Tag: hormones

Bioethics Blogs

A Feminist Neuroethics of Mental Health

By Ann E. Fink

Ann Fink is currently the Wittig Fellow in Feminist Biology at the University of Wisconsin–Madison, with an appointment in Gender and Women’s Studies and concurrent affiliations with Psychology and the Center for Healthy Minds. Her research in cellular and behavioral neuroscience has appeared in the Journal of Neuroscience, Journal of Neurophysiology, PNAS and other journals. Ann’s interdisciplinary work addresses the ethics of neuroscience in relation to gender, mental health and social justice.

Emotionality and gender are tied together in the popular imagination in ways that permeate mental health research. At first glance, gender, emotion, and mental health seem like a simple equation: when populations are divided in two, women show roughly double the incidence of depression, anxiety, and stress-related disorders^1-3. Innate biological explanations are easy to produce in the form of genes or hormones. It could be tempting to conclude that being born with XX chromosomes is simply the first step into a life of troubled mood. Yet, buried in the most simplistic formulations of mental illness as chemical imbalance or mis-wiring is the knowledge that human well-being is a shifting, psychosocial phenomenon. Learning and memory research offers a treasure trove of knowledge about how the physical and social environment changes the brain. Feminist scholarship adds to this understanding through critical inquiry into gender as a mode of interaction with the world. This essay explores how a feminist neuroethics framework enriches biological research into mental health.

Problems with “Biology-from-birth” stories

What if understanding gender and health isn’t a tale of two gonads (or genitalia, or chromosomes)?

Bioethics Blogs

‘Malignant: How Cancer Becomes Us’ / a conversation with Lochlann Jain by Tara Mahfoud

In the Stanford Hospital car park, there is a sign that reads “WARNING: This garage contains gasoline and diesel engine exhaust which is known to the State of California to cause cancer and/or reproductive toxicity.” The paradox is deadly – one runs the risk of developing cancer on their way to cancer treatment. The sign blatantly highlights the starting point of Lochlann Jain’s analysis of cancer in her 2014 award-winning book Malignant: How Cancer Becomes Us, which is to understand “the ways that key aspects of the economy involve both causing and treating cancer” (p. 12). Jain showed the image of that sign, taken from her book, during her talk at the Department of Global Health and Social Medicine’s 2015 Public Lecture at King’s College London. Malignant is an ethnographic investigation into how cancer, despite the millions spent to cure and prevent it, remains deeply entrenched in so many aspects of American life and culture. Jain uses her own cancer experience to reflect on prognosis and treatment, time and lifespans, screening and preventative treatment, misdiagnosis and malpractice, IVF and hormones, the war-loaded history of cancer and its treatments, and cancer objects like prostheses, wigs, and make-up. Malignant forces the reader to acknowledge the paradoxical, ugly, and inevitable reality of cancer today.

I am a teaching assistant on the Introduction to Social Medicine course at the Department of Global Health and Social Medicine at King’s College London, which is taught by Carlo Caduff. The course is offered as part of an interdisciplinary BA/BSc programme in Global Health and Social Medicine that combines social science and biomedical science courses.

Bioethics Blogs

Missing Genes Point to Possible Drug Targets

Every person’s genetic blueprint, or genome, is unique because of variations that occasionally occur in our DNA sequences. Most of those are passed on to us from our parents. But not all variations are inherited—each of us carries 60 to 100 “new mutations” that happened for the first time in us. Some of those variations can knock out the function of a gene in ways that lead to disease or other serious health problems, particularly in people unlucky enough to have two malfunctioning copies of the same gene. Recently, scientists have begun to identify rare individuals who have loss-of-function variations that actually seem to improve their health—extraordinary discoveries that may help us understand how genes work as well as yield promising new drug targets that may benefit everyone.

In a study published in the journal Nature, a team partially funded by NIH sequenced all 18,000 protein-coding genes in more than 10,500 adults living in Pakistan [1]. After finding that more than 17 percent of the participants had at least one gene completely “knocked out,” researchers could set about analyzing what consequences—good, bad, or neutral—those loss-of-function variations had on their health and well-being.

Gene knockouts are expected to occur more frequently in certain countries, such as Pakistan, where people sometimes marry and have children with their first cousins. That makes it much more likely that a person carrying a loss-of-function gene variation will have inherited that same variation from both of their parents.

In the latest study, a team led by Sekar Kathiresan at the Broad Institute of Harvard and MIT, Boston, turned to the Pakistan Rise of Myocardial Infarction Study (PROMIS) in hopes of finding more gene knockouts.

Bioethics Blogs

Using Inclusive Language Isn’t Enough

Celeste Orr and Erin Leigh Courtice respond to criticisms of the British Medical Associations’ guide on inclusive language which aims to ensure that trans, intersex, genderqueer, and non-binary people are not subjected to discriminatory language.

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Since January 2017, Hayden Cross has garnered a lot of media attention. He is the first publicly-known pregnant trans man in Britain. In response to the media attention, there has been considerable criticism of the 2016 British Medical Association’s “A guide to effective communication.” The guide recognizes that some trans men and intersex men may become pregnant and it calls for the use of more inclusive language. The guide recommends that medical professionals use the phrase “pregnant people” instead of “expectant mothers.”

While the guide was published in 2016, before Cross’ pregnancy, a connection between Cross and the guide persists. Many of the articles and people criticizing the guide assume or suggest that it was published since Cross’ pregnancy. In this way, Cross is being blamed for the apparently “Orwellian” instructions, which undoubtedly intensifies the cissexist violence being aimed at him.

According to Philip Davies, British Conservative MP, the guide is “completely ridiculous.” Laura Perrins, of The Conservative Woman, describes the recommendations as “anti-science, anti-women and anti-mother.” Similarly, Sarah Vine claims the guide is “an insult to mothers.”

These recent criticisms are deeply problematic. For example, Perrins’ claim that the guide is anti-science is not only ironic, but false. Her claim reproduces the scientifically unsubstantiated essentialist theory that bodies are innately sexed and gendered, as observable by various bodily characteristics and capabilities.

Bioethics Blogs

Part I: MY LOVE AFFAIR WITH THE BRAIN Bioethics, Neuroplasticity and Whimsy

Marian Diamond portraits, 1984, photos by Ed Kash

Dr. Marian Diamond, photo courtesy of Luna Productions

MY LOVE AFFAIR WITH THE BRAIN is an award winning documentary about the life and work of Dr. Marian Cleeves Diamond, PhD, neuroanatomist, researcher and educator. Filmmakers Catherine Ryan and Gary Weinberg (Luna Productions) make an argument which by all reasonable standards would support Diamond’s candidacy for a Nobel Prize, not only in science but also for peace.

MY LOVE AFFAIR WITH THE BRAIN shows Marian Diamond is a filmmakers dream. She is fluid and animated as anyone who routinely spends hours of her day on a stage before a judging audience of hundreds of students ought to be—but often are not. The camera loves her. With aesthetic wisdom the film not only focuses on Marian but on others sharing the territory she inhabits. It is a broad domain of geography, mind and family tradition. She is a catalyst for laughter fueled intelligence.

MY LOVE AFFAIR WITH THE BRAIN has established an iconic visual representation of Dr. Diamond’s vantage. It is the long view and the long shot. In Diamond’s mind the brain is always at the forefront, the seat of human intelligence and humanity. It is this view that Luna Production’s camera reflects in the film. We see Diamond watch the brain, from a distance but in sharp focus. Then we see the audience, and the world, watch her. The filmmakers take the opportunity to not only show us her but the joyous reactions of others ignited in the wake of her whimsy.

Bioethics News

Transsexuality diagnosis and treatment

‘The only thing that has been achieved so far is to try to adapt the body to the mind, instead of trying to alleviate the cerebral problem’

Diagnosis

The diagnosis of transsexualism is based on both medical and psychiatric findings, criteria that have been enshrined in medical guidelines, such as the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), drawn up by the American Psychiatric Association, or the tenth edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).²

However, before attempting to determine the existence of transsexuality and its possible immediate consequence, gender dysphoria, karyotyping should be performed to try to rule out a chromosome disorder, the result of an enzyme defect, that could lead to sexual ambiguity, as occurs in Turner’s or Klinefelter syndrome.³

According to the DSM-5, in order to diagnose gender dysphoria, there has to be objective incongruity between the sex assigned at birth and the one the individual desires, i.e. a marked difference between the gender that one feels and the one assigned at birth, and this disharmony must persist for at least 6 months.

In the case of children, gender dysphoria can manifest between two and four years old, when affected children can start to express preferences or social attitudes of the sex opposite to the gender to which they biologically belong, but this desire must be determined objectively.

According to World Professional Association for Transgender Health (WPATH) guidelines, the diagnosis of gender dysphoria is an essential condition in order for a person to be able to request sex reassignment surgery.

Bioethics Blogs

Debating the Replication Crisis – Why Neuroethics Needs to Pay Attention

By Ben Wills

Ben Wills studied Cognitive Science at Vassar College, where his thesis examined cognitive neuroscience research on the self. He is currently a legal assistant at a Portland, Oregon law firm, where he continues to hone his interests at the intersections of brain, law, and society.

In 2010 Dana Carney, Amy Cuddy, and Andy Yap published a study showing that assuming an expansive posture, or “power pose,” leads to increased testosterone levels, task performance, and self-confidence. The popular media and public swooned at the idea that something as simple as standing like Wonder Woman could boost performance and confidence. A 2012 TED talk that author Amy Cuddy gave on her research has become the site’s second-most watched video, with over 37 million views. Over the past year and change, however, the power pose effect has gradually fallen out of favor in experimental psychology. A 2015 meta-analysis of power pose studies by Ranehill et al. concluded that power posing affects only self-reported feelings of power, not hormone levels or performance. This past September, reflecting mounting evidence that power pose effects are overblown, co-author Dana Carney denounced the construct, stating, “I do not believe that ‘power pose’ effects are real.”

What happened?

Increasingly, as the power pose saga illustrates, famous findings and the research practices that produce them are being called into question. Researchers are discovering that many attempts to replicate results are producing much smaller effects or no effects at all when compared to the original studies. While there has been concern over this issue among scientists for some time, as the publicity surrounding the rise and fall of the power pose indicates, discussion of this “replication crisis” has unquestionably spilled over from scientists’ listservs into popular culture.

Bioethics Blogs

Politicize my Bioethics: Compensation for egg cells

by Celina Malavé

“This is my first piece in a series I’m thinking about calling “Politicize my bioethics,” a series that works to give us examples upon which it is absolutely crucial to bring in politics (or really just notice because they are already there), particularly when we are thinking critically about a bioethical issue. In a perfect world, we would be able to have every single identity represented at the table when we are thinking critically about the intersection of medicine, technology, and ethics, but since that is not the case, we must then acknowledge and be aware of the identities each of us is bringing to the table as we work to be future leaders in bioethics.” – Celina Malavé

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Egg donation is a recent development in the field of reproductive medicine in which healthy women voluntarily provide around 10-20 mature eggs, or oocytes, for research or assisted reproduction, in exchange for compensation. Prior to donating, donors undergo blood tests—which check hormone levels, blood type, and other markers—a pelvic exam, medical exam, and other evaluations to ensure mental preparedness for donation.[i]  Legal consent forms must also be signed and agreed upon by all parties involved.

To begin the donation process, the donor takes birth control to regulate her menstrual cycle. She is then given a series of powerful hormones injections for weeks prior to donation. A first round of hormones halts ovarian function while a second causes the woman to over-ovulate in order to produce multiple eggs. A final round of injections causes her to release the mature eggs before a minor, yet invasive surgery, is performed to collect the oocytes.

Bioethics Blogs

Could Zika Virus Have Lasting Impact on Male Fertility?

Caption: Immunofluorescence staining showing that the testes of Zika-free mice (left) are full of developing sperm (pink), while the testes of Zika-infected mice (right) contain very few sperm.
Credit: Prabagaran Esakky, Washington University School of Medicine, St. Louis

Recent research has shown that the mosquito-borne Zika virus has the potential to cause serious health problems, including severe birth defects and Guillain-Barre syndrome, in humans. But the damaging effects of Zika might not end there: results of a new mouse study show that the virus may also have an unexpected negative—and possibly long-lasting—impact on male fertility.

In work published in the journal Nature, an NIH-funded research team found that Zika infections can persist for many weeks in the reproductive systems of male mice [1]. As a result of this infection, levels of testosterone and other sex hormones drop, sperm counts fall, and, in some animals, the testicles shrink to 1/10th of their normal size, possibly irreversibly. All of this adds up to Zika-infected male mice that are significantly less fertile than their healthy counterparts—producing about a quarter as many viable offspring as normal when mated with female mice. While mice are certainly not humans, the results underscore the urgent need for additional research to examine the full spectrum of Zika’s health effects in men, women, and children of both sexes.

There are a few things that are already known about Zika virus and men. One is that the virus can be sexually transmitted. Another is Zika has been detected in the semen of men months after they were infected.

Bioethics News

Causes of transsexualism. Is there a transsexuality gene?

Definition of transsexuality

According to the most recent psychiatric medical criteria, transsexuality can be defined as a disorder of sexual identity causing gender dysphoria, understanding as such the possible psychological imbalance that may arise when there is antagonism between a person’s desired and perceived body image. This psychological imbalance can be permanent or may be resolved at any time of life, especially after adolescence.

According to the International Statistical Classification of Diseases and Related Health Problems (ICD)-10″, transsexualism can be defined as the “desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one’s anatomic sex, and a wish to have surgery and hormonal treatment to make one’s body as congruent as possible with one’s preferred sex”.

Sex and gender

Before proceeding any further, however, we think it necessary to introduce the precise terminology, to define the meaning of sex and gender. Sex is defined as the genetic, biological, anatomical and psychological characteristics of a person, while the term gender refers to the psychological identification that a person attributes to themselves — man or woman — and to their social assignment (1). Sexual identity refers to the sex to which a person feels sexually attracted (2).

Aetiology

Before continuing, it should be noted that, when talking about transsexualism, we are not referring to genetic sexual abnormalities, such as Turner’s or Klinefelter’s syndrome for example. (2)

When assessing the biomedical aspects of transsexuality, the first question that must be asked is whether transsexuality is genetically determined, i.e.