Wednesday, November 27, 2019

Science is not the patriarchy

For whatever reason, I've noticed a correlation between women and woo. Astrology. Jade eggs. Homeopathy. Women are also more religious than men. If there's no science behind something, there are usually more women who believe in it.

I can't claim to know the full reason why- my guess is there are a lot of reasons. One I hear spelled out a lot is that science is a male-dominated field. So science and modern medicine are characterized as "male ways of knowing," unfairly pushing out the traditions of our foremothers.

This narrative isn't entirely wrong. Our society has the bad habit of doing a tiny bit of scientific exploration, understanding five percent of a thing, jumping in with both feet, and only later realizing that was dangerously stupid. For instance, do you remember when x-rays were thrown around heedlessly- x-rays of laboring women, x-rays to kill ear infections, x-rays to measure children's feet for shoes? Science had gotten far enough to know what it could do, and not far enough to know what it couldn't. Likewise thalidomide, low-fat diets supplemented by corn syrup and cigarettes, and so on. A little more respect for tradition would have stopped people from diving headlong into new fads they didn't fully understand.

Likewise, for a long time doctors were worse at healing people than your granny. Neither could do much for you, but at least granny hadn't come straight from dissecting a corpse without washing her hands. To this day, obstetrics and gynecology, in practice, clings to disproven tactics like episiotomies, supine positioning, and immediate cord clamping, which any midwife could tell you aren't helping. No wonder women, whose first extended encounter with the medical profession might be when giving birth, don't trust doctors.

I'm definitely the first person to tell you the medical profession isn't perfect, or that there are a lot of things science doesn't know. But the root of science and medicine is not the bad practices of clueless doctors. The root is, or should be, the scientific method- testing claims and finding out whether or not they are true. Applied to medicine, this means randomized, controlled trials wherever possible. You don't just take a medicine and see if you feel better, because that doesn't account for randomness - you might have felt better anyway. Instead you give a hundred people the medicine, give a hundred people a sugar pill, and see what percentage of each group gets better.

This practice is what turned medicine from a haphazard collection of folk remedies and bloodletting into something that saves billions of lives. Infant mortality is a fraction of what it was. Lifespans are decades longer. Modern medicine emphatically does work, and it all came from testing remedies and carefully recording the results.

What is masculine about testing things to see if they work? Nothing at all! Dr. Gerty Cori, Dr. Helen Brooke Taussig, and Dr. Virginia Apgar would be offended at the notion. Female doctors and medical researchers have been told for generations that they couldn't have access to medical research- the thing that actually works- because it wasn't for women. But instead, excluding them was the real unscientific, purely tradition-based choice.

Is it possible that women think differently from men? Sure! But if we define it purely in the sense of "finding things out more by ways that are unrelated to truth than by ways that can be tested," all that means is dooming women to be wrong a lot. Tradition is at best a middling way of finding out what works. Gut feelings are even worse. "I feel more connected to myself when I shove a jade egg up my vagina" tells us nothing about whether it's safe or effective for any condition.

Maybe women are better at actually waiting and learning more before leaping headlong into a new discovery. For instance, Frances Oldham Kelsey was the FDA director who refused to approve thalidomide without more testing, thus preventing untold numbers of prenatal deaths and disabilities. Was it because she was a woman, or just because she was conscientious and patient? Who knows.

More contributions of women might also lead to advances in obstetric care, more resources being spent on women's conditions like endometriosis, and more credence given to women's expressions of pain. Medicine (and science in general) aren't finished; there's plenty of improvement available.

But the answer isn't to abandon the whole idea of the demonstrable and turn to woo. If you go to your doctor with pain and he dismisses you, that means you need a better doctor. If there isn't one, that's a terrible thing and tells you something about the state of medicine today. It doesn't tell you medicine is a tool of the patriarchy and true healing is only to be found by rubbing oil on your belly, shoving a rock up your nethers, and blaming retrograde Mercury. If you're going to turn to alternative medicine (as plenty of women do, including me, because of a lack of workable options within the system), you can still choose things whose safety and effectiveness have been studied. This is true of a select few essential oils, a few nutritional regimes (pro tip: anything that includes eating more vegetables will do you at least some good), many of the things trained midwives do, and so on. Your average thing trumpeted by naturalist celebrities doesn't qualify, and it won't start qualifying just because they sell it in a feminist wrapping.

Don't leave science to men because they think it's theirs. It belongs to everyone. It belongs to us.
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