The Dark Side of Mad Science

I’ll admit that I have a tendency to enjoy the benign side of mad science, the eccentric genius, the isolated pioneer, the visionary inventor, but sometimes one has to look at the dark side of to appreciate the dangers. When science is misused for dubious purposes, like eugenicists expropriating Darwin’s theory, or when it is explored in the absence of ethical considerations, as in the Tuskegee experiments, or when science becomes a tool of political manipulations, ala Lysenko, then true madness can result.

 I was reminded of these dangers this week, when I read about research involving experimental steroids being administered to pregnant women as a means of preventing lesbianism and other “masculine” behavior in their daughters The steroid in question, dexamethasone, has a number of therapeutic uses, but in addition, several researchers are using it off label to treat a condition known as congenital adrenal hyperplasia (CAH). This is an inherited disorder affecting the adrenal gland. It’s a serious condition causing a number of symptoms, one of which is that female fetuses affected by the condition can be exposed to excessive levels of male hormones. Although their internal reproductive organs perform normally, these girls often develop genetalia that superficially appear masculine.

 This type of ambiguous genital development prompted the use of dexamethasone, or dex as it is more commonly called, to be used experimentally to alleviate these symptoms. Note that it does nothing to treat the underlying condition, but has been shown to reduce these particular symptoms. This raises a number of concerns. First of all, any use of drugs during pregnancy should be undertaken only with extreme caution. The only published study on the in utero use of this drug to treat CAH was inconclusive and conducted on a very small sample of patients Currently, there is no systematic, long-term follow-up study being conducted on the effects of the drug on either the mothers or their daughters. This prompted the Journal of Clinical Endocrinology & Metabolism to publish an expert consensus calling for any prenatal use of dextmethasone to occur only via approved clinical trials and be conducted only in research centers large enough to gather meaningful data

 As alarming as this experimental use of steroids on pregnant women is, Dr. Maria New, a pediatric endocrinologist at Mount Sinai Hospital in New York and her long-time collaborator, psychologist Heino F. L. Meyer-Bahlburg, of Columbia University, made the situation infinitely worse when they suggested that dex might be useful in preventing masculine behavior in affected girls. In a paper titled: “What Causes Low Rates of Child-Bearing in Congenital Adrenal Hyperplasia?” Meyer-Bahlburg writes that

“CAH women as a group have a lower interest than controls in getting married and performing the traditional child-care/housewife role. As children, they show an unusually low interest in engaging in maternal play with baby dolls, and their interest in caring for infants, the frequency of daydreams or fantasies of pregnancy and motherhood, or the expressed wish of experiencing pregnancy and having children of their own appear to be relatively low in all age groups.”

In another paper, they suggest that there may be a link between prenatal exposure to male hormones common in CAH girls and sexual orientation. They write, “Most women were heterosexual, but the rates of bisexual and homosexual orientation were increased above controls . . . and correlated with the degree of prenatal androgenization.” They go on, “That this may apply also to sexual orientation in at least a subgroup of women is suggested by the fact that earlier research has repeatedly shown that about one-third of homosexual women have (modestly) increased levels of androgens [male hormones].”

 Think about that for a moment. Using steroids on pregnant women in order to make their daughters better conform to “the traditional child-care/housewife role,” and treating homosexuality as a symptom to be treated. What other types of non-traditional behavior might be worthy of treatment, men who like to cook, women who like sports, people who are atheist, or wear bow ties, or vote for the Green or Libertarian Parties?

New and Meyer-Bahlburg also might be interested to know that the American Psychological Association stopped classifying homosexuality as a disorder in 1973. It is not a symptom or a disease that needs to be treated. As Alice Dreger, Ellen K. Feder, Anne Tamar-Mattis pointed out in the Bioethics Forum,Needless to say, we do not think it reasonable or just to use medicine to try to prevent homosexual and bisexual orientations. Nor do we think it reasonable to use medicine to prevent uppity women, like the sort who might raise just these kinds of alarms.”


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