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We’ve Proven It With Science!

It’s a delicate thing to question science these days. When you have people in federal government denying climate change because God promised no more of that after Noah, and continuing to push Creationism in schools and generally being proud of being anti-intellectual across the board, one wants to come to the defense of science, reason, and facts at every opportunity.

But sometimes science makes it difficult. Not good science itself of course, but the foibles and biases of the people who conduct it, fund it, review it, publish it, fail to retest it, and report on it in the media.

The November issue of The Atlantic has a must-read article called “Lies, Damn Lies, and Medical Science,” by David H. Freedman, that covers the work of meta-researcher Dr. John Ioannidis. His conclusions are frightening. A huge percentage of medical research, he finds, is never successfully replicated, the hallmark of scientific validity. The studies are often conducted with tiny, non-representative samples; squishy, malleable terms; and questions that are biased before the answers ever come in. Even large randomized trials are subject to such agressive statistical analysis that they are all likely to yield something. And about 10 percent of the time even when it’s done right, the associations found are flukes.

But there’s no money, glory, prestige, and very few publication prospects in repeating someone’s work to show it’s valid, or in disproving a prestigious colleague’s work, unless it’s a high-profile enough theory to generate some buzz from being overturned. And then there’s the lazy journalists who love nothing better than a story that carries a headline like “Alcohol is good for you!” and rarely question the quality of the science.

Take female “hypoactive sexual desire disorder.” It’s not hard to see why drug companies are on the hunt for what is often called “pink Viagra.” But of course, in order to really have that whorl, they need to “prove” that women aren’t wanting sex for reasons of brain chemistry. Sometimes that’s true—as a side effect of another medication, like birth control pills or antidepressants. But trying to fashion it into a stand-alone disorder is a prime example of an attempt to medicalize something that cannot be separated from its terribly complicated social and cultural context. If we can’t even teach teenage girls about their clitoris and how it works, if we can’t reduce our horrific levels of intimate partner violence, if we can’t get to equal pay and an equal child care/homemaking balance, if we can’t figure out how to expand our ideas of what it’s acceptable for women (and men) to want sexually, and from whom, then it’s pretty funny to think that women experiencing low desire must have an organic disease. (On the good side, at least we nominally see female desire as a good thing now. Now about that male birth control pill.)

But I digress. Just weeks ago, the media went crazy over a conference presentation of non-peer-reviewed research, sample size 26, divided between self-identified HSDD and “normal” sexual functioning women, that showed that women with high and low desire have different patterns of brain activity when shown porn. Low desire is in women’s brains! the papers screamed gleefully.

Not only did they not question all the details of study, they made the oldest mistake in the book: confusing correlation with causation. As many bloggers pointed out—both sex-positive ones and neurology ones—of course our brains react differently based on our experiences. A violinist and non-musician are going to show different brain patterns when listening to a symphony, too. Someone who has been in a serious car crash is going to have a different reaction to a crash scene in a movie. In other words, this study tells us nothing about what’s causing low desire for its participants. But you wouldn’t know that from how it was promoted or covered.

This came close on the heels of the FDA’s rejection of flibanserin, the failed antidepressant from Boehringer Ingelheim that they were trying to pass off as an HSDD cure—despite very weak results and miserable side effects. (I don’t know about you, but being nauseated does not put me in the mood. Neither does fainting.) But in media terms that was a long time. And it was largely thanks to some very hard work by the folks at the New View of a Woman’s Sexual Problems Campaign (there’s a mouthful) that criticisms of flibanserin made it to the public at all.

The moral? Keep that skeptic hat handy when you move from reading politics to reading health news. You’re going to continue to need it.

—Miriam Axel-Lute

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