This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
Is the claim not, and I have no knowledge of whether the claim is true, that a lot of historic medical research upon which eg. current diagnoses and treatment plans are based was conducted primarily upon men?
No. The claim is:
In any case, men suffer more than half of burden of disease, apparently we do not address male health enough.
More options
Context Copy link
Yes, this is the claim that I also encounter most often in medical science, i.e. that the majority of the so-called gender neutral research is actually biased towards men because the majority of consenting subjects is male. And this makes me furious. Yes, medical researchers generally prefer male subjects because having to consider the period, which unfortunately can have a major influence on many medications, is an absolute pain in the ass. But if there was a huge number of female subjects desperately wishing to be included in early phase trials, they'd take them; But women are by and large very risk averse, and in particular when it comes to untested substances that give them no expected benefit. This is well reflected in the data for different phases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867082/
Phase I is for testing the safety and distribution of medication. There is no benefit for the subject, and hence the percentage of women in these trials is small, only around 22% in this particular review (but this is pretty consistent).
Phase II and later is for testing whether a drug works for humans, and hence most subject actually have a specific disease that they hope the medication will help with. Hence, the percentage of women suddenly reflects the population very well, usually around 45+%.
So somehow if women refuse to sign up for medical research that doesn't benefit them personally so men take up the slack, who is the primary victim? Obviously, the poor women.
And, just to be clear here, kudos to the minority of women who do sign up for early research. I agree this is an issue, but critically it is an issue that can only be solved by women willingly signing up more. And it also is a somewhat minor issue, since a lack of efficacy or the presence of female-specific side effects will still be caught in the later phases when women are well represented.
How does one actually sign up for these types of trials? I've long admired the conscientious objectors who got injected with infectious disease to help medical research instead of fighting in the army, but I have no idea what I should do to do something similar. Something like donating a kidney is more obvious how to do, but also seems like there's a lot more hurdles since it seems to happen so much less.
Depends a lot on the country you're in, I'd honestly have to look it up myself for most of them. I'm not really directly involved with patients nor drug development, pretty much strictly lab experiments on one side and data analysis for existing data sets on the other.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
Leaving aside the truth of that claim, I would skip right to saying that it usually doesn't matter.
Drugs that work for the goose work for the gander, and vice versa. I mean, you'd presume that in the domains that are specific to a given sex, all the studies were done on them.
I can't imagine trials for vasectomies needing women, even as the controls, or a new form of IUD needing male volunteers really into sounding.
Most of physiology is conserved between men and women. Barring gross and obvious anatomic differences, there are minor things like pain tolerances and so on, but if unisex therapies that were tested on a predominantly male population were that suboptimal for women, doctors would have noticed.
Absence of evidence is weak evidence of absence. Add up enough and you get to where I'm standing.
Would dosage not vary significantly between genders based on their relative average sizes?
For most drugs that's not particularly relevant, and where it is we already adjust for body weight in a gender neutral manner.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link