Monday, November 02, 2015

Further Comment on Galileo’s Middle Finger

My previous post did not do justice to the Alice Dreger book Galileo’s Middle Finger. Here are a few additional comments.

Intersex people. Intersex infants, children, and adults, formerly referred to by the pejorative “hermaphrodite,” are born with ambiguous genitalia—for example, with external penis and vagina, usually of different sizes, or with an external vagina and internal testes but no uterus or ovaries.

Dreger’s doctoral dissertation focused on late nineteenth and early twentieth century hermaphroditism. Because such sexual differences were seldom ever talked about, most intersex people in that period lived relatively normal lives, presumably because they assumed that everyone else was built the same way. As Dreger put it, perhaps a little surprise on the doctor’s face when examining the patient was the only awareness anyone had of the medical issue!

Sometime during the twentieth century, doctors decided they should do something about the “shameful” condition. They decided, usually only telling the parents that some infant surgery was necessary, to play God and change intersex infants into boys or girls, based entirely on their judgment of which way the infant should go.

In recent times, it seems doctors have become more transparent by telling parents what they are doing . . . but rarely, even today, have doctors or parents told their patients and children what was done to them as infants.

“Shame, secrecy, and lies” is how Dreger describes the attitudes and behavior of doctors and parents. And it is this shame, secrecy, and lying that has incensed the human sexual identity activists. Intersex people are individuals with rights just like everyone else, but they have been denied honesty, have been discriminated against, and even denied choice—over which way they want to go, or whether to go at all.

Several early chapters of Dreger’s book detail her own activism to get the medical profession to fess up and change its ways. The stone wall she hit is part of the reason she felt the depression mentioned in my previous post.*

Congenital adrenal hyperplasia. Another stone wall was hit and described in the latter chapters of Dreger’s book. A doctor in New York City has made a career of administering dexamethasone, a powerful steroid, to in utero fetuses to prevent the formation of ambiguous genitalia and other sexual anomalies that can result from this inherited disease.

Dreger tallied a number of problems with this medical practice and lobbied hard, but failed, to stop it. The off-label drug—many drugs are so used—must be administered before there is any evidence the fetus is developing in an anomalous manner.

Dreger’s math found that only one out of ten such treated fetuses stood to benefit from the drug. On the other hand, the risks? Only one study—and only one—has been conducted to discern long-term consequences. The findings of that study indicated a significant minority of the sample suffered retardation, memory difficulties, and growth disorders; as a result, the study was shut down.

The controversy centered around informed consent, much of which seems not to have been given, and bureaucratic approval to proceed with such a treatment.

At one point, charges of fraud for phantom research projects were brought up, but the whistleblower, like many operating in bureaucratic environments, was attacked and threatened with psychiatric treatment. The Feds, responsible for protecting the public from risky medical practice, did little to stop a prestigious and well-established doctor.

Dreger lost the battle.

Social justice. Dr. Dreger views herself as an activist fighting for social justice. This has pushed me to clarify in my mind the difference between social and individual justice. “Social justice” has a long history, so it is not unique to Karl Marx, but today’s advocates use it in a distinctively Marxian flavor.

Is Dreger an advocate of social justice? Not really, though I’m sure she would disagree with my interpretation of her work.

Social justice, as I define it using today’s Marxian flavor, is the virtue of fairly and accurately judging oppressed classes as underprivileged and granting them restitution in the form of additional wealth, education, employment, along with other favors that they otherwise have not been able to attain. The underprivileged include anyone who is deemed unsuccessful, but especially African Americans, women, and LGBTs. This is the collectivist definition.

Individual justice is the virtue of fairly and accurately judging individuals—oneself and others—according to the standards of honesty, integrity, courage, independence, and especially productiveness. This is the individualist definition.

I think Dr. Dreger, because of her uncompromising commitment to facts, is closer to practicing the latter form of justice than the former. This, I would say, is why she could not accept her Marxist colleagues’ epistemological relativism. Yes, African Americans, women, and LGBTs have been badly discriminated against, even enslaved, but each individual must be judged on his or her own merits. No “class,” to use Marx’s terminology, owes any other “class” anything, especially when restitution is made at the point of a gun.

To use a reductio argument against the Marxists one might say this: Ayn Rand wrote that the individual is the smallest minority on earth. Turning the thought around, can we not say that the group or “class” of individuals is the largest “class” on earth? And therefore the largest “class” on earth that has been discriminated against and oppressed??

Individuals of the world should unite! And fight off their oppressers!!

Marxists should be advocates of individualism if they are seriously concerned about justice for the oppressed.

Free speech at Northwestern. An unwavering defender of First Amendment rights, Dreger has, since the publication of her book, performed a little flipping off herself. She has resigned from the Northwestern University Medical School over her dean’s attempts to censor the content of a faculty magazine she edited. The content? About sex, of course, but also possibly “offensive” content—to the hospital’s brand name!

Sigh! As a marketing prof, I have to make one last comment. Bureaucrats, whether in academia or government, have no clue what sound marketing, including branding, means. They think the usual BS that marketing is just that and that a brand image is something made up and pawned off on the helpless, unsuspecting public. This is just good Marxist thinking about business.

Sound branding—that is, product identification—of a first class hospital should run something like this.

We use the latest, most advanced knowledge and techniques to treat and cure our patients. In the process we entertain and examine all ideas—the wilder and more offensive the better.

The better because we will then know that we have left no stone unturned in order to come up with treatments and cures to do justice [there’s that word again!] for our patients.


*To the sheltered, like yours truly, this was an eye-opening read. It also struck me as the perfect “borderline case” in the philosophical problem of universals. The existence of intersex people (and animals) demonstrates that there is no intrinsic maleness or femaleness “out there, in the thing” as the intrinsic theory of essences claims. It also took my teenage daughter to explain the difference between gender, which is social (actually, psychological), and sex, which is biological. Now I understand!


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