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Culture War Roundup for the week of June 5, 2023

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While I believe that RFK Jr has many inaccurate beliefs, some of his claims that you mention in your post are at least arguably correct, including a couple that may sound outlandish at first. However, after briefly going through all the claims you mention, I have concluded that RFK Jr makes a number of claims that are either false or hard to believe without a lot of strong supporting evidence. Also, his most explosive claims seem the most fishy. I don't think he is someone who is rigorously seeking truth, but rather someone who is prone to believe shocking claims and occasional conspiracy theories but for this reason also occasionally entertains plausible ideas that are somewhat verboten in polite discourse. Overall, I think you should be very skeptical of him but remain open to the possibility that some of his hard-to-believe claims are correct.

Let me now go through his claims one by one.

  1. Endocrine disruptors are "everywhere to be found" in our daily lives. This is hard to evaluate since the phrase "everywhere to be found is vague, but it's at least arguably true. Endocrine disrupters are found in a number of products which it is possible to encounter in everyday life, such as pesticides (though note that some products containing endocrine disrupters have been banned, e.g. DDT was banned in the US in the 1970s). I wasn't able to quickly find information about the precise prevalence of endocrine disrupters in human environments, but see here for a very long report commissioned by the EU which claims (among other things) that current tests for the presence of endocrine disrupters are insufficiently sensitive. See here for some basic information about endocrine disrupters from the NIH.

  2. [Endocrine disrupters] can sexually feminize frogs. This seems to be true. See here for one study claiming this. Tyrone Hayes at UC Berkeley has studied this extensively and claims to have subsequently been harassed by the pesticide company Syngenta who (he claims) are trying to cover up the negative effects of their products. He was recently inducted to the National Academy of Sciences, so he seems to be well respected. Here's another study claiming that exposure to endocrine disrupters present in some paint can cause masculinization in mollusks.

  3. [Endocrine disrupters] must be responsible for the apparent explosion of gender dysphoria and transgender identity that has taken place over the last 5-10 years. This claim is hard for me to evaluate. I was not able to quickly find any strong evidence in support of it. On the one hand, it does not seem totally implausible. On the other hand, some things don't quite fit. Endocrine disrupters have been around for many decades and perhaps were even more prevalent in the past (before things like DDT were banned), but the explosion in the number of cases of gender dysphoria is very recent. Also, the feminization/masculinization effects of endocrine disrupters observed in frogs and mollusks were at the level of gross anatomy whereas gender dysphoria is a (purely?) psychological phenomenon. There may have been an increase in sexual developmental disorders caused by endocrine disrupters in the environment but I'm not sure to what extent this has occurred nor to what extent this can be connected with increases in gender dysphoria. I'd be happy for someone more knowledgeable about any of this to weigh in. Also, the number of exclusively homosexual men does not seem to have seen a significant increase from the Kinsey report until today (the number of bisexual men has increased a lot, but this seems much more contingent on social facts: it is easy to imagine mildly bisexual men opting to identify as purely straight in a homophobic environment but as bisexual in a homophilic environment). At the very least, this seems like a very bold claim for someone like RFK Jr to make without strong supporting evidence.

  4. A Cochraine [sic] collaboration report has declared Pharma drugs are the third leading cause of death in the US after cancer and heart attacks. There are really two claims here: first that a Cochrane review has made this claim and second, that the claim is true. I am unable to find any Cochrane review claiming this, but I didn't look very hard and I'm open to being proved wrong. The second claim seems straightforwardly incorrect. This page from the CDC claims that the third leading cause of death in the US is covid, with about 400,000 deaths per year. Excluding covid, the third leading cause of death is accidents, with about 225,000 per year. I don't really see how drugs could be the third leading cause of death unless you split up several other causes in unnatural ways (e.g. splitting "accidents" into several smaller categories). By the way, I'm not sure why the CDC page I linked to leaves out drug-related causes, but this document claims that in 2019, there were 75,000 drug related deaths. However, about 95% of these were deaths from drug overdose, mostly illegal opiods. So even if RFK Jr's claim is true, it's only by breaking down several categories in unnatural ways and lumping all drug overdose deaths together into a single "Pharma drugs" category, which seems unreasonable.

  5. Masks are entirely ineffective in preventing the transmission of COVID-19. I'm going to skip this one because it has been written about a lot already, both on this forum and elsewhere. My personal opinion is that saying masks are "entirely ineffective" is much too strong a claim, though I'm on board with a more limited claim that their effectiveness was exaggerated in popular media, especially the effectiveness of cloth masks.

  6. 70% of advertising on the news is from pharmaceutical companies. I'm highly skeptical of this, but had trouble finding concrete data. Also it's a bit vague: what does "news" entail? Does it include news websites? Newspapers like the NYT? Weighted by viewers, spending or something else? In any case, it just defies my own personal experience. I agree there are a lot of drug ads, but I don't feel like I've ever watched TV and seen almost 3 out of every 4 ads be about drugs.

  7. Big Pharma gives twice as much as the next biggest industry to congress in lobbying efforts. This seems to not be literally true, but close enough that it's not worth the quibble. This chart by Statista shows that the pharmaceuticals/health products industry spends about $370,000,000 on lobbying in the US per year and the next leading industry, Electronics manufacturing and equipment, spends about $220,000,000. Now 370 is not quite twice 220 and I'm sure "health products" includes a number of non-pharmaceutical companies, but the claim was reasonably close to correct and violated my intuition so I'll give it to him.

On 4) I haven't delved deeper into this but the claim that medical mistakes is one of the leading causes of death requires proper context. My intuitive understanding is that technically it could be true. And yet it is only because people live much longer with the help of the modern medical system. Everyone should read Scott's article “By very slow decay...”. People who are barely alive survive only because of constant medical care, requiring 10 or more concomitant medications, constant care and procedures etc. The likelihood that overworked staff makes a fatal mistake increases exponentially and then that mistake kills the patient who was already literary on the death-bed.

Without that medical care and 10 different medications he would be already dead from natural causes but now he is dead because a nurse overdosed his insulin or pushed too much morphine into his vein or whatever. This doesn't mean much, only that medicines helps to live longer albeit with a poor quality of life and with a better care that minimises medical errors we could extend their lives even more while seriously questioning whether such efforts are worth it.

On 3) aren’t endocrine disrupters linked pretty strongly to messing with hormone profiles of the sort that dictate almost everything about human sexual expression?

Yes, but doesn't this imply that if endocrine disrupters are the main cause of the explosion in gender dysphoria cases then we should also see an explosion in sexual development disorders (with e.g. changes to anatomy) that are also linked to endocrine disrupters? I'm open to being convinced that either (1) this is wrong or (2) such an explosion is occurring. Absent such an explanation, it at least seems like a potential inconsistency in the story.

The question of whether such explosion is occurring seems pretty relevant- have sexual development disorders increased? I’d thought at least precocious puberty was more common.

This is something I'd be really interested to learn more about. I had trouble quickly finding data about sexual development disorders, especially of the sort that cause opposite gender anatomical features. You do seem to be correct that there has been an increase in cases of precocious puberty and that fact does seem relevant (and I appreciate you mentioning it). On the other hand, precocious puberty is almost the opposite of changing gender. On the other other hand, it seems at least plausible to think that endocrine disrupters would just cause an increase in all kinds of disorders including disorders that increase sexual differentiation and those that decrease it. So I think overall I take this as mild evidence for the endocrine disrupters -> gender dysphoria theory but I'm also way out of my depth on the biology knowledge needed to know how plausible all this is and what would be good supporting or contradicting evidence.

One minor point of data is that I believe precocious puberty has risen most in girls, while sexual disorders are fairly male(I believe that most trans men are psychosomatic cases driven by fear of sexualization). It’s not implausible that the same set of mutagens could cause precocious puberty in girls and brain feminization in boys.

There seems to be some tension between this idea and the fact that the increase in reported gender dysphoria cases has been driven more by gender dysphoria in biological females rather than biological males.

I think the source of the 3rd leading cause of death quip is Deadly Medicines and Organised Crime, it's a book though by Peter C. Gøtzsche. He summarizes the point in this letter to the editors of the BMJ. Oddly I can't find any reviews about that topic from him even though he's written many others.

He's attributing the underlying cause of many other immediate causes so they're not going to show up in the statistics. I tend to agree with him that drugs are overused in the medical system, but that's a personal value decision on my part, not a researched conclusion.

Thanks for digging up a plausible source for RFK Jr's claim. I agree with you that drugs are likely overused (though in part for cost-benefit reasons rather than because I think the drugs themselves are super harmful). Having said that, I don't think RFK Jr's claim is really justified. Most deaths are multi-causal, especially when you consider second and third order effects and counting every death where over-medication was plausibly involved as a "drug death" while not doing so for other causes of deaths is dishonest.

Yeah, it's at best something like Coffee/Wine/Butter gives/prevents cancer/heart disease level reporting.

Let me now go through his claims one by one.

I think you're being too charitable. "Unexceptional idea, therefore absurd idea" shouldn't count as having 50% of his claims right.

I never said 50% of his claims were right and I'm not sure why you think I did. In fact, I said "some of his claims are at least arguably correct" which I think is true and "I think you should be very skeptical of him." I don't think RFK Jr is a good source of information nor do I think most of his most extreme claims are correct. I do think that some of his claims are correct or partly correct, but that's a much weaker statement.

Also, I don't really understand what you mean by "unexceptional idea, therefore absurd idea."

Thank you for this thoughtful point-by-point response. It's exactly what I was looking for. About 2: even if these effects are real in humans, who is to say the dosages we are exposed to make a difference? I take your point that the "suddenness" and recency of the increase in transgender ID is not consistent with the endocrine disruptor hypothesis.

Yeah this seems like it's some subset of TV news that skews old, it's certainly close in my experience watching Jeopardy and Wheel of Fortune which I assume also skew old. Perhaps local TV news or cable TV news?

What you say seems plausible. However, for Hulu I think ads are targeted based on demographics. For example, I have never seen a drug ad on Hulu. It does seem plausible that RFK Jr sees a large number of drug ads online because he's relatively old and the ad targeting software has identified him as a possible major customer for pharmaceuticals.

In any case, I stand by my original comment that this claim of RFK Jr's feels very unlikely but I'm also still open to evidence that I'm wrong.

The history of masking (especially cloth) showed very little ability to slow aerosols.

Thus the default should’ve been masking doesn’t work until proven otherwise.

The CDC studies to support masking were absurd (hair dresser anyone). The closest they came was the Bangladesh study which had some problems that likely put a thumb on the scale for masking. There they found cloth masks did nothing whereas surgical masks reduced the spread by about 10% but only in the very old.

Some people took that analysis and re-examined it and found even that claim was stretching.

There just is so little evidence supporting the efficacy of masks I don’t see why anyone would start with the default you’re asserting.

It seems to me there are two different claims here. First, did the evidence for the effectiveness of masks in reducing spread of covid warrant government mandated masking? Second, is the evidence against the effectiveness of masks strong enough to warrant the claim that they are "entirely ineffective"? I am not interested in arguing about the first claim. For the second claim, which is specifically the claim OP reported RFK Jr making and therefore the claim that is relevant to this discussion, I do not think you have provided strong evidence. For example, you only mention cloth and surgical masks and do not discuss other masks such as N95. I realize that the efficacy of cloth and surgical masks is relevant to the policy question, but leaving out N95 and the like is unconvincing if you want to argue that masks are "entirely ineffective" (and note that in my original comment I specifically mentioned that cloth masks are not very effective). Also, citing a single study that claims surgical masks reduce covid spread by 10% in the old and then vaguely hand-waving about people being skeptical of that study does not convince me that masks are entirely ineffective. It might convince me that surgical masks are not very effective or that the costs of requiring masks are not worth the benefits, but that was not the question at hand.

My point is you’ve reversed the question. There is no reason to expect cloth or surgical masks do anything. It is on you to prove that; not the other way around. Has nothing to do with mandates.

I'm not sure why you keep insisting on specifying "cloth or surgical masks" when the OP just said "masks." Also, there is a major societal dispute about whether masks (including N95 and the like) are effective. It seems reasonable to expect someone who claims they are "entirely ineffective" to have decent supporting evidence.

Let me just ask you directly: do you think it's true that N95 masks are entirely ineffective at reducing the spread of covid? If so, do you think the evidence for this is so obvious that no reasonable person should question it? If not, then I'm not sure what we're arguing about.

Because that’s how language works. Focusing on an entirely non central case (ie N95) obfuscates the issue. When people say they believe in God, I don’t assume them to be talking about Odin.

But to answer your question no I don’t think N95 as used did shit