The mandatory disclaimer applies here: this post is not about disrespecting transgender or transsexual people, nor about resisting their insistence of what gender or sex they may be. I think I’ve made my position on the humane treatment of such people clear: with a very few exceptions, they should possess all the rights of everyone else.
Rather, I want to evince my surprise that an article like this got published in the respected science magazine Nature, which so far has hewed pretty close to the woke agenda. The piece implies in its title that it’s going to be one of those articles arguing that, medically, transwomen should be treated like natal women (my term for birth sex, with sex defined biologically) and transmen like natal men. But no, the point of the article is not that. Instead, it argues that recognizing the binary nature of sex at birth can make a big difference in people’s healthcare and in preventive measures. In other words, there are times when you have to treat based on birth sex rather than asserted sex or gender. What the article means by “expanding the definition of ‘women’s health'” is to recognize the biological differences between the sexes when they are relevant for medical diagnosis and/or treatment. That is not exactly something amenable to gender activists.
Click to read:
The authors implicitly use the biological definition of sex (women = big gametes or the equipment for making them, men = small gametes or the capacity to make them).
They begin with the problem of fibroid tumors of the uterus, which can occur only in biological women—except for males with developmental disorders like persistent Müllerian duct syndrome. The authors’ point is that, in medical research, such conditions have been understudied because they affect women—biological (“natal”) women:
More than one-eighth of the world’s population has a condition that can cause pain, heavy bleeding and reduced fertility, all potential consequences of benign tumours called uterine leiomyomas, or fibroids. Fibroids can be debilitating, and are a common reason for surgical removal of the uterus.
Yet fibroids have received relatively little attention from scientists, either in academia or at pharmaceutical companies. The root cause of the condition — and how to reduce its impact on fertility — has been a matter of debate for decades, leaving physicians unsure how best to treat people.
Unfortunately, fibroids are just one of many understudied aspects of health in people assigned female at birth. (This includes cisgender women, transgender men and some non-binary and intersex people; the term ‘women’ in the rest of this editorial refers to cis women.) Clinical and pre-clinical studies alike tend to focus on men: only one-third of people participating in clinical trials relating to cardiovascular disease are women, and an analysis of neuroscience studies published in six journals in 2014 found that 40% of them used only male animals. Two studies and a feature published in Nature on 5 August spotlight the achievements of research into women’s health — and the need for much more.
Asserting that “transgender men are men” won’t help with this issue; you must recognize that the biology behind the syndrome is the biology of women. (Again, I’m happy to call transgender folk whatever gender/sex they wish; we’re talking about treatment here.)
Other issues discussed are diseases like type 2 diabetes, Alzheimer’s and, especially heart disease, which affect men and women differently.
Now it’s clear that if you’re a transgender person you should tell that to your doctor (presumably the doctor can tell, but that hasn’t always been the case). But the point is that even so, you might not be treated exactly as a member of the sex to which you’ve transitioned. There are three other areas where natal sex can make a difference:
Heart attacks, for example, are a leading killer of both women and men, but women don’t always experience the ‘typical’ symptoms usually seen in men. Women are also more prone to blood clots after a heart attack, yet less likely to be prescribed anti-clotting medication by their doctors. Women are 50% more likely than men to receive an initial misdiagnosis after a heart attack, and are less likely to be prescribed medicines to reduce the risk of a second attack, according to the British Heart Foundation.
When it comes to sport, women face a risk of serious long-term injury if we continue to model training and head-injury management on data from men. As our News Feature reports, it’s becoming increasingly clear that women experience and recover from head injuries very differently from men. Research from across many disciplines will be needed if we are to understand why women are almost twice as likely as men to suffer a concussion in sports such as soccer and rugby — and to understand why women take longer to recover from such injuries.
The sports issue here is more about research that’s been neglected in natal women, but that research may lead to differential treatments or preventive measures, as noted below.
And here’s a real argument-igniter:
So far, the evidence is sparse, but preliminary data point to structural differences in the brain. Axons in women’s brains are wired up with thinner microtubules, which rupture more easily; hormonal fluctuations are also thought to contribute. Biomechanics, too, could be playing a part — in rugby, for instance, it seems that women fall differently when tackled, which could raise the risk of concussion. Training regimes designed specifically for women might help to mitigate these injuries.
If these brain differences persist through transition, and evidence shows they seem to, then this will lead to differences in training regimens between biological men and transmen.
At the end, the article reiterates that most studies that have been done, whether on humans or animals, have been done on the male sex. Their conclusion—that studies need to be done on women—implicitly assumes a binary of sex at birth:
But the clear message from those researching the sport is that it is no longer acceptable to use data solely from men in these studies. And when women are included, the data need to be disaggregated by sex and involve a sufficient number of women. A recent study looking at MRI images from elite rugby players did include women (K. A. Zimmerman Brain Commun. 3, fcab133; 2021), but of the 44 elite players only 3 were women.
But the relative dearth of women on grant review panels and scientific advisory boards has meant that few of these decision makers have direct personal experience of women’s health needs or research gaps. This makes it all the more important that funding bodies consult the public when they come to set research priorities.
Since 2016, the US National Institutes of Health has required researchers to carry out pre-clinical studies in both male and female animals, tissues and cells, or to provide an explanation for why it is not appropriate to study both sexes. Now it is up to other funders, researchers and journals to amplify the impact of this change by taking care to report sex-specific data in publications. Funders should also bolster the resources given to support studies of health and disease in women, and track how much money goes to supporting such research across all domains, not merely gynaecological conditions. That which gets measured gets done.
These are important and valuable points, and ones that have been made many times before. Women constitute half the world and deserve to be half the reserach subjects for diseases that affect both sexes.
So when they’re talking about “male and female” animals here, or the “relative dearth of women”, they are talking about biological sex, not the sex to which someone has transitioned. In the second paragraph, for instance, then they’re discussing “decision makers who have direct personal experience of women’s health needs or research gaps”, those will nearly all be biological women.
It’s clear that transsexual people will have their own unique medical issues, and these too need to be studied. All I’m saying here is that Nature published an article in which they assume a sex binary at birth that can affect medical outcomes and treatment down the line (by “binary”, I mean “almost complete bimodality”). This runs counter to the trans-activist narrative that “transwomen are women” and “transmen are men”. So I’m surprised that this article hasn’t yet been attacked.
Perhaps it will, but it still makes several good points, and if you have a clear vision, you’ll see that it’s actually a form of social justice to recognize any differences between biological women and men that obtain at birth, could have medical relevance, and then to ensure that medical issues that differ between the sexes are studied in both biological men and women—not just in samples that are mostly male. As always, recognizing differences like this implies absolutely nothing about inequality.
And while we’re dealing with the thorny issue of differences in brain structure between men and women, something repeatedly denied by sex and gender activists (again, we have the fallacious assumption that differences should not be studied because they imply ranking), here’s a new thread about the brain that has references (h/t Luana):
There are 15 tweets in this thread on brain differences, and I won’t reproduce them all, as you can access them by clicking on the first one:
2/ But, as is the case in intelligence research, the dam is starting to break under the weight of the evidence, and to deny that there are brain differences between men and women is quickly becoming scientifically indefensible.
— A New Radical Centrism (@a_centrism) August 7, 2021
. . . .
5/ Other methods have an accuracy range of more than 80% to as much as 93%.
Studies include:https://t.co/fbnQ7IXIt0https://t.co/DjkHn824e0https://t.co/3416rKV1Njhttps://t.co/UzCd1dVSyjhttps://t.co/fbnQ7IXIt0
— A New Radical Centrism (@a_centrism) August 7, 2021
6/ Some on the left respond that differences can be explained by a female brain's adaptation to “sexist” social and cultural norms during a lifetime.
But new research shows that brain differences show up in the fetus before birth.
https://t.co/r4PfUp9UVA— A New Radical Centrism (@a_centrism) August 7, 2021
. . . .
9/ … that there are sex differences in gene expression in the human *fetal* brain (before the imagined “structures of oppression” can act on it at all).https://t.co/pJo29Ips2w
— A New Radical Centrism (@a_centrism) August 7, 2021
It goes on, and you can read and check the references for yourself. It’s a bit left-bashing, as this Twitter site is wont to be, but just check the data for yourself. Given that natural and sexual selection have been going on in our species for millions of years, while civilization is only about ten thousand years old, it would be surprising if brains did not show differences between the sexes the way that other morphological traits do.
“In other words, there are times when you have to treat based on birth sex rather than asserted sex or gender” – hardly surprising, but good to see Nature taking the effort to spell it out.
What percentage of the population are transgender? Why – suddenly – do they have a public voice well beyond their size?
Is there an argument for saying that they should have their own competitive forums – like the Paralympics for disabled competitors?
Surely we can look forward to protests against this Nature editorial—and calls (perhaps coming from the ACLU?) for its authors to be fired. Come to think of it, I am surprised that scholars in academic departments of Gender Studies have not yet demanded retroactive cancellation of the Nobel prize awarded to Thomas Hunt Morgan in 1933. After all, Morgan’s studies of chromosomal inheritance in Drosophila rested heavily on the chromosome that is assigned the label “X”, the phenomenon called sex-linked inheritance, and a famous gene named—wait for it—white!. Reviewing this case of cis-genderism and white supremacism, I feel an article for Scientific American coming on.
I am one of those women who had a fibroid that caused excessive bleeding, the treatment for which was surgical removal of the uterus. I worked in a telephone company office with very expensive ergonomic chairs and was constantly in fear that I would accidentally soil them. There was one time that I was traveling by car to a different city for a meeting and had to pull in at a rest stop to try to clean up…and, of course, had no change of clothes.
Another problem not mentioned is the effects of surgical menopause. Many health problems that would normally not occur until later, occur sooner. Awareness of the problems, diagnosis and treatment are often difficult to obtain.
I am glad that more attention is being paid to the biological differences between men and women for the earlier and proper treatment of women. As has been noted many, many times, medical diagnosis and treatment of women’s health issues tends to be ignored by the scientific community as well as doctors. Most women can attest to this from personal experience and the testimony of other women.
We are moving into a world where alterations of all kinds will be possible, both around the time of conception and throughout a person’s life. Obviously all events in a person’s biological life — natal sex, transitioning operations, adding wings, or whatever — have to be made part of their medical history to inform proper medical diagnosis and treatment. This should be independent of the transition issue itself, though it might slow down those activists who would like to pretend that, once transitioned, a trans person can forget their history. Perhaps socially but definitely not biologically or medically.
My wife had some of the same problems that went on for years before they finally came to the correct conclusions. That was a hysterectomy which of course leads to other difficulties.
That was a reply to Rowena….sorry
I’m sorry to hear this Randall. My sympathy to your wife and I hope she is in reasonably good health now. My Mom had the same condition. I don’t know about other members of my family. But, I do know that women’s health issues tend to be ascribed to non-physical origins and either take a long time to be correctly diagnosed or not diagnosed at all. Same with health issues like heart and cancer whether specific to women or to all humans.
I object to the use of “natal woman” or AFAB (Assigned Female at Birth) instead of just girl or woman. The default and the overwhelming majority of humans identifying as women and girls are born that way and are identifying as the sex defined by their reproductive systems. People who want to live as the opposite of their (Assigned at birth by nature) sex should continue to be referred to as trans-women and trans-men. It is absurd to change the definitions of girls, women, boys, and men to accommodate the demands of a tiny minority of humans most of whom are not trans, especially given that an even tinier minority of trans people agree with those demands or with the bullying supposedly being engaged in on behalf of trans people by self-righteous, typically non-trans ideologues.
I agree with you, but also, using those terms gives them validity. We aren’t assigned a gender at birth, our sex is recorded.
It will be difficult for the trans-lobby to attack this article without revealing themselves to be unconcerned with the special medical problems faced by females (those with large gametes who carry the fertilised egg and give birth).
Since “gender” refers to the norms, roles, and characteristics associated with being a man or woman, transcending or crossing-over gender should be referring to “masculine women” and “feminine men.” Although some broad behavioral differences between the sexes are indeed brain-based, there’s so much variation within each sex that hard rules on what’s “masculine” and “feminine” are culturally-determined. In which case, a “transgender” person would just be someone who prefers to live according to the stereotypes of the opposite sex.
But that’s not what the term means. They’re really claiming to transcend or cross-over sex, not gender. Thus, the problems.
Well that is very good! But no surprise about human brains since gender differences in animal brains have been known for decades.
I remember some years ago when one of the studies came out announcing that human biological males and females have identifiable differences in their brains, PZ posted about it and fairly tied himself up into knots trying to play it down. It was… amusing.
I’m kind of curous about those studies, if you can recall anything about them. And the reason that I am asking is because there are supposedly studies tht show transgender people’s brains show that they are more like the sex that they believe themselves to be. There’s a great deal of conflicting information on this subject, and Dr. Gina Rippon has written that the differences between male and female brains are due to size, or the neuroplasticity that can arise from learning or experience; ie gender roles.
https://www.theguardian.com/science/2019/feb/24/meet-the-neuroscientist-shattering-the-myth-of-the-gendered-brain-gina-rippon
How much can be staked on the “shapes” in determining sex or gender (blindly?)
The only teeny bit I remember from back then was there were some proportional differences, other than overall size. Size differences may be expected from body size.
According to Helen Joyce’s new book Trans: When Ideology Meets Reality (pp 75-6) trans activists try to have it both ways:
Let me express some hope that the Nature article gets a fair hearing by people of all sexes, genders, and orientations. People who have transitioned, for example, surely realize that they retain many of the biological attributes that characterized them before the transition. My expectation is these folks will recognize that research applied to their “natal” sex could benefit them quite directly. So, while some people may not like the words that are used to describe the sexes, my hope (perhaps naive) is that people of all sorts will welcome the expanded program of research recommended by the article’s authors. It would be a shame if the article’s important message ends up being clouded by controversy. We’ll see.
There are many kinds of trans people, you have the heterosexual autogynaephiles and the homosexual autogynaephiles, for example, or the sudden onset gender dysphoria in pubescent girls (Shrier’s book is mainly about the latter), I consider them to be quite different.
I noticed that about all the man-to-woman transgenders I know retain a lot of their ‘typical male’ traits, such as wanting to dominate a conversation (including interrupting women), and a pretty aggressive stance in general, to name a few.
If there are systematic differences in male and female brains, which is more than likely, many transgenders appear to retain much of it (ie. the brain of their biological sex).
One reason for not doing so is that women can get pregnant — and ever since thalidomide, the medical profession has been very wary about research on women who might be pregnant. Recruiting only males to a research study solves this issue.
In case anyone’s interested, here’s an article from Stanford Medicine: “How men’s and women’s brains are different” https://stanmed.stanford.edu/2017spring/how-mens-and-womens-brains-are-different.html
Most men are physically and emotionally attracted to women. Many women are physically and emotionally attracted to men. This is a universal phenomenon independent of culture. It is difficult to see how these differences arise unless the organisation of the brain is somehow involved.
“Trans” seems to be an eminently sensible book. Helen Joyce has been interviewed several times on you-tube and gives a very positive impression.
good post *thumbs up*
The only way to have true inclusiveness while still recognizing that there are differences between people.
The author of The Highly Sensitive Man (2019, Tom Falkenstein) writes (pg.13): “So it seems everyone is talking about a ‘crisis in masculinity.’ It is a crisis marked by men’s insecurity about their role in society, their identity, their values, their sexuality, their careers, and their relationships. At the same time, academics are telling us that ‘we know far less about the psychological and physical health of men than of women.’ Why is this? Michael Addis, a professor of psychology and a leading researcher into male identity and psychological health, has highlighted a deficit in our knowledge about men suffering from depression and argues that this has cultural, social, and historical roots.
If we look at whether gender affects how people experience depression, how they express it, and how it’s treated, it quickly becomes clear that gender has for a long time referred to women and not to men. According to Addis, this is because, socially and historically, men have been seen as the dominant group and thus representative of normal psychological health. Women have thus been understood as the nondominant group, which deviated from the norm, and they have been examined and understood from this perspective. One of the countless problems of this approach is that the experiences and specific challenges of the ‘dominant group,’ in this case men, have remained hidden. As we have discussed, though, this is finally beginning to change, with men’s psychological health beginning to become part of our public discourse. What in the past was taken for granted is now being questioned. And perhaps it is precisely this questioning and the identification, analysis, and redefining that this entails, that is being understood as a crisis in masculinity and as a challenge to the ‘stronger sex’.”