for detection and treatment. Training improves detection, but the claim that nurses already know better than physicians is not well supported as a general rule. Individual experienced nurses may well have sharp clinical judgment; the profession as a whole has documented blind spots.
Pharmacists. Pharmacists bring specific expertise in drug interactions, anticholinergic burden, and the Beers Criteria. A Korean study of surgical oncology patients concluded that a pharmacist’s comprehensive review of preoperative medications is critical for outcomes such as delirium in older patients. A Veterans Affairs evaluation found that documented risk-benefit assessment of anticholinergic use in veterans with dementia occurred only about 13% of the time, which illustrates how often this knowledge goes unapplied when no one is assigned to apply it. However, evidence for pharmacist-led prevention specifically in surgery is still thin. A Japanese cardiovascular study noted that pharmacist-led interventions have shown limited evidence for reducing postoperative delirium in cardiovascular surgery.
Geriatricians. Geriatric medicine has produced much of the prevention evidence. A review in Current Opinion in Critical Care notes that perioperative geriatric consultation, early surgery, effective pain management, and staff education have reduced the incidence and severity of delirium in hip-fracture patients. Geriatric consultation is not routine for elective joint replacement in most settings.
Families. Families often notice changes that no clinician sees, because the subtler cognitive declines appear after discharge. An ASA representative described patients reporting that they can no longer do the crossword or find their car. These observations rarely reach the surgical team.
4. Gaps in Knowledge
Attribution. Researchers still cannot cleanly separate the effects of the anesthetic, the surgery, inflammation, pain, opioids, sleep loss, and hospitalization. The RAGA and REGAIN results suggest the anesthetic agent alone is not the main driver of delirium, but they leave the role of anesthetic depth and accompanying drugs open.
Cumulative and repeated exposure. Large observational studies disagree on whether multiple surgeries raise long-term dementia risk. No study has resolved confounding by underlying illness.
Optimal spacing between staged procedures. The literature comparing simultaneous and staged bilateral joint replacement measures mortality, clotting, transfusion, infection, and cost. It says little about cognition. There is no evidence-based minimum interval for cognitive recovery between procedures. A randomized trial comparing staged and simultaneous bilateral knee arthroplasty (NCT03564730) has an estimated completion in December 2026, but its registered description does not indicate a cognitive endpoint.
Long-term outcomes in the most vulnerable. Many joint replacement studies exclude patients with existing cognitive impairment, who face the highest risk.
Measurement. Definitions, tests, and timing vary so much that incidence figures range widely. The 2018 nomenclature was meant to address this, but adoption is incomplete.
Interventions. The Brain Health Initiative summary states that multicentre randomized trials and observational studies are still needed to determine whether current best-practice recommendations reduce perioperative neurocognitive disorders.
5. Gaps in Application
Even where knowledge exists, it often does not reach practice.
No preoperative cognitive baseline. Without a baseline test, postoperative decline cannot be measured. A German review observed that detecting perioperative neurocognitive disorders depends on extended neuropsychological testing that is often not feasible because of economically driven time constraints during preoperative assessment.
Informed consent rarely addresses cognition. ISPOCD’s authors stated in 1998 that their findings had implications for the information given to patients before surgery. Nearly three decades later, cognitive risk is still not a standard part of consent conversations for elective joint replacement.
Detection depends on staff who are not trained to find the quiet form. Hypoactive delirium, the form most often missed, looks like a calm, tired patient rather than a confused one.
Short hospital stays move the problem home. Joint replacement has shifted toward same-day or one-night stays. Delirium and delayed recovery that emerge afterward fall to family members who may not recognize them and have no clear clinician to call.
Medication review is not routinely assigned to anyone. Pharmacist review of anticholinergic and sedative burden is effective where it happens, but most surgical pathways do not require it.
No one owns postoperative cognition. The surgeon follows the joint, the primary care physician follows chronic disease, and the anesthesiologist’s responsibility ends at recovery. Cognitive follow-up falls between these roles.
Scheduling decisions draw on incomplete outcome data. When staging intervals are chosen, the evidence that informs them weighs blood loss, clotting, and cost. The cognitive dimension is largely absent, not necessarily from neglect but because the data do not exist.
6. Assessment of the Original Claim
“There are serious mental consequences with multiple replacement surgeries and anesthesia.” Partly supported. Cognitive disturbance after major surgery in older adults is common and sometimes lasting, and a prior operation is a documented risk factor for early dysfunction. Whether repeated surgeries cause lasting cumulative harm remains unresolved, and the anesthetic itself may matter less than the surgical event and surrounding medications.
“This is well known.” Well known among anesthesiologists and geriatric specialists; much less consistently known among patients, families, and some surgical teams, and not consistently reflected in consent or scheduling.
“Surgeons schedule surgeries close in time.” Close staging, including intervals of a week, is a recognized practice. The evidence base guiding it largely omits cognitive outcomes.
“Nurses and pharmacists may be more aware.” Pharmacists have specialized knowledge of the drugs most strongly linked to delirium and are underused. Nurses have the most patient contact and are crucial observers, but studies show they frequently miss delirium, especially the quiet form, unless trained and given standardized tools. Experience and judgment vary by individual more than by profession.
7. Recommendations
For health systems:
Screen cognition before elective surgery in patients over 65, using brief validated tools, so that a baseline exists.
Build pharmacist medication review, focused on Beers-listed drugs and anticholinergic burden, into the standard joint replacement pathway.
Use electronic health record alerts for high-risk medications in older patients.
Train nursing staff in standardized delirium screening with emphasis on the hypoactive form.
Assign clear responsibility for cognitive follow-up after discharge.
For researchers:
Include cognitive endpoints in trials comparing staged and simultaneous joint replacement and different staging intervals.
Stop excluding cognitively impaired patients from studies whose findings will be applied to them.
Adopt the 2018 nomenclature consistently to allow comparison across studies.
For patients and families:
Ask the surgical and anesthesia teams about cognitive risk, especially when bilateral or closely spaced procedures are proposed.
Request a medication review before surgery, including over-the-counter sleep aids and allergy medications.
Know what a baseline looks like so that changes after surgery can be recognized.
Report new confusion, unusual sleepiness, or withdrawal promptly, even after discharge.
Conclusion
The problem described in the original claim is real, but its shape differs from the popular version. The anesthetic agent is probably not the sole or main villain. The larger issue is that the surgical event, the drugs given around it, and the patient’s prior condition combine to produce cognitive harm that is common, usually temporary, occasionally lasting, and frequently unnoticed. Knowledge of these risks is spread across professions that do not consistently share it, and the decisions about scheduling repeated surgeries rest on evidence that measures nearly everything except the mind of the patient.
At a recent memorial service for a longtime member of a congregation descended from the Worldwide Church of God (WCG), an observer noted a pattern. The women wearing the most makeup were disproportionately the wives and widows of ministers. This seems ironic, since the tradition’s leadership long held a strong anti-makeup position. The irony deepens because the memorial drew a large share of the ministry in the region, with nearly every minister serving in Washington and Oregon in attendance. That gives the observation a wider base than a single household or congregation would.
This paper argues that the pattern is not best explained as hypocrisy. It follows from how the makeup rule was made, unmade, and remade within the WCG. It also follows from the social position of ministerial households, the demographics of the women involved, and the nature of the gathering itself. Rules in hierarchical religious bodies tend to be experienced as fixed at the periphery and as contingent at the center. The ministerial households of the WCG stood at the center during repeated reversals of this exact rule.
I. Background: A Rule That Changed Three Times
The makeup prohibition in the WCG was not a stable doctrine. Its history is a series of reversals, each issued from headquarters and passed down through the ministry. Herbert W. Armstrong forbade makeup for women in the church’s early years; the ban was relaxed in the 1970s, Armstrong reimposed it in 1981, and Joseph W. Tkach removed it permanently in 1988. The 1970s relaxation can be dated precisely. Christianity Today, reporting on that period’s turmoil, listed the removal of the prohibitions on makeup and birthday observance in June 1974. That change was one of a cluster of revisions made under economic and doctrinal pressure, including moving Pentecost from Monday to Sunday and modifying the divorce and remarriage policy.
So a woman who married into the ministry in the 1960s lived through a prohibition, a release, a reimposition, and a final release within about twenty-five years. After 1995, many of these households moved into successor organizations. Those bodies carried forward much of the older culture, but not always every older standard with equal force.
II. Proximity to Rule-Making Breeds a Contingent View of Rules
The single most important factor is structural. In a hierarchical body, ordinary members receive rules as finished products. They hear a ruling read from the pulpit or printed in a member publication, and they have little view of what came before it. Ministers and their wives receive the same rules from much closer. They hear the deliberations, the private reservations of other ministers, the pastoral exceptions, and the reversals before they are announced.
In the WCG, ministers were also the enforcement layer. They were responsible for explaining the rule, defending it, and applying it to members. When the rule reversed, they had to explain the reversal too. A minister’s wife who watched her husband teach a standard in 1973, set it aside in 1974, and reinstate it in 1981 could hardly treat it as a timeless command. She saw it as a policy subject to the judgment and circumstances of the man at the top. Once the final release came in 1988, she had little reason to hold onto a rule the institution itself had treated as negotiable.
Members further from the center had a different experience. For many of them, the rule settled into conscience and habit. That helps explain why some lay women of the same generation still wear little or no makeup decades after any requirement was lifted. Their compliance was internalized. The ministerial wife’s compliance was more often institutional, and it ended when the institution’s demand ended.
III. The Ministerial Wife as a Public Office
In the WCG, the minister’s wife functioned as part of a two-person office. She hosted, visited, accompanied her husband to services across a circuit of congregations, attended Feast of Tabernacles sites and ministerial conferences, and served as an example to the women of the congregation. Ambassador College, which trained much of the ministry and many of their wives, placed heavy emphasis on deportment, grooming, etiquette, and a polished appearance befitting what the church called “the Work.”
This produced a tension within the ministerial role. One standard said to avoid cosmetics. Another said to present oneself at the highest level of polish as a representative of the church. When the first standard was lifted, the second remained and became the operative norm. Women trained to be the best-presented people in the room naturally adopted the grooming conventions of the professional class whose presentation the church had always admired.
IV. Release After Maximum Scrutiny
The women who were watched most closely under a standard often move furthest from it once the standard is removed. Ministers’ wives were among the most scrutinized women in the church. Members watched their dress, their children’s behavior, and their adherence to every rule, because their conduct reflected on their husbands’ standing and fitness to serve. Retirement and widowhood removed much of that scrutiny. A widow whose life was spent as an example has, in a real sense, been released from the office. Some degree of compensation, conscious or not, is to be expected.
V. The Composition of the Memorial
The presence of so many ministers is not incidental to the observation. It shapes it in four ways.
First, it enlarged the sample. With nearly the whole regional ministry present, a large number of ministerial wives and widows were in the same room at once. That makes the pattern harder to dismiss as one or two individual cases.
Second, it changed the reference group. When a minister’s wife attends services in her own congregation, she is mainly seen by members. At a memorial attended by most of the regional ministry, she is also among the wives of her husband’s colleagues, many of whom she has known for decades through conferences, Feast sites, and transfers. Such a gathering works more like a professional reunion than an ordinary service, and people dress for their peers. If the ministerial households share a grooming norm among themselves, a large gathering of them will display it collectively.
Third, it raised visibility. Ministerial wives and widows are known faces whom members recognize and watch. Their appearance is noticed and remembered, while that of an unfamiliar woman passes with less comment.
Fourth, a memorial is a formal occasion where older women in particular want to look composed and dignified. The widows present, especially, were attending in a public setting where their own standing as the surviving half of a ministry was on display.
VI. Age as a Confounding Factor
Ministers’ widows, and wives of ministers who served long careers, are among the oldest women in any congregation. Older women more often wear foundation, blush, and lipstick to look healthy and composed, particularly at formal events. A portion of the observed pattern may therefore reflect age rather than position. Even so, age alone does not explain it. Many older lay women in the same tradition still wear little or no makeup, which points back to the different ways the rule was received at the center and at the periphery.
VII. The Biblical Foundation of the Prohibition
From a biblicist standpoint, the strength of the original prohibition depended on how firmly it rested on Scripture. The case rested more on inference than on command. The usual prooftexts were these:
2 Kings 9:30, where Jezebel paints her eyes before her death. The passage portrays a wicked queen’s final act of defiance and vanity. It does not issue a command to anyone.
Jeremiah 4:30 and Ezekiel 23:40, where painting the eyes appears in imagery of a harlot adorning herself for faithless lovers. In context the target is Judah’s spiritual adultery and seductive intent, not cosmetics as such.
1 Peter 3:3–4 and 1 Timothy 2:9–10, which direct women not to make outward adornment the source of their beauty. They point instead to the hidden person of the heart and to good works. Peter’s construction sets priorities rather than prohibitions. A strictly prohibitive reading would forbid braided hair, gold, and “putting on of apparel,” the last of which no one takes as a ban on clothing.
The scriptural principle is modesty, humility, and the priority of inward character over outward show. That principle remains binding. A blanket ban on cosmetics, however, is a human application of the principle rather than a direct command. Ministers who had to defend the rule against questions from members were well placed to recognize the thinness of the case. Their households were likely to absorb that recognition. The repeated reversals from headquarters only confirmed it.
VIII. Conclusion
The pattern noted at the memorial is better understood as a predictable outcome of institutional structure than as hypocrisy. Ministerial households stood at the center of a rule that the institution itself made, unmade, and remade within a quarter century. They experienced it as a contingent policy rather than a settled conviction. They also held a public role that demanded polished presentation, had lived under the heaviest scrutiny, and in many cases had since been released from it. The concentration of the regional ministry at the memorial turned these common circumstances into a visible collective pattern among peers.
The broader lesson concerns how rules work in religious institutions. A standard drawn by inference from Scripture and enforced by administrative authority will hold its strongest grip on those furthest from the authority that issued it. Those closest to it learn first that it can change, and they are the first to let it go when it does. Standards rooted directly in the plain commands of Scripture do not carry this vulnerability in the same way, because they do not depend on the continuing approval of the people who announced them.
North Dakota State’s first season in the Football Bowl Subdivision reframes the question of what lower-division programs can do immediately when they move up. Three conditions made the Bison’s leap workable. They had a football-only conference path. They were willing to absorb a large one-time fee and a large recurring budget increase. And in the summer of 2026 the NCAA changed its rules so that transitioning programs no longer sit out the postseason. That rule change matters most for this analysis. Under the old regime, a “bowl-eligible” newcomer was a contradiction in terms. Under the new one, a ready FCS program can compete for a bowl in its first FBS year.
This paper identifies Montana State, South Dakota State, and Montana as the FCS programs most able to repeat North Dakota State’s leap. UC Davis and a small second tier follow. On the Group of Six side, it identifies USF, Memphis, Tulane, UTSA, and James Madison as the strongest candidates for promotion into a power conference. The likeliest openings would come from an ACC fracture, which the current legislative and contractual calendar makes increasingly plausible toward the end of this decade.
I. The North Dakota State Precedent
The cost of the move
North Dakota State’s move was neither cheap nor painless. NDSU must pay a $5 million reclassification fee to the NCAA and a $12.5 million entry fee to the Mountain West, athletic director Matt Larsen confirmed. The structure of the entry fee helps explain how a school of NDSU’s size could manage it: it included a $7 million first payment due on or before July 1 with $1.1 million annual payments over the next five years.
The recurring cost is larger than the entry fees. In FY24, North Dakota State reported $30,251,922 in total athletic department operational expenses, far below the smallest Mountain West institution, San Jose State ($47,405,380). Analysts following the move estimated that the athletic budget increases would need to be in the $15ish million a year range in order to be competitive in a new league. NDSU also committed to roster growth: with additional fundraising, it plans to add 22 scholarships for football.
The structural advantage
North Dakota State could move football alone. Its other sports could stay where they were. NDSU will stay in the Summit League (with other Dakota and Midwest schools). Observers in Montana noted the significance: one circumstance benefiting North Dakota State in its move to the Mountain West is the fact that the football team competed in a football-only conference: the Missouri Valley. A program whose football conference is separate from its all-sports conference can leave for football without breaking up the rest of its athletic department. That point recurs throughout the FCS analysis below.
The rule change that made “immediate” possible
The decisive regulatory event came in June. North Dakota State and Sacramento State can now compete for bowl games in their debut FBS seasons after the NCAA Division I Cabinet voted to eliminate the two-year postseason transition penalty. This meant that the Bison would not have to wait until the end of the NCAA-mandated two year probation period to play in events such as bowl games, the Mountain West championship game, and the College Football Playoff. Before this change, programs such as James Madison suffered under the penalty. Despite winning the 2022 Sun Belt East Division title, James Madison was the most recent team kept from a bowl during the transition process; it filed a waiver to become eligible, but the NCAA denied it.
The competitive result
The Bison’s 7–2 record places them among the best teams in the Group of Six. The program entered with an exceptional foundation: since 2011, North Dakota State has amassed a 198-22 record while winning 10 of the last 15 nationals. In current composite rankings of non-power programs, NDSU sits in the top ten, alongside New Mexico 7-1, UTSA 7-1, Oregon State 5-3, James Madison 7-2, and Memphis 6-2.
II. The Evidence Base: How Recent Move-Ups Have Fared
North Dakota State is not an isolated case, but results vary widely. Before this season, four of the last six teams to transition to the FBS reached the six-win threshold for bowl eligibility in their first season, including Delaware and Missouri State in 2025. Missouri State finished 7-6 overall and 5-3 in CUSA in its first season at the FBS level in 2025 while earning a berth in the inaugural XBox Bowl. Kennesaw State’s rise was even faster. Kennesaw State went from 10 losses to 10 wins, and the win earned the program its first CUSA championship in just its second season in the conference.
The counterexample this year is instructive. Sacramento State, which moved into the MAC at the same time NDSU moved into the Mountain West, is 1–7 (0–5 MAC) under a first-year coach. Second-year programs have also regressed. Missouri State and Delaware met in October as two 2-4 Conference USA programs.
The lesson is that FCS success does not transfer automatically. What transfers is a specific combination: a stable coaching system, a deep roster that can absorb added scholarships, an established donor base, and a fan base large enough to fill a stadium against unfamiliar opponents. Sacramento State had ambition and a stadium plan. North Dakota State had a dynasty.
III. Evaluation Framework
This paper assesses candidates on two axes.
Financial readiness
Current athletic budget and its gap to the smallest members of the likely destination league
Football-specific spending
Donor capacity, shown by recent capital projects
Stadium capacity and attendance
Whether football can move without breaking up the all-sports affiliation
Competitive readiness
Sustained winning over a decade, not one peak season
Record against FBS opponents
Coaching continuity
Roster depth sufficient to absorb the jump from FCS scholarship limits
IV. FCS Programs Capable of an Immediate Leap
Tier One: Ready Now
Montana State. The Bobcats are the reigning FCS champions. The title game was decided when Montana State slipped past Illinois State 35-34 in the first FCS championship game to require overtime. Financially, Montana State already spends like an FBS program. According to data published by the Knight-Newhouse College Athletics Database at Syracuse University, Montana State was the FCS leader in 2023 on football expenses, spending nearly $8.95 million. Its competitive profile is the strongest in the subdivision now that NDSU has left. Montana State’s athletic director has publicly framed the stance this way: “We’re definitely not looking, but we are watching.”
The obstacle is structural. Montana State’s football program sits inside the all-sports Big Sky, so a football-only exit would be more disruptive than NDSU’s departure from the Missouri Valley. Montana State is also already scheduled against the Bison: NDSU is scheduled to play Montana State in the Las Vegas Classic in September 2027. That game will serve as a useful public test of the gap.
South Dakota State. The Jackrabbits combine recent championships with facilities and a structural position nearly identical to NDSU’s. South Dakota State won FCS national titles in the 2022 and 2023 seasons. Their football conference is the same football-only Missouri Valley that NDSU left. The facilities are already in place. Dana J. Dykhouse Stadium has a capacity of 19,340 (up from 11,000). The department has shown donor strength through two major projects: the $65 million Dana J. Dykhouse Stadium and the arena that was completed in the fall of 2024 at a cost of approximately $70 million. Stadium operations are also profitable. There was $5,471,000 in total revenues, while total expenditures were $4,161,000. SDSU also ranked No. 3 in FCS football expenses in 2023.
The university’s official stance is cautious. A regional report on the question was titled “Does South Dakota State have FBS aspirations? Not right now.” On paper, however, South Dakota State is the closest analogue to North Dakota State in the country. NDSU’s success in the Mountain West strengthens the Jackrabbits’ case, and it also takes away their marquee rivalry. With NDSU’s move to the FBS, it will likely put a hiatus to the Dakota Marker rivalry.
Montana. The Grizzlies have FCS-leading attendance, a national brand, and sustained playoff success. UC Davis and South Dakota – yes, the Big Sky and MVFC again – are the only two programs other than Montana State and Montana to reach the national quarterfinals in each of the last two seasons. Montana’s leadership has been the most explicit in denying active talks: “There’s been no conversations with the Mountain West or any other FBS conference,” he said. Montana faces the same Big Sky problem as Montana State. The two schools would likely move together or not at all, since separating the Brawl of the Wild rivalry carries real costs for both.
Summary of Tier One. All three schools already spend at or near the top of the FCS and draw crowds comparable to many Group of Six programs. All three have won consistently for a decade or more. Under the new postseason rules, any of them could plausibly reach six wins in a first FBS season.
Tier Two: Plausible Within a Few Years
UC Davis already has an institutional relationship with the Mountain West. UC Davis is joining the MW in all sports but football in 2026 but investing in that sport and has first right of application among FCS schools looking to join the MW in football. Davis is the one FCS school with a contractual path already in place. Its football budget and stadium are smaller than those of the Tier One schools.
South Dakota, North Dakota, and Illinois State have the competitive profile but not yet the finances. Illinois State came within a point of the 2025 title. The Missouri Valley’s depth is unusual. The MVFC sent six of its 10 teams to the FCS playoffs in 2025, including Illinois State, North Dakota, South Dakota, South Dakota State and Youngstown State. None of these programs currently spends like a Tier One school. Regional commentary in Grand Forks has urged North Dakota toward the fund-raising necessary to lock arms with the other Division I programs in South Dakota and Montana, which is an implicit acknowledgment that it is not yet there.
Where would they land?
The Mountain West is the natural destination for the Montana schools and South Dakota State. Wyoming’s athletic director has openly lobbied for expansion from the FCS. Wyoming athletic director Tom Burman has stumped in favor of the MW adding FCS schools, naming North Dakota State, South Dakota State, Montana State and Montana. For the Dakota schools in particular, geography could point to the MAC as well. The Mountain West’s current footprint already stretches far. NIU is 523 miles away from NDSU, which indicates the conference is willing to absorb long trips in exchange for strong programs.
V. Group of Six Programs Best Positioned for Power-Conference Promotion
The legislative context
The Protect College Sports Act (PCSA) shapes any discussion of promotion. The Senate voted 77-22 to pass the Protect College Sports Act, and under its terms conferences that report more than $700 million in revenue (aka the Power 4: the ACC, Big 12, Big Ten and SEC) would be limited to 20 members. Group of Six programs are treated differently from power-conference schools. Schools in the Group of Six, which includes the Pac-12, are not subject to the five-year hold. The same analysis concluded that the best path for a G6 school would be to move in a bloc of three or four to fill a significant void in the Big 12 or ACC. But if the ACC and Big 12 don’t lose schools to the Big Ten or SEC, the pipeline clogs.
In practice, then, Group of Six promotion depends almost entirely on whether power-conference schools leave first. The ACC is the league most exposed to that.
The ACC’s vulnerability
ACC Commissioner Jim Phillips has publicly expressed confidence. “We’re as healthy as we’ve ever been.” The underlying calendar is less reassuring. The settlement of the Clemson and Florida State lawsuits created a fixed exit window: the ACC’s exit fee will decline each year before leveling off around $75 million per school that season, while media deals for other leagues are expiring around that time to create at least the potential for another wave of broad realignment.
The ACC’s most valuable members are already lobbying to widen that window. The presidents and chancellors of Clemson, Florida State, Miami and North Carolina sent a letter last week to House leaders seeking to increase the bill’s membership cap for conferences from 20 to 22 schools. They also requested removing a requirement for a school to be independent for three years before joining another league. The ACC’s media contract also puts it behind its peers. Of the four power conferences, its media deal is the last to expire — in 2036. That means the other three will have time to negotiate new and surely more lucrative TV deals while the ACC is still locked into its current contract. One Virginia commentator’s conclusion was stark: there is no scenario now on the table that preserves the ACC as we’ve known it.
If the ACC loses four to eight of its strongest football schools around 2030–31, it will need to backfill in order to survive as a power conference. The Big 12 would also be positioned to take the most attractive remaining ACC schools. Either outcome opens doors for the Group of Six.
Tier One Promotion Candidates
USF. USF’s case rests on market, enrollment, infrastructure, and recent competitive improvement. USF is the fourth-largest university in Florida, and UCF successfully made the transition from the Group of 5 to the Big 12 as a massive, urban state school, and South Florida has a similar profile. The decisive asset is the on-campus stadium. USF is building a $340 million stadium that will seat about 35,000 people, including luxury and field-level suites, scheduled to open in fall 2027. It is designed to add 10,000 more seats, if future expansion is warranted. On the field, USF went 9-4 in 2025 with a win at Florida. The Bulls were ranked as highly as 18th in the Associated Press Top 25.
For an ACC rebuilding after the departure of Florida State and Miami, USF is the most logical replacement in the Florida market. It would preserve the league’s recruiting footprint and its television presence in the state. Among G6 schools, USF probably fits the ACC best.
Memphis. Memphis has the most consistent recent winning record in the American, along with corporate backing and strong basketball. In 2024, they were 11-2 overall and ended the season with a victory over West Virginia in the Frisco Bowl. The school has already shown it will spend to be promoted. Memphis did reportedly try to join the Big 12, offering the league approximately $200 million to do so, but it didn’t work out. Memphis fits the Big 12 geographically better than it fits the ACC. If the Big 12 takes ACC schools and wants a Mid-South presence, Memphis is the leading candidate.
Tulane. Tulane’s strengths are recent results and academic alignment, especially with the ACC’s research-university profile. The Green Wave were one of two G6 teams to make the CFP for the first time ever having multiple G6 teams. In earlier Pac-12 expansion assessments, Tulane was described as having a solid athletics brand, some proof of performance in sports that matter, and better TV ratings than some others considered. Tulane’s weakness is stadium size and attendance. Its 2026 season, now under .500 after a 3–4 start, shows how quickly a G6 program can fall back after a coaching change.
UTSA. UTSA combines the San Antonio market, a large public university, and current competitive form. It is 7-1 (American) this season. San Antonio is one of the largest U.S. media markets without a power-conference program. That makes UTSA a natural Big 12 target if the league backfills in Texas.
James Madison. James Madison is the clearest example of a former FCS program completing the full climb. It moved up, reached the 2025 College Football Playoff, and is now moving again. James Madison University has been accepted into the American Conference and will begin full membership there no later than July 1, 2028. The school is paying heavily to do so. James Madison will pay a $23 million entrance fee to join the American. One of the primary reasons James Madison is leaving this week is because the Sun Belt is attempting to raise its exit fees. JMU’s Virginia location makes it a direct ACC backfill candidate if Virginia Tech or Virginia were ever to leave. Its trajectory also shows FCS programs what full ambition looks like.
Tier Two Promotion Candidates
UNLV has a market, a stadium, and a new national profile. One preseason ranking listed it 1 · UNLV among G6 teams most likely to move up. Its 2026 season has been uneven, and it is less likely to be chosen than the Tier One schools.
The rebuilt Pac-12 (Boise State, Oregon State, Washington State, San Diego State, and others) is a special case. These schools are technically Group of Six, yet the Pac-12 has its own institutional identity. Its members are likelier to be absorbed into the Big 12 as a bloc than to be picked off one at a time.
North Dakota State may become a promotion candidate itself sooner than expected. During earlier Big 12 speculation, one observer noted that North Dakota State COULD generate interest in a few years. If the Bison keep winning at the FBS level, their budget will remain the only serious obstacle.
VI. Comparative Summary
Candidate
Current Level
Likely Destination
Key Asset
Key Obstacle
Montana State
FCS (Big Sky)
Mountain West
FCS-leading football spending; reigning champion
All-sports conference entanglement
South Dakota State
FCS (MVFC)
Mountain West or MAC
Football-only conference; modern stadium; donor depth
Institutional reluctance
Montana
FCS (Big Sky)
Mountain West
Attendance and brand
Same as Montana State; likely paired move
UC Davis
FCS (Big Sky)
Mountain West
Existing MW membership; first right of application
Smaller football budget
USF
G6 (American)
ACC
Florida market; new stadium in 2027
Inconsistent history before 2025
Memphis
G6 (American)
Big 12
Sustained winning; corporate backing
Geographic fit with ACC
Tulane
G6 (American)
ACC or Big 12
Academics; recent CFP appearance
Stadium size; 2026 regression
UTSA
G6 (American)
Big 12
San Antonio market
Short history at the FBS level
James Madison
G6 (Sun Belt → American)
ACC (long term)
Virginia location; proven ambition
Must first settle into the American
VII. Risks and Constraints
Financial overreach. Moving up permanently raises operating costs. Analysts made this warning plainly when Missouri State moved. Many saw the move as an expensive maneuver just to find yourself back with the same group of schools in 20 years. A program that moves up and ends up in a weakened Group of Six league may gain little revenue while taking on much higher costs.
Coaching fragility. The Sacramento State, Delaware, and Missouri State seasons show how quickly early momentum can fade when a coach leaves or the transfer portal pulls players away.
Legislative uncertainty. If the House passes the PCSA with a 20-member cap, power-conference raids will be limited and the window for G6 promotion will narrow. If the cap rises to 22 and the independence requirement is dropped, the ACC’s most valuable members gain easier exits. That would open backfill spots for USF, Tulane, and James Madison while weakening the conference those schools would be joining.
The playoff variable. The College Football Playoff expanding to 24 teams in 2027 could reduce the incentive to leave a strong Group of Six league. A conference champion’s path to the playoff would become more reliable, so the case for jumping to a power conference would rest less on playoff access and more on media revenue.
VIII. Conclusion
North Dakota State’s first season shows that an elite FCS program can be competitive in the FBS right away. The same evidence also shows that this result depends on specific institutional conditions rather than on ambition alone. Montana State and South Dakota State currently meet those conditions most closely. Montana follows, though probably only in tandem with its rival. With the postseason transition penalty gone, any of the three could realistically reach bowl eligibility in its first FBS season.
At the top of the Group of Six, USF, Memphis, Tulane, UTSA, and James Madison form the realistic pool for promotion. Their prospects depend less on their own merits than on whether the ACC holds together through the 2030–31 exit window. If it fractures, the ACC’s backfill needs and the Big 12’s opportunism will likely decide who moves up. USF’s stadium timeline and market position make it the single most logical beneficiary.
“Demon time” is a piece of internet slang that names a late-night period, or a mental state, in which ordinary restraint is set aside. Its uses range from joking self-description to open celebration of predatory behavior. When the phrase is attached to groups as different as nurses and street criminals, it carries different meanings, but in every case the people who bear the cost are mostly not the ones claiming the label. This paper sets out the term’s origin and senses, examines the two group applications that have circulated online, describes the consequences for third parties, and offers a biblical assessment of the phrase and the conduct it describes.
1. Origin and Core Meaning
The phrase took two converging paths into common use. One sense is older and tied to the hour itself: an Urban Dictionary definition dates a possible meaning back to 2011, linking the term to 3 a.m., when demons are said to come out to play. The second sense came from social media. As live-streams grew in popularity, dancers became known as demons, and demon time became associated with watching these streams—late-night Instagram Live sessions, many of them sexual in character, which surged during the 2020 lockdowns.
From these two roots, the general meaning settled into a recognizable shape. The most common meaning listed is a period in the night when all inhibitions are let loose, and the phrase has been picked up by prominent musicians. Timing is loose: it generally refers to late-night hours, typically past 10 p.m., understood as a period when inhibitions are lowered and people engage in activities they would not during the day, ranging from harmless fun to risky or chaotic behavior.
The phrase has also drifted away from the clock entirely. In sports talk it describes an athlete playing with ruthless intensity; one basketball fan used it to celebrate Steph Curry’s form. In general conversation, someone “on demon time” may simply be acting pettily, vindictively, or without mercy at any hour.
The term therefore carries four overlapping senses:
Temporal: the late-night hours, especially after midnight.
Libertine: a period of sexual license, rooted in the live-stream culture.
Predatory: a mode of acting without conscience toward others, including criminal acts.
Hyperbolic: playful exaggeration for intensity, pettiness, or chaos.
What unites them is the idea of a suspended self: a persona that takes over when normal accountability is absent and that is not held to daytime standards.
2. The Nurse Application
The pairing of nurses with “demon time” draws on two different streams of online content, and they need to be separated.
Self-deprecating night-shift humor. Nurses have long joked about the strangeness of overnight work: confused or combative patients, short staffing, and the folklore of the full moon. Nursing humor sites joke that a patient “is now demon possessed” and needs IV Ativan, and one nurse-historian’s essay observed that the sweetest daytime patient can become demon-possessed at night. In this usage, “demon time” describes the ward, not the nurse.
Accusatory commentary. A second stream, largely from relationship and divorce-focused commentary channels, uses titles like “Female Nurses Are On Demon Time” to allege that nurses as a class are prone to infidelity, ruthlessness toward coworkers, or contempt for spouses. Videos of this kind have drawn wide audiences—one carried roughly 38,000 views and was linked to a “Divorce Documentary” membership channel. These claims rely on anecdote and viral clips rather than evidence, and they turn the real strains of the job into an indictment of character.
Those strains are well documented. The greatest threat to the health of night shift nurses relates to the effects of chronic sleep deprivation, and one study found that while night nurses spent more of their hours on direct patient care than day nurses, patient outcomes were worse on the night shift. Research from Australia found that night nurses endured poorer working conditions in physical and interpersonal terms than their daytime counterparts and were less cooperative with nurses on other shifts. Fatigue, isolation from daytime family life, and tension with other shifts are real. They can produce irritability, lapses in judgment, and in some cases moral compromise. They do not establish a class-wide character flaw.
3. The Street-Crime Application
When the phrase is applied to young men in high-crime urban neighborhoods, its meaning shifts to the predatory sense. In music, social media posts, and street talk, “demon time” signals that the speaker is out at night to rob, retaliate against rivals, or commit violence without hesitation. The phrase works as a boast and a warning: a declaration that conscience has been switched off for the evening.
Several features of this use matter:
Performance. Announcing “demon time” online often precedes or celebrates actual crimes, and posts become evidence, provocation, or recruitment material.
Persona as permission. The language presents violence as the act of an alter ego rather than of the person himself, which eases the moral burden on the one committing it.
Retaliation cycles. Public boasting invites answers in kind, so one night’s “demon time” seeds the next.
A caution applies here as well. The phrase describes a subset of offenders and the culture that celebrates them. It does not describe the law-abiding majority in the same neighborhoods, who are also the most frequent victims of that small number.
4. Consequences for Others
The defining feature of “demon time” is that its costs fall mostly on people who never agreed to it.
Victims of predation. In the criminal sense, the direct consequences are robbery, assault, injury, and death. Victims in high-crime neighborhoods are usually neighbors of the offenders, not distant strangers. Families lose wage-earners, children lose parents, and survivors carry lasting injury and fear.
Neighborhoods. Late-night violence drives residents indoors, closes businesses early, depresses property values, and drives away employers. Law-abiding residents pay twice: once in danger and again in the stigma that outsiders attach to their address.
Patients. Where fatigue or misconduct degrades night care, patients bear the risk. Missed assessments, medication errors, and inattention fall on people who are sick, sedated, and unable to defend their own interests.
Coworkers. A professional culture that excuses cruelty as “demon time”—freezing out new hires, sabotaging colleagues, or neglecting shared duties—shifts the work onto others and drives out the conscientious. The old nursing complaint that the profession “eats its young” describes exactly this dynamic.
Spouses and children. In the libertine sense, a hidden late-night life costs the family its trust, its stability, and sometimes its home. Children of broken marriages carry those losses into adulthood.
Those wrongly accused by the label. The stereotype itself has victims. When an entire profession is branded as unfaithful, honest nurses face suspicion from spouses, in-laws, and the public. When an entire neighborhood is branded as predatory, its residents face suspicion from employers, police, and lenders. A label coined to describe misconduct becomes a tool for slandering people who have done nothing wrong.
The wider culture. Making light of the demonic, and treating conscience as something one switches off on a schedule, lowers the general expectation of restraint. What begins as a joke supplies a vocabulary of excuse for those who intend real harm.
5. A Biblical Assessment
The association of night with wrongdoing is ancient. Job describes those who rebel against the light in terms that cover both senses of the modern slang: the murderer who rises to kill the poor, the adulterer who waits for twilight saying no eye will see him, and the thief who digs through houses in the dark (Job 24:13–17). Proverbs 7:9 places the seduction of the simple young man “in the twilight, in the evening, in the black and dark night.” Proverbs 4:16–17 describes the wicked who “sleep not, except they have done mischief.” Jesus Christ stated the principle plainly: “every one that doeth evil hateth the light, neither cometh to the light, lest his deeds should be reproved” (John 3:20). “Demon time” is a modern name for a pattern Scripture identified long ago: darkness offers the hope of escaping accountability.
The persona does not remove responsibility. The phrase implies that a different self takes over at night. Scripture rejects that excuse. “Every man is tempted, when he is drawn away of his own lust, and enticed” (James 1:14). The sinner and the person who returns to work the next morning are one and the same, and both answer for the deed (Ecclesiastes 12:14; 2 Corinthians 5:10).
The demonic is not a joke. Scripture treats demons as real adversaries, not as party mascots. Believers are told to “give no place to the devil” (Ephesians 4:27) and to “have no fellowship with the unfruitful works of darkness, but rather reprove them” (Ephesians 5:11). Inviting the language of possession as a badge of fun treats lightly what Jesus Christ came to destroy (1 John 3:8).
The believer belongs to the day. “Ye are all the children of light, and the children of the day: we are not of the night, nor of darkness. Therefore let us not sleep, as do others; but let us watch and be sober” (1 Thessalonians 5:5–6). Paul’s charge in Romans 13:12–13 reads almost as a direct answer to the slang: “let us cast off the works of darkness… Let us walk honestly, as in the day; not in rioting and drunkenness, not in chambering and wantonness, not in strife and envying.”
Group slander is also sin. Scripture forbids false witness (Exodus 20:16) and warns against condemning the righteous with the wicked (Genesis 18:25; Proverbs 17:15). Attaching “demon time” to every nurse or to every young man in a poor neighborhood bears false witness against the many to rebuke the few. Biblical justice judges deeds individually and requires witnesses (Deuteronomy 19:15).
6. Recommendations
For individuals: Treat the slang as a warning sign rather than an invitation. Any plan that depends on darkness to avoid notice deserves scrutiny under John 3:20.
For healthcare institutions: Address night-shift fatigue, staffing, and supervision directly, and refuse to tolerate cruelty between shifts. Fatigue explains error; it does not excuse misconduct.
For communities and congregations: Counter the glamorization of nighttime violence with mentoring, visible adult presence, and honest teaching about accountability, while defending law-abiding neighbors from collective blame.
For commentators and readers: Distinguish documented misconduct from viral stereotyping. Naming specific wrongdoing is a duty; branding whole classes of people is slander.
Conclusion
“Demon time” names a real human tendency: to treat the night, or a self-declared persona, as a zone outside of judgment. Whether the setting is a hospital ward, a hidden affair, or a nighttime robbery, the costs fall on patients, coworkers, spouses, children, neighbors, and the falsely accused. Scripture’s answer is consistent: there is no hour when accountability lapses, no alter ego that bears another’s guilt, and no darkness that hides deeds from God (Psalm 139:11–12).
The United States contains a class of settlements that function as towns and cities in every practical sense except one: they have no municipal government. The Census Bureau calls them census-designated places (CDPs). Several have more than 200,000 residents, which would rank them among the hundred largest incorporated cities in the country if they were incorporated. This paper identifies the largest of these places, sets out the legal and geographic conditions that allow them to grow and persist, and assesses whether continued suburban expansion and megaregional development are likely to increase or reduce the number of large unincorporated communities. The conclusion is that the answer depends on the state. Where county government is strong, annexation is restricted, and special districts can supply urban services, sprawl tends to produce more large unincorporated places. Where state law favors incorporation or channels urban growth into existing cities, the reverse holds. The national pattern is therefore expected to diverge further rather than converge.
I. Definition and Scope
The Census Bureau’s 2020 criteria define CDPs as statistical geographic entities representing closely settled, unincorporated communities that are locally recognized and identified by name. A CDP has no legal standing. It levies no taxes, elects no council, and passes no ordinances. Its boundaries are drawn for statistical purposes, usually with input from local and county officials through the Bureau’s Participant Statistical Areas Program. Since 2000 there has been no minimum population: the Census Bureau eliminated all population threshold requirements for Census 2000, achieving consistency between CDPs and incorporated places.
The population involved is large. According to the 2010 Census, more than 38.7 million people in the United States, Puerto Rico, and the Island Areas lived in CDPs. That figure is roughly the population of California, and it understates the unincorporated population as a whole, because many unincorporated residents live outside any CDP.
II. The Largest CDPs
The table below lists the largest CDPs in the fifty states and the District of Columbia by 2020 decennial census count. Puerto Rico’s zonas urbanas are left out because the island’s municipal system is a separate case.
Rank
CDP
State
Governing entity
2020 population
1
Urban Honolulu
HI
City and County of Honolulu
350,964
2
Arlington
VA
Arlington County
238,643
3
Enterprise
NV
Clark County (unincorporated town)
221,831
4
Spring Valley
NV
Clark County (unincorporated town)
215,597
5
Sunrise Manor
NV
Clark County (unincorporated town)
205,618
6
Paradise
NV
Clark County (unincorporated town)
191,238
7
Metairie
LA
Jefferson Parish
143,507
8
East Los Angeles
CA
Los Angeles County
118,786
9
Brandon
FL
Hillsborough County
114,626
10
The Woodlands
TX
Montgomery/Harris Counties; The Woodlands Township
114,436
11
Lehigh Acres
FL
Lee County
114,287
12
Spring Hill
FL
Hernando County
113,568
13
Riverview
FL
Hillsborough County
107,396
14
Columbia
MD
Howard County; Columbia Association
104,681
15
Highlands Ranch
CO
Douglas County; Highlands Ranch Metropolitan District
103,444
Figures are 2020 census counts (see Note 1). Just below this group are Arden-Arcade (CA), Germantown, Silver Spring, Waldorf, and Ellicott City (MD), Atascocita (TX), Town ‘n’ Country and The Villages (FL), and Dale City (VA), each with roughly 70,000 to 95,000 residents.
The list is dominated by four states. Nevada, Florida, Maryland, and Virginia account for most of the largest entries, and Hawaii accounts for the single largest. Two entries are special cases. Honolulu and Arlington are CDPs only in a technical sense, since each lies inside a general-purpose government (a consolidated city-county and an urban county) that already performs municipal functions. The Census Bureau recognizes this by including them, as exceptions, in its listings of incorporated places (see Note 2). The Las Vegas Valley towns are more surprising. Enterprise grew from 14,676 at the 2000 census to more than 221,000 in 2020, which makes it one of the fastest-growing places of any kind in the country, and it did so with no municipal government at all.
III. Legal Factors
A. State incorporation and annexation law
Municipal incorporation in the United States is a creation of state law, and the states differ sharply in how easy they make it. Several legal mechanisms keep large settlements unincorporated.
Boundary-review agencies and fiscal tests. California routes every proposed incorporation through a Local Agency Formation Commission under the Cortese-Knox-Hertzberg Local Government Reorganization Act. The commission must find the proposed city fiscally viable and, under the revenue-neutrality provisions, the new city generally has to make the county whole for the revenue it would lose. For lower-income communities such as East Los Angeles, which has a modest commercial tax base relative to its population, this test is a serious obstacle. A 2012 incorporation effort there stalled largely on fiscal grounds (see Note 3).
Extraterritorial jurisdiction. Texas gives cities extraterritorial jurisdiction (ETJ) over a band of unincorporated land around their limits, and a community inside a city’s ETJ generally cannot incorporate without that city’s consent (Tex. Local Gov’t Code ch. 42). The Woodlands lay within Houston’s ETJ for decades under an agreement that deferred annexation. In 2019 Texas ended unilateral annexation by large cities (H.B. 347), and in 2023 it allowed landowners to petition for release from an ETJ (S.B. 2038). Both changes make it more likely that unincorporated areas in Texas will stay unincorporated.
Annexation moratoria. Virginia has barred city annexation of county land since 1987, and its counties can act as full urban governments. As a result, large suburban counties such as Fairfax, Prince William, and Arlington have little reason to create new municipalities, and their large CDPs (Arlington, Dale City, Centreville, Reston) remain unincorporated.
B. Strong county and parish government
The most common single cause of large CDPs is a county government that already supplies the services residents would otherwise get from a city: police, fire, roads, zoning, parks, water, and sewer.
Hawaii has no municipal level of government. The state’s four counties perform all local functions, so every settlement in the state, including the Honolulu urban core, is a CDP.
Maryland gives charter counties (Montgomery, Howard, Baltimore, Prince George’s, Anne Arundel) a full range of municipal powers. Most residents of these counties live in unincorporated places, and incorporation is uncommon.
Louisiana parishes such as Jefferson Parish govern large unincorporated populations directly. Metairie, the state’s largest CDP, has never incorporated because the parish delivers urban services.
Florida charter counties can levy taxes inside municipal service taxing units (Fla. Stat. § 125.01) to fund urban-level services in unincorporated areas. Hillsborough County, which contains Brandon, Riverview, and Town ‘n’ Country, governs a majority of its residents directly. Incorporation is governed by the Formation of Local Governments Act (Fla. Stat. ch. 165), which requires minimum population and density thresholds, a feasibility study, and an act of the Legislature.
C. Unincorporated towns and quasi-municipal status
Nevada offers the clearest case of a legal halfway house. Under Nevada Revised Statutes chapter 269, a county may create unincorporated towns with town advisory boards. These boards have no taxing or legislative power, but they give a named community a formal voice in county decisions. In the Las Vegas Valley, these towns were often created specifically to prevent annexation by neighboring cities. Sunrise Manor was created in 1957 to fight annexation by North Las Vegas. Spring Valley west of the Strip became a town in 1981. Enterprise was formed in 1996 to stave off annexation by Henderson. The Las Vegas Strip itself lies in Paradise, outside the City of Las Vegas, and the resort industry has long preferred county jurisdiction to municipal jurisdiction. This arrangement concentrates the Strip’s tax base in Clark County government, which gives the county a strong incentive to keep the towns unincorporated.
D. Special districts and private governance
In many of the largest planned communities, special districts and private associations supply the functions of a city without incorporation.
Texas municipal utility districts (Tex. Water Code ch. 54) finance water, sewer, and drainage for new subdivisions through district bonds. The Woodlands Township, a special-purpose district, provides parks, fire service, contract law enforcement, and covenant administration. The Township commissioned an incorporation study, and in November 2021 voters rejected incorporation by a wide margin (see Note 4).
Colorado Title 32 metropolitan districts, such as the Highlands Ranch Metropolitan District, finance and maintain infrastructure, parks, and open space.
Florida community development districts (Fla. Stat. ch. 190) underlie The Villages and many other master-planned developments.
Maryland’s Columbia Association, a private nonprofit funded by property-based assessments, operates recreational facilities and open space for a community of more than 100,000.
These arrangements give residents and developers most of the advantages of a city (local control over amenities and infrastructure, separate financing) without the costs of incorporation (a new tax layer, a payroll, a charter, a council). Evan McKenzie’s term “privatopia” describes the political economy of this choice (McKenzie, 1994).
E. Incorporation incentives and their reverse
Incorporation has historically been driven by a few recurring motives: defending against annexation, gaining control of land use, keeping local tax revenue, and in some periods excluding unwanted populations (Burns, 1994; Miller, 1981; Rice et al., 2014). The same motives can work in the opposite direction. Where a county already provides good services at low cost, residents gain little from a new city. Where incorporation would raise taxes, voters usually reject it. Unincorporated status also has an exclusionary side. Research on “municipal underbounding” shows that some cities have deliberately avoided annexing nearby minority communities, leaving them without municipal services (Anderson, 2008; Lichter et al., 2007). Large CDPs therefore include both prosperous planned communities that choose not to incorporate and poorer communities that have been unable to.
IV. Geographic Factors
A. Regional settlement patterns
The geography of CDPs follows the geography of local government. In New England, New York, New Jersey, and Pennsylvania, nearly all land lies inside an incorporated town, township, or borough, so large unincorporated settlements are rare. Where CDPs do exist there, as with Levittown and Brentwood on Long Island, they are hamlets inside incorporated towns (Hempstead and Islip). The town government provides municipal services, and the CDP is a statistical subdivision of it. The South and West, by contrast, have large counties, no township layer, and vast stretches of unincorporated land at the edge of each metropolitan area.
B. Sun Belt growth
Most of the largest CDPs lie in metropolitan areas that grew rapidly after 1960: Las Vegas, Tampa Bay, Houston, Denver, Washington, and southwest Florida. Rapid growth on cheap peripheral land outruns the slower political process of incorporation. Spring Hill and Lehigh Acres in Florida began as pre-platted lot subdivisions sold by mail. They filled in over decades, reaching city-sized populations before any municipal structure formed. Lang and LeFurgy (2007) call places like these “accidental cities,” and the term applies with special force to the unincorporated examples.
C. Fringe location and the edge of the urban service area
Large CDPs usually occupy the space between an older central city and newer outlying suburbs. They are dense enough to need urban services but are often too far from the central city to be annexed easily, or are separated from it by another municipality’s boundary. Brandon and Riverview sit east and southeast of Tampa, outside the city’s limits and across the county’s major highway and rail corridors. Enterprise and Spring Valley fill the land between Las Vegas, Henderson, and the federal lands bordering the valley.
D. Growth-management regimes as a counterexample
States with strong growth-management laws show the reverse pattern. Washington’s Growth Management Act (RCW 36.70A) designates urban growth areas and expects urban services to be provided by cities. This expectation helped produce a wave of incorporations in King County in the 1990s, including Shoreline, Sammamish, and Burien. Oregon’s urban growth boundaries work in a similar direction, though large unincorporated urban areas such as Aloha in Washington County show that boundaries alone do not force incorporation when a county and special districts are willing to provide services.
V. Sprawl, Megaregions, and the Future of Unincorporated Urbanism
A. The megaregional context
Jean Gottmann (1961) described the Boston-to-Washington corridor as a “megalopolis,” a continuous urbanized region spanning many jurisdictions. Later work has identified roughly a dozen such megaregions or “megapolitan areas” across the country, including the Texas Triangle, the Florida peninsula, the Front Range, and Southern California (Nelson & Lang, 2011; Regional Plan Association, 2006). Most of the projected population growth in these regions is expected on the suburban and exurban fringe, which is exactly where unincorporated land is concentrated.
B. Factors expected to increase unincorporated urbanism
Greenfield development under county jurisdiction. New master-planned communities are typically approved by counties, financed by special districts, and administered by homeowners’ associations. Each new community of this kind is a potential future large CDP.
State restrictions on annexation. Texas’s 2019 and 2023 reforms, Virginia’s annexation moratorium, and similar limits elsewhere mean that new suburbs are less likely to be absorbed into existing cities.
State preemption of municipal powers. As state legislatures in Texas, Florida, and elsewhere restrict what cities may regulate, the practical gains from incorporation shrink.
County fiscal interest. Counties that collect revenue from unincorporated commercial areas, like Clark County with the Strip, have reason to resist incorporation.
Voter resistance to new taxes. The Woodlands vote shows that even affluent communities with an organized incorporation movement may prefer the existing arrangement.
C. Factors expected to decrease it
Cityhood movements. Metropolitan Atlanta has seen a sustained series of incorporations since Sandy Springs in 2005, including Johns Creek, Milton, Dunwoody, Brookhaven, Tucker, Peachtree Corners, Stonecrest, South Fulton, and Mulberry in 2024. Florida has seen similar waves in Broward, Palm Beach, and Miami-Dade Counties. These movements are typically driven by dissatisfaction with county land-use decisions and by a desire for local control.
Maturity of established CDPs. As large CDPs age, they develop commercial cores, civic institutions, and a stronger sense of identity, all of which raise demand for self-government. Colorado’s Keystone, a former CDP, became an incorporated town in 2024 (the Town of Keystone in the Keystone, CO CDP incorporated on February 8, 2024). Millcreek, Utah, incorporated in 2016 after decades as an unincorporated part of Salt Lake County.
Growth management. States that tie urban services to cities will continue to channel new growth into incorporated jurisdictions.
Service strain. When county services fall behind rapid growth, residents tend to demand closer, more responsive government, which often takes the form of incorporation.
D. Assessment
On balance, the evidence points to divergence among states rather than a single national direction. In states with strong counties, restricted annexation, and permissive special-district law (Nevada, Florida, Texas, Maryland, Virginia, and Hawaii), continued sprawl is expected to produce more large unincorporated places and to enlarge existing ones. In states with active cityhood movements or growth-management regimes (Georgia, Washington, and to some degree Utah and Colorado), the share of residents in large CDPs is likely to fall as communities incorporate.
Megaregional growth adds a further complication. As settlement becomes continuous across county lines, the statistical boundaries of CDPs become harder to draw and less meaningful as descriptions of actual communities. The Census Bureau’s 2020 revision of its urban-area criteria already reflects this difficulty. The practical result is likely to be a widening gap between the places Americans think of as their towns and the governments that actually serve them, with counties, special districts, and private associations continuing to assume roles once reserved for municipalities. In this respect, the institutional arrangements of American local government are steadily evolving away from the classic model of the chartered city as the default unit of urban self-government.
VI. Conclusion
The largest CDPs in the United States are not anomalies. They are the predictable result of particular combinations of state law, county capacity, special-district finance, and fringe geography. Honolulu and Arlington are unincorporated because their counties are already cities. The Las Vegas Valley towns are unincorporated because they were created to resist annexation and because their county profits from the arrangement. The Woodlands, Columbia, and Highlands Ranch are unincorporated because special districts and private associations already provide what a city would. East Los Angeles is unincorporated partly because state law makes incorporation fiscally difficult for a community of its means. Whether more such places appear will depend less on the pace of sprawl itself than on the legal framework each state applies to it.
Notes
Population figures are from the 2020 Census Redistricting Data (P.L. 94-171) Summary File as published by the U.S. Census Bureau. Counts for the Las Vegas Valley towns vary somewhat among sources because Clark County’s town boundaries do not exactly match Census CDP boundaries. One local source, for example, reports 218,697 people for Spring Valley, compared with the Census CDP figure of 215,597 used here. Clark County’s own 2024 estimates show continued growth, with Spring Valley at 226,915.
The Census Bureau’s incorporated-place listings include a few exceptional census-designated places, namely Urban Honolulu and Arlington, because each lies within a government that performs municipal functions throughout its territory.
The East Los Angeles incorporation effort was considered by the Los Angeles County Local Agency Formation Commission in 2012. The commission’s fiscal analysis found the proposed city would face a structural deficit, and the measure did not proceed to a successful vote. Readers seeking documentation should consult LAFCO records for Los Angeles County.
The Woodlands Township incorporation question appeared on the November 2, 2021 ballot and was defeated by roughly a two-to-one margin. The Township’s incorporation planning studies (2019–2021) are available through the Township’s public records.
Unincorporated status in the Las Vegas Valley carries over into daily life in a way that obscures the legal reality: like other unincorporated towns in the Las Vegas Valley, it was assigned Las Vegas ZIP codes for addressing, so many residents of Enterprise, Paradise, and Spring Valley list “Las Vegas” as their address while living outside the city.
The term “boomburb” in Lang and LeFurgy (2007) is applied mainly to fast-growing incorporated suburbs, but the authors’ description of unplanned urban form applies equally to large CDPs such as Spring Hill and Lehigh Acres.
Population figures in this paper should be checked against the most current Census Bureau products before publication, since post-2020 estimates for unincorporated areas are produced by counties and states rather than by the Census Bureau’s annual place-level program.
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