by Sharon Begley
July 02, 2010
The controversy over using female hormones as part of prenatal care isn’t quite as shocking as the headlines suggest, but it does raise important questions about ethics, gender, and sexuality.
Mike Kemp/Corbis
Genetic engineers, move over: the latest scheme for creating children to a parent’s specifications requires no DNA tinkering, but merely giving mom a steroid while she’s pregnant, and presto—no chance that her daughters will be lesbians or (worse?) ‘uppity.’
Or so one might guess from the storm brewing over the prenatal use of that steroid, called dexamethasone. In February, bioethicist Alice Dreger of Northwestern University and two colleagues blew the whistle on the controversial practice of giving pregnant women dexamethasone to keep the female fetuses they are carrying from developing ambiguous genitalia. (That can happen to girls who have congenital adrenal hyperplasia (CAH), a genetic disorder in which unusually high prenatal exposure to masculinizing hormones called androgens can cause girls to develop a deep voice, facial hair, and masculine-looking genitalia.) The response Dreger got from physicians and scientists who were outraged over this unapproved use of dexamethasone caused her to dig deeper into the scientific papers of the researcher who has promoted it.
The result of that digging is a discovery that is much less outrageous than the PR push, and some media coverage, would have you believe, but one that nonetheless raises important questions about gender, sexuality, and research on unknowing patients.
In an essay titled “Preventing Homosexuality (and Uppity Women) in the Womb?” and posted on the bioethics forum of The Hastings Center, a think tank in Garrison, N.Y., Dreger and her colleagues pluck numerous brow-raising statements from the writings of pediatric endocrinologist Maria New of Mount Sinai Medical Center in New York, who has long promoted prenatal dexamethasone to treat CAH. But if that position is controversial (as I’ll explain below), what Dreger and her colleagues claim to have uncovered is even more so. New, they say, wants to use dexamethasone to prevent CAH girls from becoming lesbians, from rejecting motherhood, and from choosing traditionally masculine careers.This charge is stirring the predictable outrage, as in this Huffington Post item, which makes it sound as if some scientists are promoting the use of dexamethasone to prevent lesbianism—even tomboyishness—in all female fetuses. The press release from Northwestern is even more hyperbolic: “FIRST EXPERIMENT TO ATTEMPT PREVENTION OF HOMOSEXUALITY IN WOMB,” it screams, going on to describe how Dreger and colleagues are bringing “to national attention the first systematic approach to prenatally preventing homosexuality and bisexuality. The ‘treatment’ is targeted at one particular population of girls, but the researchers involved in the work say their findings may have implications beyond this population.”
The facts are more complicated.
New has indeed argued that prenatal androgens can affect a woman’s sexual orientation, her interest in becoming a mother and housewife, her interest in traditionally masculine careers, and—in childhood—whether she plays with dolls or trucks. I have written before on the many problems with research on such gender differences, and a book that Harvard University Press will publish in September, called Brain Storm: Flaws in the Science of Sex Differences, argues that studies claiming to find innate, sex-based brain differences are seriously flawed.
But to be fair, the idea that exposure to prenatal hormones can shape sexual orientation goes back decades, as in this 1985 paper. So New is in ample company when she and colleagues write that that there is “a dose-response relationship of androgens with sexual orientation” in women with CAH. (That’s from her 2008 paper in Archives of Sexual Behavior.) Prenatal androgens, they argue, affect sexual orientation, with the result that although “most [CAH] women were heterosexual,” the “rates of bisexual and homosexual orientation were increased above controls ... and correlated with the degree of prenatal androgenization.” From that, Dreger and her collaborators infer that New is proposing that women pregnant with a CAH daughter use prenatal dexamethasone to keep the girl from being gay.
Dreger then pounces on a 2010 paper in which New goes further. In Annals of the New York Academy of Sciences, New and a colleague suggest that women having little interest in babies and men, and being drawn to traditionally male occupations and games, is “abnormal.” Moreover, they argue, that abnormality might be prevented with prenatal dexamethasone. “Gender-related behaviors, namely childhood play, peer association, career and leisure time preferences in adolescence and adulthood, maternalism, aggression, and sexual orientation become masculinized” in CAH girls and women, they write. “These abnormalities have been attributed to the effects of excessive prenatal androgen levels on the sexual differentiation of the brain and later on behavior ... We anticipate that prenatal dexamethasone therapy will reduce the well-documented behavioral masculinization ...” in CAH girls.
...
Read more here/Leia mais aqui: Newsweek
+++++
