A press release landed in my inbox today with this headline, which raised my eyebrows (as it was obviously intended to do): "First Experiment to Attempt Prevention of Homosexuality in Womb." It starts with this quote from Alice Dreger, a Northwestern University bioethicist: "This is the first we know in the history of medicine that clinicians are actively trying to prevent homosexuality." The release was announcing the publication of a piece at the Hastings Center Bioethics Forum titled, "Preventing Homosexuality (and Uppity Women) in the Womb? -- it was written by the same authors that started quite a stir recently over one researchers use of vibrators in follow up exams with young girls to test whether their clitorises worked after he'd surgically altered them.
The gist: In an
attempt to reverse the effects of a disorder called congenital adrenal
hyperplasia (CAH), an endocrine disease that can result in ambiguous
genitalia and "increased rates of tomboyism and
lesbianism," pediatric endocrinologist Maria New has been giving dexamethasone to pregnant women to see if it will reverse the disorder (the drug isn't approved for pre-natal use, but it's used to treat the disorder itself, which results from a steroid deficiency). Time
magazine recently reported that there are questions about
whether the drug causes birth defects, whether it's being used with proper informed consent, and whether such
off-label experimental drug use should require IRB oversight (as many experts argue that it should, though it doesn't presently). Now Dreger and her colleagues are looking at another aspect of this research, namely, how the scientists involved are portraying homosexuality, what qualifies as "normal" when it comes to masculine vs.
feminine traits, and where exactly this research is going:
Most clinicians who use prenatal dexamethasone for CAH seek
prevent the development of ambiguous genitalia. But the New York-based
group of clinical researchers ... suggest that prenatal dexamethasone
can also be used in this population to prevent the "abnormality" of
homosexuality, as well as the
"abnormal" interest these girls tend to have in traditionally masculine
careers and hobbies.
I've been a wee bit busy writing and talking about another big bioethics story (i.e. the one in my book, The Immortal Life of Henrietta Lacks), so I haven't dug into this one, but my gut reaction is that the
headline of the press release strikes me as sensational and misleading: The researchers
are looking at this drug's impact on various aspects of a disorder -- they haven't engineered an experiment in which they're giving this drug to pregnant women in an attempt to prevent homosexuality. (Unfortunately, sensational headline like this lead to other freaked-out headlines like, "Awful Doc Drugs Pregnant Women to Make Their Babies More Girly.") Dreger and her colleagues are concerned that this research is headed in that direction because the scientists involved have said that their studies may apply to
homosexuality in general. Dreger is also disturbed by how this research approaches the idea of biologically "normal" female behavior:
In another paper called "What Causes Low Rates of Child-Bearing in Congenital Adrenal
Hyperplasia?" [New's colleague] 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." ... [the paper] suggests that treatments with
prenatal dexamethasone might cause these girls' behavior to be closer
to the expectation of heterosexual norms ... [another paper goes] further,
constructing low interest in babies and men - and even interest in what
they consider to be men's occupations and games - as "abnormal," and
potentially preventable with prenatal dex ...
Hot button issue? Indeed. Dreger has written a detailed post over at Psychology Today that starts with the provocative question, "What's wrong with taking a steroid, while you're pregnant, to try to
increase the odds that your female fetus will someday grow up to be a
straight woman who gives you grandchildren, and not a lesbian daughter
more interested in puppies?" And of course, there's more on this in the full Hastings Center piece, which you can read online here.
(Photo credit here)