It seems many surgical tools are still being made with male hands (generally larger than female ones) in mind. A new study argues that tools for smaller hands are needed (which would of course also help males with smaller hands). Strikes me as a nice example of the way that non-obvious barriers to women’s advancement may remain in place even once obvious ones have been removed. Also makes me really appreciate the additional barriers that a surgeon friend of mine undoubtedly had to face even once she got past the people (surgeons, in the UK) telling her that she shouldn’t be a surgeon because she’s a woman, and even after she’d convinced them (a lengthy battle) to allow her to work part-time in order to get some time with her daughter. (Thanks, Jender-Parents!)
in 40 years, 13 out of every 10 … August 18, 2008
In 40 years 13 out of every 10 US citizens will not have landlines. The kind of reasoning that leads to this conclusion also supported the recent claim that in 40 years 10 out of 10 Americans will be obese. As the Numbers Guy in the Wall Street Journal points out:
The phone forecast is impossible, of course, but it’s arguably no less solidly grounded than the obesity forecast. The weight projection uses three data points spread out over nearly three decades to estimate a linear trend — then brazenly draws that line into the future.
Human beings have real deficits in reasoning about probability, and that can include people giving medical advice, but you don’t really expect it to show up in a scientific journal, even an online journal like Obesity (link corrected thanks to Noumena in comments), where it was published. Certainly, at least not one backed by the highly respected Nature Publishing Group.
The recent study was intended by lead author Youfa Wang “to send a message” to public-health officials, he says. Dr. Wang, associate professor of international health and epidemiology at Johns Hopkins University, adds that there is no conflict between this goal and the standards of scientific inquiry. He notes the scientific pedigree of his co-authors, who include Hopkins colleagues, and researchers at the University of Pennsylvania and at the federal Agency for Healthcare Research and Quality.
And the response when confronted with the problem?
“This study isn’t designed to predict what the future actual situation will be,” Dr. Wang says. “We just say, if you take these assumptions, this is what the future may be.”
…
Richard Bergman and David Allison, editor and associate editor, respectively, of Obesity, wrote in an email: “Each scientific paper is hoped to be an ever closer approximation to the best possible answer to a question than was the work that had gone before. We believe Dr. Wang’s paper fulfills that spirit.”
On the fact of it, I’d say the paper deserves a C or a D and a good scolding that centers around not presenting propaganda as though it were truth. And the editors? Well, I just hope they are not the sort that grumble at cocktail parties about how post-modernism is the curse of academia.
Is that too harsh? What do you think?
(And thanks to Tara Parker-Pope’s article for the link to the Numbers Guy.)
Explaining psychopathologies August 15, 2008
My friend, Louis Sass, has said he thinks people attracted to philosophy are at least schizotypal. Seems a bit confining to me, but explaining oneself and one’s academic colleagues can be challenging. And it is not just all fun and giggles. Apparently Kissinger said that the reason academic politics is so nasty is that the stakes are so small. I’m inclined to think it’s the reverse; academic politics is so nasty because many academics are the sort of people to fight over very small stakes.
One of the things I have found attractive about cognitive neuroscience is that it gives us a largely new take on what in the world is going on with us. And it is one free of the dark weapon that Freudian approaches can turn out to use. In too many people’s hands, Freudian explanations completely epistemically disenfranchise the subject, and then advance demeaning explanations. People who cannot understand creativity, for example, happily tell themselves that someone dedicated to a project is really self-promoting. “You may think you were trying to help, but you were really trying to … ” goes a too familiar refrain. Even feminists who are skeptical about objective truths will be convinced they understand another’s soul.
But cognitive neuroscience invites us to think about the complexity that can underlie a pattern of human behavior. At what points in that complex of person and environment is that problem arising? And the explanation of behavior can be enlightening. Or it can be extremely puzzling.
One thing many cognitive neuroscientists endorse is the view that human beings need to act and react much more quickly than reason can accommodate. (Yes, just as Hume said.) And, simplifying a bit, that need is served in part by structures in the brain that can send send something like alarm signals. The alarms go off very quickly, more quickly than we can think. For example, most human beings get a negative kick when they have visibly hurt someone. Think of scolding a colleague and see their eyes well up. Most of us will stop and back up. Not everyone. I have a friend who will later call you up and start in again, perhaps just to make sure the message got in. It’s a good bet he doesn’t have much in the way of von economo cells in his anterior cingulate cortex, since they provide the kick in human beings.**
I think chimps have some sparse amount of von economo cells, and elephants remain a possibility. But frankly, my dear, most of our animal friends don’t give a damn, though some learn to fake it. (OK, there’s a bit of speculation there.)
And another alarm goes off when norms are broken in most people. If I’m in some supposedly cooperative game with you and I give you a mean share, or you do that to me, an alarm will go off in my anterior insula. And maybe yours too. But not in everyone’s. A recent article in Science claims to have found a neural marker for borderline personality disorder. And it is precisely a deficit in the anterior insula.
The classic description of BPD people is that they are unstable. They have emotional swings and rages and an inability to establish long term relationships. They also fear abandonment; they are a sort of natural tragedy since their behavior seems geared to bring about what they most fear. Other characteristics include harming themselves; they can be cutters. They apparently go in for splitting; that is, things are black or white, people are good or bad. A friend of mine who was a therapist tells me that they are very manipulative and typically very successful at it. Some people claim that the BPDs among academics have very distinctive characterisitics, though others say we’re unlikely to have it (which is one down, anyway).
It is very recent work in Science claims that a distinguishing factor in BPD is a deficit in the anterior insula, In particular, the BPD participants had no trouble detecting that they were doing an injustice. What they didn’t seem to get was when an injustifice was being done to them. Or at least they didn’t get the rapid alerm going off.
It is very difficult to understand how a lack of a perception of injustice inflicted upon one would lead to any of the syndrome’s features. The authors conjecture that BPDs really have severe problems understanding other people, which perhaps brings the marker in closer to the syndrome.
I suggest there is a whole area for philosophical investigation here. What is it about norm violation and the failure to detect it that might play an explanatory role in BPD? We are learning from cognitive neuroscience that traditional distinctions among perception, action and emotion may be quite mistaken and that there is something like affective perception. We might wonder whether a knowledge of norm violation has a first and third person variations, some of which are more tied into something like the automatic and instinctive kind of reactions the anterior insula may give us.
So back to Freud: what’s the fole of unconscious desires, the id and the ego? What seems to me to be the highly capitalistic assumption that we are doing what we want may be passing away. Instead, we are products of a much larger complex that includes the environment and our ability to see what is going on.
There is a new science of the self being constructed. It would be wonderful to have more feminist scholars participating, though the women already in the field are certainly doing their share.
**Much of the work on von economo cells has been done by John Allman at Caltech.
Contraception: Makes women choose ‘wrong’ partner August 13, 2008
I’m not making this up, though I wish I was. And it’s not in some right-wing paper either. I imagine we’ll be hearing a lot about this. (Thanks, BTPS.)
UK Lesbian and Bisexual Women’s Health July 29, 2008
Stonewall’s report on this important topic is out. Here are their key recommendations to the NHS:
1. Understand lesbian health needs:
Only one in ten lesbian and bisexual women said that healthcare workers have given them information relevant to their health care needs.
2. Train staff:
Only three in ten lesbian and bisexual women said healthcare workers did not make inappropriate comments about their sexual orientation.
3. Don’t make assumptions:
Two in five lesbian and bisexual women said that in the last year healthcare workers had assumed they were heterosexual.
4. Explicit policies:
Only one in eleven say that their GP surgery displayed non-discriminatory policy.
5. Tell lesbians what they need to know:
Three quarters of lesbian and bisexual women think they are not at risk from sexually transmitted infections.
6. Improve monitoring:
One in ten lesbian and bisexual women stated that when they did come out to a healthcare worker they were either ignored, or the healthcare worker continued to assume they were heterosexual.
7. Increase visibility:
Half of young lesbian and bisexual women have self-harmed in the last year. Increased visibility of lesbian and bisexual women will help improve self-esteem and morale.
8. Make confidentiality policies clear:
One in eight lesbian and bisexual women are not sure what their GP’s policy is on confidentiality.
9. Make complaints procedures clear:
Half of lesbian and bisexual women have had a negative experience in the health sector in the last year.
10. Develop tailored services:
Only two per cent of lesbian and bisexual women have attended a service tailored towards their needs.
Lots here that seems to me of interest to those interested in issues at the intersection of politics and epistemology: the importance of not making false assumptions based on prevailing norms, the importance of actively working to facilitate communication on sensitive matters, the importance of actively combatting dangerous false beliefs, the importance of knowing what information is relevant. And yes, put in these terms this stuff is not just about lesbians and bisexuals. These are good general practices, but the particular case of lesbians and bisexuals helps to make clear their importance. (Thanks, Heg!)
Doctors required to lie July 23, 2008
I’m a little late to this one, but it bears mentioning:
Doctors in South Dakota are now required to tell a woman seeking an abortion that the procedure “will terminate the life of a whole, separate, unique living human being.
You can argue over ‘whole’, over ‘unique’, over ‘living’, over ‘human being’. But separate? I don’t think so. (Thanks, Jender-Parents.)
Abortion and the Web July 11, 2008
Women in countries where abortion is restricted are using the web to obtain abortifacient medications. There are some significant safety concerns, and it also looks like there’s considerable variation between various services. But Women on the Web sounds like a very responsible organisation. It looks like it is generally legal to use this service, even if abortion is illegal where one is located. A very interesting and important use of the web to help women who really need help. (Thanks, Mr J!)
Gardasil and Women’s Experience July 9, 2008
It seems that the vaccination against HPV, Gardasil may have contributed to paralysis in one 13-year-old girl and has had a number of complaints filed against it (from here and here).
Gardasil has faced a great deal of resistance (most vocally from religious groups - it turns the teenage girls promiscuous!), but despite has been approved by the FDA.
The reaction from here is that this is primarily an attack on women’s sexual health and freedom. It’s an attempt to spread fear.
However, in the context medicine regulating and shaping women’s reproduction it’s hardly unusual for procedures to be done for ‘women’s good’ without adequate testing and fully informed choice (examples include forced sterilisation, early IUDs, Depo-Provera and Norplant amongst others).
Futhermore, it is usually disadvantaged women such as disabled, poor or minority women that are targeted ‘for their own good’ and in clinical trials. (h/t blackamazon). The price of sexual freedom for a few women came at the cost to these groups.
Obama and Abortion July 7, 2008
Obama recently said (to a Christian publication) that he would only support 3rd trimester abortions where necessary for a woman’s physical, not mental health.
I have repeatedly said that I think it’s entirely appropriate for states to restrict or even prohibit late-term abortions as long as there is a strict, well-defined exception for the health of the mother. Now, I don’t think that “mental distress” qualifies as the health of the mother. I think it has to be a serious physical issue that arises in pregnancy, where there are real, significant problems to the mother carrying that child to term. Otherwise, as long as there is such a medical exception in place, I think we can prohibit late-term abortions.
As laid out very clearly here and here, this is a position deeply at odds with the state of abortion law in the US. So the Democratic presidential candidate has now come out in favour of reducing abortion rights. Of course, he quickly backpedalled.
My only point is that in an area like partial-birth abortion having a mental, having a health exception can be defined rigorously. It can be defined through physical health, It can be defined by serious clinical mental-health diseases. It is not just a matter of feeling blue. I don’t think that’s how pro-choice folks have interpreted it. I don’t think that’s how the courts have interpreted it and I think that’s important to emphasize and understand.”
And that’s a perfectly reasonable distinction to make. The problem is that he didn’t make it earlier. I think Zuzu has a great analysis of what’s going on: abortion just isn’t something he has thought much about. The guy’s a constitutional law professor– if he’d thought much, he would have been far more careful in his initial remarks. We need to make him think about this– and make him think well. (Do that here.) Being thoughtless on this sort of thing sure as hell isn’t going to win back the Clinton supporters. more generally, Obama is doing a pretty dramatic version of the standard general election shift-to-the-right, and I don’t think we should just sit idly by on any of it. (Thanks, Mr J, for your help on this one.)
On the necessity of ingesting semen July 4, 2008
Marie Stopes was a leading British campaigner for family planning, and Marie Stopes clinics are a major provider of family planning services in the UK. Like many early advocates of family planning, Stopes held some appalling eugenicist views, even disowning her son for marrying a near-sighted woman and breeding inferior stock. That’s well-known. What’s less well-known is her view on the ingestion of semen. Crucial for a woman’s sexual health apparently. A woman who doesn’t get enough semen into her body from her male partner is at risk– her sex drive will run wild, and she may even turn to the vices of lesbianism or masturbation.
Can anything be done? Of course, self-stimulus, or masturbation, is extremely common… Masturbation is always unsatisfactory… Another practical solution which some deprived women find is in Lesbian love with their own sex…
But these will never satisfy:
…homosexual excitement does not really meet their need for the physiological fact (I have never yet seen it clearly stated anywhere, but it is of the greatest importance in a consideration of this problem) is that… a woman’s need and hunger for nourishment in sex union is a true physiological hunger to be satisfied by the supplying of the actual molecular substances lacked by her system… the chemical molecules produced by the glandular systems of the male.
Fortunately:
It has been found possible to prepare some at least of the very molecular compounds really nourishing to the woman’s system, and which she lacks and requires.
That’s right ladies– artificial semen for you, in capsule form! And she even gives a recipe (though sadly it’s not made from ordinary household ingredients).
(Many thanks Stella, for passing on this wisdom! Quotes are from Enduring Passion, 29-32.)
Update: the VA and health care for women vets June 21, 2008
Thanks to Ms for this update on women vets’ health care,which we discussed here:
Veterans Affairs Secretary James Peake said on Friday that the agency is working to improve the health care offered to women vets. The announcement follows an internal VA study that found that female veterans have more difficulty obtaining quality outpatient healthcare than their male counterparts.
“We are making a full-court press to ensure that women veterans receive the highest quality of care,” Peake said, according to the Associated Press.
There has been a consistent air of understatement in the announcements about women and health care. Have a look at travelvet’s comments in our previous post and see if that looks like a story about her having “more difficulty.” “Incapable of getting care needed to save her life” is more like it.
Do women have a special perspective on health care? June 17, 2008
Let me count the ways!
Some perspectives are not at all welcome ones, as we point out here, for example. And another recent example is found at Ms. As the Associated Press reports, a recent study sees discrepancies in VA care for women:
Health care for female military veterans lags behind the care offered to male vets at many VA facilities, an internal agency report says, even as women are serving on front lines at historic levels.
There are clear needs for more physicians trained in women’s care and more equipment to meet women’s health needs, said Friday’s review by the Department of Veterans Affairs.
It did add that strides are being made, such as creating onsite mammography services and establishing women’s clinics at most VA medical centers. The department also is attempting to recruit more clinicians with training in women’s care.
For now, female veterans aren’t getting the same quality of outpatient care as men in about one-third of the VA’s 139 facilities that offer it, the report said. That appeared to validate the complaints of advocates and some members of Congress who have said more emphasis needs to be placed on women’s health.
………..
Let’s hope no one reading this article thinks that somehow understanding the male body is just understanding the human body. Women, who are over 50% of the US/worldwide population, are not some sort of strange creatures, despite the years and years in which medical research tended to privilege research involving male subjects.
But some of the news is surprisingly good:
The VA’s review noted that other studies have found better surgical outcomes and decreased mortality for women at VA hospitals compared to women who receive care under the Medicare Advantage Program or under private care. And, performance of breast and cervical cancer screening exceeds that of commercial and some government plans.
But also mixed:
Data were not available to compare the inpatient quality of care between men and women.
Sen. Patty Murray, D-Wash., who is on the Senate Veterans Affairs Committee, said in a statement that the findings confirm what she has been hearing from women veterans for years.
She encouraged passage of legislation that would, among other things, force the agency to do comprehensive studies of women veterans’ care and conduct a pilot program providing child care for veterans seeking mental health care.
Among the other findings of new report:
_Older and younger veterans appear to be receiving the same quality of care;
_About 86 percent of homeless veterans seen by VA received primary care, mental health care and/or substance abuse services;
_About 98 percent of appointments were completed within 30 days in primary care clinics and about 97 percent were completed during that period at specialty clinics;
_Overall quality of care appears to be good when reviewed using commonly accepted health care benchmarks;
_Minority veterans surveyed were generally less satisfied with inpatient and outpatient care than white veterans, but it wasn’t clear if the quality of care offered was different. A more comprehensive study of care for minority veterans is expected to be complete this summer.
NOW call for action June 11, 2008
Here’s the call for action:
Support International Women’s Health Services
Restore funds for the United Nations Population FundMillions of girls and women around the world are suffering and many are dying due to deplorable reproductive-related health services and they need our help.
Contact your senators and tell them to join Sen. Hillary Clinton (D-NY) in sponsoring and supporting the United Nations Population Fund Restoration Act of 2008 (S. 2682). This legislation will provide funding to the United Nations Population Fund in order to distribute medical equipment, establish maternal health services, distribute contraceptives, and promote the abandonment of female genital mutilation and child marriage worldwide.
Women around the world should be able to have children and raise their families without the fear of disability, suffering, and death. A woman’s right to safe and sufficient health services is a human right. All women should be able to live healthy lives and enjoy their sexuality and child bearing years free from forced pregnancies and the dread of disease and death.
At the bottom of the page, NOW have an electronic form for e-writing your senators (linked to here and in the message). It looks as though the appropriate senators are determined by your address, so expats might need to work that issue.
US Senate Passes Measure to Restore Affordable Birth Control May 25, 2008
See the call for action at the end!
The US Senate passed a supplemental war spending bill on Thursday, which included a provision to restore government subsidies for birth control pills sold at university and low-income health centers. … For almost 20 years, pharmaceutical companies provided college health centers and clinics servicing low income women with birth control at deeply discounted prices. But the Deficit Reduction Act of 2006, which went into effect in January 2007, has eliminated these discounts for campus and low-income health centers.
The President, OF COURSE, is not happy about it, but he is not threatening a veto.
And another bit of good news from Ms: a key administration anti-contraception advocate has resigned:
Susan Orr, President Bush’s controversial appointee to head the Office of Population Affairs in the Department of Health and Human Services (HHS), resigned this week after less than a year in the position. Orr’s appointment was criticized from the beginning by lawmakers and women’s rights groups because of Orr’s long history as an opponent of contraceptives.
Her position oversees the administration of title X.
You can use this opportunity to make sure Secretary of Health and Human Services Mike Leavitt knows how you feel about preserving Title X funding for low-income women and men by sending him a letter here. Remember, Title X helps keep students able to stay in school.
And thanks to Reality Check for the link.
Reproductive Justice Victories in the UK May 21, 2008
Good news all round today, as the BBC tells us that the 24-week limit on abortion has been upheld (despite moves to lower it to 22 or or even 12 weeks); and that fertility clinics are no longer being required to consider the need for “a mother and father” when deciding whether to offer treatment. Instead, they will be required to consider the need for “a loving family”.
US readers may experience a bit of culture shock when they learn that the Tory leading the charge against the latter move said the following about lesbian parents: “I hope, like everybody else, we would want any such relationship to prosper and the child would benefit.” There certainly is homophobia over here, plenty of it– but totally blatant expressions of it are far less socially acceptable than in the US.
Femmostroppo Awards May 20, 2008
From Cara, I’ve learned of the Femmostroppo Awards, for best 40 feminist blog posts of the year. So far, I’ve only read one, from La Lubu, and I’m still haunted by her description of giving birth to a premature baby; losing her job for taking time off from work to be at the hospital; and losing her health insurance. And by the fact that all the other parents of very ill children that she met had also lost at least one job due to their child’s illness. And by the lifetime caps on coverage which are apparently standard for health insurance in the US. It really brings home to me how fortunate those of us in countries with national health insurance are. And how desperately bad it is to be in a country without that.
Did we need to know this? May 20, 2008
From the NY Times:
“If it is done before she comes into heat, spaying virtually eliminates the risk of breast cancer, the most common type of cancer” in female dogs, she** said. In female cats, too, breast tumors are common, and 90 percent of them are malignant. But a cat spayed before age 2 is one-seventh as likely to develop them.
Spaying also prevents ovarian or uterine cancer, uterine infections and other diseases. And it cancels the risks associated with giving birth.
In dogs and cats, males that have not been neutered are at risk for testicular cancer, prostate disease and hernias, among other problems. Neutering also often reduces fighting, roaming and scent marking, behaviors that may land a pet in a shelter, where euthanasia is a risk.
So does this generalize to other species? As in, ours? So the message is that just being able to have sex is very dangerous?
**Dr. Brenda Griffin, director of clinical programs in shelter medicine at the School of Veterinary Medicine at Cornell.
What sorts of people do we want? May 17, 2008
I could swear that until recently I - and I assume many others - heard questions about what sorts of people as questions about morality and education. The extremely rapid increase in biotechnological knowledge and procedures means that all of us now face public policy questions based largely on new sets of possibilities, ones that for many individuals lead or will be leading to issues of immense practical importance. And the possibilities will continue to expand; we are only at the beginning.
A new project and blog is, consequently, of considerable interest:
What Sorts of People, the new blog, says it is:
The Canadian-based What Sorts of People Should There Be? project, has 61 researchers from 15 different disciplines. The team also includes members of the community. Among the exciting possibilities is their potential to ask illuminating and well-defined questions, and to reach some conclusions based on genuine inquiry.
As the homepage (linked above) says, “Human enhancement, normalcy, and variation are topics of immediate public interest and with far-reaching implications for the future.”
Another take on Germaine Greer May 5, 2008
As folks around here know, I work hard to be kind and civil to everyone even vaguely feminist or possibly sympathetic to feminism. But I’m going to make an exception for Germaine Greer. Stoat’s criticisms are spot-on, but, well, too polite for my taste.
The Feminist Blogosphere has been filled with discussions of whether Amanda Marcotte’s and SEAL Press’s apologies and promises to change are an adequate response to criticisms. Greer, as Stoat notes, belittled the injustices faced by Muslims and racial minorities while at the same time demonstrating her view that the only women (who count) are white and secular. AND SHE IS COMPLETELY UNREPENTANT. As far as I know, she has never in her life apologised for anything, or conceded that she has anything to learn from those who are not her. As Laura Miller from Salon said 9 years ago, Greer’s method is “inflating her own personal trials into theories about the condition of women”. Sounds almost precisely like what Elizabeth Spelman calls the method of White Solipsism. She is totally uninterested in women’s health, as shown by her opposition to PAP smears and the HPV vaccine, and her support for FGM; and she has a long history of transphobia.* Why the hell are we are all being so tolerant of her? Because she wrote an important book a long time ago? Well, a lot has happened since then and she should have made an effort to keep up.
For a much funnier, better-written take on Greer from roughly the same perspective, check out Natalia Antonova. And for another excellent post by someone just as annoyed as me by the FEM 08 talk, go here.
*In general, I think that feminism is enriched by a diversity of views, when these views are backed up by well-reasoned arguments. But Greer’s are not. Instead, they’re based on ignoring the perspectives of those who are unlike her. This does not enrich feminism.
Update on “abortion”/POPLINE April 4, 2008
From Women’s Health News, April 4.
“
Today, Michael J. Klag, MD, MPH (Dean of the School at Hopkins) has released a statement detailing the events and indicating that the ability to search the database for “abortion” will be restored.
Dr. Klag notes:
I was informed this morning that the word “abortion” was blocked as a search term in the POPLINE family planning database administered by the Bloomberg School’s Center for Communication Programs. POPLINE provides evidence-based information on reproductive health and family planning and is the world’s largest database on these issues.
USAID, which funds POPLINE, found two items in the database related to abortion that did not fit POPLINE criteria. The agency then made an inquiry to POPLINE administrators. Following this inquiry, the POPLINE administrators at the Center for Communication Programs made the decision to restrict abortion as a search term.
I could not disagree more strongly with this decision, and I have ordered that the POPLINE administrators restore “abortion” as a search term immediately. I will also launch an inquiry to determine why this change occurred.
The Johns Hopkins Bloomberg School of Public Health is dedicated to the advancement and dissemination of knowledge and not its restriction.”
