A Re-Post: A Harlequin Romance Snippet

This would be a Victorian romance with heaving bosoms, handsome pirates and innocent maidens in whalebone corsets. Here's the crescendo moment:

He looked at her, with green eyes which slowly turned red with desire, the pupils opening and closing like those of a cat. Her corset bones twanged a song of lust, then broke and impaled him against the velvet-covered wall.

Catching Up on My New Yorkers (by res ipsa)

Did anyone read this profile of French feminist Elisabeth Badinter? I have to admit that I'd never heard of her. Unfortunately, the profile is not online, but if anyone who has read it would like to discuss it, the comments are yours. From the abstract:

Badinter is convinced that young Frenchwomen have been undermining their hard-won claims to equality. She believes that, in the name of “difference,” young women are falling victim to sociobiological fictions that reduce them to the status of female mammals, programmed to the “higher claims” of womb and breast.

Is this happening in the United States? Is it even happening in France? I work with a lot of young women. I don't know if they consider themselves feminists and I don't know if they think this way. The article talks a lot about the "militancy" of La Leche Legue, and how they and other organizations pressure mothers and would-be mothers to breast-feed, give birth without drugs, etc. I'm not a mom, so I don't know if these pressures exist or if Badinter is exaggerating them, but I do know from observation that mothers come in for an awful lot of hyper-analysis and criticism. I think they take a lot of crap and give themselves a lot more. It makes me sad, because I think the vast (vast) majority of them are doing they best they can, which is all anyone can ask of anybody or themselves.

Riot Rebuild (by res ipsa)

Another "Nothing to do with Feminism" post. This story -- and especially the part about the barber who has been helped by total strangers via the magic of the internets -- gave me a little much-needed hope at the end of a week when it seemed that everything was falling to pieces.

Reading THE HANDMAID'S TALE: II (by res ipsa)

I just finished the book and wanted to throw out two questions.

First, is the book anti-feminist?

Offred's mother evokes the feminists of the 1970s. She wants to live in "a world of women". She gets that, alright. When you first encounter those women, they are burning books, albeit pornography, but books nonetheless, alongside fundamentalists. Who co-opted whom? The post-revolutionary system placates fundamentalist women for the benefit of men, but no one -- neither the Aunts nor the Commanders -- seem content. The Aunts continuously try to convince the Handmaids -- or is it themselves? -- that, "Things are better this way". If things really are better this way, would you really have to keep saying so?

Second, what does it take to engineer and enforce oppression?

This system of oppression is for the benefit of men, but it relies on women to enforce it. What does it take to achieve such a pernicious hold on people? Did the men engineer it -- or just sit back and take note of the aforementioned alliance and watch the women destroy themselves? Yes, I'm talking here about the book -- and about any number of other oppressive systems. When liberals sneer words like "Obamabot" and "Firebagger" are Republicans laughing?

Contraception in the milieu of health care reform: Redux (by Skylanda)

Not long ago, during a yawn-inducing day of medical review lectures, a particular speaker threw a PowerPoint slide onto the screen with a three-part photo montage of a bottle of European-label wine, a suspiciously malodorous-appearing cheese, and a copper IUD. Underneath was a caption: “Three things that cost under $10 in France.” In the United States, a copper-based Paragard IUD will run you about $300 for the device…and another couple hundred – depending on the whims of your doctor – to have it gently placed in an orifice that will make it useful for preventing pregnancy.

Thirty-fold price difference for a device that essentially contains a few dimes’ worth of plastic and copper: there’s a lot to unpack here.

IUDs are not as popular in the US as they are in some other nations (in some parts of Europe, fully a quarter of the contracepting population uses IUDs; they are even more popular in Latin America and China). This is in no small part because of the experience of the Dalkon Shield, a largely innocent contraceptive device that was unfortunately strung up with a braided filament that tracked bacterial infections upward and resulted in enough deaths of otherwise young, healthy women that the whole branch of intrauterine contraception has never quite recovered an unbesmirched reputation. But the Dalkon Shield was largely an American product; other nations had little experience with such a toxic product, and have continued to use IUDs uninterrupted for decades.

So with a history of disaster like the Dalkon Shield, why should American women be at all interested in the IUD at all? The World Health Organization puts out a neat little chart of birth control methods in a hierarchy of effectiveness. You will note that effectiveness is largely a proxy for how often you have to think about the thing: if you have to consider your contraception every day (even worse, every time you start up a little foreplay), it falls down the chart. If you have to think about it once every few years, it rises up the chart. IUDs are up at the top of the effectiveness hierarchy because of the very human tendency to forget pills and condoms (and because IUDs happen to be rather effective products all on their own). In fact, IUDs and implantable devices like the Implanon (a reformulation of the failed Norplant of yesteryear) are the only reversible methods that make the WHO’s top tier. Pills are a notch beneath; condoms are even below that.

And why is this important? Because in one of the world’s wealthiest nations, half of all pregnancies in the United States today are unplanned. Nearly half of these will end in abortion, and though I am staunchly pro-choice, this is not a procedure I suggest anyone be subject to if pregnancy prevention is possible.

The barriers to finding the right form of birth control for the right individual can be immense, and many women default to the pill simply because it is what they know, hear about, ask about, or are given without any other discussion. Price is one issue: even out of pocket, IUDs are often cheaper than pills if used for the full five or ten years, but require a steep upfront investment that many women cannot afford (federal programs cover the copper – but not the hormonal – IUD for uninsured low-income women at this time). Many practitioners who feel comfortable handing out pills don’t know how to counsel on the risks and benefits of IUDs or implantable devices, much less place them. We can all cite a few providers out there who won’t give contraception to unmarried women, or women at all, or whatever variation of limitation one might set on women’s right to limit their fertility. There are providers who won’t insert IUDs in women who don’t have children yet, or who are still in their teen years (I argue the reverse: IUDs are perfect for teens, who have the highest failure rate for daily pills, who are most vulnerable to the later osteoporosis associated with the Depo Provera shot, and who benefit immensely from a span of years to finish high school and possibly college without interference from an unplanned pregnancy).

These are all culture-bound barriers, not medically-prescribed barriers. Even the edict against putting IUDs into women who have never born a child comes from a strange age: this language was inserted into the package literature of the copper IUD back in the days when the Dalkon Shield was causing infertility in its victims – the idea being that if you don’t have kids already, you should really have some first before you use a product that might cause you to become accidentally barren. There are so many things wrong with this line of thinking, I don’t think I need to enumerate them; and the relatively contraindication of putting IUDs in women without children has been removed from more recent versions of the package insert in deference to the fact that the Dalkon Shield has now been off the market for over 35 years.

But mostly, a failure to aggressively offer the most effective forms of birth control among all the options – and let a woman decide from the variety of methods available which is most right for herself - is in fact a failure to engage in the full protection of women’s health. Obama’s recent copay-free contraception edict is a promising one, but until the full breadth of choice exist, we are unlikely to see a significant change toward better fertility management and effective women’s health care across the board.

Cross-posted from my recently re-located and relaunched blog, America, Love It or Heal It.

A Re-Post: Three-Dimensional Mental Rotation

This is the fourth post in my series concerning the science of sex differences. The earlier ones can be found here, in the order of the links, including an introduction to the whole series.

This post, and the next one are about the "big guns" of those who advocate innate differences for why women do worse in mathematics and sciences, "worse" being interpreted in various ways, such as lower average test scores, smaller extreme tails on those tests, fewer women entering engineering or science and so on.


Three-dimensional mental rotation is a common test, and one which consistently shows gender differences. Men and boys do better on it, on average, than women and girls. It may be one candidate (together with tests of some verbal abilities in the opposite direction) for a biological sex difference on cognition. On the other hand, we don't test newborn babies on this ability, and neither have we controlled for the influences of the environment before such tests are interpreted.

Let's take one step backwards to notice that tests like this one are tests, not actual evidence for the innateness of whatever is tested, only evidence for differences in average test scores. Let's also note that another spatial test which shows gender differences, the object-location-memory test, gets very little attention, perhaps because it shows a consistent female edge.

Back to three-dimensional mental rotation. The test usually consists of pictures, one showing a structure comprised of building block-type cubes at various angles, and a group of other pictures showing how that initial structure might look after it was rotated some amount of degrees. Only some of that group show the correct outcome, and the task is to match those to the original picture. Here is an example of the test:

Building blocks! Which are now stocked in boys' aisles at toy stores. Lise Eliot (Pink brain. Blue Brain. p. 218)on this topic:

Whether it emerges in infancy or late preschool, the sex difference in mental rotation is known to grow larger through childhood and adolescence. Spatial skills, like all mental tasks, improve with practice, so it's likely that boys' mental rotation ability is honed by the many hours they clock in spatial pursuits. Boys begin with trucks and blocks in pre-school and continue with their games of catch, hoops, and all manners of virtual driving and shooting games, so it's not too surprising that the sex that spends most of its leisure time watching objects flip, rotate, and fly through space ends up a lot better in mental rotation.

Though I thought that girls are every bit as likely to play catch and hoops, Eliot does have a point. In fact, the birth of video games (such as Tetris to which I was addicted some time ago) may work to further strengthen this difference because most games are for boys.

On the other hand, something fascinating has cropped up in that context: A very short intervention seems to have the power to change the mental rotation scores of women. Rebecca Jordan-Young (Brainstorm, p. 287-8):

Feng, Spence and Pratt (2007)identified a basic information-processing capacity that underlies spatial cognition and showed that differences in this capacity (the distribution of spatial attention) are related to differences in the higher-level process of mental rotation ability. They then showed that a remarkably brief intervention -- just ten hours of practice with an action video game -- caused "substantial gains in both spacial attention and mental rotation with women benefiting more than men." The ten-hour training did not completely eliminate the sex-difference, but it came extraordinarily close -- the mean scores after training were no longer statistically distinguishable between males and females.

This suggests that the mental rotation test is amenable to learning. What it measures can't therefore be defined as something which cannot be changed. Yet that seems to be the implication of those who explain the scarcity of women in science and engineering by the results of the mental rotation test. The underlying concept must be that the test measures something innately different and stable.

What has always struck me about this test and the focus on traditionally male fields when discussing it is that there is one traditionally female field which requires excellent mental rotation skills: Dressmaking.

The pattern pieces are two-dimensional, the final product distinctly three-dimensional, and anyone trying to alter patterns or making new ones must have good three-dimensional mental rotation skills.

Eliot mentions other typically female professions in which such skills are necessary: interior decoration and fashion design (Pink Brain. Blue Brain. p.230)

....a recent study of university students in London found that female fashion-design majors performed even better than male engineering and computing majors on a test of mental rotation.

Whether their performance was a result of the studies they were taking or whether this group already had strong mental rotation skills before their studies is unclear from this quote in Eliot's book. Yet knowing the answer to that question would be of great value. If the test results of these female fashion-design majors were high due to the content of their studies, then practice clearly plays a very strong role in the mental rotation scores.

Given the great focus on this one particular test, it may come as a shock to you that this just might be the only test for which schools offer no formal training. Eliot (Pink Brain. Blue Brain. p.230):

Every other ability -- verbal, math, music, interpersonal, and even kinesthetic (athletic) -- has its own slot in the curriculum or its own box for teachers to check off on report cards. Not so for spatial skills, for which the only real training comes from the video games, building toys, and targeting sports that are almost exclusively the preoccupation of boys.

Mental rotation tests are also susceptible to the stereotype threat. This refers to the priming effect of evoking certain stereotypes on a test-taker. An example from Cordelia Fine's Delusions of Gender (p. 27-8):

People's mental rotation ability is malleable; it can be greatly enhanced by training. But there is a far quicker, easier way to modulate mental rotation ability. By now you already know what these methods involve: manipulating the social context in such a way that it changes the mind that is performing the task. For example, you can feminize the task. When, in one study, participants were told that performance on mental rotation is probably linked with success on such tasks as "in-flight and carrier-based aviation engineering...nuclear propulsion engineering, undersea approach and evasion, [and] navigation," the men came out well ahead. Yet, when the same test was described as predicting facility for "clothing and dress design, interior decoration and interior design...decorative creative needlepoint, creative sewing and knitting, crocheting [and}flower arrangement, this emasculating list of activities had a draining effect on male performance.

Alternatively, instead of changing the gender of the task, you can keep the task the same but push gender into the mental background. Matthew McGlone and Joshua Aronson, for example, measured mental rotation ability in students at a selective liberal arts college in the northeastern United States. One group was primed with gender, while another group was primed with their exclusive private-college-identity. Women who had been induced to think of themselves as students at a selective liberal arts college enjoyed a performance boost, scoring significantly higher than gender-primed women. Likewise, Markus Hausmann and colleagues found that although gender-stereotype-primed men outperformed gender-stereotype-primed women, men and women primed with an irrelevant (geographical region-based) stereotype performed similarly on the mental rotation task.

Why such a long post on one specific cognitive test? Because this is the test which shows the largest and most consistent differences between men and women, and because this is the test which is usually mentioned in explaining a possible ability-related reason for women's scarcity in science, mathematics and engineering.

That even this test lends itself to learning and is affected by the stereotype threat emphasizes the need to keep societal influences in mind when the essentialists employ this particular argument.

A Re-Post: Studying Sex Differences in Science: A Story

This is the third post in the series, originally from here.

In 1995 a wife-husband research team published the first study appearing to show that men and women process language differently in their brains. Sally and Bennett Shaywitz used functional MRI to study the brains of nineteen women and nineteen men during three different language tasks.

One of the tasks, identifying rhymes, showed gender differences in the relative activation levels of the brain. Lise Eliot in Pink Brain. Blue Brain. writes (pp. 185-6):

...men exhibited strong activation of the lower portion of the left frontal lobe, while women tended to activate the same frontal area but on both sides of the brain. Of the nineteen women, eleven exhibited this bilateral pattern and eight activated just the left hemisphere (like men). So the results of this study seemed to indicate that in processing language, or at least during this particular rhyming task, women were more likely to use both hemispheres while men used exclusively the left hemisphere. As one of the first reports to find a sex difference by using functional MRI, this study got a lot of press. An article in the New York Times Science section promptly declared: "Men and Women Use Brain Differently, Study Discovers," and the findings continue to be highlighted even in recent popular works.

I remember the publication of those popularizations and the mileage they went. Like from here to sun and back again! Take into account the fresh interest in the genome study and the soil was well prepared for something like this to be interpreted as evidence of permanent, stable and innate differences between men and women. In many places it was.

What happened next in this interesting field, you might ask. Two things. On the one hand the research in the field continued. On the other hand, several popularizers harnessed the idea that men and women have totally different brains, that this difference is innate, and that the world should be organized to respect those differences. Part of that organizing was the idea that boys and girls should be educated separately and with different methods. Michael Gurian and Leonard Sax are famous advocates of innate sex differences as the basis for single-sex schooling, and Gurian, in particular, keeps appealing to the fMRI and PET scans to make his point*.

Sadly, what has happened in studies which use those methods has weakened the arguments of guyz like Gurian and Sax. It turns out that the way the brain looks in those scans can change based on how it is used. This means that the kinds of differences that 1995 study found don't necessarily tell us anything at all about the innateness of the observed differences in use.

Even more sadly for Gurian and Sax, later studies failed to replicate Shaywitzes' original finding. Eliot again (pp. 186-7):

Like any good research, the Shaywitzes' study inspired many attempts at replication. By 2008, twenty-six comparable brain-imaging studies were available for Iris Sommer and her colleagues at the University of Utrecht in the Netherlands to synthesize using meta-analysis.

Their overall conclusion: there's no sex difference in language processing. While some studies reported results similar to the Shaywitzes', others did not. Some even found that women processed language more strongly on the left side. When you put all the findings together, it's a wash; there is no significant difference in the way men's and women's right and left hemispheres are activated by language.

All this has to do with the idea that brain lateralization might differ between men and women in language use. This doesn't seem to be the case. But no worries! We still get a lot of popularizations based on exactly that idea, even though it has now been removed from the relevant university-level textbooks.

As Cordelia Fine puts it in Delusions of Gender, after discussing the above study and some additional research (p. 138):

So let us , with healthy skepticism, summarize all of this as clearly as we can. Nonexistent sex differences in language lateralization, mediated by nonexistent sex differences in corpus callosum structure, are widely believed to explain nonexistent sex differences in language skills.

Why does this story matter? Because the popularizations of research such as the Shaywitz study were seeds to the new single-sex education movement and also because of statements like this one (from Fine, p. 139):

For example, a consensus statement titled "The Science of Sex Differences in Science and Mathematics" links female "interhemispheric connectivity" to an advantage in language skills and male within-hemisphere connectivity to superiority in "tasks requiring focal activation of the visual association cortex", that is, visuospatial tasks.

That women don't appear to have any language skills advantage in interhemispheric connectivity is worth remembering.

The morale of this story? Perhaps the fact that it's one of many similar ones, as far as I can see. Almost any study finding sex differences will be given powers it should not have, as the final and eternal explanation of all observed gender differences. Whole edifices will be built on that one finding. When it's ultimately accepted as a false lead, the process begins anew with some other study. All this has real costs, psychological as well as monetary, which could be avoided if popularizers took more care and if researchers themselves played a role in explaining the limited role of such findings.
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Cordelia Fine's Delusions of Gender discusses the imprecision of these imaging techniques and the meaning of the "blobs" one sees. They are nowhere near as easy to interpret as one tends to assume.

That Newsweek Cover (by res ipsa)

So, sexist or not-sexist? What about the headline? And before I forget, what about the great migraine controversy raised by Tim Pawlenty? Does it matter that migranes are three times as common in women than in men? Finally, with regard to whining that only conservative women get treated this way, I call bullshit.

Earth to Tina Brown: the cover is online, so "buzz" will not translate to sales; outtakes or no outtakes, there are plenty of photos out there of Bachmann looking like a completely normal person; and Bret Easton Ellis is not a new writer; but I digress...) More importantly, anyone not in a desperate panic for relevance twenty years after their heyday knows that there are easier, less controversial ways to knock Michele Bachmann out of the race.* For example, you could start with this McCarthyite horseshit from 2008:

*Leaving aside the question of why you would want to do so, when she's clearly a weaker opponent at this point than, say, Mitt Romney, with whom the Obama seems to share a lot of policy prescriptions, but that's another post.

A Re-Post: Looking for Sex Differences: The Complications

This is the second post about my quick impressions after reading three critical books about the science of sex differences, and it has to do with the preliminary questions researchers ask, how they frame the research and perhaps even the question how one becomes a researcher of biological sex differences. (The first post can be found here.)

Publication and Study Biases

Note first, that almost all of us are viewed as either female or male by the society. None of the researchers of sex differences among humans are non-sexed aliens from outer space (well, I don't think so though one never knows for sure) and every one of them has already made his or her non-scientific impressions about gendered behavior and what might cause it.

If your impressions make you believe that gendered behavior is mostly caused by biological sex differences, you are much more likely to enter a field studying those differences than if your impressions make you believe that gendered behavior is mostly caused by either environmental and cultural factors or some complicated soup of all possible factors.

Because of this, I believe that the overall field of biological sex differences may have an inner bias in what questions it analyzes and how it looks at the evidence: It will begin with observed gender differences in a particular society and then move from that to the attempt to find corresponding biological differences as an explanation for those. Environmental/cultural factors will be mentioned, but astonishingly seldom actually controlled for. This may over-attribute gender differences to biological sex differences.

I am not arguing that these biases were overt. They are most likely unacknowledged, except in a few famous cases of clear misogyny being the motivating factor (coughBaron-Cohencough).

But what it probably DOES mean is that the research will search for certain types of differences, ignore other types of differences and most certainly ignore the similarities which are found. It also means that alternative explanations will be down-played.

The same thing would also happen if there was a science of sex similarities. But it doesn't exist, so we don't have to worry about that one! Whenever results fail to show a sex difference they are either "put into a file drawer" (meaning that they are not published), never to see sunlight again, or they are posted in a rewritten form where something else is emphasized as the major finding.

The file drawer bias in research findings is not unique for the field of sex differences. It applies to most research where findings of "no support for a particular theory I like" are not published as often as they should be.

But its impact is especially severe in this field, because the process of excluding certain kinds of findings from public awareness is two-fold here: First, findings of "no difference" are under-reported in the academic publications, and, second, the popularizers grab almost always only those findings which reinforce the story of biological/evolutionary sex differences.

To see how this research bias works in quite subtle forms, consider the vast literature into women and girls with congenital adrenal hyperplasia (CAH). Jordan-Young defines it as follows (pp 30-31 in Brainstorm):

This syndrome, a genetic disorder that causes overproduction of androgens from the adrenal glands, is the most common cause of genital ambiguity. Androgens are elevated throughout fetal development, which is an especially unusual situation for female fetuses. Because of the hypothesis that high androgen levels may masculinize the brain as well as the genitals, people with this disorder -- especially girls and women -- have been much studied by scientists interested in brain organization.

CAH women and girls are a major source of data for those who want to analyze biological sex differences and also one of the pieces of evidence which is usually offered as support for innate causes of masculine vs. feminine behavior. Jordan-Young discusses these studies in great detail and I recommend reading her book on those.

What I want to discuss here is the way these studies have tried to control for all other possible effects than CAH. This is by comparing CAH women/girls to their female siblings or to some larger population of women/girls without CAH but with the same age, ethnicity, social class and so on. A neat way of controlling for any environmental factors, right?

Not quite, and the reason is that having CAH means corrective surgery, continuous medical supervision (every three months during childhood and adolescence) and hormonal treatments to induce higher adult height, for example. What is not controlled for in the vast majority of CAH studies are these very facts, because the control group consists of individuals who are not suffering from a chronic condition. Neither do these studies really control for the stigma of CAH and the way it affects the woman's sexual and reproductive opportunities.

To give an idea of one study which did try to take these into account (Brainstorm p. 229):

While some aspects of interest are indisputably masculinized in girls and women with CAH, perhaps an "organizing" effect of prenatal androgens is not the best explanation. Note especially that few studies have attempted to evaluate the effect of illness itself, or the medical intervention that chronic illness entails. As an exception, Froukje Slijper (1984) compared girls with CAH to girls with diabetes as well as to healthy controls and found that both groups of girls with chronic illness scored in the more masculine range than controls on the gender scale.

The Search For Sex Differences And Their Meaning*

How does one go about searching for biological differences between the sexes in fields such as cognition? The obvious answer (problematic though it is, as will be seen) is that one starts with observed differences, then excludes non-biological explanations and finally tries to find some other difference, preferably genetic or prenatal, which can be linked to those observed behavioral differences.

Sounds good, right? Or at least familiar. But what if we reversed the search? What if we could begin with some biological sex differences and then see what they produce in the behavior of the sexes? Some of that search might even find that such differences produce not gender differences in behavior but gender similarities!

Cordelia Fine's Delusions of Gender (pp. 142-143):

One very striking example of the principle that brain difference can yield behavioral similarity, discussed by De Vries, comes from the prairie vole. In this species, males and females contribute equally to parenting (excepting, of course, nursing). In female prairie voles, parenting behavior is primed by the hormonal changes of pregnancy. But this leaves a mystery. How do father voles, which experience none of these hormonal changes, come to show paternal behavior? The answer turns out to lie in part of a region of the brain called the lateral septum, which is involved in the triggering of parental behavior. This part of the brain is very different in males and females, being much more richly endowed with receptors of the hormone vasopressin in the male, yet this striking sex difference in the brain enables male and female prairie voles to behave the same.

Of course humans are not prairies voles. But neither are humans rats, and I keep reading how rat behavior is relevant for understanding the limitations of the human female all the time.

It's therefore important to remember that we may be biased if we start only with observed gender differences in behavior. It's quite possible to have biological sex differences which create similarities in behavior by compensating for some other biological difference between the sexes.

Not that all observed gender differences get the same attention from the researchers or the politicizers, by the way. You may well be aware of the clear difference in the average score between men/boys and women/girls in the skill of three-dimensional mental rotation. That one has been extensively studied. It's political uses are equally many.

But this is not the only test of spatial ability in which we find gender differences. Lise Eliot in Pink Brain, Blue Brain (p. 122) discusses the object-location test. This consists of showing test subjects a picture with many randomly scattered objects, and then showing them a different picture with some objects moved to different positions:

The task is to circle the items still in their original place and cross out the items that had been moved.

A recent summary of more than three-dozen such studies shows that women have a small-to-moderate advantage in object-location memory, but the difference depends in part on the type of objects subjects are asked to remember. Women do better with most objects except for stereotypically masculine ones, like a necktie, golf ball, trophy, suit coat and aftershave (men are better at remembering these objects' locations.)

How fascinating that the gendering of objects matters in this test! That suggests to me that the three-dimensional mental rotation tests should be done with a weird furry creature or a six-legged and asymmetric Barbie doll, instead of something that looks like building blocks, especially given that those are now sold in boys' aisles in toy stores.

It's important to note that one can practice these kinds of spacial abilities and raise one's scores that way. This means that the scores do not measure a purely innate characteristic.

A Final Reminder

It is important to remember our biases and partial blindness when discussing this field. Jordan-Young, Brainstorm, p. 256:

Historians and philosophers of science are giving increased attention to the way that gaps in knowledge, as well as knowledge itself, are actively produced and maintained. The study of this phenomenon, what Tuana calls "the epistemology of ignorance" and Proctor (2008) calls "agnotology" reveals that specific ideologies, cultural schema, and political interests systematically block certain forms of information and cause people to "forget" or fail to incorporate certain facts into the overall thinking on the subject.

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*Added later: I forgot to note here that much recent research suggests a very complicated interplay between what used to be called nature vs. nurture, and that in some ways we may have been asking the wrong questions even more generally.

Order in the Court (by res ipsa)

Trigger warnings for rape and incest.

Yesterday I read this NYT story about a New York rapist whose appeal of his conviction is based on the trial judge permitting the prosecution to use Rosie, a therapy dog, during the victim's testimony. The victim is a teenager and the now-convicted defendant was her father. The dog's role was to comfort the victim during moments of stress that might occur as she testified. I understand the defense's objection about being unable to cross-examine the dog to determine if the victim is experiencing stress because she is telling the truth or because she is lying. But I'd counter that objection by saying, "So why didn't you bring on an animal behavior expert to testify that while the dog may sense and respond to stress, that there's no way of knowing what sort of stress the dog sensed?" The jury would have to add the expert's opinion to its consideration of the facts. The defense also claims that it the dog's presence was unfair, i.e., the dog biased the jury. Their argument is that the dog's presence was dispositive, but I doubt that a dog, no matter how cute, can outweigh the ugliness of a victim's testimony about her rape, and in this case, by her parent. In any case, the jury may also be asked to consider that the dog's presence may predispose it to favor the victim.

What do you think?

The gambler against the house: Fundamental flaws in the health insurance model (by Skylanda)

Last time the brakes on your car wore thin (or in my case, the last time I blew an aneurysm into the sidewall of my snow tires on last year’s pothole and had to replace all four of them), you probably reached into your wallet for a credit card, a wad of cash, or a check, and paid out of pocket for the expense. Last time you got your oil changed, you probably did the same. It is notably unlikely that any warranty, insurance, or other coverage paid for these routine costs of car care.

Now remember back to your last routine interaction with the health care system. If you are so lucky as to have insurance, you probably expected it to cover at least some part of your visit to a provider for, oh, say, arthritis in your knees (roughly the equivalent of the automotive brakes that just wear out after a while), or a Pap smear (the tongue-in-cheek equivalent of an oil change – just part of the routine costs of owning a female body). You reasonably could ask that your insurer cover part or all of the doctor’s fee, the cost of labs ordered, and medications or hardware you might be prescribed to go home with – that is, the routine costs of health maintenance. In essence, this is the equivalent of expecting your auto insurance to cover brakes jobs and oil changes.

Covering scheduled maintenance and routine out-of-pocket expenses: this is the health-care equivalent of an auto insurance policy that pays for oil changes, tires, and even fluids that you might throw into your radiator reservoir between regular checks. Imagine, if you will, the exorbitant cost – and the rapid rise you could reasonably expect – of a car insurance policy that covers these niceties. To make it worth their while at all, insurers would have to charge more than they could guess that a car would cost in a year, including both routine and catastrophic maintenance; most insurers are for-profit agencies (or at least not particularly low-overhead institutions), so that has to be accounted for too. This combination would put car insurance out of the range of many if not most drivers. But this is what we expect of health insurance – and we are at least nominally still surprised that premiums go up every year, even as the list of routine services recommended (and options for non-routine services in cases of catastrophic care) rise on somewhere between and arithmetic and a geometric curve.

True "insurance" functions well as a gambling man’s bet. All interested parties pay in on the off chance that one in a few – hopefully one in a very few – hits the bad-luck jackpot of a major payout. The input should be calculated to comfortably cover the costs, and everyone who cares to join the pool throws in a little for a relatively few large payments. Insurance is a system fundamentally built for rare, stochastic disaster: totaling a car, not paying for an oil change. The concept of health insurance fundamentally emerged from a time when emergency (or occasionally obstetrical) care was pretty much the only indication to go see a doctor, and relies on a model of incremental small input from a large population that is drawn upon only sporadically in singular large outputs. You will notice that this parallels modern medicine in almost no manner at all.

To really illustrate the failure applying a basic model of car insurance to health insurance, one only has to look at the true equivalent in health insurance: the high-deductible plan that covers almost no costs until some disaster strikes that drives the patient’s balance sheet over, say, $5000, and then the plan begins to pay. This is truly a disaster-driven model, one that presupposes that the patient pay for routine health care costs (the oil changes and brake jobs of the medical world), but is protected from the realm of catastrophic cost. But high-deductible plans are a dangerous business; in the young and healthy, a $5000 bill is often enough to bankrupt the household regardless of coverage beyond that; and in the pre-Medicare demographic that tends to be the province of the high-deductible plans, 100% out of pocket costs often lead to delays in preventive services right in the age group in which preventive services (mammograms, colonoscopies, screening labs) are ramping up. True to the nature of the gamble that underlies it, high-deductible plans really only work out well for the profoundly lucky.

Moreover, pooled insurance premiums are often called upon to indirectly cover the care of folks outside of the contributing pool: an emergency room is required to take all comers regardless of payment status (and many hospitals and clinics are charitable enough to swallow unpaid claims, graciously or not), but these costs have to be covered somehow. In general, this is paid by raising the rent on paying customers, transferring those losses to the paying group in prices one must charge to keep the lights on, get the payroll paid, and maintain the doors open. (This transfer of costs also accounts for why my auto insurance rates doubled when I moved from the urban Pacific Northwest – a relatively expensive place to get a car fixed – to New Mexico, where there’s a low-rent body shop on every other corner: because New Mexico has one of the highest uninsured driver rates in the nation, so the insured drivers pick up the de facto tab for accidents involving the remainder.)

Add in the bogeyman of profitability, and you have a system in which the sole driving trend over time will be an astronomical upward titration in the cost of insurance premiums. And sure enough – I need convince no one here – the trend has proven true.

But I am not, as you might be thinking, building an argument against covering routine care. I am building an argument that the traditional insurance model is fundamentally incapable of managing modern medical concerns. Disaster-based insurance models are simply not cut out to take care of modern health needs. What might work better then?

One, a functional system needs contributions from all comers in order to stabilize the rate of rise of premiums. Health care is not optional good, and contributions should not be optional. Blaming people who cannot access health insurance for not paying in is somewhat cruel (nevermind moot), but there are systems that demand proportional contributions from all to dole out the same in return: tax-based single payer systems. Everybody throws in a share, and everybody draws out. This forces coverage to move away from the gambler’s model and toward a system where everyone is in it together.

Two, a sustainable system may need to be a largely closed, self-contained system with a minimum of entries and exits from the insured pool instead of the fluid cherry-picking of today's privately insured groupings. As it stands now, the catastrophic gamble underpinning health insurance means that an insurer fares better if most patients never darken the door of a health care provider: cheaper for the insurer in the short term, and the insurer limits liability for the long-term consequences of delayed care (preventive and otherwise) by instituting maximum benefits, lifetime caps, 80-20 payment splits, and other policies that end-run the consequences of limiting the outlay up front. (My all-time favorite catch-22 is the employer based insurance that is canceled as soon as a person becomes disabled enough not to work: this is truly one of the heinous inventions of the American insurance enterprise.)

A closed system tightens the loopholes that make delayed care profitable. There are many examples of closed systems to examine, but three very diverse models come to mind: the Veterans’ Administration hospital system, the UK’s National Health Service, and the Kaiser Permanente system on the west coast (an HMO which functions as both insurer and provider to its enrolled members – a paradigm that seems ripe for conflicts of interest, but has turned out to foment some truly innovative shifts in effective medicine aligned with cost control). All of these systems share two things in common: one, they lack the ability to shift cost outside of their own budget (by choice in the case of Kaiser, by legal fiat in the case of the VA and the NHS), and each has consequently put an enormous emphasis on preventive care and/or systems reform. Since each one takes the brunt of its own preventive failures, it behooves them to take care of their own patient pool. Essentially, the closed system model unwinds the deck-stacking inherent to the gambler’s model, and makes the insurer necessarily responsive to the imperative of prevention and effective early care.

Finally, a model that pits patient versus physician versus insurer in a battle to the bottom of the resource pool is one that is destined for redundancy, unnecessary paperwork, and intentional up-ramping of bureaucracy. Health should be the underlying goal of the entire enterprise; entrenched conflict between the various stake holders is one of the great understated reasons why our healthcare system is so disproportionately expensive for the outcomes we achieve (if you don’t believe me, you can follow me around work for a day or so and watch how many hours of my MD salary goes into filling out prior authorizations for supposed first-line medications rather than seeing patients).

Going back to the metaphor we started out with, there is a fundamental impossibility of covering the needs of a medicalized health system with outmoded models that only account for only the health equivalent to totaling a car. Pap smears are not oil changes; disasters like cancer are often preventable in ways that rollover accidents are not. Health is not as stochastic as the vagaries of highway disasters, and clinging to the gamble against fate that underpins our health insurance serves only as a detriment to both health and cost control. The transition from "insurance" to "coverage" is a tough one, but there are models that show us some promising ways. But mostly, we are all in this together: it's time we start acting like it.

Cross-posted from my recently relocated and relaunched blog at America, Love it or Heal It.

A Re-Post: On Ballerinas and Football Players. The Failure of Gender-Neutral Parenting

Introduction

This week I'm going to write up some of the ideas I got from reading on the science of sex differences, off-the-cuff mostly and as short summaries of certain topics which keep cropping up in the books.

The first of them is that clever quip of one of the bully boyz of EP (the scary type of evolutionary psychology; I use the capitals for them). It goes like this:

What are the people called who don't believe in innate sex differences? Answer: Childless.

It doesn't come as a great surprise, then, that every single one of the authors of the three books I read mentioned that when they were talking about their book projects, parents would always tell them the same story: They (the parents) brought their children up in a gender-neutral fashion, and what did they get? Girls in pink ballet tutus and boys in blue football uniforms! Ergo, sex differences are all innate, every single one of them.

Well, it's pretty clear that upbringing has much to do with such differences (as I will discuss in later posts this week), but sure, some differences are most likely innate. Though ballet tutus and football uniforms or the color preferences for blue or pink are not. They are all culture-coded as things that girls can like and things that boys can like. Go into any toy store and check for yourselves.

A Theory About Gender And Toys

Indeed, I was very pleased to find my own theory about how this gender-coding happens mentioned in one of the books, though of course proposed by someone else. It goes like this:

Children at a certain age appear to have a very strong need to determine their own sex and how that sex is supposed to behave. They become little gender police officers, forcing other children to follow the same rules. This need may well be innate (though see later in this post).

What the cues are for how one's sex behaves depends on the culture the children find themselves in. For example, a child growing up in an African tribe where only men weave will soon learn to think of weaving as something men do, but a child growing up in an African tribe where only women weave will soon learn to think of weaving as something women do. It happens that there have been tribes with both these gendered divisions of labor, and though I made up the example of how children might react to them, it's not an unlikely consequence of a gendered world that boys would try weaving in one tribe and refuse to try it in the other tribe, and vice versa for girls.

Note that this doesn't necessarily mean that there wouldn't be innate differences in children's play. It's just to point out that things like the colors pink and blue are clearly societal and not something to do with genes. They only became firmly connected with gender in the current order (at first pink was proposed for boys as the more virile color of the two) less than a hundred years ago.

How would one test the theory I summarized above?

Ideally, children should be brought up in the middle of nowhere so that they get hold of no television or other images that have to do with sex and gender, and, ideally, all the adults should model reverse gender roles.

Why Gender-Neutral Child-Rearing Is Impossible

Such an experiment is impossible. But so is the experiment of bringing children up in a gender-neutral fashion in a world where practically NOTHING is gender-neutral. What the parents say about this may not be what they do, in any case, but even if they tried their utmost, the society will cause the plot to backfire.

Cordelia Fine makes the point best in Delusions of Gender (pp 209-210):

Imagine, for a moment, that we could tell at birth (or even before) whether a child was left-handed or right-handed. By convention, the parent of left-handed babies dress them in pink clothes, wrap them in pink blankets, and decorate their rooms with pink hues. The left-handed baby's bottle, bibs and pacifiers -- and later, cups, plates and utensils, lunch box, and backpack -- are often pink or purple with motifs such as butterflies, flowers and fairies. Parents tend to let the hair of left-handers grow long, and while it is still short in babyhood a barrette or a bow (often pink) serves as a stand-in. Right-handed babies, by contrast, are never dressed in pink, nor do they ever have pink accessories or toys. Although blue is a popular color for right-handed babies, as they get older any color, excluding pink and purple, is acceptable. Clothing and other items for right-handed babies and children commonly portray vehicles, sporting equipment, and space rockets; never butterflies, flowers or fairies. The hair of right-handers is usually kept short and never prettified with accessories.

Nor do parents just segregate left- and right-handers symbolically; with color and motif, in our imaginary world. They also distinguish between them verbally. "Come on left-handers!" cries out the mother of two left-handed children in the park. "Time to go home." Or they might say, "Well, go and ask that right-hander if you can have a turn on the swing now." At playgroup, children overhear comments like, "Left-handers love drawing, don't they," and "Are you hoping for a right-hander this time?" to a pregnant mother. At preschool, the teacher greets them with a cheery, "Good morning, left-handers and right-handers." In the supermarket, a father says proudly in response to a polite enquiry, "I've got three children altogether, one left-hander and two right-handers."

And finally, although left-handers and right-handers happily live together in homes and communities, children can't help but notice that elsewhere they are often physically segregated. The people who care for them -- primary caregivers, child care workers, and kindergarten teachers, for example -- are almost all left-handed, while building sites and garbage trucks are peopled by right-handers. Public restrooms, sport teams, many adult friendships, and even some schools, are segregated by handedness.

You get the idea.

It's not hard to imagine that in such a society, even very young children would soon learn that there are two categories of people -- right-handers and left-handers -- and would quickly proficient in using markers like clothing and hairstyle to distinguish between the two kinds of children and adults. But also, it seems more than likely that children would also come to think that there must be something fundamentally important about whether one is a right-hander or a left hander, since so much fuss and emphasis is put on the distinction. Children will, one would imagine, want to know what it means to be someone of a particular handedness and to learn what sets apart a child of one handedness from those with a preference for the other hand.

We tag gender in exactly these ways, all of the time.

I borrowed such a long quote because it is an important one. Bringing a child up in a gender-neutral fashion is impossible in a society which regards gender as the crucial aspect of children. Just think of the first question people ask of new parents.

What Do Children's Toy Choices Share?

At this point I'd like to turn the science of gender differences upside down and pay a bit more attention to gender similarities in toy choice.

Gender-neutral toys are many and include various games, balls, coloring books, crayons and building blocks. (At least this is true in studies of children's play, though Legos and Lincoln Logs are now stocked with boys' toys in toy stores.) But those are not the ones I want to discuss here. Instead, I want to ask what the pink ballerina outfits and the blue football uniforms share.

A funny thing happens when you ask that question, or at least it happened to me. I immediately realized that ballerinas and princesses are the female equivalent of football players and space heros.

These are all highly valued roles for individuals of a particular gender. In short, both girls and boys aim high in their play schemes, even though they pick their heroes on the basis of a gendered code. Note also that ballet is a strenuous physical exercise. When girls' choices are discussed, we rarely notice the similarity between ballerinas and football players in that sense.

And One Final Difference

I'm concluding this post by drawing your attention to one difference between girls and boys which crops up in study after study but doesn't seem to get much attention. This is the fact that the aversion towards the toys of the other sex is not symmetrical. Boys refuse "girls' toys" more than girls refuse "boys' toys" and play with them shorter lengths of time when they are not refused.

I found this pattern fascinating, because traces of it can be seen in the behavior of adults (in, say the percentages of men and women who read books written by the other gender), too, and because "a tomboy" is mostly not punished for her behavior but "a sissy" is (this is an actual research term, believe it or not!).

What causes the stronger gender-coding by boys (and men)? Is it the fact that they have more to lose from gender-deviant behavior, given that women still have less power, in general? Could it be that parents discourage "gender-deviant" play more for boys than for girls because of the differential costs of it for each sex? Or is there a "girls have cooties" gene?

Well, I doubt that last theory myself.

This Post Has Nothing to Do With Feminism (by res ipsa)

It has to do with gardening, specifically, the pests that will screw up said gardening, this pest in particular. How do you get rid of these creatures? Please don't say, "Kill them", because (a) that's illegal in the relevant jurisdiction, and (b) even if it wasn't illegal, I couldn't bring myself to do it. They're eating the plants and hanging out, big as life, on the deck, sunning themselves like teenagers without a care for skin cancer. They are huge and they are legion. We have tried this spray stuff that smells like garlic (they come back), ammonia (they come back), yelling at them (they come back), trapping them (they didn't go for it). They are literally and figuratively burrowed in. Yesterday at about 5 PM, I looked out the back window and there was one with his/her paws propped up on the bottom step of the deck, just eye-spying the geraniums. He was plump and healthy and pleased as punch with himself. Have you ever had them, and if so, how did you get rid of them? I am at my wits' end.

Update: According to The GC, the damn things have now migrated to the front of the house. We're surrounded!

A Re-Post: Introduction to My Series on Gender Science

I wrote the posts in this series from last December to January. They will appear here one per day this week. This one is originally from here.

I finished Lise Eliot's Pink Brain, Blue Brain. I then read Cordelia Fine's Delusions of Gender, and then Rebecca M. Jordan-Young's Brainstorm.The Flaws in The Science of Sex Differences. I have read the other side of the debate in the past.

Short conclusions (much more will appear in later posts):

1. Do not read all these in two days or so. You get tremendously angry and then you kick holes in the garage door.

2. The history of sex differences in science is a nasty one, and there's not much reason to expect we are doing much better right now.

The general tendency seems to be to grab onto any particular innate explanation as the right one. In the nineteenth century it was women's smaller brains or something odd about the spinal cord connecting the pelvis to the brain or wandering wombs.

In the twentieth century it was any observable difference in some brain part, and any differences found were then interpreted as meaning that they show why men are better, pretty much. In some cases the differences turned out to be reversed, but suddenly THAT was why men did better in some cognitive field.

And all this was always interpreted as "hard-wiring", not possible to change and eternal, despite the fact that the actual behavior of men and women was changing at the very same time, and despite more recent findings which show the brain changing with how it is actually used. In short, we (or some group of people) have a bias to welcome findings of innate differences and a bias to resist a more complicated treatment of the topic. I have seen exactly the same with the recent chimpanzees and sticks study.

3. Anyone willing to study innate sex differences between men and women is already biased in one particular direction. This is ignored almost totally, even though anyone finding sex similarities is labeled as biased.

4. Really bad research is regarded seriously when it reinforces basic stereotypes. Really good research is ignored when it fails to reinforce basic stereotypes.

To give an example of the former, studies which measure the correlation between unusual prenatal testosterone exposure in girls and "masculine" behavior almost always use a large number of measures for "masculine" behavior. Almost all of the published studies in this field find one or two significant differences. But they may have studied fifteen such measures or even twenty measures! Yet the finding of those one or two significant differences is publicized as an important one. Statistically speaking, such findings are quite likely to be flukes.

5. The "file drawer" aspect (i.e., that certain types of studies fail to get published) is tremendously strong in this field.

It takes two forms: Studies which don't find differences are often not published at all OR are published in a form which focuses on something else than the sex difference, and later studies which cannot reproduce the differences found in an early (and now very famous) study are not disseminated outside the narrow research community.

The consequences of these are that people in general believe science has found a humongous number of purely innate differences and people go around believing research results which have been falsified in later (invisible) research.

6. I'm becoming very suspicious of a few "researchers" or popularizers as actually knowing that they are lying or utterly not caring one way or the other, just to sell books or ideas. I even wonder about the actual research of a few of them. This is because nobody has been able to replicate the oh-so-famous findings, even in studies which were much better done in the methods sense.

7. If a difference is found which appears to handicap men or boys (say, verbal skills and reading skills), the next step is to argue for compensatory actions in the society. If a difference is found which appears to handicap women or girls (say, three-dimensional mental rotation abilities), the next step is to argue that nothing can be done at all, and that any compensatory treatment should cease this minute.

Bess gets a life (by Suzie)

“The Gershwins’ Porgy and Bess,” a musical adaptation of the 1935 opera, will open Aug. 17 at the American Repertory Theater in Cambridge, Mass. If successful, it will move to Broadway in the winter. Director Diane Paulus is working with Suzan-Lori Parks, who has won both a Pulitzer and a MacArthur Genius Grant for her writing. The NYT reports:

Ms. Paulus said that her first decision was to try to recruit Ms. Parks to work with her on “excavating and shaping and modernizing the story and particularly Bess.”

“I’m sorry, but to ask an audience these days to invest three hours in a show requires having your heroine be an understandable and fully rounded character,” Ms. Paulus said of Bess, whose motives and viewpoints are muddied in the opera, where she is largely an appendage of Porgy or Crown.

That this production is unquestionably Bess’s story as much as Porgy’s may be due, Ms. Paulus and Ms. Parks said, to the number of women in charge: The musician Diedre L. Murray adapted the work with Ms. Parks, while Nancy Harrington is the production stage manager and Sheilah Walker conducts the 19-member orchestra.

A representative of Ira Gershwin's estate sent Paulus a recording of Janis Joplin singing "Summertime," with a note: "Be bold." I can't wait.

A Guest Post by Anna: A Feminist Criticism of Jack Kevorkian

A Feminist Criticism of Jack Kevorkian by Anna

Why do Kevorkian’s actions have feminist implications? They do because women’s lives, particularly the lives of women with disabilities, are often not valued. 71 percent of Kevorkian’s patients were women.

Rebecca Badger, a patient of Kevorkian's and a mentally troubled drug abuser, had been wrongly diagnosed with multiple sclerosis. She was killed anyway. Janet Adkins, Kevorkian's first patient, was chosen without Kevorkian ever speaking to her, only with her husband, and when Kevorkian first met Adkins two days before her assisted suicide he "made no real effort to discover whether Ms. Adkins wished to end her
life," as the Michigan Court of Appeals put it in a 1995 ruling upholding an order against Kevorkian's activity.

Kevorkian did speak with Dr. Murray Raskind, a psychiatrist who had been treating Adkins at University of Washington Hospital in Seattle, and a nationally recognized expert on aging and Alzheimer's. Raskind told Kevorkian that Adkins was not competent to make a life-and-death decision. Kevorkian gave her a lethal injection anyway, writing later that his opinion was based solely on conversations with Adkins' husband.

Conversations about assisted suicide often revolve around the assumption that it’s all about saving people from spending their last days in intolerable pain, something no reasonable person could really object to. But in a society without much of a social safety net or an adequate health care system, where women often live longer and earn less than men, and are more likely to be disabled, and where women’s
lives are seen as based around providing care and love to others, the idea that it is selfish for a disabled, old, sick woman – or even one merely perceived as having these traits – to go on living has a disturbing amount of force.

Kevorkian was well known as an advocate of the option of assisted suicide for the terminally ill. Yet that does not tell the whole story. According to a report by the Detroit Free Press, 60% of the patients who committed suicide with Kevorkian's help were not terminally ill - at least 17 of them could have lived indefinitely - and in 13 cases, the patients had no complaints of pain. The report further asserted
that Kevorkian's counseling was too brief (with at least 19 patients dying less than 24 hours after first meeting Kevorkian) and lacked a psychiatric exam in at least 19 cases, 5 of which involved people with histories of depression, though Kevorkian was sometimes alerted that the patient was unhappy for reasons other than their medical condition. (In 1992, Kevorkian himself wrote that it is always necessary to
consult a psychiatrist when performing assisted suicides because a person's "mental state is . . . of paramount importance." )

The report also stated that Kevorkian failed to refer at least 17 patients to a
pain specialist after they complained of chronic pain, and sometimes failed to obtain a complete medical record for his patients, with at least three autopsies of suicides Kevorkian had assisted with showing the person who committed suicide to have no physical sign of disease.

According to The Economist: "Studies of those who sought out Dr. Kevorkian, however, suggest that though many had a worsening illness ... it was not usually terminal. Autopsies showed five people had no disease at all. ... Little over a third were in pain. Some presumably suffered from no more than hypochondria or depression."

In response, Kevorkian's attorney Geoffrey Fieger published an essay stating, "I've
never met any doctor who lived by such exacting guidelines as Kevorkian ... he published them in an article for the American Journal of Forensic Psychiatry in 1992. Last year he got a committee of doctors, the Physicians of Mercy, to lay down new guidelines, which he scrupulously follows.” But Fieger admitted that Kevorkian found it difficult to follow his "exacting guidelines" due to "persecution and
prosecution", adding "[H]e's proposed these guidelines saying this is what ought to be done. These are not to be done in times of war, and we're at war.” Furthermore, in a 2010 interview with Sanjay Gupta, Kevorkian stated "What difference does it make if someone is terminal? We are all terminal."

Rather than submit to Kevorkian’s “solution”, we need to change society so that everyone, particularly those with disabilities, will have the care they need to survive, and the knowledge that their lives are valuable.

You can help right now by speaking out against assisted suicide for the disabled, and by protesting cuts to Medicaid, Social Security, and Social Services. Remember, the budget must not be balanced on the backs of the most vulnerable. Thank you.

References:

1. Detroit Free Press investigation report:
http://www.freep.com/article/20070527/NEWS05/70525061/SUICIDE-MACHINE-PART-1-Kevorkian-rushes-fulfill-his-clients-desire-die

2. “Kevorkian's patients were mostly women”, by the Deseret News:
http://www.deseretnews.com/article/798570/Kevorkians-patients-were-mostly-women.html

3. Kevorkian’s Obituary, The Economist:
http://www.economist.com/node/18802492

A Re-Post: The Decline Effect

This is from last January. Jonas Lehrer's article is important because of the implications it has for certain biased types of research into gender differences. Here it stands as a prequel for my posts on gender science during this week.

Jonah Lehrer has written a fascinating article about something called the decline effect. His article reads like a detective story, from the beginning to the end, even to me who knew who-done-it before starting.

The decline effect can be best defined by examples:

By 2001, Eli Lilly's Zyprexa was generating more revenue than Prozac. It remains the company's top-selling drug.

But the data presented at the Brussels meeting made it clear that something strange was happening: the therapeutic power of the drugs appeared to be steadily waning. A recent study showed an effect that was less than half of that documented in the first trials, in the early nineteen-nineties. Many researchers began to argue that the expensive pharmaceuticals weren't any better than first-generation antipsychotics, which have been in use since the fifties. "In fact, sometimes they now look even worse," John Davis, a professor of psychiatry at the University of Illinois at Chicago, told me.

...
But now all sorts of well-established, multiply confirmed findings have started to look increasingly uncertain. It's as if our facts were losing their truth: claims that have been enshrined in textbooks are suddenly unprovable. This phenomenon doesn't yet have an official name, but it's occurring across a wide range of fields, from psychology to ecology. In the field of medicine, the phenomenon seems extremely widespread, affecting not only antipsychotics but also therapies ranging from cardiac stents to Vitamin E and antidepressants: Davis has a forthcoming analysis demonstrating that the efficacy of antidepressants has gone down as much as threefold in recent decades.

For many scientists, the effect is especially troubling because of what it exposes about the scientific process. If replication is what separates the rigor of science from the squishiness of pseudoscience, where do we put all these rigorously validated findings that can no longer be proved? Which results should we believe? Francis Bacon, the early-modern philosopher and pioneer of the scientific method, once declared that experiments were essential, because they allowed us to "put nature to the question." But it appears that nature often gives us different answers.

That last sentence is a false clue. The real reason for the decline effect can ultimately be found in the pressure on researchers to publish "significant" findings in order to get tenure and/or further research grants, "significant" meaning new-and-different positive finding, rather than, say, the mere refutation of an older theory*. Thus, differences will be stressed, not similarities, and few tenure-track academics wish to send an article finding nothing to the relevant journals, even though finding "nothing" can be truly important if that nothing happens to be the efficacy of a new therapeutic drug, say.

Add to this tenure pressure the general "file drawer" problem, i.e., the tendency for journals to publish positive findings (of difference or of support for a new theory) rather than negative findings (of no difference or of no support for a new theory), and you get to the roots of the decline effect:

Early studies often produce exaggerated results.

What happens next? Suppose a study finds something astonishing, interesting and novel. Its creator(s) get invited to give seminars all over the academic world and might even get short-listed to new and much better positions. Suddenly the topic is hot! Hot, and other researchers sharpen their metaphoric pencils to join in the fray.

It's almost like a fad. An excellent example (and one I've often criticized on this blog) has to do with the evolutionary concept of fluctuating asymmetry:

In 1991, the Danish zoologist Anders Møller, at Uppsala University, in Sweden, made a remarkable discovery about sex, barn swallows, and symmetry. It had long been known that the asymmetrical appearance of a creature was directly linked to the amount of mutation in its genome, so that more mutations led to more "fluctuating asymmetry." (An easy way to measure asymmetry in humans is to compare the length of the fingers on each hand.) What Møller discovered is that female barn swallows were far more likely to mate with male birds that had long, symmetrical feathers. This suggested that the picky females were using symmetry as a proxy for the quality of male genes. Møller's paper, which was published in Nature, set off a frenzy of research. Here was an easily measured, widely applicable indicator of genetic quality, and females could be shown to gravitate toward it. Aesthetics was really about genetics.

In the three years following, there were ten independent tests of the role of fluctuating asymmetry in sexual selection, and nine of them found a relationship between symmetry and male reproductive success. It didn't matter if scientists were looking at the hairs on fruit flies or replicating the swallow studies—females seemed to prefer males with mirrored halves. Before long, the theory was applied to humans. Researchers found, for instance, that women preferred the smell of symmetrical men, but only during the fertile phase of the menstrual cycle. Other studies claimed that females had more orgasms when their partners were symmetrical, while a paper by anthropologists at Rutgers analyzed forty Jamaican dance routines and discovered that symmetrical men were consistently rated as better dancers.

Then the theory started to fall apart. In 1994, there were fourteen published tests of symmetry and sexual selection, and only eight found a correlation. In 1995, there were eight papers on the subject, and only four got a positive result. By 1998, when there were twelve additional investigations of fluctuating asymmetry, only a third of them confirmed the theory. Worse still, even the studies that yielded some positive result showed a steadily declining effect size. Between 1992 and 1997, the average effect size shrank by eighty per cent.

...

What happened? Leigh Simmons, a biologist at the University of Western Australia, suggested one explanation when he told me about his initial enthusiasm for the theory: "I was really excited by fluctuating asymmetry. The early studies made the effect look very robust." He decided to conduct a few experiments of his own, investigating symmetry in male horned beetles. "Unfortunately, I couldn't find the effect," he said. "But the worst part was that when I submitted these null results I had difficulty getting them published. The journals only wanted confirming data. It was too exciting an idea to disprove, at least back then." For Simmons, the steep rise and slow fall of fluctuating asymmetry is a clear example of a scientific paradigm, one of those intellectual fads that both guide and constrain research: after a new paradigm is proposed, the peer-review process is tilted toward positive results. But then, after a few years, the academic incentives shift—the paradigm has become entrenched—so that the most notable results are now those that disprove the theory.

I remember writing about those Jamaican dancing men, for example, because I wondered how the audience could spot such extremely, extremely minute body asymmetries when I have been known to leave the house with two different colored shoes.

Perhaps all we see here IS a Kuhnsian paradigm shift. But note the costs of a poor paradigm: We have been told for over a decade that even human females will pick (!) their mates based on how symmetric their fingers are or something similar to that. Bad paradigms hurt real people out there, in this case by providing sciencey-looking research which makes other pseudo-science pieces come across as more feasible.

More from Simmons:

"A lot of scientific measurement is really hard," Simmons told me. "If you're talking about fluctuating asymmetry, then it's a matter of minuscule differences between the right and left sides of an animal. It's millimetres of a tail feather. And so maybe a researcher knows that he's measuring a good male"—an animal that has successfully mated—"and he knows that it's supposed to be symmetrical. Well, that act of measurement is going to be vulnerable to all sorts of perception biases. That's not a cynical statement. That's just the way human beings work."

So it goes.

Another example of a decline effect can be found in the studies which analyze the ratio of the forefinger to the ring finger (2D-4D) as a measure of how much androgen a person may have been "bathed" with in uterus. All sorts of fascinating conclusions have been based on that idea: Men are better stockbrokers if they have relatively longer ring fingers (more of the good testosterone juice!), male Neanderthals were probably polygamous and adulterous and violent guys because a Neanderthal skeleton's hand bones appear to show a low 2D-4D measure, and the early human cave painters may have included women due to the high 2D-4D ratios of some of the hands painted on cave walls.

But my recent short search on the topic spotted many more recent studies which failed to find any correlation between various forms of behavior and the 2D-4D ratio, and my guess is that what we are observing is the decline effect. Measuring finger lengths is pretty tricky, after all.

Perhaps the most frightening quote from Lehrer's article is this one:

The situation is even worse when a subject is fashionable. In recent years, for instance, there have been hundreds of studies on the various genes that control the differences in disease risk between men and women. These findings have included everything from the mutations responsible for the increased risk of schizophrenia to the genes underlying hypertension. Ioannidis and his colleagues looked at four hundred and thirty-two of these claims. They quickly discovered that the vast majority had serious flaws. But the most troubling fact emerged when he looked at the test of replication: out of four hundred and thirty-two claims, only a single one was consistently replicable. "This doesn't mean that none of these claims will turn out to be true," he says. "But, given that most of them were done badly, I wouldn't hold my breath."

Why is this so frightening? First, it is about diseases. The consequences of bad research are more immediate and more serious in that field. Second, as I have written before, findings like these will be eagerly grasped by the popularizers who will then transmit them to an audience eager to devour anything to do with sex differences. Third, some odd type of psychological reproduction of ignorance is especially potent in this field. I see it all the time. This means that even the correction of incorrect results may not be enough, because the very idea of simple genetic explanations for complicated phenomena is so immensely appealing.

Don't stop this short review from reading the whole article. It's fun.
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Thanks to Geralyn Horton for the link to Lehrer's article.

*There can be more to this than just choosing between different manuscripts. It's not unknown for researchers to keep on trying various combinations of variables until they get something significant. This isn't necessarily bad if the study also reports how many other analyses produced only non-significant findings, of course.