'The Weaker Sex'

[dragon wench]

Hmmm....
Comments?

The Weaker Sex
By MARIANNE J. LEGATO

WHEN I say I study gender-specific medicine, most people assume I mean women's health. Patients ask me, "Do you take care of men too?"

I may be partly to blame for the confusion: in the years since the revolutionary 1985 report on women's health from the United States Public Health Service, I — along with many of my colleagues — have tried to atone for the fact that for so long the majority of diseases that afflicted both genders were studied exclusively in men.

Over the past two decades, we've radically revised how we conduct medical research and take care of our female patients. And we've made valuable discoveries about how gender helps determine vulnerability to illness and, ultimately, the timing and causes of death. But I now believe that we doctors and researchers may have focused too much on women.

What emerges when one studies male biology in a truly evenhanded way is the realization that from the moment of conception on, men are less likely to survive than women. It's not just that men take on greater risks and pursue more hazardous vocations than women. There are poorly understood — and underappreciated — vulnerabilities inherent in men's genetic and hormonal makeup. This Father's Day, we need to rededicate ourselves to deepening our knowledge of male physiology.

Men's troubles begin during the earliest days in the womb. Even though there are more male than female embryos, there are more miscarriages of male fetuses. Industrial countries are also witnessing a decline in male to female birth ratios, and we don't know why.

Some scientists have argued that the probability of a male child declines as parents (especially fathers) age. Still others have cited the prevalence of pesticides, which produce more birth defects in male children.

Even when a boy manages to be born, he's still behind the survival eight ball: he is three to four times more likely than girls to have developmental disorders like autism and dyslexia; girls learn language earlier, develop richer vocabularies and even hear better than boys. Girls demonstrate insight and judgment earlier in adolescence than boys, who are more impulsive and take more risks than their sisters. Teenage boys are more likely to commit suicide than girls and are more likely to die violent deaths before adulthood.

As adults, too, men die earlier than women. Twice as many men as women die of coronary artery disease, which manifests itself a decade earlier in men than women; when it comes to cancer, the news for men is almost as bad. Women also have more vigorous immune systems than men: of the 10 most common infections, men are more likely to have serious encounters with seven of them.

While depression is said to be twice as frequent in women as in men, I'm convinced that the diagnosis is just made more frequently in women, who show a greater willingness to discuss their symptoms and to ask for help when in distress. Once, at a dinner party, I asked a group of men whether they believed men were depressed as often as women, but were simply conditioned to be silent in the face of discomfort, sadness or fear. "Of course!" replied one man. "Why do you think we die sooner?"

Considering the relative fragility of men, it's clearly counterintuitive for us to urge them, from boyhood on, to cope bravely with adversity, to ignore discomfort, to persevere in spite of pain and to accept without question the most dangerous jobs and tasks we have to offer. Perhaps the reason many societies offer boys nutritional, educational and vocational advantages over girls is not because of chauvinism — it's because we're trying to ensure their survival.

It's possible, too, that we've simply been sexist. We've complained bitterly that until recently women's health was restricted to keeping breasts and reproductive organs optimally functional, reflecting the view that what made women valuable was their ability to conceive and bear children. But aren't we doing the same thing with men? Read the questions posed on the cover of men's magazines: how robust is your sexuality? How well-developed are your abs? The only malignancy I hear discussed with men is prostate cancer.

It's time to focus on the unique problems of men just the way we have learned to do with women. In 2004, the National Institutes of Health spent twice as much on studies done only on women as only on men. We are not devoting nearly enough money to men's health; worse yet, we may be spending those insufficient funds to answer exactly the wrong questions.

The National Institutes of Health should therefore convene a consensus conference to identify the most important threats to men's well-being and longevity and issue a request for research proposals to address them. Would an estrogen-like molecule postpone the onset of coronary artery disease in susceptible males? Are there ways to strengthen the male immune system?

Thinking about how we might correct the comparative vulnerability of men instead of concentrating on how we have historically neglected women's biology will doubtless uncover new ways to improve men's health — and ultimately, every human's ability to survive.

Marianne J. Legato, the director of the Partnership for Women's Health at Columbia, is the author of "Why Men Never Remember and Women Never Forget."

[snoopyofour]

Interesting. Well I guess everyone has their Achilles' heel. I'll bet radical feminists are having a field day with this information. I tend to be against things that suggest any kind of biological determinism or inferiority. Andrea Dworkin was too. You should read the address the gave to one group of radical lesbians who wanted to come to a kind of final solution to the man problem. She's a really interesting writer when she's not giving God the finger for gving her a vagin@.

[shana]

Quote--DW: Considering the relative fragility of men, it's clearly counterintuitive for us to urge them, from boyhood on, to cope bravely with adversity, to ignore discomfort, to persevere in spite of pain and to accept without question the most dangerous jobs and tasks we have to offer.


I have been watching Hell's Kitchen (I know, I know--but its summer and nothing else is on, plus Gordon Ramsey amuses me) and something on there reminded me of this statement. Last week, a woman chef burned her hand and was immediately iced down and rushed to the hospital. This week, a male chef burned his hand, and he was yelled at for being too slow and acting wimpy.

I thought this was terribly unfair.

[Chimaera182]

Biological inequality: the only real kind.

Nature designs animals with population control in mind, and keeping male populations down is a much more efficient way of controlling numbers than managing female populations. Women go through menopause in mid-life and become incapable of bearing children, whereas men--so long as they can get it up--can have babies with women well into their 60s, 70s, probably even 80s. As a result, it's in nature's best interests to keep guys biologically inferior: the more that die out sooner, the less likely they will reproduce and add to the numbers of a swelling population. And since society has long propagated the notion that men should be strong, brave, and withstand pain, it adds to the lengthy list of complications men suffer as indicated by this article. One case where nature and nurture actually go hand in hand.

[dragon wench]

I should just point out, while the above piece does seem to refer to various studies and research, we should bear in mind that it *is* an Op ED rather than an article, as such.
Though, that being said, here is some more information on Legato. One gets the sense she probaly does know what she's talking about.

For myself, I don't know enough about medical research to really comment on the biological aspects. I found, however, that it threw some interesting perspectives out.

But, I will say, if there is validity to Legato's statements, it seems more needs to be done to ensure that medical research is balanced rather than having a lopsided swing toward either one gender or the other.

[Fiona]

@ DW. You are right to point out is is an op-ed piece: the tone of some of it is a little too odd and anecdotal for comfort. Some of the facts included are very well known indeed, for example the susceptibility of male embryos to miscarriage and the higher infant mortality rates for males have been reported for a very long time, presumably on the basis of epidemiological studies.

in the years since the revolutionary 1985 report on women's health from the United States Public Health Service, I — along with many of my colleagues — have tried to atone for the fact that for so long the majority of diseases that afflicted both genders were studied exclusively in men.

In 2004, the National Institutes of Health spent twice as much on studies done only on women as only on men.

So the thesis is that there has been a disproportionate focus on women's health for just over 20 years and "enough is enough"? This seems a little strange to me. Medical research has been going on for a very long time indeed. If this is true is it really an injustice? Just a thought. I am not trying to suggest we should devote all resources to the research on women, just wondering how much of an imbalance we are really talking about and how long a time it would take to "catch up" if it is true that before 1985 nearly all rresearch exclusively studied men. Either there are gender differences in which case it seems quite a short time to reach an equitable state of knowledge: or there are not, when it doesn't matter if we focus exclusively on women for 20 or 200 years since the knowledge will be applicable to both genders. I don't see a case here.

While depression is said to be twice as frequent in women as in men, I'm convinced that the diagnosis is just made more frequently in women, who show a greater willingness to discuss their symptoms and to ask for help when in distress. Once, at a dinner party, I asked a group of men whether they believed men were depressed as often as women, but were simply conditioned to be silent in the face of discomfort, sadness or fear. "Of course!" replied one man. "Why do you think we die sooner?"

This is the kind of story you can hear in any pub. I do not dismiss it because of that, but I am a little cautious. I have heard similar claims couched slightly differently, for example that men self-medicate more often with alcohol and are therefore excluded from the figures for depression:while women seek conventional medication and are included. There may be research to support that kind of idea? I am not in a position to say but I do know that the UK health authorities are acting on the idea that men do not seek medical help readily and they are trying to change that

As adults, too, men die earlier than women. Twice as many men as women die of coronary artery disease, which manifests itself a decade earlier in men than women

This seems to be a very partial account of the evidence. I am not qualified to comment but I have read things in the media which report that the high incidence of heart disease in men is largely due to life style factors and that the difference between men and women is reducing as women increasingly drink. smoke, eat and work in the traditional male pattern. It may be too early to judge the effects of these changes but there is anecdotal evidence to that effect. Possibly the difference in incidence is not due to a biological difference or not wholly due to that. In this connection I found this:

http://64.233.183.104/search?q=cache...n&ct=clnk&cd=9

It is lengthy but it points to changes in incidence following political and lifestyle changes in different parts of the world; different incidences in different populations; higher rates of heart disease among women in some parts of the world than men in others (though within populations the gender differences still seem to obtain) and a host of other things which at least point up the complexity of such epidemiology and the difficulty of reaching conclusions.

It's possible, too, that we've simply been sexist. We've complained bitterly that until recently women's health was restricted to keeping breasts and reproductive organs optimally functional, reflecting the view that what made women valuable was their ability to conceive and bear children. But aren't we doing the same thing with men? Read the questions posed on the cover of men's magazines: how robust is your sexuality? How well-developed are your abs? The only malignancy I hear discussed with men is prostate cancer.

Is there no difference between what is done in health research and clinical practice and what is on the front page of men's magazines? That is just dishonest, IMO


I want to emphasise that I am not opposed to research "to identify the most important threats to men's well-being and longevity and issue a request for research proposals to address them." as called for in the article. If there is a need for such research (and there may well be) then it must compete for the limited resources along with everything else. It is just that this article seemed to make claims which it did not substantiate. I was uncomfortable with the tone and the intent

[Adahn]

Well, there are some feminists that are so radical that they believe that giving women equality as far as the ability to perform the same jobs and functions as men - is acctually copying men. And thus isn't acctually true feminism. That true Feminism should be women creating their own jobs, for themselves and disallowing men to perform them just as men forbade women any of our modern day professions.

(btw, I'm back after my long silence ^^)

[Fiona]

Originally Posted by Adahn

Well, there are some feminists that are so radical that they believe that giving women equality as far as the ability to perform the same jobs and functions as men - is acctually copying men. And thus isn't acctually true feminism. That true Feminism should be women creating their own jobs, for themselves and disallowing men to perform them just as men forbade women any of our modern day professions.

(btw, I'm back after my long silence ^^)

Oooh I haven't seen a separatist in real life. Though I read about them a lot! Do you know many? We are a little backward in Scotland, perhaps

Hello Adahn, nice to meet you

[Athena]

Enough with the fine print, girl power!

[Fallenhero]

This article didn't surprise me. I've often heard of women being hardier as a gender when looked at from conception on.

It makes sense from an evolutionary standpoint. An individual female is more valuable than a male. One alpha male can father numerous children in a short period of time and push his brothers to the sidelines. The clan needs more females to survive to increase the chance of reproductive success.

The male also doesn't have to use a lot of energy to do his part ("Tell me about it"-Mrs Fallenhero.) but without a strong constitution few females would survive the strain of pregnancy and nursing. It's a lot more complex than that but it just makes sense that there would be a built in "advantage" that allowed females a better chance of survival.

[Ode to a Grasshopper]

Works for me, I generally get along better with women than men anyway. I wonder if there's any way to use this to get some sort of tax break or something...

I've always found it amusing that Genesis gives the first human being as Adam, a male, when biologically human foetuses (foetii?) begin as female.

[The Z]

Women are definitely stronger; what else can make men so miserable or happy, depending on the situation? Just the way they can play with your head gives them power over people that no man has.

I hate to spam but reading this reminded me of an email I got.

A Spanish teacher was explaining to her class that in Spanish, unlike English, nouns are designated as either masculine or feminine.

"House,'' for instance, is feminine: ''la casa.''
''Pencil,'' however, is masculine: "el lapiz.''

A student asked, ''What gender is 'computer'?''
Instead of giving the answer, the teacher split the class into two groups, male and female, and asked them to decide for themselves whether 'computer'' should be a masculine or a feminine noun.

Each group was asked to give four reasons for its recommendation.

The men's group decided that ''computer'' should definitely be of the feminine gender (''la computadora'') because:

1. No one but their creator understands their internal logic;

2. The native language they use to communicate with other computers is incomprehensible to everyone else;

3. Even the smallest mistakes are stored in long term memory for possible later retrieval; and

4. As soon as you make a commitment to one, you find yourself spending half your paycheck on accessories for it.

(THIS GETS BETTER!)

The women's group, however, concluded that computers should be masculine (''el computador'') because:

1. In order to do anything with them, you have to turn them on;

2. They have a lot of data but still can't think for themselves;

3. They are supposed to help you solve problems, but half the time they ARE the problem; and

4. As soon as you commit to one, you realize that if you had waited a little longer, you could have gotten a better model.

The women won.

[Chimaera182]

You also have to take into account the fact that women have babies. If guys had babies instead of girls, men might be of heartier stock.

[Gauda]

I'm not quite sure what to make out of this article, and what Legato's point is. It almost seems to me as Legato is trying to suggest that men is an endangered species (which is an outrageous claim), and that research on mens health is imperative for the continued survival of this sex. And while I support the idea of more research, this point seems rather shallow for this article, and it seems more likely that the real purpose of this article is to "prove" that men are the weaker sex. Men and women are different, and any biased author can "prove", by making a careful selection of differences, that men/women is a weaker sex than women/men. And also, I noticed this:

"Girls demonstrate insight and judgment earlier in adolescence than boys, who are more impulsive and take more risks than their sisters. Teenage boys are more likely to commit suicide than girls and are more likely to die violent deaths before adulthood."

Is not this not a result of the way the gender develop in the society, rather than being biological? Is it ever proven that this is biological, and thus sex-related?

Maybe I am unable to see the obvious, maybe I'm stupid, but I would like to hear what other people think her point is, before I wish to discuss this article further

[fable]

Originally Posted by Gauda

"Girls demonstrate insight and judgment earlier in adolescence than boys, who are more impulsive and take more risks than their sisters. Teenage boys are more likely to commit suicide than girls and are more likely to die violent deaths before adulthood."

Is not this not a result of the way the gender develop in the society, rather than being biological? Is it ever proven that this is biological, and thus sex-related?

We went through a lot of this before in several other threads. I think CElegans posted links to several scientific articles showing that such arguments (men as more impulsive, or prone to violence) were purely the results of nurture, not nature. Of applauding little Johnny when he acted aggressively in the sandbox, while telling little Janie that she should get along with all the other little girls.

The fact that this article even includes such a point pretty much throws it completely into the "pop science" category, by my reckoning.