Post-modern assumptions about gender harm women

Until last year, women in the US had been unwittingly overdosing on sleeping pills for nearly twenty years.

In January 2013, the American Food and Drug Administration (FDA) ordered drug companies to slash the dosing of Zolpidem (an insomnia drug known as Ambien) by half for women. Side-effects from over-dosing on Zolpidem (known as Stilnox in Australia) include impaired thinking and reaction time, sleep-driving and sleep-eating.

The FDA ordered the makers of Ambien to provide different dosing instructions for males and females. Prior to their decision, the instructions for men and women were exactly the same. Why? Because we still don’t have enough information about how men and women metabolise drugs differently.

Phyllis Greenberger, CEO of the Society for Women’s Health Research in the US wrote just last month in a blog for Huffington Post: “the reality is that we do not know whether a drug will harm women until after they have started taking it.”

It is the year 2014 and women are at risk of harm from easily preventable biomedical errors. How on earth did we get here?

Firstly, drugs are tested on animals before they make it to human trials. Female animals are more difficult to test on, due to a more complex hormonal profile. The neuroscientist Larry Cahill is on record saying that the scientific understanding of women’s neurobiology is pitiful. He explains that 93% of the animals used in neuroscientific research are male, simply because they’re easier to study.

Secondly, medical and health researchers, including neuroscientists and psychologists, avoid studying sex differences out of a fear of being labeled “sexist”. One psychologist consistently name-calls neuroscientists publishing work on sex differences, dismissing such work as “neurosexism” and “neurotrash”. Researchers wanting to enjoy controversy free careers understandably avoid the sex differences arena.

In the field of medicine, heart disease, the number one killer of women in Australia, is known to affect men and women differently. More women die from heart attacks than men and females are at higher risk of extensive bleeding after heart surgery. Women’s brains are also more sensitive to neural deterioration. This leads Alzheimer’s to be more prevalent amongst women compared with men. It follows that research focusing on sex differences at the level of the neural substrate, is a pressing women’s health issue. Implying that it is a niche interest of “neurosexists”, in 2014, is simply reprehensible.

The dismissing of sex difference research stems from a deeply ingrained false assumption – that males and females are the same in matters of biology. To understand this probably unconscious assumption, we have to go back to Rousseau and his idea of the tabula rasa. The “tabula rasa,” means in Latin, “scraped tablet” or to us, that a baby is born with no preconceived ideas, his or her mind being a “blank slate”.

According to the assumption, culture writes upon this blank slate, shaping an individual until they conform to social norms. Tabula rasa thinking has been around for a long time, but it reached its zenith in the 1970s and 1980s when post-modern philosophy became popular.

The post-modern theorist Michel Foucault famously eyed biology and medicine with suspicion. He characterised “knowledge-producing” institutions, such as the medical clinic as potential tools of oppression. According to post-modernists, traditional research agendas were racist, classist and sexist, (albeit often unintentionally).

These ideas have been incredibly influential. In many undergraduate humanities courses – such as English Studies or Gender Studies – a student learns that the scientific method is biased for the fact that “if you ask certain questions you get certain answers”. Simply asking a question about sex differences reinforces a potentially constraining cultural dichotomy.

Today anti-vaccination advocates cite post-modern arguments in their suspicion of the pharmaceutical industry. Anthropologist Anna Kata has written:

Anti-vaccination protestors make postmodern arguments that reject biomedical and scientific “facts” in favour of their own interpretations…these postmodern discourses must be acknowledged in order to begin a dialogue.

Post-modern ideas are often presented in a very complicated language. At their heart however, lies an implicit manifesto of questioning socially received “binaries”, dichotomies hitherto thought to be self evident, such as male versus female, normal versus abnormal, or biology versus culture. Post-modernism tells us that these binaries are arbitrary, that gender is fluid for example, and in doing so has helped many men and women who don’t fit into straight-laced ideals of masculinity and femininity explore sex and gender with an open mind.

Unfortunately however, post-modern philosophy and the cultural baggage of the tabula rasa has not helped women in areas of health and medicine. In fact it has harmed us. This is simply because there is much more to biological sex than reproductive anatomy. And when it comes to testing biomedical hypotheses or interventions, we need to apply strict binaries. We need to test control groups against experimental groups, and women against men, to eliminate noise and bias, so that we can make causal inferences.

Zealous activists may argue that incorporating sex differences in studies may provide ammunition to those wishing to make sexist generalisations about women. However we also need to be aware that a dismissive attitude towards sex differences research constructs an arbitrary binary. If sex differences research is automatically viewed as “bad” while proof of similarities is viewed as “good”, then we are failing to think critically. (If Foucault could see how rigid his inheritors have become, he’d be turning in his grave).

The bottom line is that women’s health needs to be taken seriously. While sex differences research should be treated with a healthy skepticism (like any other research agenda) if we are too afraid to ask the questions, we will end up with no answers.

.foucault

6 Comments

  1. Jurij Fedorov

    The question or discussion topic here is: are post-modernism only great and good or does it have some harmful aspects in it?

    There are examples of science such as gender studies, race studies and intelligence studies being obstructed by post-modernism organizations such as part of feminism, leftist organizations or other “holistic” thinkers. But in many cased this science could be very helpful and even save life. We are very close to making completely different medicine for men and women as a general as we discover more and more differences year after year between genders. And doctors are looking at the race before subscribing pills. Not because they are racist but because different populations as a whole have very different genes and respond differently to different medicine and various viruses. And intelligence science can show us how it would be reasonable to structure an education for a certain group. Both for the unique individual and for groups. Some groups are build for the savanna some for the forests. And they have different physique and some genetic differences in mentality too as BIG5 personality traits are partly inherited. Homo sapiens are not all the same. We do not have races but we still have various genetic differences that can influence or lives. We are different – but how do we study this without causing harm?

  2. DaleK.

    So, I might be a “bad” feminist BUT as I read this I thought, “Wt? Why wouldn’t they test for differences between sexes? Hormones effect pretty much everything including metabolism.”

    To test for potential differences between the sexes seems like common sense to my HouseMD medical training and unscientific mind.

    And now I’m LOLing because I literally just came from listening to a podcast about beliefs where the question was asked, “What is something you’ve always believed, why did you believe it, and how did you come to discover your belief was false?”

    In fact, not testing for differences between the sexes sounds so moronic to me that I’m still not sure I actually believe this…… and I should, because….

    I’m a recovering personal trainer. One thing that always irritated me was the lack of research & studies conducted using female test subjects. Most sports/fitness relevant research is conducted on male college athletes. So really, my clients paid me to be a guinea pig. Maybe this will work but hey it might not because no one really cares about studying women, or now, come to find out, it’s politically incorrect.

    Seems kinda sexist to me actually.

  3. Farmer42

    One of the few fields that has really studied the difference between men and women? Baseball, actually. There is a TON of research about the differences in physiology and mechanics involved in, of all things, pitching.

  4. Jonathan Ferguson

    Reblogged this on jonathan1723 and commented:
    Interesting perspective for those interested in gender (e.g. the equity/gender feminism debate), as well as books such as Pinker’s “The Blank Slate,” or indeed the Science Wars in a general sense. And what about yin/yang in Chinese tradition? How do sex and/or gender distinctions that are not from the natural sciences possibly impact on these debates? (See also purush, prakrti etc)…

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