It is fitting that as I was reading Alice Dreger’s new book “Galileo’s Middle Finger,” news reports were full of “Deflategate,” in which the New England Patriots were accused of doctoring footballs, and the travails of NBC anchorman Brian Williams, accused of fabricating past exploits.
Lying and deceit have been around for a long time—forever, probably—but what makes Dreger’s book so compelling is where she dug them up: among health activists, academics and ethicists who we normally associate with honesty and integrity. If even a portion of what Dreger says is true—and I suspect most of it is—we have a big problem on our hands.
Dreger, a historian of science and medicine currently at Northwestern University, first encountered controversy through her work on intersex, people who have sexual characteristics of both males and female. (Full disclosure: I once wrote a letter in support of this research). Having originally studied the history of intersex as a scholar, Dreger eventually became an activist, arguing that the common practice of childhood genital-altering surgery to “correct” intersex individuals was unethical and unwarranted. That is, it was wrong to surgically shorten enlarged clitorises of XX women and build penises in babies with one male chromosome. Such surgery, Dreger found, not only led to sexual dysfunction but great unhappiness.
Even though Dreger would receive lots of opprobrium for her public stance on these issues, the controversy over intersex surgery proved to be the easiest of her missions. Today, professional organizations more or less agree with Dreger and her fellow activists, and surgery has become much less commonplace.
If it can be argued that the surgeons who insisted on correcting intersex genitalia were mostly misguided, the same cannot be said for other villains in Dreger’s book. Her work in intersex eventually led her into the world of transgender, in which individuals reject the gender assigned to them at birth and eventually pursue strategies—such as hormone therapy or surgery—for being recognized as the other gender.
Dreger’s primary focus here was not transgender itself, but rather the ways in which scientific evidence about the topic was being evaluated. To make a long story short, Dreger became a vocal supporter of a psychologist named Mike Bailey, whose research had led him to conclude that some males wish to become women because they are sexually aroused at the notion of doing so. That is, they have what an earlier researcher had termed “autogynephilia.”
The problem was that to a segment of activists who had worked hard to make transgender about gender identity rather than sexuality, Bailey’s research was not politically correct. It wasn’t that Dreger necessarily agreed with Bailey, although when she later reviewed his findings, she felt that they had scientific merit. Rather, she was appalled at how some of the activists had turned their horror at Bailey’s findings into a very public vendetta against him and his family. At one point, they even falsely claimed that Bailey sexually abused his children. Yet despite these outrageous and unsubstantiated claims, Bailey’s accusers remained prominent transgender activists.
The Bailey affair was the first of several instances in which Dreger would discover a disturbing gap between activism and science. It is probably reasonable to argue that most scholars in the history and ethics of medicine tend to associate activism with virtue. After all, crusades against smoking, drunk driving and binge drinking over the past 50 years have led to desperately needed social change. But to use Al Gore’s phrase, Dreger kept finding “inconvenient truths” in the worlds of health and medicine in which the supposed “good guys” were the ones with both the bad data and an inclination to defame anyone who did not agree with them.
Another unpopular researcher who Dreger defends is the anthropologist Napoleon Chagnon. Chagnon had studied the Yanomamo, an indigenous people who lived on the border of Brazil and Venezuela. Chagnon’s controversial finding was that Yanomamo men demonstrated domestic brutality, ritualized drug use and ecological indifference, far from the usual romanticized characterization of those who live in primitive rain forests. Chagnon situated his findings in the theory of sociobiology, which argued that culturally-specific behaviors have an evolutionary basis—again, not a politically correct theory among academics worried about genetic determinist visions of the world.
The main villains in the Chagnon story are two anthropologists who came out in strong support of a 2000 book by journalist Patrick Tierney that made several astounding claims about the behavior of Chagnon and one of his fellow researchers. Among the charges were that these men deliberately caused an outbreak of measles among the Yanomamo to prove their “eugenic” theories. Not only had the two anthropologists taken Tierney’s dubious claims at face value, they had gotten the American Anthropological Association to do so as well. As might be expected, by the end of her detective work, Dreger concludes that it was not the Yanomamo who were harmed but rather Chagnon, hanged on the cross of political correctness.
Toward the end of the “Galileo’s Middle Finger,” Dreger turns her attention back to the world of intersex, where she learns of research being done on pregnant women whose fetuses are at risk for congenital adrenal hyperplasia (CAH), a condition that causes the masculinization of girls. As she digs deeper, Dreger discovers that the research, which was funded by the National Institutes of Health, was full of irregularities. For example, women were being enrolled into the study without full disclosure that it was a potentially harmful intervention and that most of those enrolled in the study—which involved giving a steroid compound to the pregnant woman—stood no chance of benefitting.
Dreger’s claims did not go unchallenged. Several prominent bioethicists came to the defense of the lead researcher, who had been a longtime advocate for people with CAH. Yet through the use of Freedom of Information requests, Dreger uncovers worrisome conflicts of interest among these supporters.
“Galileo’s Middle Finger” is at times an uncomfortable read. Although Dreger tries to be as modest as she can, admitting her own mistakes, the fact is that she portrays herself as a cowboy with the white hat, rooting out perfidy in the words of academia and bioethics.
But that is precisely the point of this book. The fascinating problem that Dreger has unearthed is our disturbing tendency to reflexively equate good causes with good data—i.e., the “truth.” Well-meaning commentators who automatically throw up their hands, arguing that scientific controversies are complicated and have two sides, have become the problem. Like her hero Galileo, Dreger believes that the “real” truth does exist and we are all for the worse when we don’t seek it out. It is an argument that deserves more of our attention.
First published on forbes.com on March 13, 2015