Forthcoming Fall 2021. This book is a history of the life of the idea, in the twentieth and twenty-first century biosciences, that a pregnant woman’s health, behavior, and milieu can have intergenerational effects on her descendants. Today, research on maternal effects is emerging as a robust program of study in medicine, public health, psychology, evolutionary biology, and genomics. Tracing a genealogy of ideas about heredity and maternal-fetal effects, The Maternal Imprint offers a critical analysis of conceptual and ethical issues provoked by the striking rise of epigenetics and fetal origins science in postgenomic biology.
The Harvard GenderSci Lab developed a scoring scheme and Report Card to evaluate the comprehensiveness of socially relevant, intersectional data publicly reported by each state. We scored each state on their reporting of selected socially relevant variables (age, sex/gender, race/ethnicity, and comorbidity status), and on reporting of interactions between these variables. The results document the paucity of comprehensive disaggregated COVID-19 surveillance reporting among states. Only three states received an “A”, while 30 states received a “D” grade or lower.
Although gender parity has been reached at the graduate level in the geosciences, women remain a minority in faculty positions. First authorship of peer‐reviewed scholarship is a measure of academic success and is often used to project potential in the hiring process. Given the importance of first author publications for hiring and advancement, we sought to quantify whether women are underrepresented as first authors relative to their representation in the field of geoscience. We compiled first author names across 13 leading geoscience journals from January 2013 to April 2019 (n 1⁄4 35,183). Using a database of 216,286 names from 79 countries, across 89 languages, we classified the likely gender associated with each author's given (first) name. We also estimated the gender distribution of authors who publish using only initials, which may itself be a strategy employed by some women to preempt perceived (and actual) gender bias in the publication process. Female names represent 13–30% of all first authors in our database and are substantially underrepresented relative to the proportion of women in early career positions (30–50%). The proportion of female‐name first authors varies substantially by subfield, reflecting variation in representation of women across geoscience subdisciplines. In geoscience, the quantification of this first authorship gender gap supports the hypothesis that the publication process—namely, achievement or allocation of first authorship—is biased by social factors, which may modulate career success of women in the sciences.
The increasing influence of private equity in a range of health care delivery settings such as physician staffing, nursing homes, and hospitals is not new. But our research reveals a precipitous rise of private equity activity in women’s health. The recent rise of private equity in this area marks a novel form of investor attention with unknown implications. To determine how the incentives of private equity firms interact with clinicians’ mission of caring for women, policymakers, researchers, and the general public need to stay vigilant. Deals between private equity firms and health care providers should be transparent, and ethical standards should be put in place to ensure that profits don’t get in the way of people, and that patients are able to access comprehensive, equitable, and affordable care.
We document formerly non–private equity women’s health care companies, including physician networks, practices, and fertility clinics, that gained a private equity affiliation between 2010 and 2019. This analysis shows a substantial increase in private equity affiliations in women’s health care since 2017. Private equity–affiliated OB/GYN offices are located in urban locations, with an average 2017 median household income 24% higher than the 2017 national average. How the incentives of private equity firms interact with the clinical mission of women’s health is a critical area of inquiry. Future debate about private equity in women’s health will likely be shaped by the associations between economic incentives and quality of care, elective or cosmetic procedures, and access to reproductive health services, especially among low-income, LGBTQIA, and other disadvantaged populations.
Since March 2020, our group at the Harvard GenderSci Lab has been critiquing sex essentialist explanations of COVID-19 outcome disparities. Using interdisciplinary tools from feminist philosophy, science studies, and critical public health, we work collaboratively to critically examine COVID-19 sex-difference research and to explore and elevate the role of social variables in driving biological disparities. We argue that, in public health research and messaging, data on sex disparities must be contextualized to avoid reinforcing harmful sex essentialist assumptions and to help the public understand how social factors influence these patterns. In the case of COVID-19, doing so can clarify risks and save lives. Here, we describe our methods and share some of our findings.
A few months into the first wave of the Covid-19 epidemic, men in aggregate appear to have higher fatality rates. But ascribing this outcome to biological sex-related variables, as some have rushed to do, is unlikely to lead to effective interventions. In past epidemics, what at first appeared to be a sex difference turned out to be largely a result of the difference in life experiences between women and men. Occupations, behaviors and pre-existing conditions mattered more than whether one was a woman or a man.
The sleep drug zolpidem (Ambien) is a leading example used by advocates of sex-based medicine. In this Op-Ed, Heather Shattuck-Heidorn and I argue that there is no evidence for sex differences in zolpidem dosing -- and that the paradigmatic example of zolpidem is actually a cautionary tale of the dangers of an overfocus on sex differences.
Fifteen years ago, the society that produces this journal was established to advance research on the Developmental Origins of Health and Disease (DOHaD). But, as we show here, extending our previous work, DOHaD research has been more concerned with exposures in the fetal period than in any other window of development. This interest manifests as an abundance of studies on the potential effects of the health and lifestyle of mothers around the time of pregnancy on the health of their children. We argue that this focus reflects deeply-held assumptions, among researchers, clinicians, policy makers, the media and the public, that maternal pregnancy exposures are the most important, causal determinants of offspring health. We call for the DOHaD research community to recognize and challenge these assumptions.
In this essay, we pose the biosocial turn as presenting an opportunity to creatively expand the range of empirical inquiries into gender as a biosocial variable and to newly articulate the importance of attending to gender in biological science. Feminist scientists and science theorists, we argue, would do well to engage the reservoir of innovative new biosocial research as a resource for developing methods and theories for the study of sex/gender. Similarly, we call on biosocial scientists to attend as assiduously to gender as they have to other intersecting foci of analysis, such as racial discrimination and socioeconomic disadvantage.
Decades of research across scientific disciplines have built an understanding of human sex as a multidimensional trait with biological and social components that can vary over the life course. Against this scientific consensus, the proposed HHS definition marshals bits and pieces of biology in order to exclude millions of transgender citizens — whose sexual or gender identity often does not match their natal genitals — from civil rights protections.
Research on the developmental origins of health and disease (DOHaD) has traditionally focused on how maternal exposures around the time of pregnancy might influence offspring health and risk of disease. We acknowledge that for some exposures this is likely to be correct, but argue that the focus on maternal pregnancy effects also reflects implicit and deeply-held assumptions that 1) causal early life exposures are primarily transmitted via maternal traits or exposures, 2) maternal exposures around the time of pregnancy and early infancy are particularly important, and 3) other factors, such as paternal factors and postnatal exposures in later life, have relatively little impact in comparison. These implicit assumptions about the “causal primacy” of maternal pregnancy effects set the agenda for DOHaD research and, through a looping effect, are reinforced rather than tested. We propose practical strategies to redress this imbalance through maintaining a critical perspective about these assumptions.
My answer to the question: What are the implications of epigenetic science for theories of the plasticity of human sex, gender, and sexuality?
Abstract: The new science of epigenetics has raised hopes of an embrace of greater plasticity and variation within the biology of sex, gender, and sexuality than previously appreciated. This essay describes and analyzes the integration of epigenetics research into the scientific study of core biological pathways related to sex, gender, and sexuality in the brain in the post-Human Genome Project era. Through a close reading of the primary scientific literature, it demonstrates that epigenetic approaches in this subfield remain continuous with historically well-entrenched models of hardwired brain sexual dimorphism. Considering the opportunities and dilemmas of feminist engagements with the fast-moving and still nascent field of epigenetics, it argues that while epigenetics might become a resource for studies of the development and plasticity of gender-sexed bodies and identities, this will require active feminist contestations of the ontological and epistemological commitments of mainstream research in this field. Feminist attraction to the possibilities for epigenetic research to enable material investigation of gender embodiment and sexual variation follow a long tradition of feminist theoretical interest in plasticity-affirming biologies. Careful consideration of the case of epigenetics suggests a need for revised and more nuanced feminist appraisals of both plasticity-affirming and programming-centric models of biology, body, and sociality.
Many brain and behavioral disorders differentially affect men and women. The new National Institutes of Health requirement to include both male and female animals in preclinical studies aims to address such health disparities, but we argue that the mandate is not the best solution to this problem. Sex differences are highly species-specific, tied to the mating system and social ecology of a given species or even strain of animal. In many cases, animals poorly replicate male-female differences in brain-related human diseases. Sex/gender disparities in human health have a strong sociocultural component that is intimately entangled with biological sex and challenging to model in animals. We support research that investigates sex-related variables in hypothesis-driven studies of animal brains and behavior. However, institutional policies that require sex analysis and give it special salience over other sources of biological variance can distort research. We caution that the costly imposition of sex analysis on nearly all animal research entrenches the presumption that human brain and behavioral differences are largely biological in origin and overlooks the potentially more powerful social, psychological, and cultural contributors to male-female neurobehavioral health gaps.
Women are constantly bombarded with advice about what to eat and drink and how to behave during pregnancy. Rather than add to this growing roster with yet another simplistic injunction, the CDC should do everything it can to provide women with credible information about how to weigh reproductive risks.
Will requiring study of sex in basic laboratory research produce meaningful and relevant science for remedying health disparities between men and women? Our Harvard-based working group of feminist scientists and science studies scholars spent a year reading and discussing the primary documentation supporting the new policy. In a recent article in Proceedings of the National Academies of Sciences, we argue that as an approach to addressing health disparities between men and women in adverse drug events, the policy is misguided.