Catholic priests: SHUT UP!

The Irish Catholic bishops have issued a statement on medical care given to Savita Halappanavar…

Wait. What the fuck does anyone care what a mob of ignorant assholes say about reasonable, ethical medical care? I can’t even imagine the degree of arrogance involved for these self-righteous, unqualified old men to be so seriously offering advice on life-or-death issues of obstetrics and gynecology — to be piously asserting their importance even now in the aftermath of a death that would have been avoidable if Catholic doctrine had not meddled.

I can give advice, too. Catholic priests, sit down and shut the fuck up. Learn some humility for once in your privileged, pompous, puffed-up lives. This is the part where you should wake up and realize you are not qualified to run hospitals.

Instead, listen to the doctors. Like Jen Gunter, who finds the bishops’ advice to be inconsistent, incoherent, and confusing. That they even felt that their recommendations would be helpful or needed is damning.

All that their statement tells me is that they haven’t learned a single goddamned thing. They still think they’re qualified to interfere in medical decisions.

Douche defends douching

There is a small group of obsessives who really hate Atheism+ — they hate it so much that they pick over every thread on the Atheism+ forum, looking for nits. And then, unfortunately, they write to me in email and twitter and tell me how stupid they are. The latest example: an atheism+ mod writes a short comment rejecting the utility of vaginal douching, complete with a link to a scientific review of the practice.

Douche is emblematic of the patriarchy. It’s a completely unnecessary product marketed to women as vaginas are icky. In many cases, it actually makes things worse. It’s basically completely awful.

So yeah, douching is in no way a natural or automatic part of life as a woman (or even as a cis woman), nor does it appear to be even remotely a good idea, so how do you figure the word is sexist?

That’s pretty much the world consensus. There are only a few benighted places on the planet, the United States among them, where people believe that flushing out the urogenital tract with scented water is beneficial.

So then I see this tweet flash by from some manic goon going by the name @NYBoxTurtle, who claims that Atheism+ mangles scientific data.

#AtheismPlus takes a stand on vaginal douching. How do they interpret scientific data? FIND OUT! http://www.reddit.com/r/AntiAtheismPlus/comments/13tszo/how_atheism_plus_mods_interpret_scientific_data … #FTBullies

11:12 PM – 26 Nov 12

Here’s what Mr @NYBoxTurtle claims is evidence of science abuse by Atheism+:

Science:

Studies around vaginal douching “conflict…and the strength of association varies enormously between studies” resulting in “less agreement…for hygiene and relief of vaginitis symptoms” with “many potentially confounding factors blur[ring] the epidemiologic assessment.” Additionally, “conflicting results are reported regarding sexually transmitted infections and douching…cross-sectional studies cannot determine reliably whether the douching preceded the disease or if the symptoms led to the douching.” And while “there are several ways by which douching may contribute to disease,”…it’s also noted that “different types of douching liquids have various antimicrobial effects” which “may be less harmful or may be beneficial.”

Atheism Plus mod:

Cites that very source and summarizes:

“It’s a completely unnecessary product…It’s basically completely awful.”

Wait. I read the article. It’s a very thorough review of the scientific literature on douching, which reports on a few studies and meta-analyses that showed a possibility of slight benefits, but also found studies that conflict, and other studies that showed marked deleterious effects, including increased incidence of cancers and ectopic pregnancies. It’s all couched in the neutral and objective language of a scientific paper, but the review is very, very clear: douching is not a good thing. Women shouldn’t do it at all, although it reserves the possibility that there are some specific, serious medical conditions that might be addressed by some douching. Mr @NYBoxTurtle was doing some serious cherry-picking to find a few phrases that could be pulled out of context and made to sound as if the paper were endorsing douching.

I read the paper. I was appalled. It was the most dishonest distortion of scientific results I’ve read since the last time I read a creationist’s claims. Mr @NYBoxTurtle was basically lying about the paper to make a petty and false case against Atheism+.

So I fired back, briefly, by quoting the conclusion of the paper:

Conclusion of the cited article: “since there are no demonstrated benefits to douching and considerable evidence of harm, women should be encouraged to not douche”. The linked summary is actually an accurate interpretation of the work. It’s unnecessary. There is no evidence of an advantage. There is evidence of harm.

Did you even bother to read it?

Seriously. Read the paper. The conclusions are completely unambiguous and strong. Here’s the introduction if you don’t believe me:

Vaginal douching is the process of intravaginal cleansing with a liquid solution. Douching is used for personal hygiene or aesthetic reasons, for preventing or treating an infection(1), to cleanse after menstruation or sex, and to prevent pregnancy (2). For at least 100 years, there have been conflicting views on the benefits or harm in douching. Although there is a broad consensus that douching should be avoided during pregnancy, there is less agreement regarding douching for hygiene and relief of vaginitis symptoms. Two earlier reviews of douching data in women (3) and adolescents (4) have concluded that douching is harmful and should be discouraged because of its association with pelvic inflammatory disease, ectopic pregnancy, and perhaps other conditions. Nonetheless, douching continues to be a common practice. We seek to review the evidence of the impact of douching on women’s health.

And here are the full conclusions.

The present review suggests that future studies must assess more directly the extent to which douching is a causal factor in diseases such as pelvic inflammatory disease and bacterial vaginosis, or if douching is merely a behavior that is more common among women who are at risk of sexually transmitted diseases and/or that douching is done in response to symptoms (15). The effects of different solutions and devices must be considered in more detail. Perhaps there are adverse effects associated with douching if only certain solutions are used but less or no harm with other solutions.

The weight of the evidence today suggests that stronger regulations for vaginal douche products may be indicated, including ingredient control, clearer labeling, and a required statement on product advertisements and on the products themselves that douche products have no proven medical value and may be harmful. A prospective cohort study or, if serious ethical concerns can be resolved, a randomized clinical trial may address these questions. A randomized “community” trial could be considered, where the communities studied are a large group of people from the same area, such as a college or a city. They could be assigned at random to treatment and no treatment, where the treatment group would receive an educational program regarding the potential dangers associated with douching and the women would be encouraged to not douche. Douching prevalence and sexually transmitted disease rates could be assessed before the educational program and at regular intervals during the program. The no treatment group, receiving no such educational intervention, would be assessed in a similar way. The study endpoint could compare rates of douching and sexually transmitted diseases. However, because motivational factors for douching are individualized and often women strongly feel the need to douche, the educational program may not influence enough women to stop douching, affecting the statistical power of such a study. Feasibility and cost may be prohibitive, in which case we may continue in our present state of knowledge/ignorance.

It is accepted that pregnant women should avoid douching. Intrapartum vaginal antiseptic lavage can be highly beneficial, but this is a completely different irrigation event than repetitive vaginal douching. There are limited data that suggest that douching in symptomatic women may have some utility. The preponderance of evidence shows an association between douching and numerous adverse outcomes. Most women douche for hygienic reasons; it can be stated with present knowledge that routine douching is not necessary to maintain vaginal hygiene; again, the preponderance of evidence suggests that douching may be harmful. The authors of the present review believe that there is no reason to recommend that any woman douche and, furthermore, that women should be discouraged from douching.

Many women douche, especially African Americans. Because the population-level health risks attributable to this common practice could be very large if douching predisposes to even a fraction of the disease burden discussed in this review, the potential salutary impact of reducing douching activity is substantial. Intervention studies may be the very best way to gain both health benefit and insight into the temporal associations of douching and adverse outcomes. We also believe that responsible government, health, and professional organizations should reexamine available data and determine if there is enough information to issue clear policy statements on douching. We believe that, when they conduct such reviews, they will conclude, with us, that since there are no demonstrated benefits to douching and considerable evidence of harm, women should be encouraged to not douche.

So this morning I discover that Mr @NYBoxTurtle has replied…by accusing me of cherry-picking.

What a lovely little cherry-pick! (And if anybody knows cherry-picking…)

Let’s look at those full conclusions, yes?

Seems to me, across the board, as I’ve indicated, the final conclusions are out and more studies need to be done in terms of ingredients, labeling, instructions, and quality, but that douching in and of itself has not proven helpful or harmful, depending on a case-by-case study. Some results are positive and some are not. Not, as the AtheismIdiot mod indicated and advised:

“It’s a completely unnecessary product…It’s basically completely awful.”

Funnily enough, the article didn’t mention “douching” in terms of “partiarchy” or “ableism” as the Atheism Plus mod was abstracting it.

So. My analysis (that results are inconclusive) is much more accurate than those of the Atheism Plus mod (that results are in and douching is bad bad bad – unless it’s a substitute for an ableist word, in which case it’s complely sanctified).

PS- Remember that time on your “Dungeon list” when you referred to the vulva as “the most odious of anatomical features”? Maybe ask whoever you’re doing to…uh…douche. I know, I know, the vulva’s external. Still. “Odious”? Time for a deep clean.

By the way, I’d like to remind you of something from our sidebar:

If you’re PRO-AtheismPlus, your comments won’t be too welcome. Go to their little circle-jerk.

Keep it in mind, drunky. And belated happy Thanksgiving. Sorry that, the next day, we all saw you tweet your way through it. It was pretty fucking sad.

The paper says “no demonstrated benefits to douching and considerable evidence of harm”. Mr @NYBoxTurtle says “results are inconclusive” is a more accurate assessment. I’ll let you read the conclusion quoted above or the whole paper if you’re more ambitious, and then you can be the judge. Looking at @NYBoxTurtle’s interpretation, it’s a lovely exercise in how not to read a scientific paper.

I am totally unsurprised and find it not ironic at all that an anti-atheism+ kook is defending douches against all the evidence. It seems somehow…appropriate.

The bottom line is this: women should not douche, unless they are treating a specific and serious ailment and have the recommendation of a doctor. It’s a peculiar practice promoted by pseudo-science and the cosmetics industry — it really is part of a culture that shames women for the reality of their private parts.

(By the way, the claim that I called the vulva “odious” is typical of this guy. I did not. I was sarcastically referring to the anti-woman attitude of raving misogynist troll who was banned for his bigotry.)

(Also, you can look up my struggle to tweet through Thanksgiving. It consists of all of five tweets, four of them automatically generated links to posts on Pharyngula. I spent most of Thanksgiving reading lab reports. @NYBoxTurtle just makes shit up.)

Amanda Marcotte weighs in. Maybe that link will attract even more douches!

A beautiful answer to a hideous problem

When he was a boy in Afghanistan, Massoud Hassani and his brother made toys that would roll across the desert landscape pushed by the wind. Too often they’d lose those toys. Not in a neighbor’s yard, or a tree too tall to climb, but because the toys would blow into land that had been filled with one of the most horrible weapons of modern warfare: land mines, which  have killed or injured over a million people worldwide since 1975.

Now Hassani is back in Afghanistan, developing a grown-up version of one of his old toys, the Mine Kafon, as a way of safely detonating landmines for about 1/100th the cost of conventional mine-clearing methods.

Thankfully, landmine use has dropped rather significantly since a treaty barring their use was enacted about 15 years ago, but they’re still used in a number of places today. (Notably and unsurprisingly, the U.S. hasn’t signed the treaty.)  They can cost as little as $1 per mine to place, and are often dropped from the air, making precise mapping hard. Conventional means for finding and disarming the mines — designed to maim rather than kill, thus tying up other soldiers’ time and energy in caring for their wounded comrade — can run up to $1,000-1,500 per mine.

Hassani says his Mine Kafon costs about $50 to build and can detonate three or four mines in a single trip. That brings the cost to underdeveloped communities of getting rid of the mines to only about 10 times what it cost the armies to put them there in the first place. It’s certainly not a complete solution, but it’s an elegant one — and well within the reach of many of the communities most-affected by land mine placement. Sometimes simpler technology really is beautiful.

More on the general topic of landmines at the Landmines and Cluster Munitions Monitor.

The Fantastic Bonus theory of female orgasm

Larry Moran put up this video of Elisabeth Lloyd discussing the problem of assuming adaptation in evolutionary studies. I think it’s excellent and makes points I wish more people would consider…but strangely, most of the comments over there are expressing extreme distaste while failing to mention any specifics about what they dislike.

Maybe some of you can watch it and explain lucidly what you object to…or what you don’t find objectionable. I get the impression that a lot of people rather rabidly turn their brains off at the merest mention of the word “spandrel”.

In case you didn’t watch it, here’s the main point.

She’s criticizing methodological adaptationists. This is a style of thinking that assumes that only adaptation and selection are important or interesting, and as a philosopher she objects to the replacement of a reasonable null hypothesis (that is, that no selective evolution is occurring for a trait) with the pretense that selections is the null hypothesis…and that if analysis of a trait reveals an absence of evidence for selection, then they will move on to consider other hypotheses.

But they don’t. As she demonstrates with the example of the evolution of the female orgasm, several prominent evolutionary biologists are so fixated on selection that they just make endless chains of adaptive hypotheses, and don’t even consider other explanations (such as drift, genetic hitchhiking, architectural constraints, or developmental mechanisms) as legitimate answers to the question of evolutionary function. It’s a new kind of teleology — they are reluctant to consider that some features of our history were completely purposeless.

It must be “Let’s all beat up Evo Psych” Day!

Earlier, when I was writing up that criticism of Rybicki and Stangroom, I read through that article on shopping and foraging and evolution that he had cited in defense of his views. There was something in it that drove me to distraction and made me want to find a match and light the whole paper on fire (a bit of indulgent exorcism of annoying work that is getting increasingly difficult to do; I was reading it on my iPad). It’s something that afflicts almost all of the evo-psych work on the evolution of sex differences, and it rankles. So let me try to purge my irritation in a way other than incinerating an expensive bit of electronics. Let me instead pretend to be an evolutionary psychologist.

First, let me stipulate that everything is a product of selection; that the only interesting features in human evolution are adaptive ones. This one really, really hurts, because I’m by no means a panadaptationist, and think a lot of features are far easier to explain as a product of pure chance rather than having to come up with an elaborate just-so story to rationalize them. But have no fear, I’ll return to a pluralist view at the end.

Second, the paper included this nice chart on the differences in roles in hunter-gatherer societies (it’s relevance to a paper on shopping preferences in 19 year old American college students is still in question).

I will stipulate that every single cell in that table is true. I’ll go further and stipulate that the correlation with the sexes is absolute and perfect: in all hunter-gatherer societies, women never hunt and use those hunting skills, and men never gather and use those gathering skills. I’m not an anthropologist, so that table could be totally crackers and there could be a thousand exceptions, but I’m not going to worry about it; we’re stacking the odds to favor the evo-psych hypotheses as much as possible right now.

Further, I will stipulate that many of those skills are biologically based and founded on genetically determined cognitive abilities, and that they have no overlap. That is, for instance, hunters need a theory of mind that is built on an elaborate cortical substrate in order to more efficiently predict the behavior of prey; this ability is not used by gatherers when they’re searching for tubers. Gatherers, on the other hand, need very precise sensitivities to color and nuances of shape to assist in pattern-matching while searching, abilities that hunters do not use.

I will also stipulate that these specific cognitive and perceptual abilities have no utility outside hunting or gathering. There are no social circumstances, for instance, in which these abilities might be an exaptation.

Finally, I stipulate that the circumstances that produce these adaptations are still relevant today, and that 95,000 years of human evolution in hunter-gatherer societies completely dominates and makes irrelevant the last 5,000 years of evolution in agricultural and urban societies; we can ignore any processes that might have undone prior adaptations.

Is that enough yet? Have I given enough of the store away? ‘Cause I’m really feeling a little psychic stress here, since giving up some of those premises makes me want to claw them back and stab them a few times, until they’re bleeding and dead. But I’m playing the game, let’s give evo-psych every possible advantage, and grant them every assumption they make as a default.

Now here’s the part that infuriates me when reading these sex difference papers. They almost always act as if they’re discussing two independent breeding populations facing different selection pressures.

But…

Every hunting man had a gatherer mother; every gathering woman had a hunting father.

Seriously, it’s this feeling that I have to remind them that they’re not dealing with two species, Man and Woman, or even two populations, the man-tribe and the woman-tribe, but one goddamned species, obligately breeding within themselves. If there is a ‘spatial navigating gene’, both men and women have it. If there is a gene that grants us the color sensitivity to distinguish puce from plum, we all carry it. With the exception of a minuscule number of genes involved in sex-specific trait determination on the Y chromosome, we’re sharing everything.

Wait, the naive among you are wondering, does that mean men are carrying genes for large breasts, wide hips, and ovaries, while women are carrying genes for baldness, baggy scrotums, and testicles? Yes, we are. All shared. But these genes are also regulated so that they are expressed or repressed differently in the different sexes. You have to think of each one as a Gene Plus: a gene plus an added switch to turn it on or off differently in different sexes (commonly, they’re regulated differently by the presence or absence of testosterone.)

In most of these reproductively relevant sex differences, it’s easy to understand what maintains the Plus; a man whose testes did not see the signal to make male-specific gonads and instead produced some very confused ovaries would be a reproductive failure. Some of the secondary characteristics are only weakly maintained — breast size, for instance, doesn’t seem to be a major factor in reproductive success, and we see a large variation in that parameter…but there are stronger pressures that have maintained lactation, and so that function is more reliable (but not invariant!)

This is the problem for the evolutionary psychology of sex differences: for each trait that you want to claim is a product of selection for a behavior that is different between sexes, you have to postulate a Plus that restricts its expression to a single sex.

You can’t simply have a just-so story that Woman evolved ability X to cope with gathering berries; you have to also have a just-so story that explains why Man evolved a repressor to shut off X for better hunting. And vice-versa for ability Y that aids in hunting.

So, sure, tell me that humans evolved cognitive mechanisms to aid in navigating by landmarks for better fruit and tuber searching, and I might well believe it to be reasonable; now tell me why you think it would only operate in women, and how it would be actively suppressed by genetic mechanisms in men. Then you can tell me why navigating by distance and direction is actively shut off in women. You’re the ones who like purely adaptive explanations: why would there be an advantage to individuals having each only half the suite of potential genetic navigation tools switched on?

And then you can go through each line in the table up above and explain how confining each of those abilities to only one sex or another led to more babies being made than if both had it, and how having that trait in an ‘inappropriate’ sex would be culled by death or reduced fertility…because you know that’s how evolution works, right?

Right about then, my inner pluralist will come roaring back to life, and I’ll have to point out that your feeble rationalizations, even if I were to accept them, can only represent tiny fitness effects, and that in small populations of humans drift is going to dominate over small fitness coefficients, and selection won’t even see your hypothetical advantages. And maybe you don’t understand how evolution works, after all.

I think a better answer is that there are evolved human traits that are shared among every individual in the population without regard to sex, and that culture acts as the repressor/enabler of particular attributes in particular individuals. That ought to be the default assumption, with exceptions requiring exceptional evidence beyond just reading the cultural codes. Change the culture, and all those fully human abilities can be expressed in everyone, not just the ones permitted by convention.

Anything else is a betrayal of our potential.

The electrochemical orange

I missed posting the Wednesday Botanical yesterday (this is happening a lot lately — seriously, people, my brain is totally fried by this semester, and it’s getting worse as I limp gasping and moaning into the final weeks), so you’ll have to belatedly make do with this:

That’s an orange lit by the dim glow produced by the electrical interactions between zinc-coated nails and citric acid. It’s really dim: it took a 14 hour exposure to get that image.