Are the Sexes Interchangeable?

To get a little ahead of ourselves, the moral of this story is: ignore reality at your peril. Among other things, if you ignore the biological differences between the sexes you will be endangering women’s health.

Neuroscientist Larry Cahill of UC, Irvine has been researching the question. He was interviewed by the OC Register (h/t LT).

Here is what happens when medical science fails, as Cahill puts it, “to take gender-based brain differences seriously:”

The differences exist at virtually all levels, he says, from those of tiny cells to large structures in the brain, from brain chemistry to what he calls intriguing differences in the way men and women remember emotionally searing events.

And a failure to see the differences can have medical consequences. Men and women react to pain medications differently. They show differences in symptoms of schizophrenia. Chronic stress can damage men's brains but, on average, has far less severe effects on women.

Hormonal differences can affect memory; one of Cahill's students made waves in 2011 when she discovered that taking the pill can cause women's memories of emotional material to more closely resemble those of men.

Virtually any brain disease, Cahill says, comes along with male-female differences big enough to call for major differences in medical treatment.

When physicians ignore the biological differences between men and women they fail to diagnose heart disease in women.

Cahill explains:

 First of all, it turns out the No. 1 killer of women – which might surprise you – is heart attacks. More women die of heart problems than of all cancers combined.

Interestingly, women are much more likely to present the doctor with what are called atypical heart-attack symptoms. It isn't pain in the chest or down the left arm. They might be tired.

But you know why they are considered atypical heart-attack symptoms? Because they're not men. What is defined as typical heart-attack symptoms is defined on the basis of men. They're not atypical heart-attack symptoms if you're a woman. The typical woman is much more likely to go to the typical doctor and not be diagnosed properly.

Whatever you think of the politics of equality, when it comes to biology men and women are not the same:

To equally treat men and women for heart care, pain, depression, schizophrenia, you have to understand not just how they are similar, but how they are different. So if you treat women just like men, someone is not being treated equally.

We cannot optimally treat women by continuing to pretend they are simply men with pesky sex hormones. It is very, very clear that the brain mechanisms of pain perception are similar in some respects and different in other respects in men and women. Yet attempts to develop pain medications, to my knowledge, pay almost no attention to the differences. Therefore it must be the case that pain medications being developed largely on the basis of male animals are going to be suboptimal on females. 

Cahill’s more salient and controversial views show how men and women differ when it comes to cognitive abilities and problem solving. The differences show up on both male rats and male humans… which would confirm the view of many women that men are all overgrown rats anyway.

Cahill explains:

It is the case that male humans and male rats seem to navigate through space differently than female humans and female rats. It turns out that male rats and male humans are more likely to navigate by dead reckoning – knowing which way is north, east, south and west. Female humans are more likely to navigate through landmarks – go up to this 7-11, turn left. There's an intriguing difference right there.

It inevitably leads to the joke: Will male rats stop and ask for directions? The answer is no, because they're males.

If men and women process data differently, if they remember trauma differently, if they orient themselves in the world differently… then it does make a difference whether you choose a man or a woman to do a specific job.

Apparently, the sexes are not interchangeable. Each sex has strengths and weaknesses.

Who knew?