Guest Blogger Elysia: Evo Psych and Icky Girls

Friend of Shapely Prose Elysia (who writes the blog Born That Way) is an evolutionary biologist, and she had some choice words for the latest dude to use evolutionary psychology as an explanation for why he believes seriously douchey things about women. Please give Elysia a warm welcome. — Kate

My friend Sweet Machine brought a recent post by Amanda Hess to my attention.  In her essay, Ms. Hess discusses a blog entry on the Scientific American Mind website, written by one Dr. Jesse Bering. Once you’ve read her post, come back here to see me talk about how good (and bad) science can be totally skewed by reporters.  Even scientists.  Just so we start on the same page: Dr. Bering discussed the concept of menstruation as shameful or dirty.  He presented some good evidence for the social context of menstruation as having a huge impact on the way women experience/remember first menses (although he also seemed to be saying that Western feminism was wrong in concluding the same thing).

Dr. Bering is described as an evolutionary psychologist – a title which always makes me uneasy, because as “just” an evolutionary biologist (actually, I’m a population and evolutionary geneticist), I have seen very little thus far from the field of evo psych that actually gets the evolution part right.  (I’m always willing to give it a try, though, in hopes that someone will prove me wrong about the field.)  Let’s start out with the premise: a male researcher is curious about women’s first menses, and the psychological context and consquences thereof.  Fair enough.  What else does Dr. Bering have to say?

“Without a doubt, the best studies on the subject of menarche are those that have attempted to reconcile individual differences in age of female pubertal onset with various evolutionarily relevant variables in girls’ social environments.”

The best studies?  Not my field, so I can’t judge, although “without a doubt” with respect to a set of studies on a very general topic being the “best” of anything is a standard not often met in science. However – evolutionarily relevant is my field.  So the question becomes: has evolution, of either culture or biology, shaped human psychological response to first menstruation?  There follows in Dr. Bering’s essay a series of anecdotes and studies grounded in 20th-century data.  From a strictly biological viewpoint, this is hardly even the blink of an eye, and evolution simply cannot have occurred and been detected.  Let me repeat: citing only data from the last 100 years, approximately five generations, is insufficient to demonstrate that biological evolution has occurred.

“[G]irls growing up in homes where the biological father is absent but the stepfather is present tend to mature faster than those living under the same roof as their biological fathers (their bodies are essentially competing with their mothers for the attention of this genetically unrelated male …)”

I’ve spent a fair amount of time studying and discussing mammalian reproduction during my graduate work and professional life.  My response to the quoted passage: Wait, what?  The last time I talked about this type of interaction was during a lab meeting, in the context of mouse mating behavior.  Female mice experience an acceleration in sexual development because they are being influenced by an adult male’s presence, via hormones he produces – they’re not competing with their mothers for matings, but experiencing a side effect of cohabiting with non-parental males.  (Read more here and here.)  My evolutionary just-so story, err, hypothetical explanation for this observation is that some male mouse had a different body chemistry that could induce sexual maturation in any female nearby, which would mean he’d have more babies than other males because he’d be, you know, there when the females matured.  His sons might have that same capability, and if this provided enough of an advantage relative to other males (and survives a number of other conditions, including pressure by female biology working against it), you could end up with males generally affecting female sexual development – regardless of any relationship between the male and nearby females.  Please note that a juvenile female mouse’s mom does not appear in this model.  The implication of your phrasing – “their bodies are essentially competing with their mothers” – does hint at the lack of volition in this situation (the idea that girls’ bodies are simply reacting to a biological stimulus) but sets up a mother-daughter rivalry where none exists.  Mom has nothing to do with this, except having gotten remarried.  Not to mention, there’s no accounting in your summary for siblings, stepsiblings, the role of stress…it’s a fascinating observation, but there’s a lot of careful dissection of the situation that has to be done before it’s appropriate to flag this as mother-daughter competition.  (If such detail exists in the professional scientific literature, please, someone let me know!)

“reminds me of that shower scene in Steven King’s Carrie (you know the one).”

Excuse me, sir, your preconceptions are showing.  (Really?  A horror flick?  Really? Let me guess – you also consider menstrual blood to be dirty.  This and other word choice throughout the essay is consistent with that position – is that what you meant to convey?)

“[The Head Teacher] suggested that ‘nobody would want to talk about it’ and that there would be ‘hell to pay’ from his many ‘conservative parents’ if he put his name to the research.”

Sooo…because some parents might have been unhappy, this means that the girls themselves were necessarily ashamed?  Because that’s sort of how that reads.  The research study was challenging because of – oh wait! – a larger societal attitude that might or might not have accurately reflected the girls’ own feelings.

“Such anecdotes would appear to pose some serious problems for traditional feminist theories, which tend to argue that Western negative attitudes toward everything from menstruation to vaginas at large are simply the result of cultural constructions.”

When you follow this sentence by a paragraph of examples of how women in different cultures experience different responses to the onset of menstruation, it…doesn’t sit well with a lot of readers.  Especially when you go on to say:

“According to most Western females, however, nothing could be more nightmarish than the prospect of “leaking” in public, and so perhaps it’s not too surprising that so many teenagers say that, in retrospect, their preparation for womanhood amounted to little more than a how-to guide for hiding their menstrual blood from all other eyes.”

As a layperson in psychology and sociology, I can only say that this doesn’t surprise me, given how much Western culture seems to prize cleanliness in…everything, to the point where it seems to be backfiring.  (Hygiene hypothesis, anyone?)  Seriously, it seems like a viable alternative hypothesis is just that cleanliness is so highly valued that any and all sexuality gets shoved into the shadows.  How often do we talk about men remembering the first time they ejaculated?  Popular humor about boys suddenly doing their own laundry seems on its face to be consistent with the same “cleanliness above all” hypothesis.  I’d love to know if anyone has studied the influence of Puritans and other Protestant groups that largely shaped early American culture, the evidence of which we still see today, and how their feelings about cleanliness and purity have contributed to this. (Sweet Machine, editor/human extraordinaire, suggests the work of Mary Douglas for further information.)

In fact, Dr. Bering, you allude to something like this when you discuss Joan Jacobs Brumberg’s work.

Oh, and I’m not the local expert on this, but I hear there’s this thing out there – this idea that men have, for many years, tried to control female sexuality.  Wouldn’t propagandizing menstruation be a convenient way to do that?

” When the researchers asked 157 white, middle-class ninth-grade girls what advice and information they would give to younger girls about menarche, […] one lone teenage girl of this entire group of 157 participants—ever linked menstruation to reproduction …”

Do you really think that this shows “clearly that, in the minds of these newly fertile adolescents, reproductive biology—that is to say, the actual purpose of periods—was a complete afterthought in their thinking”?  Or could it be that those girls were trying to pass on practical information to their peers, since they were asked what advice they would give?  Trust me, my public school sex ed made it abundantly clear that menstruation was part of reproductive biology.  But that’s not much comfort when you’re not ready to reproduce, and it’s not helpful in understanding the logistics of being a pubescent girl.

“I’m sure many of my straight male friends are indeed praising Allah for the invention of Kotex.”

If you have a daughter or a wife or girlfriend or sister – please understand that she may hear you say things like this and not want to discuss menstruation with you.

” … here comes my British accent—bloody companies and their concern with the bottom dollar.”

Your (public) Facebook page tells me that you hail from Ohio.  That doesn’t rule out a British accent, but I am rather curious.  Also, in making puns of the word “bloody,” you are actually engaging in a joke based on slang, not accent.  To perpetuate a quote I rather like, words mean things (link goes to an OT explanation).   And distorting those meanings as you do here gives me pause; were I grading this, I would become suspicious that you were attempting to sound smart so I wouldn’t notice any problems with your work.

“In fact, I’ve often wondered if the tremendous reservation that most parents have in communicating with their children about sex has the ironic consequence of making their children more curious about it—a curiosity that translates into earlier and more frequent sexual activity.”

Trust me, you’re not the first.  In fact, I’m willing to wager that the vast majority of people at or past their teens in Western society have pursued various “illicit” exploits because their parents forbade them or refused to talk about them.  (Also, have you ever studied Prohibition?)

“And that makes me wonder if there weren’t (and aren’t) perhaps some natural selection pressures at work here, forces favoring parental modesty over candor in the sex education of children.”

Seriously?  Your hypothesis is that modest parents will have higher fitness (i.e., in the long run, will have a reproductive advantage) than immodest parents (and the word “modest” is so subjective that I feel this is already a difficult hypothesis to argue).  That means that the children of modest parents must in turn be modest parents to their own children, or you simply have a fluctuation with a period of a generation, right?  My very own parents decried their parents’ modesty and had fairly frank discussions with me, as appropriate.  And while there’s such a thing as temporally-varying selection..this doesn’t seem to be such a case.  (By way of explanation: temporally-varying selection.  Put simply, sometimes the force that makes a particular feature favorable can itself change over time.  Say you have dandelions in your yard – the features of a dandelion plant that grows well in rainy March that let the plant have more babies may not do a lick of good for that plant’s offspring when dry July comes around.  Here, well, you can imagine that modesty might be bad if we were facing certain kinds of famine, as it would mean fewer babies and a higher chance that they’d survive, but it’s unlikely that every single generation – or every few generations – we’d alternate between stark feast and famine.  Even if it were true, biological evolution in humans takes thousands of years, so it would be extremely hard for me to come up with a plausible mathematical model in which relatively recent social mores affect biological fitness.)

No offense, but this is a poor reflection of the basic components of evolutionary biology.  No, strike that – I hope to offend you enough to get you to stop and think, because as an evolutionary biologist and instructor, I am left to deal with the aftermath of students who come in to my classroom with serious biases about a field they’ve only ever seen misrepresented.   Partly because essays like yours get into the lay media.  It’s especially infuriating to see sloppy or inaccurate science used to justify positions from the mildly offensive to the abhorrent.  Please don’t let the entire field of evolutionary psychology devolve into a mere shadow of the science it could be – I’d rather it be “based on” rather than “inspired by” evolution.

Yes, it’s important to realize that cultural constructs influence the way biological events are experienced and recalled.  It’s important to link biological and cultural evolution, and to remember that we humans are animals.  And as a male ape, you are well within your rights to wonder how female apes differ from you; just please remember while you call elderly women apes that you are one, yourself.  More importantly, it’s great for you as a human man to want to understand the human woman’s experience, and I encourage you to reframe your language to make it clear that you understand that distinction. Because your personal discomfort with my menstruation – or my feminism – does not a sound scientific discussion make, and dismissing my humanity when you examine my biology ill befits a doctor of psychology.

For the record: I make no claim to perfect impartiality here – this is just me, a professionally trained scientist and a self-identified feminist talking about why a particular piece of popular science writing raised my personal and professional hackles.  Like any good scientist, when I’m working, I try to minimize the impact of my own bias on my research, but you know what?  I’m human, and biased, and the best I can do is own those biases and be honest about them with friends, students, and colleagues.


According to the Vancouver Sun, there’s a new way to torture yourself through dieting. Literally:

The medical procedure involves stitching a small piece of polyethylene mesh onto a patient’s tongue, making it painful to ingest solid foods and forcing a low-calorie, liquid diet.

You pay a nice man named Dr Nikolas Chugay to spend 10 minutes to stitch a torture device into your mouth, and you pay him $3,000 for the privilege, and then you eat 750 calories a day for a month. And you lose weight! And also you forgo all pleasure in life because you are combining constant pain with a sub-torture level of sustenance!

According to the article, “Since last September, Chugay says 35 people have opted for the surgery.” That’s 35 people who hate themselves so profoundly that they paid a doctor $3,000 to sew a pain patch into their mouths.

Can someone please wake me when we’re in that post-feminist world full of jolly fat people that I keep hearing so much about? I’m going to go huddle in a closet with T-Rex till then.

SP Round Table: Fat baby denied health insurance

Kate started us off by pointing to this horrifying story about a 4-month-old baby in Colorado who was denied health insurance for being too fat. Super fun quote from the article:

By the numbers, Alex is in the 99th percentile for height and weight for babies his age. Insurers don’t take babies above the 95th percentile, no matter how healthy they are otherwise.

We began this roundtable with general email screaming. Once we calmed down, here’s what we had to say.

Tall Chairs Round Table (by moriza)
Tall Chairs Round Table (by moriza)

A) The kid is at the 99th percentile for height AND weight, so WTF? B) This is exactly why we need universal health insurance. Because, setting the height thing aside, let’s say the kid really is bizarrely fat at 4 months. There’s virtually no chance that this is the parents’ fault in any way. (Not that it would be the parents’ fault if the kid were old enough to eat solid food and exercise, mind you, but go with me here.) Which means that if this kid IS much fatter than one could reasonably expect him to be, it’s almost certainly because of * the possibility that it’s a genetic disorder — of the sort that gets older kids stolen from their parents because authorities are convinced it’s all calories in/calories out — becomes increasingly likely. And I would not be one fucking bit surprised if that’s part of the insurance company’s calculation here — not that fatness will make the baby expensively sick down the line, but that fatness suggests the baby might ALREADY be expensively sick. And of course, the important thing is making sure we don’t spend money on sick children.

Sweet Machine:
I find it really sad that the parents in the article are joking about the diets they’ll have to put the baby on. Because of course that’s the kind of joke that I’d make, too, but it actually points to the problem so well: is this what the insurance people want? What exactly can you do to an infant to make them skinnier that does not constitute grievous harm? I’m no pediatrician, but really, what the hell?

That upset me primarily because I’m not sure how long it will remain a joke. It’s one of those bits of satire that’s so close to some people’s reality that it’s uncomfortable. I mean, people switch their babies to skim milk, and put them on diets while they’re still in diapers. Making a crack about weaning the kid to Slimfast is funny, especially with the jab at expensive weight-loss products, but it isn’t even far enough outside of the norm to function as satire. Some people hearing that joke are going to say “and well you should.”

If they’re in a position where they can either let the kid remain uninsured or put him on a diet, they’re going to put him on a diet. It’s all very well to recognize that feeding a baby Slimfast is absurd, but a) it’s not absurd for a lot of people and b) how long can they afford to acknowledge its absurdity?

A Sarah:
My first thought was of how incredibly, incredibly fragile the first year of life has been for most of human history.  Getting babies adequate nutrition and hydration to live on is a GODDAMN SERIOUS ISSUE for our species, seeing how human newborns come into the world VERY dependent relative to the young of other primates.  (Tradeoff for the bipedalism and the big brains.)  Plenty of healthy babies still are one infection, bout of diarrhea, or disruption in the food supply away from life-threatening malnutrition.  The arrogance of saying, “Well, the baby’s fat, and healthy… but FAT, and FAT babies might become FAT GROWNUPS, and I mean… EW! and anyway, all the other insurance companies are doing it.  I mean, there’s MONEY involved, y’see.”

FUCK.  I mean, FUCK. Have these people ever seen a sick infant?  A truly sick infant?  Or, hell, a WELL infant?  I’m so angry.

That is such a great point. I mean, there’s a reason that chubby babies have traditionally been seen as desirable, right? It’s really obscene.

And of course this points to, once again, the complete clusterfuck that is the US health system. Which will make me all rantypants if I say another word about it.

As infuriating as this is, denying obese adults health insurance might be even more infuriating. Babies who can’t get health insurance are the top 5 percent of heavy babies — the adults who can’t get health insurance are, as we hear over and over again, the top 30 percent.

Have y’all read amandaw’s post about pre-existing conditions and how ableist it is to be, like, extra-angry about only the more outrageous cases? It’s on my mind because she reposted it on the new FWD blog, and I’m wondering how this plays into it. I think basically it actually highlights the ableism involved in denial of care, because, as amandaw says, the underlying assumption of our ableist culture is that if someone’s sick, they did something wrong. Somewhere, somehow, sometime, they secretly brought it on themselves (though of course some patients are “more deserving” than others). But a 4-month-old, pretty much by definition, can’t have done anything wrong. It really points to the identity-versus-behaviors problem of the “obesity epidemic.” Here is someone who is innocent in every way we understand that word — but who is being treated as guilty by a system that assumes that if adults are fat or sick, it’s their fault.

Throwing this into the mix, not sure how it fits: I was astounded, when I had kids, to realize just how vulnerable even a very very very healthy young baby (like, 6 mos.) is. Up to some point (can’t remember how many months) a fever over 101 is a medical emergency and you don’t call the doctor, you call 911.  To have the misfortune of getting chicken pox and strep at the same time can be life-threatening.  Diarrhea is pretty serious.  Frequent well baby checkups if you’re going by the AAP recommendations.  Lots of things that are vaccinated against now routinely killed children before immunizations (and very rare vaccine reactions injure babies today.)  That’s not to be all OMG PARENTING MEANS MARINATING IN FEAR — because it also turned out that a bump on the head or an accidentally-burned finger or the TV being on or some store-bought baby food does not in fact teach babies NEVER TO LOVE OR LEARN — but since we’re talking about things that send babies into the healthcare system, it seems pertinent.

So we have these poor little innocent babies (and yeah, I mean, who doesn’t love babies?) but when one considers how great are the healthcare needs even of young babies with NO known medical conditions, it just seems so ridiculous and disingenuous.  So, okay, insurance company, you’re concerned that the baby might be eating too much breastmilk (omgwtf?!?) and, what, will be fat and expensive and selfish and lazy someday?  Right. Couldn’t be that babies are big consumers of healthcare, or that they’re one of the groups for whom there sometimes are public programs, or that you’re just looking for a way to save a buck without appearing like the hater of human life that you are.

*ETA: My original language there was problematic. –Kate

On death panels

You might have heard that people like everyone’s favorite anti-feminist, Sarah Palin, are spreading lies about the proposed US health care reform including mandatory “death panels” that encourage elderly people to just up and off themselves already to save all us youngsters some cash. You might have also heard that Sarah Palin is a lying sack of shit. Hopefully those of you who are following what passes for “grassroots activism” about health care know what’s what and do not appreciate that people who openly advocate killing elected leaders would rather have children die from a neglected toothache than bother to look up the word “socialism.”

According to national godsend, here’s what these “death panels” are actually about:

In truth, that section of the bill would require Medicare to pay for voluntary counseling sessions helping seniors to plan for end-of-life medical care, including designating a health care proxy, choosing a hospice and making decisions about life-sustaining treatment. It would not require doctors to counsel that their patients refuse medical intervention.

Voluntary counseling sessions helping seniors to plan for end-of-life medical care. Voluntary counseling sessions. There’s your death panel! Heaven forfend!

Let me tell you a little something about end-of-life medical care. I’ve mentioned here before that my mother has Parkinson’s disease. What I have not mentioned here before is that she is dying. For the last several months, she has been receiving at-home hospice care. She spends most of her time sleeping in a hospital bed in the bedroom she shares with my stepfather. She can no longer sit up on her own or speak more than a word at a time. She can look at magazines but she can’t read or sign her name. She likes to listen to oldies on the radio station, and she likes to get visits from people, but she can’t really stay awake and attentive for more than half an hour or so. In the last five years or so, she has gone from having some bouts of confusion to being profoundly incapacitated. For many people, end-of-life neurological diseases operate more slowly, giving them time to adjust their lives to their progressive disabilities. For my family, by the time we had a diagnosis, things were already changing, almost too fast to keep up. This is complicated by the fact that my mother probably also has other neurological conditions which compound her dementia.

We did not get a lot of non-medical guidance throughout this process. My mom was in denial at first about how serious things were; she refused to see doctors, refused to face what was coming. By the time the rest of us realized how seriously her body and mind were changing, her dementia was pronounced enough that it became very difficult to communicate with her about long-term care decisions. You know what my family could have used, way back when we first realized that my mother had a progressive neurological disease, even before we had a specific diagnosis? A fucking death panel. Voluntary counseling sessions helping seniors to plan for end-of-life medical care. If someone had sat us down, as a family, including my mother while she could still communicate clearly and thus advocate for herself, and told us tactfully but directly that there would come a time when she would not be able to express her wishes, and that we should figure out now what she wanted then, our lives would have been, if not easier, less painful now. Because, the way it is, my stepfather and I are really just guessing. We don’t know if she would like a DNR directive, for instance. We don’t know if she would want to be buried or cremated. We don’t know what state she would want to be buried in, for god’s sake. We decided to enroll her in a neurological study (which involves an autopsy after her death) because she used to be a scientist and we think she would appreciate contributing to science even in her death. But that’s actually just an assumption we have made. We don’t know. We’re guessing.

Some of this, surely, is about family communication. Maybe we could have been more open with each other about death in general, or about our personal beliefs. But I don’t share a religion with my parents; my mom and stepfather don’t share a political ideology; we don’t necessarily have common ground to start with in our beliefs about death and care. My mom could have written a living will before she got so sick; she probably should have. Except, like the rest of us, she was scared out of her mind at what was happening to her, and she wasn’t thinking clearly about the future, because the future seemed impossibly distant compared to the terrifying immediacy of now. It took my stepfather and me almost a year to convince her to go to a neurologist in the first place; I can’t imagine that we could have, on our own, convinced her to imagine herself dying so that she could write down what we should do with her corpse.

That’s why we need counselors, professionals who know what it means to face end-of-life care and who know, pragmatically, what decisions have to be faced while you still have time to think. My family has been struggling on our own for years to coordinate my mother’s medical care while helping her have some semblance of a social life. Engaging hospice care was emotionally brutal, because it meant acknowledging that she was dying. I guess Sarah Palin and her cronies would call that giving up. But what it really meant was that we finally could get the resources we needed — medical, social, and personal — to give my mom some dignity. We are not just collections of organs that sometimes go bad. We are whole people, and counseling should be a part of medical care. When my mom was just profoundly ill, it was a family problem. Now that my mom is “officially” at the end of her life, it is a community effort: both publicly run (hospice care) and privately volunteered (help from her church community).

We are so terrified of death in this country — so sure that if we just do everything right, we will never face it, so sure that death is something that only happens to the very bad or the very old — that the idea of a counselor sitting you down to discuss your ideas about death petrifies people. We refuse to look at the reality of death, the fact that our minds are actually part of these bodies we live in, and that means they will one day cease. Death, in and of itself, is not a tragedy: it is part of our humanity. The tragedy here is that there are politicians trying to convince you that Obama wants to kill your grandma, when what he really wants is to protect my mom.

Now that’s what I call a surgeon general

It appears that Obama and his administration, while educating themselves admirably on health care issues as they’ve been doing for the past several months, have also clued in to the fact that there are doctors who aren’t on TV. Even before the inauguration, there were reports that  Obama had asked Sanjay Gupta, a fatphobic blowhard of a TV doctor, to be his surgeon general (as Kate said at the time, “what, the Australian dude from ‘House’ wasn’t available?”). Six months later, Gupta having taken himself out of the running, they have suddenly hit what looks to me like a hole in one.

Meet Regina Benjamin. She runs a rural family health clinic serving the poor and underserved. It’s been destroyed twice by hurricanes George and Katrina, and she’s rebuilt it from the ground up. She believes in education and public health care. She’s won a MacArthur and several humanitarian awards. Bonus: she’s kind of fat.

Now, it’s not like having a fat surgeon general automatically means that she’ll be sensitive to fat issues. Some of the ugliest attacks we hear come from fellow fatties who find it terrifying when we tell them they don’t have to suffer. And Dr. Benjamin’s father died of diabetes-related complications, though I don’t know what type, so she probably feels very strongly about at least some of the diseases that are associated with fat — if she thinks they’re also unequivocally caused by fat, she may go ahead with the calls for public anti-obesity measures. They just won’t be as offensive to me as Gupta’s would have been because she seems like a real nice lady.

But this does mean that there’s a chance, however small, that Dr. Benjamin understands that fat is not automatically inimical to health. And her position as a doctor in a poor rural area probably means that she is more sensitive to the effects of poverty on health and food access, and might understand that lack of access to good nutrition or unbiased health care or leisure for activity — not fat bodies themselves — are problems to be solved. That’s a chance I didn’t expect us to get.

The surgeon general is often mocked as being a symbolic role, but it is possible to effect some change in the position, even if many people don’t — especially now, when the health system is potentially in overhaul. What would you want Dr. Benjamin to be aware of? What kinds of changes would you want her to instigate?

(P.S. go here for a much thinkier and generally better analysis of reactions to Benjamin’s body type.)

Midweek link roundup

When I was in school I always used to get in trouble for talking or passing notes with my friends instead of doing my work. Little did I know it would prefigure my blogging habits. Sure, we haven’t turned in a lot of essays, but here’s a peek at what we’ve been passing notes about in the last week or so:

Adams’ argument applies on several levels here. The ad displays both the meaty sandwich and the female body as objects ready for masculine consumption. The woman in the ad is not meant to enjoy the burger, for this is not about her. Like the meat, she is a thing to be consumed, a thing that will provide the viewer with a hearty dose of masculinity and virility. In an interesting twist, this ad, which is clearly intended to sell a piece of meat to straight men, also presents the phallic stand-in as something desirable. Men are supposed to see this image and think something along the lines of: “I like BJs and burgers, cuz I’m a real man. I need some BK,” yet the ad makes the meat into a sexualized, fetishized masculine object.

So is it “natural” for me to weigh 300 lbs? I have no fucking idea. Maybe if I hadn’t lost and regained (and lost and regained, and lost and regained) so much weight as a kid and teenager, I would weigh less now. Maybe if I hadn’t started dieting at nine years of age and possibly affected what would have become a normal adult metabolism, I would weigh less now. I have no way of knowing. And I can’t travel back in time (….yet) to find out whether doing things differently would have led to a different result. And even if I could, I don’t know that I would bother.

  • I’m curious about this article — the thesis seems to be that obesity has always been treated as a product of metabolism and genetics, but maybe instead it should be treated as an eating disorder. Was this published in Proceedings of the Bizarro Academy of Sciences?
  • BMI may be even less accurate for African-Americans. There’s increasing evidence that race needs to be a factor in at least some medical decision-making, but as in so many other areas of life, able-bodied white men are the default and everyone else is considered an outlier or a deviation. It’s good that research is being done, but I’m thinking the medical community needs to listen to Lesley: bodies are not variations on a narrow template.
  • Friend of the blog Robin Abrahams (otherwise known as Miss Conduct) wrote an excellent piece about how to handle situations where the rules of etiquette and one’s personal preferences for treatment are at odds. We’ve been kicking around ideas about a post on “safe space” (and also a very belated review of Robin’s book) so look for those in the future, but meanwhile, you get a slightly-less-belated link.

Just as we expect more than etiquette strictly demands from those whom we love, we should be willing to accept less than etiquette demands if there are no emotions at stake. That’s how it works with those whom we love and who love us: we learn which buttons to avoid and which ones we can happily pound away on all day.

And it’s absolutely vital to sanity to realize that when you step out of your circle of loved ones, you no longer have the right to that kind of customized treatment. People will say things that are hurtful to you, and if those things are within the common bounds of civility we’ve defined as a society, you cowboy up and answer them politely.

  • Hanna Rosin at Double X writes about a new documentary on sex changes in Iran and makes our heads explode. Don’t tell me I’m “used to thinking of ‘transgender’ as the last stop on the gay train to freedom and self expression,” Rosin  — believe it or not, I think that the ability to become the opposite gender is not actually all gay folks’ ultimate goal. (Watch also for the part where she claims to have a better idea of “the universal truth about being transgender” than trans activists do!) Still, the documentary sounds very interesting.
  • Sweet Machine’s looking for a go-to dress for summer, something as versatile as this one (or at least, as versatile as that one would be if you weren’t a total remixing GENIUS). Do you have a go-to piece that acts as the underpinning of infinite outfits?
  • “The pudgy John Hodgman” hit a home run with his astute and funny speech at the Radio and TV Correspondents’ Dinner:
  • ETA: Holy shit, just saw this from Jez. Ableism doesn’t get a lot more blatant, folks.

So what have you guys been talking about?

Asshole of the Day

That would be Dr. Carl J. Lavie, medical director of cardiac rehabilitation and prevention at the Ochsner Medical Center in New Orleans. Regarding the so-called “Obesity Paradox” (one of them anyway)—that obesity is correlated with an increased risk of heart disease, yet fat people seem to recover from cardiac issues better than thin people—Lavie says:

It’s well-known that obesity leads to heart disease, and that’s a big part of the paradox. These people wouldn’t have developed heart disease in the first place if they weren’t obese. A thin person is getting it [heart disease] for a different reason, so he or she is getting a worse form of the disease, getting the disease despite being thin.

OK, seriously. “These people wouldn’t have developed heart disease in the first place if they weren’t obese”—immediately before you talk about thin people getting heart disease? And thin people get “a worse form of the disease” because… you think it’s unfair that they got it at all? Fuck the what? 

Here’s what else this DIRECTOR OF CARDIAC RESEARCH AND PREVENTION AT AN ACTUAL HOSPITAL has to tell us about obesity and heart disease.

Obesity in the United States is a major problem. It is increasing in skyrocketing proportions.

Evidently, he missed the good news from the CDC. A year and a half ago.


There are several possible explanations for the paradox, Lavie said.

One is that obese people visit physicians earlier than others because they develop symptoms, such as fatigue and breathing problems. Heart disease is more treatable if identified early.

Evidently, he also missed the studies showing that fat people do not seek medical treatment as quickly as thin people, because they are so terrified of being mistreated by fatphobic doctors.

Let me help you out, Dr. Lavie.

Two studies in the journal Obesity Research in 2003 found that many physicians harbor negative attitudes toward fat people: A University of Pennsylvania study of 620 primary care physicians found that more than half reported viewing obese patients as “awkward,” “unattractive,” “ugly” and “noncompliant”; a Yale study reported that health professionals strongly associated being overweight with being “lazy” and “stupid.”

Such negative views, some experts charge, may be helping to drive patients away: These experts point to a 2000 study of 11,425 women, which found heavy women less likely to obtain cancer screenings such as Pap smears and mammograms even though they’re at higher risk of dying from cervical cancer and breast cancer. Newer research has produced similar findings: A 2006 study of 498 women, published in the International Journal of Obesity, found that obese women delayed cancer screenings more than other women. Negative attitudes of health-care providers and disrespectful treatment were among the reasons cited for postponing care.

Negative attitudes? Such as?

[Lavie] wanted not only to remind doctors of the paradox, but also to warn them and the general public that it offers no excuse for being fat, he said.

That is the whole thing in a goddamned nutshell. The director of cardiac research and prevention at an actual hospital—like entirely too many of his colleagues—believes fat people are looking for excuses to stay fat, as opposed to looking for compassionate, realistic, trustworthy medical care. I can only guess he assumes we’re having such a grand old time being fat—what with all the donuts and relaxing, the totally never suffering any discrimination or humiliation because of the size of our bodies, the being blissfully ignorant of/willfully blind to the daily screaming headlines about how we’re gonna drop dead any minute—that we’re simply not motivated to go out and get permanently thin, which is totally possible. (Second link is a PDF.) He believes we might just be in the doctor’s office all the time, following up on minor symptoms that could portend larger problems, instead of putting off treatment until we’re so sick we can’t stand it. Instead of dying alone because our doctors told us not to come back still fat. He believes obesity is “skyrocketing,” when the last NHANES results told us there’s been no change overall since 2003-2004, no change for women since 1999. And he believes that fat people who have heart disease have it because they are fat, while thin people who have heart disease have it despite being thin. No possibility of a common cause. Fatties are a different breed. Hell, it’s a different disease altogether in thin folks! A thin person is getting it for a different reason, so he or she is getting a worse form of the disease.

And the fact that fat seems to have some protective value in terms of surviving potentially deadly illness? Bah. You wouldn’t get the illness in the first place if you weren’t fat! I mean, unless you were one of those thin people who got a worse form of the disease, like I mentioned, but… wait, shut up. You just want an excuse to be fat!

This is the logic, y’all. This is the science. This is the director of cardiac research and prevention at an actual hospital. 

This is why fat people are afraid to go to the doctor. This is why we advise people in the book to seek out a fat-friendly health professional instead of putting themselves through the torment of being naked and vulnerable in front of a “professional” who takes one look at a fat body and sees someone ugly, lazy, stupid, and non-compliant.

This is why shit needs to change.