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Newborn
Identification: A National Patient Safety
Initiative A recent TSG article by Dr.
Tom Syzek entitled “Medical
Errors, Communication, Teamwork and End of Life:
Lessons from Angola”
speaks to the importance of correct patient
identification and the safety implications
surrounding it. This article dovetails nicely with
the new 2019
Joint Commission National Patient Safety
Goal (NPSG) regarding
newborn identification, so I thought this would be
the perfect opportunity to keep the conversation
relevant and on-topic by addressing this new
NPSG. Hospitalized newborns are a
vulnerable population at considerable risk for
misidentification. Several unique features of the
newborn population lead to
misidentification: Furthermore, well-known
misidentification errors such as wrong
patient/wrong procedure have resulted in many
errors, including: All these errors have the
potential to cause patient harm and parental
distress. A reliable identification system is
necessary to prevent these types of serious errors
and prevent harm to the newborn; hence, the birth
of this safety initiative. The need for updated and
improved newborn identifiers was recognized by the
AAP and other leaders in the field of safety. Gray
et al. found that similar medical record numbers
followed by similar or identical surnames made up
the bulk of misidentification errors. Heightened
awareness to this issue provided the impetus for
much needed scrutiny of current practices. After
research of the literature, public review, and
engaging discussion the safety leaders developed
the National Patient Safety Goal
(NPSG.01.01.01). Effective January 1,
2019, all hospitals caring for newborns will be
required to use at least two patient
identifiers when providing care, treatment and
services to newborn infants. Examples of methods to
prevent misidentification as cited by the NPSG may
include the following: Safe Practices for Infant
Identification Vigilance for accurate
patient identification is a quality and safety
issue that should be embedded into our daily
hospital routines. The busyness of hospital
routines such as infant feedings, circumcision,
cardiac screens, hearing screens, bilirubin
assessment and lab draws should not undermine the
importance of correct patient identification.
Everyone working with newborns is responsible to
ensure that misidentification does not happen and
that safety is always maintained. Resources Source:
blog.thesullivangroup.com/newborn-identification-a-national-patient-safety-initiative American
Medical Association Recommends Removing Sex From
Birth Certificates - 8/5/21 In an incredibly significant
— and long overdue — move, the American
Medical Association (AMA) has recommended that the
“sex” designation be removed from the
public facing portion of babies’ birth
certificates, reserving that information for
medical professionals. The recommendation comes
because “assigning sex using a binary variable
and placing it on the public portion of the birth
certificate perpetuates a view that it is
immutable,” the AMA’s LGBTQ+ advisory
committee stated in a June
report. Further, the
committee says that designating babies as either
“male” or “female” at birth
“fails to recognize the medical spectrum of
gender identity.” The current requirement to
list a baby’s binary sex or gender category in
publicly available documentation can lead to many
challenges, disproportionately impacting trans,
non-binary, and intersex people. For instance,
people whose gender identity or presentation
doesn’t match the sex on their birth
certificate can experience discrimination or
harrassment when registering for school, getting
married, or adopting a child. "We unfortunately still live
in a world where it is unsafe in many cases for
one's gender to vary from the sex assigned at
birth," Jeremy Toler, MD, a delegate from GLMA:
Health Professionals Advancing LGBTQ Equality, told
WebMD. The AMA also points out that
birth certificates have historically “been
used to discriminate, promote racial hierarchies,
and prohibit miscegenation.” “For that
reason, the race of an individual’s parents is
no longer listed on the public portion of birth
certificates,” the report continues.
“However, sex designation is still included on
the public portion of the birth certificate,
despite the potential for
discrimination.” Blank birth certificate has
been stamped with baby's footprints. It sits on a
table with a pen, ready to be filled in. Trans People Will Finally Be
Able to Get a Corrected Birth Certificate in
Ohio The new policy will be rolled
out on June 1. Large numbers of trans people
still don’t have documentation that reflects
their lived gender. According to a study from
earlier this year, an estimated 34%
of trans Americans don’t have
identification that
aligns with their gender identity. Currently,
14
states offer a third gender option for birth
certificates, but
wiping out the public-facing sex designation could
competely allow for uniform policies across all
states. Even though it’s proven
that sex is not binary — just look at the
existence of intersex people, as well as the lived
experiences of trans and nonbinary people —
right-wing media coverage has gone into full
panic-mode about this recommendation. Though the
report has not gotten much mainstream media
coverage, conservative outlets have been all over
it, including The Federalist, Fox News, and The
National Review. It marks a continuation of the
ongoing right-wing
fear mongering campaign
against trans rights and inclusion. The AMA’s report notes
that making this change “will not address all
aspects of the inequities transgender and intersex
people face, but such an effort would represent a
valuable first step.” No word on whether it
will stop cis people from continuing to
stage
gender reveals,
though. Get the best of what’s
queer. Sign up for them.'s weekly newsletter
here. Hospital
removes gender identification from bracelets -
11/14/18 The Bulletin newspaper in
Bend reports the St. Charles Health System adopted
the change last month. The ID bracelet is designed
to provide caregivers an easy way to identify
patients based on two distinct
identifiers. “It was something that
everybody felt had to be on there because it was
always on there,” said Rebecca Scrafford, a
psychologist at St. Charles who was involved in
recommending the change. “It’s providing
no benefit, but it’s causing
harm.” The ID bracelet is designed
to provide caregivers an easy way to identify
patients based on two distinct identifiers. But
staff generally check the patient’s name and
date of birth, not gender. Until recently, the
hospital’s record system did not distinguish
between sex assigned at birth, legal gender and
gender identity. The ID bracelet had been showing
the patient’s legal name and sex assigned at
birth. “For a lot of those
patients, that didn’t match, and that was
distressing for our patients,” Scrafford said.
“This is one little baby step in providing
affirming care that is probably the first visible
sign of many efforts that are underway at St.
Charles and communitywide.” Last year the hospital held a
transgender health care training event for
providers, and this year convened an internal
sexual orientation and gender identity work group
to guide initiatives around welcoming transgender
patients. Meanwhile, the new Central Oregon
Transgender Healthcare Coalition held its first
meeting last month, establishing a goal of
expanding capacity for transgender health in the
community. The hospital has now trained
its staff about when and how to ask about gender
identity, and how to record that information in the
patient’s record. “You can have the nicest
provider in the world, but if the person at the
front desk says the wrong name and gender,
it’s not going to be the greatest
experience,” Scrafford said. Surveys show many transgender
people have had negative experiences interacting
with the health care system and nearly half say
they avoid medical care because of it. “Patients will access
care first and foremost if they feel safe accessing
care,” said Dr. Christina Milano, a professor
of family medicine at Oregon Health & Science
University in Portland, and an expert in
transgender health issues. “Unfortunately,
transgender and gender diverse individuals have a
long history experiencing things like
discrimination or inappropriate questions and
comments regarding their gender when accessing
health care.” Limitations in electronic
health records, she says, often mean printed labels
or ID bracelets don’t align with a
patient’s gender identity. “A wristband that a
patient is wearing in a hospital during a critical
time, a scary hospital admission, that’s
something that they’re staring at 24/7 during
their waking hours,” Milano said. “So
having that being gender affirming by either having
the correct gender or having no gender marker
— so avoiding the risk of the wrong gender
marker — is a big positive.” But the limitations of the
record system often mean transgender patients must
sacrifice their privacy to get things
corrected. “I’ve had to
publicly out myself many times,” said Rob
Landis, a transgender man from Prineville and a
board member of the Human Dignity Coalition.
“If I was any other transgender person, I
could have gotten very offended and hurt by
that.” Landis recounted a visit to
one clinic where the woman checking him in for his
appointment burst out laughing when she pulled up
his records. “That’s so weird.
There’s an F here on the screen where there
should be an M,” he recalls her saying.
“Yeah, it’s not really funny because
I’m transgender.” Another time he had to
explain why he was coming for an appointment with a
gynecologist. “I had to out myself
again, to say I had some female parts that needed
to be removed,” he said. Still Landis says he has seen
tremendous change in Central Oregon. When he
started his transition six year ago, he had to
research which providers locally were familiar with
transgender health issues and if offices would
treat him with respect. “I thought Central
Oregon was like its own little island that has been
kept from the real world,” Landis said.
“But doing some research, there are a lot of
providers out there locally. I don’t have to
go to Portland.” The Human Dignity Coalition
has served as a clearinghouse for transgender
individuals seeking health providers, sharing
word-of-mouth reviews of which doctors were
knowledgeable and accommodating. It also holds
training sessions for providers and staff on
transgender issues. Coalition president Jamie
Bowman has two transgender daughters and tries to
pre-empt problems by informing the front desk when
she checks in that her child’s legal name
isn’t the name she now uses. “I just hope that the
waiting room full of parents and other children
didn’t hear, and then hope and cross my
fingers that when the nurse comes to the door to
call my child, she would call the right name,”
Bowman said. “And just last week, they
didn’t.” Two years ago, her daughter
received an ID bracelet with the wrong gender at
the emergency room at St. Charles
Redmond. “I just looked at it and
sighed. And then the admit person came back with a
different bracelet, took the M off, and put an F on
instead,” she said. “Even that little
bitty thing, it just made all the difference to my
child.” There are an estimated 1.4
million transgender people in the United States,
representing about 0.6 percent of the population,
although those numbers may represent an
undercount. Remove
Sex From Public Birth Certificates, AMA Says -
6/10/21 Requiring it can lead to
discrimination and unnecessary burden on
individuals whose current gender identity does not
align with their designation at birth, namely when
they register for school or sports, adopt, get
married, or request personal records. A person's sex designation at
birth would still be submitted to the U.S. Standard
Certificate of Live Birth for medical, public
health, and statistical use only, report authors
note. Willie Underwood III, MD,
author of Board Report 15, explained that a
standard certificate of live birth is critical for
uniformly collecting and processing data, but the
government issues birth certificates to
individuals. Ten States Allow
Gender-Neutral Designation According to the report, 48
states (Tennessee and Ohio are the exceptions) and
the District of Columbia allow people to amend
their sex designation on their birth certificate to
reflect their gender identities, but only 10 states
allow for a gender-neutral designation, usually
"X," on birth certificates. The State Department
does not currently offer an option for a
gender-neutral designation on U.S.
passports. "Assigning sex using binary
variables in the public portion of the birth
certificate fails to recognize the medical spectrum
of gender identity," Underwood said, and can be
used to discriminate. Jeremy Toler, MD, a delegate
from GLMA: Health Professionals Advancing LGBTQ
Equality said transgender, gender nonbinary, and
individuals with differences in sex development can
be placed at a disadvantage by the sex label on the
birth certificate. "We unfortunately still live
in a world where it is unsafe in many cases for
one's gender to vary from the sex assigned at
birth," Toler said. Not having this data on the
widely used form will reduce unnecessary reliance
on sex as a stand-in for gender, he said, and would
"serve as an equalizer" since policies differ by
state. Robert Jackson, MD, an
alternate delegate from the American Academy of
Cosmetic Surgery, spoke against the
measure. "We as physicians need to
report things accurately," Jackson said. "All
through medical school, residency, and specialty
training we were supposed to delegate all of the
physical findings of the patient we're taking care
of. I think when the child is born, they do have
physical characteristics either male or female and
I think that probably should be on the public
record. That's just my personal
opinion." Sarah Mae Smith, MD, delegate
from California, speaking on behalf of the Women
Physicians Section, said removing the sex
designation is important for moving toward gender
equity. "We need to recognize gender
is not a binary but a spectrum," she said.
"Obligating our patients to jump through numerous
administrative hoops to identify as who they are
based on a sex assigned at birth primarily on
genitalia is not only unnecessary but actively
deleterious to their health." Race Was Once Public on
Birth Certificates She noted that the report
mentions the race of a person’s parents used
to be included on the public portion of the birth
certificate and that information was recognized to
sometimes lead to discrimination. "Thankfully, a change was
made to obviate at least that avenue for
discriminatory practices," she said. "Now,
likewise, the information on sex assigned at birth
is being used to undermine the rights of our
transgender, intersex, and nonbinary
patients." Arlene Seid, MD, ,an
alternate delegate from the American Association of
Public Health Physicians, said the resolution
protects the data "without the discrimination
associated with the individual data." Sex no longer has a role to
play in the jobs people do, she noted, and the
designation shouldn't have to be evaluated for
something like a job interview, she
said. "Our society doesn't need it
on an individual basis for most of what occurs in
public life," Seid said. How
Hospitals Respond When It’s Uncertain If the
Newborn Is a Boy or a Girl Mike and Julie were eagerly
counting down the days until they’d get to
meet their baby girl, Emma. But hours after her
birth, their joy turned to worry. Doctors had made
a discovery that shocked them: Their newborn
daughter had what appeared to be testes. The next 24 hours were a blur
as Emma underwent several tests, and her parents
were told that for unexplained reasons, she was
born with XY chromosomes. “They told us ‘you
don’t need to raise your baby as male or
female. You can be gender neutral for the first
year,’” Julie remembers. “It blew
our mind. Maybe in a perfect world we could, but
this isn’t a perfect world and society
doesn’t allow you to raise a nongender child.
How could we ever choose a gender for our child? My
heart was just broken for her imagining how hard
her life would be.” “At the time, we were
just so uneducated about this topic. We felt
extremely alone and isolated.” About 1 in 1,500 babies are
born with a disorder,
or difference, of sex development
(referred to by some
outside the medical community as intersex), in
which development of the sex chromosomes, gonads or
sex anatomy is atypical. While families are then often
faced with the difficult and controversial decision
of whether they should surgically reinforce a
child’s gender, few hospitals are equipped
with specialist teams highly qualified to treat
these conditions. In fact, there’s
significant difference in how institutions across
the country respond to such cases — having a
major impact on a family’s experience and
decisions about sometimes irreversible procedures,
according to a new study led by members of the DSD
team at University of Michigan C.S.
Mott Children’s Hospital. “A family’s
experience and potential care for these conditions
may be drastically different depending on where
their child is born,” says senior author
David
Sandberg, Ph.D., a
pediatric psychologist at Mott. “We found
substantial variability across health care
institutions in the ways that they organized and
delivered care for these patients and families as
well as how families were counseled prior to
genital or reproductive anatomy
surgery.” The study included 22 sites
that offer DSD services and is the first to examine
clinical practices for these conditions at U.S.
medical centers. The findings were published in the
American
Journal of Medical Genetics,
along with a second U-M-led study addressing the
importance of psychosocial screenings in DSD
care. “Our findings suggest
the field has significant room to improve
guidelines for diagnosing and treating disorders of
sex development,” Sandberg says. “We need
stronger collaboration among providers to determine
the most effective practices to guide families as
they make major decisions about their child’s
well-being and future.” ‘Pioneering the
way’ The first few days after
Emma’s birth at a Grand Rapids-area hospital
were brutal for Mike and Julie as they tried to
educate themselves on Emma’s condition and
determine the best next steps. “People were just
flooding our room and we were putting on smiles
when inside we were broken. We didn’t know who
to tell,” Julie says. “We spent the first
10 months living a double life, having test after
test done and still not knowing exactly what she
had or what to do. “We had one
endocrinologist actually tell us that we would know
what gender to pick by age 2 or 3 depending on if
our child played with Barbies or cars and
dinosaurs. That made us lose faith in the
system.” A year later, through their
own research and a DSD support group, the couple
connected with other experts and found their way to
Mott, where their experience immediately changed.
There, they found an interdisciplinary team of
endocrinologists, geneticists, urologists,
surgeons, gynecologists, social workers,
psychologists and others who worked as a team to
customize care for each family. Through further testing, the
couple learned they each had rare genetic traits
that increased the chance their children would be
born with the specific DSD condition Emma had. And
a few years later, her little sister was born with
the same one. This time, they were more prepared
and supported by their health care team and other
families they had connected with who had similar
journeys. “We felt more informed
and had doctors who understood us and were on our
team. We needed that big-time,” Julie says.
“We felt so fortunate to have found them; it
solidified that this was what it was supposed to be
like. This team is pioneering the way it should be
handled everywhere. Nobody should have to
experience what we did the first
time.” “We want to protect our
children’s privacy but also want to share our
story in order to raise awareness about DSD,”
she adds. “There can be so much stigma and
shame attached but mostly because people
aren’t educated about DSD, just like we
weren’t until it affected us.” Optimizing care in the
future While most sites in the U-M
study reported some degree of involvement of
pediatric urology, surgery and endocrinology in the
care of DSD patients, gynecology and neonatology
were most frequently not represented. Sites were surveyed on
multiple areas of practice, including the consent
process for helping families understand potential
risks of treatment, the possibility a child later
identifies with a different gender, surgical
complications, possible effects on sexual function
and fertility,hormonal consequences of removing the
gonads (accompanied by the need for lifelong
hormone replacement) or psychological
impacts. Sandberg says the survey
suggests that sites would benefit from a network
that facilitates the sharing of resources and
strategies to improve care and patient outcomes. He
notes that clinician perceptions of service may
also differ from the experience of
patients. “All institutions share
the goal of optimizing care of patients with DSD,
but delivering patient- and family-centered care
for these conditions is often complex and
challenging, requiring the input of multiple
providers and families,” Sandberg
says. “Many factors likely
play a role in why there is so much variability in
practices, but we need to better understand the
reasons so we can establish which practices and
model of care are associated with the best patient
outcomes. We need to work together as providers to
identify opportunities for change that enhance
health and quality of life outcomes for patients
and families affected by DSD.” Disorders/Differences
of Sex Development The DSD Clinic at C.S. Mott
Children’s Hospital is an interdisciplinary
clinic designed to: The birth of a baby with any
physical difference is stressful. A DSD may be
additionally overwhelming because of the rareness
of these conditions and the possible initial
uncertainty about gender, as well as how to explain
this to family and friends. Often these are
conditions that parents have never read about or
encountered before. At conception, “we all
start out the same.” DSD are differences in
the typical path of sex development between
conception and birth. These different paths may be
influenced by the arrangement of sex chromosomes,
the functioning of our gonads (i.e. testes,
ovaries), and our bodies’ response to
hormones. DSD can occur in both boys and
girls. Since DSD are already present
at birth, they are usually detected in infancy or
early childhood. However, some DSD are not apparent
until later in life. For example, the first sign of
a DSD might be that a child’s body does not
show signs of puberty at the expected
age. Members of
the
University of Michigan DSD
team at C.S. Mott Children’s Hospital
understand that each child with a DSD is unique,
and that each family has different concerns and
needs. Our team of providers specializes in
diagnosing DSD and providing clinical care for
infants, adolescents and young adults and provides
seamless transition to adult
specialists. Our mission is to partner
with our patients and their families to provide
comprehensive, coordinated care that meets
long-term physical, social and emotional needs. Parent-infant
communication differs by gender shortly after birth
- Reuters Health - 11/4/14 Researchers also found that
mothers may be more likely to vocalize back and
forth with female babies compared to male
babies. “We know that talking
and playing with an infant improves cognitive and
language skills,” said senior author Dr. Betty
R. Vohr of the pediatrics department at Women &
Infants Hospital in Providence, Rhode
Island. “Early conversations
start in infancy and infants appear primed to
communicate shortly after birth,” Vohr told
Reuters Health by email. “Both mothers and
fathers can play an important role in their
infant’s developmental
progress.” The study included 33 infants
born to two-parent households. The babies wore
speech-activated recording devices in customized
vests for 10 to 16 hours in the hospital at birth,
again at about one month old, and again at seven
months old. Researchers analyzed the
recordings for adult word count, infant
vocalizations and conversational exchanges.
“The findings of female and male adult speech
reflecting the actual mothers’ and
fathers’ speech was based on logs the families
kept for each recording,” Vohr and colleagues
reported in Pediatrics. Even though very young babies
do not yet speak, they do vocalize and can have
reciprocal “conversations,” Anne
Fausto-Sterling said. Fausto-Sterling, the Nancy
Duke Lewis Professor of Biology and Gender Studies
in the Department of Molecular and Cell Biology and
Biochemistry at Brown University, was not part of
the new study. The researchers found that
infants were exposed to more speech from females
than males at each time point. Female adults also
responded more frequently to infant vocalizations
than male adults. “It’s not very
surprising because mothers are more involved in
childcare,” Fausto-Sterling told Reuters
Health by phone. “Infants hear women talk more
than they hear men talk and learn to identify
female voices first.” To newborns, adult females
spoke an average of 1,263 words per hour on the
recordings, compared to 462 words per hour for male
adults. Mothers responded more to
baby girl vocalizations at birth and at one month
old, the researchers found. “This was an unexpected
finding and deserves replication,” Vohr said.
“We know that it is important for both parents
to talk, play and be engaged with their
infant.” “At the moment all we
can say is that adult talk appears important for
encouragement of infant vocalizations and
conversation turns in early infancy,” she
said. A previous study by Vohr and
colleagues of preterm infants using the same
recording software showed that the more parents
talked and had conversation turns with their infant
in the neonatal intensive care unit, the higher the
child’s cognitive and language skills at 18
months of age, she noted. “At least within the
standard psychological literature there has been a
longstanding view that girls develop language
skills more quickly than boys,”
Fausto-Sterling said. Some researchers believe the
difference in language development is innate, but
this study suggests that adults may treat infant
girls differently than infant boys at a very young
age, which may help explain the difference, she
said. “Not very many people
have looked at children this young, preverbal kids,
whether the input they’re receiving has a
gender imbalance,” she said. To confirm that reciprocal
vocalizations with adults in infancy are linked to
langue aptitude later on, a new study would need to
follow children from birth through when they are
old enough to talk, she said. In the meantime,
“it’s certainly not gong to hurt anything
to tell dads to talk more to their kids,”
Fausto-Sterling said. “Both parents and in
fact all caregivers need to be told about the
importance of talking, singing and playing with
their infant or child,” Vohr said. Do
we teach boys and girls differently? It can be uncomfortable to
talk about boy/girl differences, especially in
schools, because of the fear of being unfair or
stereotyping. The classroom is a highly influential
place for a young child, it being where they spend
the majority of their time, and so the language
they are exposed to in there is a vital part of
their learning. In order to create environments
that nourish all children and guide them to
success, it is important to open up the
conversation and explore whether there is a
problem. So, do teachers teach boys
and girls differently? If yes, how does this
influence achievement levels? Is there a gender problem
in class rooms? Research
suggests that,
subconsciously, teachers may be more likely to
associate boys with underachievement and girls with
high achievement. This can create misconceptions
about the expected behaviours and characteristics
of the respective groups, which may lead to these
students being treated differently. Here are a few ways in which
teaching may differ: The Language
Used Using gender stereotypes such
as “boys don’t like writing” and
“girls settle down and get on with it”
may not relay a positive message to students. This
could lead to a tendency where boys are seen in
terms of things they cannot, will not and do not
do, whereas girls are seen in terms of the things
they have achieved and their compliant
behaviour. Being aware of our own gender
biases will allow educators to take a step back and
look at the bigger picture. Saying something like
“girls are better writers” – a
comment made by more than 8 teachers in a
survey
carried out at the English Department in a high
school – can
have more of an impact on students than it may
seem. Girls who are underachieving
may feel extra pressure to do well, and high
achieving boys may feel that their efforts have
gone to waste. Teachers are in a unique and
privileged position to vocally challenge common
stereotypes and show their students that they can
be successful in every subject, regardless of their
gender. Compliments in the
Classroom Research on observations
in the classroom have
shown that teachers in that study gave 54 positive
comments towards girls, and only 32 towards boys.
Over the course of 36 classes, the girls received
22 negative comments with their male counterparts
receiving 54. These figures are an
indication of the type of support and responses
students receive from their teachers on a day to
day basis. Girls are praised much more often for
their good work and behaviour, contributing to the
continuation of it. If boys do not receive this
same feedback, it is fair to expect them to be less
likely to exhibit these behaviours. A fascinating
report by the Department of Education, in 2009,
suggested that positive interaction with the
teacher in whole-class sessions kept students,
especially boys, motivated and involved. That is
one of many examples of the importance
of good teacher-students
relationships. Asking questions in
class The under-achieving girl is
the least likely to be invited to answer a question
in class, and the under-achieving boy is the most
likely to be called on to respond. This creates a
hurdle in the path to improvement for girls as they
may well be overlooked in the classroom. Due to the perceived norm of
boys underachieving, the majority of the focus
tends to stay on them. There is almost a whole
branch of research dedicated to supporting boys in
schools, whilst underachieving girls are often
invisible. Not getting the same opportunities for
improvement can have long-lasting detrimental
effects. In order to combat these
effects and get students more involved, teachers
could divide the questions up equally or introduce
a traffic light system which has shown to enhance
learning. It is a simple and effective technique
that gets students to use the colours of the
traffic
light to indicate
their level of understanding. For more tips, check
out our blog on how
to help students raise their
game. Pull, Don't
Push Achievement levels are a good
predictor of behaviour and interaction in the
classroom, even more significant than gender.
High-achieving students are often focused and
disciplined, and underachieving students can fall
into one of two groups: they are either quiet and
disengaged, or loud and
attention-seeking. This sometimes-disruptive
behaviour can have negative effects on the other
students and may hinder their learning. But
remember: pull, don’t push. This means
creating an environment that fosters motivation and
entices students so that they feel a pull towards a
goal, instead of using the pressure of looming
deadlines and fear of failure to push them into
something. If teachers aim to get students engaged
and interested, they will be better in the
classroom in every possible way, from completing
tasks to interacting with their peers. Final
Thoughts In order to boost achievement
levels and sustain those already outstanding ones,
it is important to create equal opportunities that
allow all students, regardless of their gender, to
succeed and feel supported. It is the subconscious
biases that are often the hardest to break, but
they are also the ones that can yield the best
results if broken. ‘Troublesome
boys’ and ‘compliant girls’: gender
identity and perceptions of achievement and
underachievement - 101910 Working within a
methodological framework that identified four focus
groups, high-achieving boys and girls and
underachieving boys and girls, this article
presents teachers' perceptions of how gender
identity is seen to influence achievement levels.
Beliefs about gender identity informed the
teachers' perceptions in relation to each of the
four focus groups, whereby the underachieving boy
and the high-achieving girl were seen to conform to
gender expectations; the high-achieving boys were
seen to challenge gender norms; and the
underachieving girl emerges as largely overlooked.
The perceived characteristics of the high-achieving
girl are presented as describing all girls. There
appears to be a tendency to associate boys with
underachievement and girls with high
achievement. The
gender biases that shape our brains -
5/24/21 My daughter is obsessed with
all things girly and pink. She gravitated to pink
flowery dresses that are typically marketed for
girls before she even turned two. When she was
three and we saw a group of children playing
football, I suggested she could join in when she
was a bit older. "Football is not for girls," she
replied, firmly. We carefully pointed out that
girls, though in the minority, were playing too.
She was unconvinced. However, she's also boisterous
and loves to climb and jump, attributes often
described as boyish. Her overt ideas about what
girls and boys should do were somewhat unexpected
so early on, but considering how gendered many
children's worlds are from the outset, it's easy to
see how this occurs. These initial divisions may
seem innocent, but over time our gendered worlds
have lasting effects on how children grow up to
understand themselves and the choices they make
– as well as how to behave in the society they
inhabit. Later, gendered ideas continue to
influence and perpetuate a society which
unknowingly promotes values linked to toxic
masculinity, which is bad news for all of us,
however we identify. So how exactly does our
obsession with gender have such a lasting impact on
our world? The idea that women were
intellectually inferior to men was regarded as fact
several centuries ago. Science has long sought to
find the differences that underlined this
assumption. Slowly, numerous studies have now
debunked many of these proposed differences, and
yet our world remains stubbornly
gendered. When you think about it, this
is wholly unsurprising due to the way we are
socialised as infants. Parents and caregivers don't
mean to treat boys and girls differently, but
evidence
shows they clearly do. It
starts before birth, with mothers describing their
baby's movements differently if
they know they are having a
boy. Male babies were
more likely to be described as "vigorous" and
"strong", but there was no such difference when
mothers did not know the sex. Ever since it was possible to
identify biological sex from a scan, one of the
first questions asked of prospective parents is
whether they are having a boy or a girl. Before
then, the
shape and size of a bump
has been used to guess the sex, despite there being
no evidence this works. More subtle are the
different words we use to describe boys and girls,
even for the exact same behaviour. Throw gendered
toys into the mix and this reinforces the subtle
traits and hobbies that are already assigned to
male and female. The way children play is a
hugely important part of development. It's how
children first develop skills and interests. Blocks
encourage building whereas dolls can encourage
perspective taking and caregiving. A range of play
experiences is clearly important. "When you only
funnel one type of skill building toys to half of
the population, it means that half of the
population are going to be the ones developing a
certain set of skills or developing a certain set
of interests," says Christia Brown, a professor of
psychology at the University of
Kentucky. Children are also like little
detectives, working out what category they belong
to by constantly learning from those around them.
As soon as they understand what gender they fit
into, they will naturally gravitate towards the
categories that have been thrust upon them from
birth. That's why from the age of about two,
girls
tend to navigate more to
pink things while
boys will avoid them. I witnessed this first-hand
when my then two-year old stubbornly refused to
wear anything she perceived as slightly boyish,
despite my futile attempts not to overtly gender
her clothing early on. It's no surprise then that
pre-school children learn to identify with their
gender so young, especially as
parents and friends tend to give children toys
associated with their gender
early on. Once children understand which "gender
tribe" they belong to, they become more responsive
to gender labels, explains Cordelia Fine, a
psychologist at the University of Melbourne. This
then influences their behaviour. For instance, even
how a toy is presented can
change a child's interest
in it. Girls have been found to be more interested
in typically boyish toys if they were pink, for
instance. This has consequences though.
If we only give girls and not boys dolls or beauty
sets, it primes them to associate themselves with
these interests. Boys can be primed to like more
active pursuits by toy tools and cars. Yet boys
clearly enjoy playing with dolls and buggies
too, but these are
not as typically bought for them. My son cradles a
toy baby just as his sister did and likes to push
it around in a toy buggy. "Boys in the first years
of life are also nurturing and caring. We just
teach them really early that that's a 'girl skill',
and we punish boys for doing it," says
Brown. If from infancy, boys are
discouraged from playing with toys we might
associate as feminine, then they may not develop a
skill set that they might need later in life. If
they are discouraged by their peers from playing
with dolls, while at the same time they see their
mother doing most of the childcare, what does that
say about whose role it is to care? And so we enter
the realm of "biological essentialism", where we
ascribe an innate basis to a behaviour that is,
when you delve a bit deeper, highly likely to be
learned. Toys are one thing, but
traits are also prone to gendered stereotyping.
Parents of boys often talk about how they are more
boisterous and enjoy rougher play, while girls are
more gentle and meek. The evidence suggests
otherwise. In fact, studies show that
our own expectations tend to frame how we view
others and ourselves. Parents have
attributed gender neutral angry faces as
boys while happy and
sad faces are labelled as girls. Mothers are more
likely to emphasise their boys' physical attributes
– even setting more adventurous targets for
boys than for girls. They also over-estimate
crawling abilities for their sons compared to
daughters, despite
there being no reported physical difference. So,
people's own biases could be influencing their
children, and so reinforcing these
stereotypes. Language plays a powerful
role too – girls reportedly speak earlier, a
small but identifiable effect but this could be due
to the fact that research
also shows that
mothers speak more to their baby girls than to baby
boys. They speak more
about emotions to girls too.
In other words, we unknowingly socialise girls to
believe they are more talkative and emotional, and
boys aggressive and physical. Brown explains that it's
clear why these misconceptions then continue later
in life. We disregard the behaviours that do not
conform to the stereotypes we expect. "So you
overlook all the times the boys are sitting there
quietly reading a book or all the times that girls
are running around the house loudly," she says.
"Our brains seem to skip over what we call
stereotype inconsistent information." Parents will also buy their
girls toys and clothes typically marketed for boys
but rarely the reverse, often in an attempt to be
gender neutral. This in itself gives an interesting
insight into how we view gender. Males have always
been viewed as the dominant and powerful sex,
meaning parents, whether overtly or not, will
discourage boys from liking girly things. As Fine
explains, "we start to see manifestations of the
gender hierarchy – boys seemingly starting to
respond
to the 'stigma' of femininity even in this early
period [of childhood]." It reveals why parents are
much more comfortable with girls in boys clothes
than boys in girls clothes. Or why growing up as a
tomboy attracted positive comments for me – I
never liked dolls and loved climbing trees. The
opposite occurs for boys who dress or act girly. To
be seen as girly or exhibiting feminine traits
diminishes status for men – those
who do so even earn less. Gender scholars agree that
these preferences are highly socially conditioned
– but there remains disagreement about
whether
any gendered behaviour is
innate, for instance,
there is evidence that girls who have been exposed
to higher levels of androgens in the womb,
prefer
toys we typically
categorise as for boys. Even here Fine points out
it could be the environment shaping their
preferences. These girls do not consistently show
better spatial ability either – a skill that
is often said to be better in men. We also know that babies are
extremely
sensitive to social cues
around them, they can spot differences early on.
Regardless of how these preferences develop, it is
adults as well as peers who continue to condition
and expect certain behaviours, creating a gendered
world with worrying consequences. For instance, when girls
first enter pre-school – a gender gap in maths
does
not exist, but
it
later begins to widen
as their teacher and self-expectations come into
play. This is especially problematic because these
reinforced gender stereotypes are "at odds with the
contemporary gender egalitarian principle that your
sex shouldn't determine your interests or future",
says Fine. When specific toys are
marketed to boys it could also be changing the
brain to strengthen the connections that are
involved in, for instance, spatial recognition.
Indeed, when one group of girls played the game
Tetris for three months, the
brain area involved in visual processing was
larger than for those
who did not play the game. If girls and boys are
presented with different types of hobbies, brain
changes could naturally follow suit. As neuroscientist and author
Gina Rippon of Aston University explains, the fact
that we live in a gendered world itself creates a
gendered brain. It creates a culture of boys who
feel conditioned to behave in more typically
masculine traits – they may get excluded by
peers if they do not. If we focus on differences,
it also means, as Rippon says, we begin to accept
myths such as boys being better at science and
girls at caring. This continues as adults.
Women have been shown to underestimate their
abilities when asked how well they scored on maths
tasks, whereas
men will overestimate their
scores. Women will
also do worse on a test if they are
first
told that their sex typically does
worse. Of course this
could and does affect school, university and career
choices. Even more concerning is the
idea that the way some masculine traits are
emphasised early on and then conditioned, is linked
to male sexual violence against women. We know for
instance that the individuals who perpetrate sexual
violence tend
to be high in "hostile
masculinity", says
psychologist Megan Maas of Michigan State
University. These are the beliefs that men are
naturally violent, need to have sexual fulfilment,
and that women are naturally submissive. Studies also show that girls
who are heavily into princesses are
more concerned with their
appearance and more
likely to "self-objectify – so they think of
themselves as a sexual object," says Maas. The
girls that scored highest on "sexualised gender
stereotypes" also downplayed traits associated with
intelligence. Early on, both girls and boys have
been shown to view attractiveness as
"incompatible
with intelligence and
competence" a study
found. Brown and colleagues
have
now also argued in a 2020
paper that sexual assault by men against women is
so common precisely because of the values we
condition onto children. This socialisation comes
from a combination of parents, schools, the media
and peers. "Sexual objectification for girls starts
really early," says Brown. One reason that these
gendered ideas and self-assumptions continue to
exist is, in part, because there
are still regular reports of innate brain
differences between men and
women. However, most
brain imaging studies that do not find any gender
differences don't mention gender at all. Or still
others are unpublished. This is known as the
"file
drawer" problem
– when no effects are found, they are simply
not mentioned or scrutinised. And of those that do find
small differences, it's hard to truly show how much
culture or stereotyped expectations play a role.
Adult brains cannot be neatly categorised into male
brains and female brains either. In a study
analysing 1,400 brain scans, neuroscientist Daphna
Joel and colleagues found "extensive
overlap between the distributions of females and
males for all grey matter, white matter, and
connections assessed".
That is, overall we are more
similar to each other than
different. One study
even showed that women
acted just as aggressively as
men in a video game
when they were told their gender would not be
disclosed, but less so when told the experimenter
knew if the participants were male or
female. It follows that women tend to
be considered as less aggressive and more
empathetic. When we consider
physiological responses to situations that might
invoke empathy, women and men
actually respond the same,
it's just that from an early age, women have been
socialised to act upon this apparently
feminine emotion more. This means that in order for
there to be any significant change, people have to
first understand their biases and be mindful of
when their preconceptions don't fit into the
behaviours they see. Even small differences of what
they expect of girls versus boys can build up over
time. It's therefore worth
remembering why people are conditioned to think
that boys are more boisterous and take note of the
times this is not true. My daughter is certainly
just as loud – if not more so – as her
brother, while he also loves pretending to cook.
While these are not necessarily representative
examples, they also don't fit into our ideas of
what boys and girls like. It would be easy for me
to otherwise have highlighted my son's propensity
to climb on everything and my daughter's preference
for pink, glossing over the numerous times she
plays with cars and he with dolls. When our children do
inevitably start pointing out gendered divisions we
can help by revising stereotypes with other
examples, such as explaining girls can and do play
football and that boys can have long hair too. We
can also encourage a diverse range of toys
regardless of what gender they are intended for. We
need to provide as many opportunities as possible
"for them to have experiences that go against this
sort of avalanche of gendered play", says
Maas. If we fail to understand that
we are more alike from birth than we are different
and treat our children accordingly, our world will
continue to be gendered. Undoing these assumptions
is not easy, but perhaps we can all think twice
before we tell a little boy how brave he is and a
little girl how kind or perfect she is. Melissa Hogenboom is the
editor of BBC Reel. Her upcoming book, The
Motherhood Complex, is out 27 May 2021. She is
@melissasuzanneh on Twitter. The
sexist myths that won't die - 9/30/19 When I meet the cognitive
neuroscientist Gina Rippon, she tells me one
anecdote that helps demonstrate just how early
children can be exposed to gender
stereotypes. It was the birth of her
second daughter, on 11 June 1986 – the night
that Gary Lineker scored a hat trick against Poland
in the men’s Football World Cup. There were
nine babies born in the ward that day, Rippon
recalls. Eight of them were called Gary. She remembers chatting to one
of the other mums when they heard a loud din
approaching. It was a nurse bringing their two
screaming babies. The nurse handed her neighbour a
“blue-wrapped Gary” with approval –
he had “a cracking pair of lungs”.
Rippon’s own daughter (making exactly the same
sound) was passed over with an audible tutting.
“She’s the noisiest of the lot – not
very ladylike,” the nurse told her. “And so, at 10 minutes
old, my tiny daughter had a very early experience
of how gendered our world is,” Rippon
says. Rippon has spent decades
questioning ideas that the brains of men and women
are somehow fundamentally different – work
that she compellingly presents in her new book,
The
Gendered Brain. The
title is slightly misleading, since her argument
hinges on the fact that it’s not the human
brain that is inherently “gendered”, but
the world in which we are raised. Subtle cues about
“manly” and “ladylike”
behaviours, from the moment of birth, mould our
behaviours and abilities, which other scientists
have then read as inherent, innate
differences. Rippon’s writing
bristles with frustration that this argument still
needs to be stated in 2019. She describes many of
the theories about gender differences as
“whack-a-mole” myths that keep on
arising, in another guise, no matter how often they
are debunked. “We've been looking at
this whole issue of whether male brains are
different from female brains for about 200
years,” she says. “And every now and then
there's a new breakthrough in science or
technology, which allows us to revisit this
question, and make us realise that some of the past
certainties are clearly wrong. And you think that,
as a scientist, you might have addressed them and
put them right, and people will move on and not use
those terms or conclusions anymore. But the next
time you look at the popular press you find that
the old myth has returned.” One of the oldest claims
centres on the fact that women have smaller brains,
which was considered evidence for intellectual
inferiority. While it’s true that, on average,
women’s brains are smaller, by about 10%,
there are several problems with this
assumption. “First of all, if you
just thought it was a ‘size matters’
issue, then sperm whales and elephants have got
bigger brains than men, and they're not renowned
for being that much brighter,” says Rippon.
Then there’s the fact that, despite the
average difference in size, the overall
overlap in the distributions of men and
women’s brains is huge.
“So that you get women with big brains and men
with small brains.” It’s worth noting that
Einstein’s
brain was smaller
than that of the average male, and overall, many
studies find that there is next to no
mean difference between men and women’s
intelligence or
behavioural
traits. Yet the
claims continue to persist in the media. Rippon argues that the
apparent structural differences within the brain
itself have also been exaggerated. The corpus
callosum, for instance, is the bridge of nerve
fibres that connects the left and right hemispheres
of the brain, with some initial studies finding
that this information highway is bigger in
women’s brain’s than in men’s
brains. This was used to justify all kinds of
stereotypes – like the idea that women are
inherently illogical, since their feelings from the
“emotional” right hemisphere were
interfering with the processing in the cooler,
rational left hemisphere. As Rippon explains in her
book: “Men’s more efficient callosal
filtering mechanism explained the mathematical and
scientific genius… their right to be captains
of industry, [their ability to] win Nobel
Prizes and so on and so on.” But such claims are often
based on just a small number of participants, she
says – and the techniques to measure the
“size” of any region are still rather
crude and open to interpretation, meaning that even
the existence of such brain differences is on very
shaky foundations. (And of course, the idea of the
“left” and “right" brain is itself
something of a myth.) Despite decades of research,
it has been very difficult to reliably
identify significant “hardwired”
differences in the structure of the male and female
brain. Raging
hormones What about our sex hormones?
Surely they, at least, should have a very clear
impact on our minds and behaviours? Yet the
evidence has been misinterpreted to denigrate
women’s abilities, Rippon says. The concept of premenstrual
syndrome, for instance, first emerged in the 1930s.
“And it became well established as a reason
for women not being given positions of power.”
As she points out, women
were even initially barred from the US space
programme due to concerns around having such
“temperamental psycho-physiologic
humans” on board
the craft. While few today would hold
this view, we still consider PMS to bring about a
range of cognitive and emotional changes that are
less than desirable. Yet some of the observed
symptoms may be a psychosomatic response – the
result of expectation rather than inevitable
biological changes to the brain. In one study by Diane Ruble
at Princeton University, for instance,
women
were given false feedback about where they were in
their menstrual cycle.
“They could give an approximate date about
when they expected the period to start – but
you could give them a fake blood test saying,
actually, you are now in the pre-menstrual phase,
or you're in the intermenstrual phase,” Rippon
explains. And they were then asked to fill out a
questionnaire on various elements of
PMS. The study found that the
women who were told they were in the pre-menstrual
phase were much more likely to report the symptoms
of PMS – even if they were not at that stage
of the cycle, supporting the idea that some of the
symptoms arose from their expectations.
(Read
about how the “nocebo effect” means our
beliefs can produce real medical
symptoms.) “I wouldn't want to
underplay the reality of the hormonal changes that
are associated with the menstrual cycle, or to deny
that people do have changes associated with
fluctuations in hormones – as they should,
because the word hormone means stir to
action,” Rippon says. “But if you
actually look at things like menstrual diaries, or
objective measures of mood changes, the effect is
nothing like as profound as the person believes. So
the very fact that you believe that [you
are] experiencing a mood change, and that must
be associated with the premenstrual cycle, becomes
a kind of self-fulfilling
prophecy.” The perceptions of PMS also
betray a certain confirmation bias among
researchers studying sex and gender differences,
who have tended to conduct studies that back up the
stereotypes rather than looking for the evidence
that may question prevailing assumptions. Rippon
says that women may actually experience a
cognitive
boost at certain points in the menstrual
cycle, for instance
– but these have been largely ignored, thanks
to scientists’ preoccupation with women’s
perceived weakness. “We've done some studies
showing that cognitively, there are fluctuations
through the menstrual cycle,” she says. Verbal
and spatial working memory, for instance, improve
when oestrogen is highest. “And that there are
very positive changes about the time of ovulation
– improved responsiveness to sensory
information, for example, and improved reaction
time.” But Rippon says that while
the standard tool to measure PMS is the Moos
Menstrual Distress Questionnaire, “I haven't
come across an ‘ovulation euphoria
questionnaire’”. The focus, it seems, is
always on the negative. Pink and blue
tsunamis One of the challenges of
studying sex differences has been accounting for
the role of culture. Even when apparent differences
in the structure of the brain can be observed,
there is always the possibility that they arise
through nurture rather than nature. We know that the brain is
plastic, meaning it is moulded by experience and
training. And as Rippon observed with the birth of
her own daughter, a boy and a girl may have very
different experiences from the moment they enter
the world, as certain behaviours are subtly
encouraged. She points to research showing that
children as young as 24 months are highly sensitive
to gender typical behaviours. They are, she says,
“tiny social sponges absorbing social
information”, and adopting those behaviours
themselves will eventually rewire their neural
circuits. “A gendered world produces a
gendered brain.” This is why the gender
stereotyping of toys is such an important issue to
address. “A lot of people think
that the idea that we should avoid gendering toys
is actually a bit of PC [politically
correct] nonsense,” she says. “But I
think if we take a neuroscientific approach to
this, we can see that there's quite profound
implications of the toys that we play with when
we're very young.” These moments of play can
be seen as “training opportunities” that
can mould a child’s brain into an adult
one. Consider a construction toy
like Lego or Duplo or games such as Tetris. As the
child plays, rotating bricks and finding
increasingly inventive ways to fit them together
into new structures, they will be building the
neural networks involved in visual and spatial
processing. Then, as you get to school, you might
perform slightly better at those tasks – and
be praised for your abilities, meaning you’ll
continue to practice them. Eventually, you may even
find a profession that that asks you to spend all
day, every day, strengthening those
abilities. “Now, if all of those
toys and training opportunities are gendered, then
you can start getting what looks like a clear
gender divide based on the biological sex of an
individual, as opposed to the different training
opportunities that individual has had,” says
Rippon. The psychologists Melissa
Terlecki and Nora Newcombe have shown that the
apparent sex
differences in spatial
cognition diminish
when you account for the amount of time someone has
spent playing video games like Tetris, for
instance. A few campaigns – like
Let
Toys Be Toys in the
UK and Play
Unlimited in
Australia – have had some success in
persuading retailers to change their gendered
marketing, but in general, Rippon argues that
children are still being pigeonholed in many other
ways. “One of the problems we
have in the 21st Century is that what I call gender
bombardment is much more intense,” says
Rippon. “There's much more in the social
media, and a whole range of marketing initiatives,
which make a very clear prescriptive list of what
it's like to be male, or what it's like to be
female.” And this is why Rippon is
especially frustrated by the
“neurosexism” out there. The more that
tenuous conclusions, from weak data, reach the
public, the more likely we are to pass on these
messages to children, strengthening those
self-fulfilling prophecies. “If we believe that
there are profound and fundamental differences
between men's and women's brains, and more than
that – that the owners of those brains
therefore have access to different skills, or
different temperaments or different personalities
– that will certainly affect how we think
about ourselves as male or female,” says
Rippon. It will also affect how we think about
other people and what their potential might be, she
warns. “So scientists need to
be really careful,” she says.“Of course,
we need to understand where there are sex
differences and what they might mean. But we should
be careful not to talk about fundamental or
profound differences, because we're giving the
wrong impression to people who are really
interested to know what the answers are to the
questions that we're asking.” Ultimately, we need to accept
that each of us has a unique brain – and our
abilities cannot be defined by a single label like
our gender. “An understanding that
every brain is different from every other brain,
and not necessarily just a function of the sex of
the brain’s owner, is a really important step
forward in the 21st Century,” urges
Rippon. *The video that accompanies
this article is part of a BBC
Reel Playlist called
Re:Think, where you
can watch more thought-provoking films about the
human brain. David Robson is a writer
based in the London and Barcelona. His first book,
The
Intelligence Trap: Why Smart People Do Dumb
Things, is out now.
He is d_a_robson on Twitter. Study
finds some significant differences in brains of men
and women - 4/11/17 Do the anatomical differences
between men and women—sex organs, facial hair,
and the like—extend to our brains? The
question has been as difficult to answer as it has
been controversial. Now, the largest brain-imaging
study of its kind indeed finds some sex-specific
patterns, but overall more similarities than
differences. The work raises new questions about
how brain differences between the sexes may
influence intelligence and behavior. For decades, brain scientists
have noticed that on average, male brains tend to
have slightly higher total brain volume than female
ones, even when corrected for males' larger average
body size. But it has proved notoriously tricky to
pin down exactly which substructures within the
brain are more or less voluminous. Most studies
have looked at relatively small sample
sizes—typically fewer than 100
brains—making large-scale conclusions
impossible. In the new study, a team of
researchers led by psychologist Stuart Ritchie, a
postdoctoral fellow at the University of Edinburgh,
turned to data from UK
Biobank, an ongoing,
long-term biomedical study of people living in the
United Kingdom with 500,000 enrollees. A subset of
those enrolled in the study underwent brain scans
using MRI. In 2750 women and 2466 men aged
44–77, Ritchie and his colleagues examined the
volumes of 68 regions within the brain, as well as
the thickness of the cerebral cortex, the brain's
wrinkly outer layer thought to be important in
consciousness, language, memory, perception, and
other functions. Adjusting for age, on
average, they found that women tended to have
significantly thicker cortices than men. Thicker
cortices have been associated with higher scores on
a variety of cognitive
and general
intelligence tests.
Meanwhile, men had higher brain volumes than women
in every subcortical region they looked at,
including the hippocampus (which plays broad roles
in memory and spatial awareness), the amygdala
(emotions, memory, and decision-making), striatum
(learning, inhibition, and reward-processing), and
thalamus (processing and relaying sensory
information to other parts of the
brain). When the researchers adjusted
the numbers to look at the subcortical regions
relative to overall brain size, the comparisons
became much closer: There were only 14 regions
where men had higher brain volume and 10 regions
where women did. Volumes and cortical
thickness between men
also tended to vary much more than they did between
women, the
researchers report this month in a paper posted to
the bioRxiv server, which makes articles available
before they have been peer reviewed. That's intriguing because it
lines up with previous work looking at sex and IQ
tests. "[That previous study] finds no
average difference in intelligence, but males were
more variable than females," Ritchie says. "This is
why our finding that male participants' brains
were, in most measures, more variable than female
participants' brains is so interesting. It fits
with a lot of other evidence that seems to point
toward males being more variable physically and
mentally." Despite the study's
consistent sex-linked patterns, the researchers
also found considerable overlap between men and
women in brain volume and cortical thickness, just
as you might find in height. In other words, just
by looking at the brain scan, or height, of someone
plucked at random from the study, researchers would
be hard pressed to say whether it came from a man
or woman. That suggests both sexes' brains are far
more similar than they are different. The study didn't account for
whether participants' gender matched their
biological designation as male or
female. The study's sheer size makes
the results convincing, writes Amber Ruigrok, a
neuroscientist at the University of Cambridge in
the United Kingdom who has studied sex differences
in the brain, in an email to Science. "Larger
overall volumes in males and higher cortical
thickness in females fits with findings from
previous research. But since previous research
mostly used relatively small sample sizes, this
study confirms these predictions." Ruigrok notes one factor that
should be addressed in future studies: menopause.
Many of the women in the study were in the age
range of the stages of menopause, and hormonal
fluctuations have been shown to influence brain
structures. That may have played some role in the
sex differences noted in the study, she
says. The controversial—and
still unsettled—question is whether these
patterns mean anything to intelligence or behavior.
Though popular culture is replete with supposed
examples of intellectual and behavioral differences
between the sexes, only a few, like higher physical
aggression in men, have been borne out by
scientific research. For the moment, Ritchie says
his work isn't equipped to answer such heady
questions: He is focused on accurately describing
the differences in the male and female brain, not
speculating on what they could mean. Hines’ study supports
the possibility that in some ways, sex, via
testosterone, is affecting who we learn from, but
the environment determines what we learn. If the
environment is gendered, our toy preferences will
be. The mosaic
brain At first glance, the idea
that sex isn’t necessarily the only way traits
are transferred between generations seems
incompatible with evidence. Studies
show that the genetic
and hormonal components of sex affect the structure
and function of the brain. However, recent
research in rats on
the effects of sex on the brain reveal that these
effects may vary and even be opposite under
different environmental conditions, such as varying
levels of stress. Are brains male or
female? These interactions between
sex and the environment, which can also be
different in different parts of the brain, give
rise to brains made up of idiosyncratic
“mosaics”
of features. Such mosaics were recently observed
in
humans. In other words, sex affects
the brain, but this doesn’t mean that there
are two distinct types of brains – “male
brains” and “female brains”.
Although you could predict a person’s sex with
accuracy above chance on the basis of their brain
mosaic, attempting the reverse prediction –
predicting someone’s unique brain mosaic on
the basis of the form of their
genitalia –
would be beyond difficult. Back to gender
debates The possibility that a key
role of our genetic inheritance is in learning
gender from our surrounding culture supports
organisational initiatives in favour of gender
balance. The down side is that the
prevalence of “gendering” environments
means that many relevant aspects of the environment
have to change in order for gender patterns to
significantly shift at the population
level. Those working to increase the
representation of women in technology and
leadership have a lot of work to do. Still, humans
are unique in their capacity to transform their
environments. A century or so ago, our
gender debates focused on whether women were suited
to higher
education and voting.
Today, such debates are laughable, thanks to the
progression of social attitudes and science. Now
the debate is around technology and
leadership. As history has shown, when
cultural ideas of what roles women and men are
“built” to perform change, the Would
gender differences exist if we treated all people
the same from birth? 11/22/16 Gender identity is not a
simple concept. It is usually defined as whether
someone thinks of themselves as male or female,
though it’s more than that. Even this is not a
simple, binary division between all human beings.
However, we do know that the hormones the brain is
exposed to in early pregnancy have powerful effects
on gender identity. For example, there’s a
condition called androgen
insensitivity syndrome.
Girls with this condition are born looking just
like other girls. Only at puberty do things start
to change. This is because they are actually
genetic males (they have the male XY chromosomes).
They also have testes, hidden in their abdomen, but
no uterus or ovaries. The condition is caused by a
genetic
insensitivity to the hormone
testosterone, so that
while these girls secrete male-type levels of
testosterone, it doesn’t have any effect on
their brain (or anywhere else). The important point
is that their gender identity is female. Does that
mean that testosterone is ultimately what makes
someone masculine? The experimental evidence
suggests as much. Giving little female rats
testosterone during early life makes them very
male-like, and the opposite occurs if little males
are castrated. Testosterone seems to be
important, but is it the whole story? Is the fact
that individuals with androgen insensitivity
syndrome look like women responsible for others
treating them as female, thus influencing how they
see themselves? In the 1960s, John Money, a
prominent psychologist, convinced himself that
gender identity was independent of early hormones.
Put simply, if a parent thought their baby was a
boy, and treated him as such, then he developed a
male gender identity, and vice versa.
This
idea was put to the test:
after a surgical accident, a one-year old boy was
castrated and given a vagina. He was dressed as a
girl and given a female name. But it failed.
Eventually, the “girl” reverted to being
a boy. You might think that was the end of the
“parent” theory of gender identity. But
a
second case, which
started when the baby was two months, succeeded.
The “boy” grew up as a “girl”
and accepted her gender identity, though she was
bisexual. So why the different results?
Note that single case reports are unreliable as
evidence. But it seems likely that exposure of the
brain to testosterone during development does
influence various aspects of sexuality, including
gender identity. We also know that the brain in
early life is very susceptible to external events.
So both testosterone and parental behaviour can
influence gender identity. Beyond
hormones But gender identity is also
how a person expresses themselves in that society.
In a society that represses expressions of
sexuality, this will alter how women and men see
themselves. The important point here is that gender
identity is both “biological” and
“social”. But none of these factors
results in a simple binary division. So could we abolish
differences in gender by altering upbringing?
Schemes exist to minimise gender-stereoptypical
play behaviour, for example some
Scandinavian nurseries.
While this may have some impact, research
has nevertheless shown
that little boys still prefer to play with trains,
and little girls with dolls. Giving such toys to
societies that have never seen them in real life
has the same result. There are, of course,
established gender differences in muscular strength
and height that are not controversial. And yet
there are women who are stronger or taller than
some men: in other words, there is an overlap
between the sexes despite the sex difference.
Accepting that there may be gender differences in
brain function has proved much
more controversial.
Many studies
have shown, for
example, that males are better at visuo-spatial
tasks and females are better at languages and
empathy. These differences are small and overlap,
so sometimes they are not observed; but we should
not discount their influence. There are also
well-established
but very small gender differences in the brain,
such as men having a larger
hypothalamus. The
hypothalamus is responsible for initiating eating,
drinking, sex and other behaviours essential for
survival. Relating these differences to those in
behaviour has not, so far, been very successful:
this may reflect our ignorance of how the brain
actually works. Soceity’s
responsibility There are those who decry the
small differences that have been recorded, or even
consider that they do not exist. But why should we
want to abolish them? It seems to me that these
both reflect identity and contribute to
it. It’s no secret that sex
differences have been used as an excuse for gender
inequality. But that just means we need to redress
that inequality, not deny that gender differences
exist. It’s opportunity that is
crucial. A man’s job? Alfred T.
Palmer If this were equal, would we
see an even distribution of males and females
across all occupations and activities? Not in my
opinion. If a job requires physical strength, then
it is likely that men will predominate. Also, in
the branch of medicine dealing with brain
disorders, about 50%
of psychiatrists are female,
but only about 15-20% are neurologists, and a mere
5% neurosurgeons. Is this gender-related prejudice,
or individual preference? Should we insist on an
equal gender distribution? Of course not, provided
the choice was unfettered. It may be that males are
attracted by more technical aspects of medicine,
and females by the more person-orientated
specialities for reasons that are not just due to
upbringing or expectations, but genuine
differences in the brain. But, of course, social norms
also contribute to which professions we choose. So
we have to make an effort to ensure that women are
not hindered from a free choice of profession by
social expectations, burdens of child-rearing or
selective education. But ultimately, an unequal
gender distribution is no longer controversial if
opportunities are the same for all. If gender
differences then remain, we should accept
them. Thankfully we now see an
increasing number of women as distinguished
scientists, CEOs of major companies and world
leaders. We don’t even bat an eyelid when a
woman plays King Lear, that most masculine of
roles. Gender identities are changing; but let us
not muddle the essential distinction between
similarity and equality. Sweden's
'gender-neutral' pre-school 7/8/11 On the surface, the school in
Sodermalm - a well-to-do district of the Swedish
capital - seems like any other. But listen
carefully and you'll notice a big
difference. The teachers avoid using the
pronouns "him" and "her" when talking to the
children. Instead they refer to them as
"friends", by their first names, or as "hen" - a
genderless pronoun borrowed from
Finnish. Changing
society? It is not just the language
that is different here, though. The books have been carefully
selected to avoid traditional presentations of
gender and parenting roles. So, out with the likes of
Sleeping Beauty and Cinderella, and in with, for
example, a book about two giraffes who find an
abandoned baby crocodile and adopt it. Most of the usual toys and
games that you would find in any nursery are there
- dolls, tractors, sand pits, and so on - but they
are placed deliberately side-by-side to encourage a
child to play with whatever he or she
chooses. At Egalia boys are free to
dress up and to play with dolls, if that is what
they want to do. For the director of the
pre-school, Lotta Rajalin, it is all about giving
children a wider choice, and not limiting them to
social expectations based on gender. "We want to give the whole
spectrum of life, not just half - that's why we are
doing this. We want the children to get to know all
the things in life, not to just see half of it,"
she told BBC World Service. All the staff are clearly
passionate about this. Teachers say the aim is to
help both boys and girls "I want to change things in
society," says 27-year-old Emelie Andersson who is
fresh out of her teacher training, and specifically
chose to work at Egalia because of its policy on
gender. "When we are born in this
society, people have different expectations on us
depending if we are a boy or a girl. It limits
children. "In my world, there is no
'girl's world' and there is no 'boy's world'," she
says. Last year a Swedish couple
provoked a fuss in the media by announcing that
they had decided to keep the gender of their young
child, Pop, a secret from all but their closest
family members. There was a similar case
recently in Canada with a baby called
Storm. But is it not confusing for a
young child to blur gender boundaries like
this? It is a criticism that Egalia
director Lotta Rajalin has heard many times before,
but she contests it vigorously. "All the girls know they are
girls, and all the boys know that they are boys. We
are not working with biological gender - we are
working with the social thing." The verdict of child
psychologists and experts in gender is divided -
with most supportive of the aims, but questioning
the means. "The sentiments are
excellent, but I'm not sure they are going about it
in exactly the right way," says British-based
clinical psychologist Linda Blair. "I think it's a bit stilted.
Between the ages of three and about seven, the
child is searching for their identity, and part of
their identity is their gender, you can't deny
that," she told BBC World Service. Gender
obsessed? But Sweden takes gender
issues seriously, and for a number of years now,
the government has been taking its battle to the
playground. Gender advisers are now
common in schools, and it is part of the
national curriculum to work against discrimination
of all kinds. Sweden is often praised as
being one of the most equal countries in the world
when it comes to gender, but there are critics at
home who think things have gone too far. "This equality idea, it has
become so absurd, it has become a really stupid
industry," rails Swedish blogger Tanja Bergkvist,
who argues that the nation has an unhealthy
obsession with gender. "Gender researchers have
convinced politicians that the solution to all
problems is a gender perspective. "That's quite dangerous
because they spend money and resources on the wrong
things." The Egalia school - which is
state-funded - is proving popular though, and
boasts a long waiting list. Pia Korpi, a metal designer,
and her husband Yukka, a dancer and choreographer,
have two children at the pre-school. Ms Korpi says she, and her
husband in particular, had to battle to pursue
their chosen interests because they sat uneasily
with gender expectations, and they want their
children to feel free from these
restraints. She says most of their
friends and family are 100% behind them, but admits
some people might not understand their choice.
"People who don't know what this is about - and
especially in the countryside - they think it's
brainwashing." Swedish way The idea of working with
children in pre-schools - between the ages of one
and five years old - is to help shape them from a
young age, but many doubt there are any lasting
effects. Egalia is the Swedish word
for equality "It's a real world out there
- we cannot isolate people from that real world,"
says clinical psychologist Linda Blair. Philip Hwang, Professor of
Psychology at the University of Gothenburg - who
has conducted long-term studies of children's
development - chuckles slightly when talking about
this scheme. "I don't think it's anything
bad," he says. "But it is naive to say the
least. It is a symbolic gesture. I find it a bit
funny - who do they think they are
fooling?" "It's very Swedish in a
sense. Swedes have a tendency to think that if they
institutionalise something, it will automatically
change - it's the Swedish way," he told the
BBC. "But lasting effects - when
it comes to issues embedded in our culture - that
takes generations." How
parents unconsciously treat baby boys and girls
differently. - 12/10/16 Parents everywhere will tell
you this. They will say their baby boys
and girls develop differently—even the
thoroughly modern type of parent who goes to
lengths not to treat their boys and girls
differently—proving nature trumps nurture
every time. Except it probably still is
nurture that makes your baby girl a faster talker,
and your baby boy a better walker. Neuroscientist Lise Eliot
first brought this to people’s attention in
2009 when she published a book based on a lot of
scientific study in this field. She discovered that
actually, even before a baby is displaying much of
a personality, parents will unconsciously behave
differently around boys and girls and altering
their development in ways that conform to gender
norms. Study after study found
parents were attributing traits to their offspring
based on their gender without even realising it.
One study Eliot cited in her book took baby boys
and girls, and disguised them as the opposite sex.
Then it asked parents to observe the babies and
make judgements about their behaviour. The “boys” were
more often described as angry, while the
“girls” were more often described as
“happy” and
“social”. Except the boys were really
girls, and the girls were really boys. This was seven years ago, and
yet we still see arguments every day about the
“innate differences” between boys and
girls as proof that men and women are suited to
different roles in our society Would you buy your son a
doll? Post continues after video. The thing is, a lot of our
developmental “stuff” is happening in
those early months. So if parents are ascribing
behaviours to boys and girls without realising it,
they are ultimately going to fundamentally alter
the way those babies develop. If, as studies suggest,
parents are more social with baby girls, then the
baby girl’s language and expression are going
to develop more fully and faster than the baby
boy’s. Baby brains are elastic,
suggestible blank canvases. And how parents treat
them really does determine a lot. So next time you
hear someone say girls and boys are different
because of nature, not nurture, you might want to
point them this way. Can
parents treat boys and girls differently without
realising? There are differences in
girls and boys aren’t there? Girls are said to
be more social, and love to talk and socialise, but
boys are more introverted but physically stronger
than girls, right? Not necessarily. In one
study, scientists attempted to show how parents
make a number of assumptions about their baby boy
or girl. So they dressed newborns in
gender-neutral clothes and told adults the boys
were girls and girls were boys. The adults spent
time with the newborns and described the
‘boys’ (actually girls) as angry or
distressed more often than the adults in the study
who thought they were observing girls. The adults
spending time with the ‘girls’ (actually
boys) described the babies as happy and socially
engaged. Many other disguised-gender
experiments have also noted that adults perceive
baby boys and girls differently - choosing, to see
the behaviour they expect from the sex. What these studies show is
that how we perceive boys and girls—and how we
treat them therefore affects experiences we give
them. Much of our developmental
behaviours form in the early months of life so if
parents are encouraging certain behaviours amongst
boys and girls without realising it; they are
fundamentally affecting the way their baby
develops. So, if parents are more
social with baby girls, then the baby girl's
language and expression is naturally going to
develop more fully and faster than baby
boy's. Baby brains are often
described as little sponges. So the affect parents
have on them does determine a lot. Whether
consciously or not, it seems parents do make
assumptions about the gender preferences of their
little ones which have an effect on how they
develop. Gender neutral parenting
tips Source:
www.bounty.com/family/family-dynamics/boys-and-girls-differently Developmental
Differences Between Boys and Girls -
12/15/21 The difference between boys
and girls is pretty obvious when it comes to
anatomy. But what about developing gross motor
skills, talking and meeting other major
milestones? As it turns out, in many
areas the disparities between the two sexes are
actually pretty small. In fact, behavior and
development have more to do with a child’s
genetics and life experiences than they do with
sex. And, of course, every child
is an individual who will grow and develop at his
or her own pace. So, in order for your tot to reach
his or her full potential, your cutie needs lots of
attention and encouragement from the
get-go. Read on to learn about where
(and how much) your child’s sex plays a role
in development, from walking and talking to potty
training. When it comes to boys versus
girls in the walking department, this one is a
draw. Anecdotally, many parents say boys reach
gross-motor milestones like sitting up, cruising
and walking earlier than girls, but some
pediatricians swear the opposite. Yet both are wrong: Studies
show no significant differences between boys and
girls when it comes to these motor skills in
infancy. Both sexes generally start walking
independently after turning 1, often around month
14. Still, some parents believe
boys start sooner. One study found that mothers of
11-month-old infants overestimated their boys’
motor skills and underestimated their
daughters’. This belief could be related to
physical size since boys tend to be heavier than
girls between 8 and 12 months. How you can help Build up your baby’s
muscles by giving your little guy or gal plenty of
tummy time in the early months — and making
sure your tot doesn’t spend too much time
confined to the stroller, car seat or play
yard. Physical size and
growth Right from the start, boys
tend to weigh more at birth and this trend
continues as babies age, with girls measuring about
a half pound less. But girls catch right up as the
toddler years approach. Most of them reach half their
adult height by 19 months of age. Boys, on the
other hand, achieve this size when they’re
closer to 2 years old. Of course, each child is
different, from infancy to toddlerhood to puberty.
Growth spurts vary, and in general, both boys and
girls spend middle childhood about the same
size. When adolescence begins,
girls typically start outpacing their brethren. In
middle school, girls are usually taller, though
males catch up and typically measure taller than
some girls in a year or two. How you can help No matter your child’s
weight or height, make a point of offering healthy
meals and snacks as often as you can. Focus on
fruits, veggies, whole grains, lean protein and
low-fat dairy products, depending on your
child’s age, current weight and health
status. Your pediatrician can offer
important nutrition and allergy
guidelines. Talking One milestone that
consistently differs between boys and girls is
talking. Some research has found that sons are more
likely to be late talkers and that girl babies tend
to have larger vocabularies than boy babies as
early as 18 months. But sex only explains a small
part of the differences in toddlers’ verbal
skills. Other socioeconomic factors and
opportunities also influence how soon they
talk. Exposure to language and a
child’s environment can make a huge difference
in the number of words they learn — and
science backs this up. Research has found an
association between larger vocabularies by the age
of 4 and the number and variety of words kids heard
during the first three years of life. How you can help Talk, talk and talk some
more! Parents should narrate the day, sing songs
and read to their babies consistently, whether
they’re girls or boys. Studies have shown that
reading to your child helps him or her achieve
strong language skills well into their school
years. Avoid screens (including TV, phones,
computers and tablets) as much as possible —
except for video chatting with family and friends.
Potty
training If you’re wondering when
the diaper stage will end, expect it to happen
sooner with daughters than sons. Girls usually
ditch their diapers faster. While most girls start toilet
training anytime from 22 to 30 months, boys can
take approximately six months longer. But a
child’s desire and ability to potty train
varies widely, so it’s helpful to try and spot
the signs of readiness. For example, girls can often
sleep through the night without having a bowel
movement around 22 months of age, while boys often
do so by 25 months. And when it comes to pulling up
underwear or training pants, girls usually master
it by 29 months versus 33 months for
boys. How you can help
Even if your little boy takes
more time to get the hang of potty training, bring
out the potty around his second birthday and just
let him have fun with it. Set it up and let your
tot sit in it, both with clothes and
without. Offer loads of praise (or
something tangible like stickers) when success
comes, but be patient when those inevitable
accidents occur. From the What to Expect
editorial team and Heidi Murkoff, author of What to
Expect When You're Expecting. What to Expect
follows strict reporting guidelines and uses only
credible sources, such as peer-reviewed studies,
academic research institutions and highly respected
health organizations. Learn how we keep our content
accurate and up-to-date by reading our medical
review and editorial policy. Be Worried About Boys,
Especially Baby Boys - Psychology Today
- 1/8/17 We often hear that boys need
to be toughened up so as not to be sissies.
Parents' toughness toward babies is even celebrated
as “not spoiling the baby.” Wrong! These ideas are based
on a misunderstanding of how babies develop.
Instead, babies rely on tender, responsive care to
grow well—resulting in self-control, social
skills, and concern for others. A review of empirical
research just came out by Allan N. Schore, called
“All
Our Sons: The Developmental Neurobiology and
Neuroendocrinology of Boys at
Risk.” This thorough review shows
why we should be worried about how we treat boys
early in their lives. Here are a few
highlights: Why does early life
experience influence boys significantly more than
girls? How are boys affected more
than girls? What can we conclude from
the data? Boys are more vulnerable to
neuropsychiatric disorders that appear
developmentally (girls more vulnerable to disorders
that appear later). These include autism,
early-onset schizophrenia, ADHD, and conduct
disorders. These have been increasing in recent
decades (interestingly, as more babies have been
put into daycare settings, nearly all of which
provide inadequate care for babies; National
Institute of Child Health and Human Development,
Early Child Care Research Network,
2003). Schore states, “in light
of the male infant’s slower brain maturation,
the secure mother’s attachment-regulating
function as a sensitively responsive, interactive
affect regulator of his immature right brain in the
first year is essential to optimal male
socioemotional development.” (p.
14) "In total, the preceding
pages of this work suggest that differences between
the sexes in brain wiring patterns that account for
gender differences in social and emotional
functions are established at the very beginning of
life; that the developmental programming of these
differences is more than genetically coded, but
epigenetically shaped by the early social and
physical environment; and that the adult male and
female brains represent an adaptive complementarity
for optimal human function." (p. 26) What does inappropriate
care look like in the first years of
life? “In marked contrast to
this growth-facilitating attachment scenario, in a
relational growth-inhibiting postnatal environment,
less than optimal maternal sensitivity,
responsiveness, and regulation are associated with
insecure attachments. In the most detrimental
growth-inhibiting relational context of
maltreatment and attachment trauma (abuse and/or
neglect), the primary caregiver of an insecure
disorganized–disoriented infant induces
traumatic
states of enduring negative affect in the child
(A.N. Schore, 2001b, 2003b). As a result,
dysregulated allostatic processes produce excessive
wear and tear on the developing brain, severe
apoptotic parcellation of subcortical–cortical
stress circuits, and long-term detrimental health
consequences (McEwen & Gianaros, 2011).
Relational trauma in early critical periods of
brain development thus imprints a permanent
physiological reactivity of the right brain, alters
the corticolimbic connectivity into the HPA, and
generates a susceptibility to later disorders of
affect regulation expressed in a deficit in coping
with future socioemotional stressors. Earlier, I
described that slow-maturing male brains are
particularly vulnerable to this most dysregulated
attachment typology, which is expressed in severe
deficits in social and emotional functions.”
(p. 13) What does appropriate care
look like in the brain? “In an optimal
developmental scenario, the evolutionary attachment
mechanism, maturing during a period of
right-brain
growth, thus allows epigenetic factors in the
social environment to impact genomic and
hormonal
mechanisms at both the subcortical and then
cortical brain levels. By the end of the first year
and into the second, higher centers in the right
orbitofrontal and ventromedial cortices begin to
forge mutual synaptic connections with the lower
subcortical centers, including the arousal systems
in the midbrain and brain stem and the HPA axis,
thereby allowing for more complex strategies of
affect regulation, especially during moments of
interpersonal stress. That said, as I noted in
1994, the right orbitofrontal cortex, the
attachment control system, functionally matures
according to different timetables in females and
males, and thus, differentiation and growth
stabilizes earlier in females than in males (A.N.
Schore, 1994). In either case, optimal attachment
scenarios allow for the development of a
right-lateralized system of efficient activation
and feedback inhibition of the HPA axis and
autonomic arousal, essential components for optimal
coping abilities.” (p. 13) Note: Here is a
recent
article explaining
attachment. Practical implications for
parents, professionals, and
policymakers: 1. Realize that boys need
more, not less, care than girls. Separation of mom and baby at
birth is harmful for all babies, but Schore points
out how much more harm it does to boys: “Exposing newborn male
... to separation stress causes an acute strong
increase of cortisol and can therefore be regarded
as a severe stressor” (Kunzler, Braun, &
Bock, 2015, p. 862). Repeated separation results in
hyperactive
behavior, and “changes ... prefrontal-limbic
pathways, i.e., regions that are dysfunctional in a
variety of mental disorders” (p.
862). 3. Provide responsive
care. Mothers, fathers and other caregivers
should avoid any extensive distress in the
child—“enduring negative affect.”
Instead of the normalized harsh treatment of males
("to make them men") by letting them cry as babies
and then telling them not to cry as boys, by
withholding affection and other practices to
“toughen them up,” young boys should be
treated in the opposite way: with tenderness and
respect for their needs for cuddling and
kindness. Note that preterm boys
are less able to spontaneously interact with
caregivers and so need particularly sensitive care
as their neurobiological development
proceeds. 4. Provide paid parental
leave. For parents to provide responsive care,
they need the time, focus and energy. This means a
move to paid maternal and paternal leave for at
least a year, the time when babies are most
vulnerable. Sweden has other family-friendly
policies that make it
easier for parents to be responsive. (This link is
broken. Refer to the Sweden article in the index at
the start of this page.) 5. Beware of environmental
toxins. One other thing I did not address, that
Schore does, is the effects of environmental
toxins. Young boys are more negatively affected by
environmental toxins that also disrupt the
brain’s right hemisphere development (e.g.,
plastics like BpA, bis-phenol-A). Schore agrees
with Lamphear’s (2015) proposal that the
ongoing “rise in developmental disabilities is
associated with environmental toxins on the
developing brain.” This suggests we should be
much more cautious about putting toxic chemicals
into our air, soil, and water. That is a topic for
another blog post. Conclusion Of course, we should not just
worry about boys but take action for all babies. We
need to provide nurturing care for all children.
All children expect and need, for proper
development, the
evolved nest, a
baseline for early care which provides the
nurturing, stress-reducing care that fosters
optimal brain development. My lab studies the
Evolved Nest and finds it related to all the
positive child outcomes we have studied. Next post: Why
Worry About Undercared for Males? Messed up
Morals! Note on
circumcision: Readers have raised questions
about circumcision. The USA dataset reviewed by Dr.
Schore did not include information about
circumcision, so there is no way to know whether
some of the findings might be due to the trauma of
circumcision, which is still widespread in the USA.
Read more about the psychological effects of
circumcision here. Note on basic
assumptions: When I write about
child-raising, I assume the importance of the
evolved
nest or evolved developmental
niche (EDN) for
raising human infants (which initially arose over
30 million years ago with the emergence of the
social mammals and has been slightly altered among
human groups based on anthropological
research). The EDN is the baseline I use
to examine what fosters optimal human health,
wellbeing and compassionate morality.
The niche includes at least the following:
infant-initiated breastfeeding for several years,
nearly constant touch early, responsiveness to
needs to avoid distressing a baby, playful
companionship with multi-aged playmates, multiple
adult caregivers, positive social support, and
soothing perinatal experiences. All EDN characteristics are
linked to health in mammalian and human studies
(for reviews, see Narvaez, Panksepp, Schore &
Gleason, 2013; Narvaez, Valentino, Fuentes, McKenna
& Gray, 2014; Narvaez, 2014) Thus, shifts away
from the EDN baseline are risky and must be
supported with lifelong longitudinal data looking
at multiple aspects of psychosocial and
neurobiological wellbeing in children and adults.
My comments and posts stem from these basic
assumptions. My research laboratory has
documented the importance of the EDN for child
wellbeing and moral development with more papers in
the works (see my website
to download papers). References Kunzler, J., Braun, K., &
Bock, J. (2015). Early life stress and sex-specific
sensitivity of the catecholaminergic systems in
prefrontal and limbic systems of Octodon degus.
Brain Structure and Function, 220,
861–868. Lanphear, B.P. (2015). The
impact of toxins on the developing brain. Annual
Review of Public Health, 36,
211–230. McEwen, B.S., & Gianaros,
P.J. (2011). Stress- and allostasis-induced brain
plasticity. Annual Review of Medicine, 62,
431–445. Schore, A.N. (1994). Affect
regulation the origin of the self. The neurobiology
of emotional development. Mahwah, NJ:
Erlbaum. Schore, A.N. (2001a). Effects
of a secure attachment relationship on right brain
development, affect regulation, and infant mental
health. Infant Mental Health Journal, 22,
7–66. ?Schore, A.N. (2001b). The
effects of relational trauma on right brain
development, affect regulation, and infant mental
health. Infant Mental Health Journal, 22,
201–269. Schore, A. N. (2017). All our
sons: The developmental neurobiology and
neuroendocrinology of boys at risk. Infant Mental
Health Journal, e-pub ahead of print doi:
10.1002/imhj.21616 National Institute of Child
Health and Human Development, Early Child Care
Research Network (2003). Does amount of time spent
in child care predict socioemotional adjustment
during the transition to Kindergarten? Society for
Research in Child Development, Inc.
Source:
www.psychologytoday.com/us/blog/moral-landscapes/201701/be-worried-about-boys-especially-baby-boys Why Worry About Undercared
for Males? Messed up Morals! - Psychology
Today - 1/15/17 Males are more susceptible to
early stress, resulting in higher rates of
developmental disorders like autism, ADHD, early
schizophrenia, and conduct disorders. As indicated
by Allan Schore in his review, these are signals of
early development gone awry. But they are mostly
social disorders that end up harming everyone else.
In fact, early undercare negatively influences
capacities for ethics and morality. I have written
about this in many publications, including my 2014
book, Neurobiology and the Development of Human
Morality: Evolution, Culture and Wisdom. Unfortunately, we have come
to expect a good number of adult males to be
egoistic, aggressive and/or reactive (even when
this is not the case in other cultures). But it
turns out the causes may not be genetic but
epigenetic—effects of experience on how genes
are expressed and the very “plastic”
young brain is shaped. We can think of moral
development like Leo Tolstoy’s discussion of
happy and unhappy families in his novel, Anna
Karenina. He noted, to paraphrase, that happy
families are all alike but unhappy families are all
unique. Similarly, moral flourishing
looks similar across individuals as a form of
dynamic, high-minded, self-controlled, flexible
selfless sociality with resilience (e.g., making
amends) when setbacks occur. Harry Potter is a
fictional exemplar of these capacities. Nelson
Mandela exemplifies a real person who characterized
this type of moral resilience. For example, he was
able to move past his anger and forgive his enemies
while continuing to work for justice in his country
of South Africa. In contrast, as with unhappy
families, there are multiple ways for individual
moral development to “go wrong” (which
perhaps makes them more interesting and more
available as characters). There are individuals who
are habitually low-minded (Al Bundy in Married with
Children), un-self-regulated (Homer Simpson from
The Simpsons), rigid in social relations (Archie
Bunker from All in the Family), ruthless in
treatment of others for his own ends (Francis
Underwood of House of Cards), unable to take
perspectives of others (Sheldon Cooper from The Big
Bang Theory), or unable to forgive (George Costanza
from Seinfeld). Why is it so easy to find
disordered male characters? As noted in the
previous post Be Worried about Boys, Especially
Baby Boys, boys are more vulnerable to
neuropsychiatric disorders that appear
developmentally such as autism, early onset
schizophrenia, ADHD, and conduct disorders (Schore,
2017). This may be the reason that boys make for
more interesting characters in fiction. The roots for moral disarray
often begin in early childhood, when toxic stress
or poor care have greatest impact. Early experience
initially shapes moral values by engraving
neurobiology, setting one on a better or worse
trajectory in terms of moral development and
influencing one’s deep moral
values. We will focus on two
fictional characters, Sheldon Cooper from "The Big
Bang Theory" and Francis Underwood from "House of
Cards." Sheldon Cooper has been told
rules for life by his mother and others, and has
committed many to memory, but they do not match up
with his own anti or non-social intuitions and
reactions. Francis Underwood is not as autistic
(socially awkward in perception, sensitivity and
behavior) but he has similar antisocial attitudes.
Both do not care much about other people, except
instrumentally, using them to help get what they
want. What happened? It looks like
when they were babies they were smart enough as a
baby to “go into their heads” when needs
were not met, as a defense against trauma
(Winnicott, 1965). Like those with avoidant
attachment, they took an intellectual route to
social development. At the same time the
development of their emotional intelligence was
thwarted, all during sensitive periods of brain
development. Both Sheldon and Francis show
how a person can learn rules from explicit
instruction that don’t match up with implicit
(subconscious) understandings of the world. While
such a person may comply with others’ moral
values when necessary, he has not internalized the
values—does not internally believe, understand
or know them. So then, what kinds of morality are
Sheldon and Francis exhibiting? Morality based in
enhanced survival systems. All of us are born with
survival systems to keep us alive. They include the
emotion systems located in the extrapyramidal
action nervous system: fear, anger, panic/grief,
and basic lust—all well mapped in mammalian
brains and integrated with the stress response
(Panksepp, 1998). When toxic stress takes place
in early childhood, the survival systems are kept
active, undermining capacities for sociality which
are otherwise scheduled to develop at that time
(Narvaez, 2014). Survival systems kick in under
stress and promote such things as territoriality,
imitation, deception, struggles for power,
maintenance of routine and following precedent
(MacLean, 1990). When survival systems take
over the mind, they change perception of what seems
good in the moment. If they trump other values and
guide behavior, we can call them a
self-protectionist ethic (Narvaez, 2008, 2014,
2016). Self-protectionism becomes apparent as a
mindset when individuals hold themselves apart from
others, unable to relationally attune as an equal
to others, just what we see in Sheldon and
Francis. Sheldon displays social
withdrawal enhanced by intellect, what I call
detached imagination. Detached imagination
represents emotionally-detached intellectualism
that does not attend to responsibility towards
others, and plans without a sense of long term
consequences on the web of life. Our studies have
found detached imagination related to personal
distress and social distrust (Narvaez, Thiel, Kurth
& Renfus, 2016). Recent real-life examples of
this mindset include the bankers and mortgage
brokers who caused the 2008 USA financial crash
(illustrated in The Big Short by Michael Lewis).
More everyday examples are found in our fictional
characters like Homer Simpson who regularly causes
disasters for others by not thinking through
possible consequences of his actions. Francis Underwood displays
social opposition enhanced by intellect, a vicious
imagination. Vicious imagination (inflamed by
social opposition) represents planful control or
harm of others. Our studies found it strongly
related to insecure attachment and trait aggression
(Narvaez, Thiel et al., 2016). We can note other examples.
Crake in the novel, Oryx and Crake, by Margaret
Atwood, exemplifies viciousness as he secretly
develops both a new life form to inhabit the earth
while at the same time a way to kill off humanity
with a pill containing a virus with a delayed
effect. But less extreme cases are found in
everyday life with characters like George Costanza
as he seeks to take revenge on those who he thinks
slighted him. These types of protectionist
ethics indicate a hierarchical mindset (dominance
or submission) to which survival systems are
oriented to promote self-safety. When the stress
response is active, blood flow shifts towards
mobilization for safety and away from capacities
for openness. The shift can occur by situation and
can happen so quickly that it is not apparent to
the individual (Narvaez, 2014). Someone can shift into
aggression under particular circumstances, as when
George Costanza pushed everyone at a daycare out of
the way to escape when he thought there was a fire
in the building. Individuals can dispositionally
favor aggressing or withdrawing, or shift between
them opportunistically like George does. In my lab we have shown that
individuals whose childhoods were more inconsistent
with the evolved nest are more likely to have
protectionist ethics and behaviors (Narvaez, Thiel
et al., 2016; Narvaez, Wang, & Cheng, 2016).
Those with protectionist ethics were more
distrustful, less prosocial and had lower integrity
scores. BUT But you might argue that it
is normal for mothers to be unresponsive and foster
the types of disorders the data show are more
common in boys (autism, conduct disorder,
schizophrenia, ADHD). To believe this is contrary
to billions of years of evolution where disordered
individuals just don’t make it—a poorly
developed individual is not going to have
descendants over the long term that can outcompete
the well developed rivals. And this view is
contrary to human evolution according to Darwin. We
take these things up in the next post. Conclusion We now face a world full of
males who have been undercared for. Look around at
the leadership in fields like business or politics
and you can see many self-centered males (perhaps
more or less extreme than Sheldon or Francis).
Sociologist Charles Derber contends that to get
ahead in the USA you have to be
sociopathic. People with
self-protectionist ethics represent a danger to the
rest of us because they lack the evolved "moral
sense.". WHEN I WRITE ABOUT HUMAN
NATURE, I use the 99% of human genus history as a
baseline. That is the context of small-band
hunter-gatherers. These are
“immediate-return” societies with few
possessions who migrate and forage. They have no
hierarchy or coercion and value generosity and
sharing. They exhibit both high autonomy and high
commitment to the group. They have high social
wellbeing. See comparison between dominant Western
culture and this evolved heritage in my article
(you can download from my website): Narvaez, D. (2013). The 99
Percent—Development and socialization within
an evolutionary context: Growing up to become
“A good and useful human being.” In D.
Fry (Ed.), War, Peace and Human Nature: The
convergence of Evolutionary and Cultural Views (pp.
643-672). New York: Oxford University
Press. WHEN I WRITE ABOUT PARENTING,
I assume the importance of the evolved nest, the
evolved developmental niche (EDN) for raising human
infants (which initially arose over 30 million
years ago with the emergence of the social mammals
and has been slightly altered among human groups
based on anthropological research). The EDN is the baseline I use
to examine what fosters optimal human health,
wellbeing and compassionate morality. The niche
includes at least the following: infant-initiated
breastfeeding for several years, nearly constant
touch early, responsiveness to needs to avoid
distressing a baby, playful companionship with
multi-aged playmates, multiple adult caregivers,
positive social support, and soothing perinatal
experiences. All EDN characteristics are
linked to health in mammalian and human studies
(for reviews, see Narvaez, Panksepp, Schore &
Gleason, 2013; Narvaez, Valentino, Fuentes, McKenna
& Gray, 2014; Narvaez, 2014) Thus, shifts away
from the EDN baseline are risky and must be
supported with longitudinal data looking at
multiple aspects of psychosocial and
neurobiological wellbeing in children and adults.
My comments and posts stem from these basic
assumptions. My research laboratory has
documented the importance of the EDN for child
wellbeing and moral development with more papers in
the works (see my Website to download
papers): Narvaez, D., Gleason, T.,
Wang, L., Brooks, J., Lefever, J., Cheng, A., &
Centers for the Prevention of Child Neglect (2013).
The Evolved Development Niche: Longitudinal Effects
of Caregiving Practices on Early Childhood
Psychosocial Development. Early Childhood Research
Quarterly, 28 (4), 759–773. Doi:
10.1016/j.ecresq.2013.07.003 Narvaez, D., Wang, L.,
Gleason, T., Cheng, A., Lefever, J., & Deng, L.
(2013). The Evolved Developmental Niche and
sociomoral outcomes in Chinese three-year-olds.
European Journal of Developmental Psychology,
10(2), 106-127. We also have a paper in press
showing the relation of the EDN to adult wellbeing,
sociality and morality. We also have a recent
paper look at adult effects: Narvaez, D., Wang, L, &
Cheng, A. (2016). Evolved Developmental Niche
History: Relation to adult psychopathology and
morality. Applied Developmental Science, 4,
294-309.
http://dx.doi.org/10.1080/10888691.2015.1128835 See these for theoretical
reviews: Narvaez, D., Gettler, L.,
Braungart-Rieker, J., Miller-Graff, L., &
Hastings, P. (2016). The flourishing of young
Children: Evolutionary baselines. In Narvaez, D.,
Braungart-Rieker, J., Miller, L., Gettler, L.,
& Harris, P. (Eds.), Contexts for young child
flourishing: Evolution, family and society (pp.
3-27). New York, NY: Oxford University
Press. Narvaez, D., Hastings, P.,
Braungart-Rieker, J., Miller, L., & Gettler, L.
(2016). Young child flourishing as an aim for
society. In Narvaez, D., Braungart-Rieker, J.,
Miller, L., Gettler, L., & Hastings, P. (Eds.),
Contexts for young child flourishing: Evolution,
family and society (pp. 347-359). New York, NY:
Oxford University Press. Also see these
books: Evolution, Early Experience
and Human Development (Oxford University
Press) Ancestral Landscapes in Human
Evolution (Oxford University Press) Contexts for Young Child
Flourishing: Evolution, Family and Society (ed.
with Braungart-Rieker, Miller-Graff, Gettler,
Hastings; OUP, 2016) Neurobiology and the
Development of Human Morality (W.W.
Norton) References MacLean, P.D. (1990). The
Triune Brain in Evolution: Role in Paleocerebral
Functions. New York: Plenum. Narvaez, D. (2008). Triune
ethics: The neurobiological roots of our multiple
moralities. New Ideas in Psychology, 26:,
95–-119. Narvaez, D. (2014).
Neurobiology and the development of human morality:
Evolution, culture and wisdom. New York, NY: W.W.
Norton. Narvaez, D. (2016). Embodied
morality: Protectionism, engagement and
imagination. New York, NY:
Palgrave-Macmillan. Narvaez, D., Thiel, A.,
Kurth, A., & Renfus, K. (forthcoming, 2016).
Past moral action and ethical orientation In D.
Narvaez, Embodied morality: Protectionism,
engagement and imagination. New York, NY:
Palgrave-Macmillan. Narvaez, D., Wang, L, &
Cheng, A. (2016). Evolved Developmental Niche
History: Relation to adult psychopathology and
morality. Applied Developmental Science, 4,
294-309.
http://dx.doi.org/10.1080/10888691.2015.1128835 Panksepp, J. (1998).
Affective neuroscience: The foundations of human
and animal emotions. New York: Oxford University
Press. Schore, A. N. (2017). All our
sons: The developmental neurobiology and
neuroendocrinology of boys at risk. Infant Mental
Health Journal, e-pub ahead of print doi:
10.1002/imhj.21616 Winnicott, D. (1965). The
maturational processes and the facilitating
environment. New York: International Universities
Press: London: Circumcision’s
Psychological Damage - Psychology Today
- 1/1/16 As psychologists, we are
deeply concerned by the recently announced CDC
guidelines promoting circumcision for all males,
and in particular children. The CDC guidelines are
based on a sharply criticized 2012 policy statement
by the American Academy of Pediatrics. The 2012
statement was condemned by a large group of
physicians, medical organizations, and ethicists
from European, Scandinavian, and Commonwealth
countries as “culturally biased” and
“different from [the conclusions]
reached by physicians in other parts of the Western
world, including Europe, Canada and Australia”
(Frisch et al., 2013). The new CDC guidelines
highlight methodologically flawed studies from
Africa that have no relevance to the United States.
They chose to ignore studies that were conducted in
the United States and show no link between
circumcision and the risk of sexually transmitted
diseases, including HIV (Thomas et al.,
2004). Worse, the CDC has completely
ignored the psychological effects of genital
cutting on male children. This article outlines the
psychological research that demonstrates the
relationship between circumcision and psychological
harm. The authors, along with other psychologists,
have appealed to the CDC and Congress to reevaluate
this policy in light of the psychological harm it
will cause infants, children, and teens. Psychological Effects on
Infants 1. Circumcision Causes
Immediate Harm Circumcision is often
performed on infants without anesthetic or with a
local anesthetic that is ineffective at
substantially reducing pain (Lander et al., 1997).
In a study by Lander and colleagues (1997), a
control group of infants who received no anesthesia
was used as a baseline to measure the effectiveness
of different types of anesthesia during
circumcision. The control group babies were in so
much pain—some began choking and one even had
a seizure—they decided it was unethical to
continue. It is important to also consider the
effects of post-operative pain in circumcised
infants (regardless of whether anesthesia is used),
which is described as “severe” and
“persistent” (Howard et al., 1994). In
addition to pain, there are other negative physical
outcomes including possible infection and death
(Van Howe, 1997, 2004). 2. Pain from Circumcision in
Infancy Alters the Brain Research has demonstrated the
hormone cortisol, which is associated with stress
and pain, spikes during circumcision (Talbert et
al., 1976; Gunnar et al., 1981). Although some
believe that babies “won’t remember”
the pain, we now know that the body
“remembers” as evidenced by studies which
demonstrate that circumcised infants are more
sensitive to pain later in life (Taddio et al.,
1997). Research carried out using neonatal animals
as a proxy to study the effects of pain on
infants’ psychological development have found
distinct behavioral patterns characterized by
increased anxiety, altered pain sensitivity,
hyperactivity, and attention problems (Anand &
Scalzo, 2000). In another similar study, it was
found that painful procedures in the neonatal
period were associated with site-specific changes
in the brain that have been found to be associated
with mood disorders (Victoria et al.,
2013). 3. Infant Circumcision has
Psychological Consequences for Men Over the last decade there
has been a movement of men who were circumcised as
infants and have articulated their anger and
sadness over having their genitals modified without
their consent. Goldman (1999) notes that shame and
denial is one major factor that limits the number
of men who publicly express this belief. Studies of
men who were circumcised in infancy have found that
some men experienced symptoms of post traumatic
stress disorder, depression, anger, and intimacy
problems that were directly associated with
feelings about their circumcision (Boyle, 2002;
Goldman, 1999; Hammond, 1999). Psychological Effects on
Children and Adolescents 1. Medical Procedures in
Childhood are Often Experienced as
Traumatic The CDC fails to consider
that many medical procedures, even those that are
described as routine, are often experienced as
traumatic by children and adolescents (Levine &
Kline, 2007). Circumcision, for example, clearly
meets the clinical definition of trauma because it
involves a violation of physical integrity. In
fact, research has demonstrated that medical
traumas in childhood and adolescence share many of
the same psychological elements of childhood abuse,
such as physical pain, fear, loss of control, and
the perception that the event is a form of
punishment (Nir, 1985; Shalev, 1993, Shopper,
1995). 2. Procedures Involving
Children’s Genitals Produce Negative
Psychological Effects The psychological
consequences of medical procedures are even greater
when they involve a child’s genitals. Studies
have examined the psychological effects of medical
photography of the genitals (Money, 1987), repeated
genital examinations (Money, 1987), colposcopy
(Shopper, 1995), cystscopy and catheterization
(Shopper, 1995), voiding cystourethrogram (Goodman
et al., 1990), and hypospadias repair (INSA, 1994).
The studies found that these procedures often
produce symptoms which are very similar to those of
childhood sexual abuse, including dissociation and
the development of a negative body image. The
effects often persist into adulthood as evidenced
by a study that examined the effects of childhood
penile surgery for hypospadias. Men who had this
surgery in childhood experienced more depressive
symptoms, anxiety, and interpersonal difficulties
than men who did not have the surgery (Berg &
Berg, 1983). 3. Circumcision Causes
Significant Psychological Harm in Children and
Adolescents Circumcision in childhood and
adolescence has significant negative psychological
consequences. Following a traumatic event, many
children experience anxiety, depression, and anger;
and many others try to avoid and suppress these
painful feelings (Gil, 2006). In addition, children
often experience a debilitating loss of control
that negatively affects their ability to regulate
emotions and make sense of the traumatic experience
(Van der Kolk, 2005). In a study of adults
circumcised in childhood, Hammond (1999) found that
many men conceptualized their circumcision
experience as an act of violence, mutilation, or
sexual assault. Kennedy (1986) detailed the
psychological effects of circumcision in a case
study describing the psychotherapy of a boy who was
circumcised at three years of age. The sense of
inadequacy, feelings of victimization, and violent
sexual fantasies experienced during this boy’s
adolescence were found to be both consciously and
unconsciously linked to his experience with losing
part of his penis (Kennedy, 1986). In a study
examining the psychological effects of circumcision
on boys between four and seven years of age,
Cansever (1965) used psychological testing to
measure boys’ level of distress. The results
of the study indicated that circumcision was
perceived as an aggressive attack on the body that
left children feeling damaged and mutilated
(Cansever, 1968). Cansever (1968) also noted that
these boys experienced changes in body image (with
many feeling smaller and incomplete), feelings of
inadequacy and helplessness, as well as a tendency
to withdraw psychologically. 4. The Majority of Boys
Circumcised as Children and Adolescents Meet
Diagnostic Criteria for Post Traumatic Stress
Disorder (PTSD) The most comprehensive study
available that assesses the psychological impact of
circumcision on children after infancy was
conducted by Ramos and Boyle (2000) and involved
1072 pre-adolescent and adolescent boys who were
circumcised in a hospital setting. Using an adapted
version of a clinically established PTSD interview
rating scale, the study’s authors determined
that 51 percent of these boys met the full
diagnostic criteria for PTSD and noted that other
variables such as age at circumcision
(pre-adolescence versus adolescence) and time
elapsed since the procedure (months versus years)
were not predictive of a PTSD diagnosis (Ramos
& Boyle, 2000). As a point of comparison, the
rate of PTSD among veterans of the Iraq war is
approximately 20 percent (NIH, 2009). 5. By Encouraging
Circumcision, Medical Professionals are Shaming
Boys’ Bodies If the CDC guidance is
followed, medical providers will be communicating a
psychologically damaging message to boys with
intact genitals—that their penises are somehow
“bad” or inferior. The negative effects
of such communications have been studied with
regard to intersex children and have been found to
be frightening, shaming, and embarrassing to the
child (Rusch et al., 2000). This is a particularly
cruel message to send to adolescents, many of whom
are already experiencing concerns regarding body
image. Conclusion The circumcision of children
has myriad negative psychological consequences that
the CDC has failed to consider. Removing healthy
tissue in the absence of any medical need harms the
patient and is a breach of medical providers’
ethical duty to the child. We believe that all
people have a right to bodily autonomy and
self-determination and deeply respect this
fundamental tenet of international human rights law
(UNESCO 2005). As children cannot advocate for
themselves, they need adults to understand the
complexities of their emotional experiences and
provide them special protection. We oppose the
CDC’s circumcision recommendation and
encourage all parents to do the same in order to
protect their children from physical and
psychological harm. Parents: For clear, easy and
plain-language help making the circumcision
decision, try the Circumcision Decision
Maker. For more information, also
read the following: Circumcision in childhood is
linked to increased risk of autism. Practical Tips for Men
Distressed by Their Circumcision References Anand, K.J., & Scalzo,
F.M. (2000). Can adverse neonatal experiences alter
brain development and subsequent behavior? Biol
Neonate, 77, 69-82. Berg, R., & Berg, G.
(1983). Castration complex: Evidence from men
operated for hypospadias. Acta Psychiatrica
Scandinavica, 68, 143-153. Boyle, G.J., Goldman, R.,
Svoboda, JS., & Fernandez, E. (2002). Male
circumcision: Pain, trauma, and psychosexual
sequelae. Journal of Health Psychology, 7,
329-343. Boyle, G.J., & Ramos, S.
(2000). Ritual and medical circumcision among
filipino boys: Evidence of post-traumatic stress
disorder. Humanities & Social Science Papers,
114. Cansever, G. (1965).
Psychological effects of circumcision. British
Journal of Medical Psychology, 38,
321-331. Frisch, M., Aigrain, Y.,
Barauskas, V., Bjarnason, R., Boddy, S.A.,
Czauderna, P., de Gier, R.P., de Jong, T.P.,
Fasching, G., Fetter, W., Gahr, M., Graugaard, C.,
Greisen, G., Gunnarsdottir, A., Hartmann, W.,
Havranek, P., Hitchcock, R., Huddart. S., Janson,
S., Jaszczak, P., Kupferschmid, C., Lahdes-Vasama,
T., Lindahl, H., MacDonald, N., Markestad, T.,
Märtson, M., Nordhov, S.M., Pälve, H.,
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Loewenich, V.C., Wallander, J., Wijnen, R. (2013).
Cultural bias in the AAP's 2012 Technical Report
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3015-3028. Gender
stereotyping may start as young as three months,
study of babies' cries shows - 5/12/16 Adults attribute degrees of
femininity and masculinity to babies based on the
pitch of their cries, as shown by a new study by
researchers from the University of Sussex, the
University of Lyon/Saint-Etienne and Hunter College
City University of New York. The research is
published in the journal BMC Psychology. The study found: Despite no actual difference
in pitch between the voices of girls and boys
before puberty, the study found that adults make
gender assumptions about babies based on their
cries. Dr David Reby from the School
of Psychology at the University of Sussex
said: "There is already
widespread evidence that gender stereotypes
influence parental behaviour but this is the
first time we have seen it occur in relation to
babies' cries. "We now plan to
investigate if such stereotypical attributions
affect the way babies are treated, and whether
parents inadvertently choose different clothes,
toys and activities based on the pitch of their
babies' cries. "The finding that men
assume that boy babies are in more discomfort
than girl babies with the same pitched cry may
indicate that this sort of gender stereotyping
is more ingrained in men. "It may even have direct
implications for babies' immediate welfare: if a
baby girl is in intense discomfort and her cry
is high-pitched, her needs might be more easily
overlooked when compared with a boy crying at
the same pitch. "While such effects are
obviously hypothetical, parents and care-givers
should be made aware of how these biases can
affect how they assess the level of discomfort
based on the pitch of the cry alone."
Professor Nicolas Mathevon,
from the University of Lyon/Saint-Etienne &
Hunter College CUNY, commented: "The potential
implications for parent-child interactions and
for the development of children's gender
identity are fascinating and we intend to look
into this further.” The researchers recorded the
spontaneous cries of 15 boys and 13 girls who were
on average four months old. The team also
synthetically altered the pitch of the cries while
leaving all other features of the cries unchanged
to ensure they could isolate the impact of the
pitch alone. The participating adults were a
mixture of parents and non-parents. 'Sex Stereotypes Influence
Adults' Perception of Babies' Cries' is published
in the BMC Psychology journal. It is authored by
David Reby from the University of Sussex, Florence
Levrero and Erik Gustafsson at the University of
Lyon/Saint-Etienne and Nicolas Mathevon at the
University of Lyon/Saint-Etienne & Hunter
College CUNY. California
Will Now Recognize Nonbinary Identities on Death
Certificates - 7/13/21 California passed two
pro-LGBTQ+ bills last week (2021),
and there’s plenty more to come. Governor Gavin Newsom signed
Assembly Bills 439 and 378 into law on Friday, per
the local LGBTQ+ publication the Bay
Area Reporter. The
former will allow nonbinary people to be
represented in accordance with their lived
identities on death certificates, while the latter
will remove gendered language from a huge number of
state codes relating to government positions.
Currently, California state officials are referred
to with “he” pronouns in these
codes. Both bills were authored by
Assemblywoman Rebecca Bauer-Kahan (D-16th
District), who celebrated the move on Twitter. She
said AB 436’s passage will ensure that
nonbinary individuals “are respected in their
death as they are in life.” Bauer-Kahan affirmed to the
Bay Area Reporter that she was “beyond
thrilled that Governor Gavin Newsom has signed
these two bills into law.” “It's 2021 and
our laws need to reflect that anyone, regardless of
gender, can hold California's highest
offices,” she said of the gender-neutrality
bill In addition to affirming
respect for the dead, a nonbinary designation on
death certificates will strengthen the LGBTQ+ data
available to public health researchers, according
to the California Fox affiliate KTVU. Given that
nonbinary people are only just now starting to be
studied on a population level, this designation
will better assist California in researching its
nonbinary population’s health. It’s not an
unprecedented move, either: New York City announced
in 2019 that its Health Department would start
including an “X” option on death
certificates, and Oregon has been offering
gender-neutral markers on such documents since
2018. Though the Golden State is
often one step ahead of the rest of the country
when it comes to trans equality, California is only
the latest to revise its state laws to be gender
neutral. Minnesota removed gender-specific language
from its laws in 1986, according to Newsweek. A
similar bill revising “archaic gender-specific
pronouns” in California’s vehicle and
insurance codes is still pending in the
legislature. Californians, meanwhile, have
been able to get “X” gender markers on
state IDs since 2019. While the death certificate
bill is the first pro-LGBTQ+ legislation that the
governor has approved this year, it’s likely
far to be the last. According to the Bay Area
Reporter, lawmakers hope to put 10 other LGBTQ+
bills on Newsom’s desk before the end of the
legislative session in September. That includes two bills
sponsored by Assemblyman David Chiu (D-17th
District), which aim to protect
the privacy of trans people
receiving gender-affirming care and prohibit public
universities from deadnaming
trans students in
academic records. While California has some privacy
protections for those receiving “sensitive
services,” which encompasses mental health and
gender-affirming care, the bill allows all patients
to request increased confidentiality measures for
their medical information. Other bills include the
Safer
Streets for All Act,
which would repeal California’s version of the
“walking while trans” law criminalizing
“loitering for the intent to engage in
prostitution.” As critics have noted, the
enforcement of these laws is highly subjective and
results
in the disproportionate
targeting of
transgender women of color, especially Black trans
women. Lastly, another bill would
require large retail stores to remove gendered
signage from toy and childcare aisles. A previous
version of the bill included children’s
clothing, but this stipulation was removed as a
compromise in order to move the bill
forward. The bills passed Friday will
go into effect on January 1.2021
Newborn
Identification: A National Patient Safety Initiative A recent TSG article by Dr. Tom Syzek entitled “Medical Errors, Communication, Teamwork and End of Life: Lessons from Angola” speaks to the importance of correct patient identification and the safety implications surrounding it. This article dovetails nicely with the new 2019 Joint Commission National Patient Safety Goal (NPSG) regarding newborn identification, so I thought this would be the perfect opportunity to keep the conversation relevant and on-topic by addressing this new NPSG. Hospitalized newborns are a vulnerable population at considerable risk for misidentification. Several unique features of the newborn population lead to misidentification:
Furthermore, well-known misidentification errors such as wrong patient/wrong procedure have resulted in many errors, including:
All these errors have the potential to cause patient harm and parental distress. A reliable identification system is necessary to prevent these types of serious errors and prevent harm to the newborn; hence, the birth of this safety initiative. The need for updated and improved newborn identifiers was recognized by the AAP and other leaders in the field of safety. Gray et al. found that similar medical record numbers followed by similar or identical surnames made up the bulk of misidentification errors. Heightened awareness to this issue provided the impetus for much needed scrutiny of current practices. After research of the literature, public review, and engaging discussion the safety leaders developed the National Patient Safety Goal (NPSG.01.01.01). Effective January 1, 2019, all hospitals caring for newborns will be required to use at least two patient identifiers when providing care, treatment and services to newborn infants. Examples of methods to prevent misidentification as cited by the NPSG may include the following:
Safe Practices for Infant Identification
Vigilance for accurate patient identification is a quality and safety issue that should be embedded into our daily hospital routines. The busyness of hospital routines such as infant feedings, circumcision, cardiac screens, hearing screens, bilirubin assessment and lab draws should not undermine the importance of correct patient identification. Everyone working with newborns is responsible to ensure that misidentification does not happen and that safety is always maintained. Resources
Source: blog.thesullivangroup.com/newborn-identification-a-national-patient-safety-initiative American
Medical Association Recommends Removing Sex From Birth
Certificates - 8/5/21 In an incredibly significant — and long overdue — move, the American Medical Association (AMA) has recommended that the “sex” designation be removed from the public facing portion of babies’ birth certificates, reserving that information for medical professionals. The recommendation comes because “assigning sex using a binary variable and placing it on the public portion of the birth certificate perpetuates a view that it is immutable,” the AMA’s LGBTQ+ advisory committee stated in a June report. Further, the committee says that designating babies as either “male” or “female” at birth “fails to recognize the medical spectrum of gender identity.” The current requirement to list a baby’s binary sex or gender category in publicly available documentation can lead to many challenges, disproportionately impacting trans, non-binary, and intersex people. For instance, people whose gender identity or presentation doesn’t match the sex on their birth certificate can experience discrimination or harrassment when registering for school, getting married, or adopting a child. "We unfortunately still live in a world where it is unsafe in many cases for one's gender to vary from the sex assigned at birth," Jeremy Toler, MD, a delegate from GLMA: Health Professionals Advancing LGBTQ Equality, told WebMD. The AMA also points out that birth certificates have historically “been used to discriminate, promote racial hierarchies, and prohibit miscegenation.” “For that reason, the race of an individual’s parents is no longer listed on the public portion of birth certificates,” the report continues. “However, sex designation is still included on the public portion of the birth certificate, despite the potential for discrimination.” Blank birth certificate has been stamped with baby's footprints. It sits on a table with a pen, ready to be filled in. Trans People Will Finally Be Able to Get a Corrected Birth Certificate in Ohio The new policy will be rolled out on June 1. Large numbers of trans people still don’t have documentation that reflects their lived gender. According to a study from earlier this year, an estimated 34% of trans Americans don’t have identification that aligns with their gender identity. Currently, 14 states offer a third gender option for birth certificates, but wiping out the public-facing sex designation could competely allow for uniform policies across all states. Even though it’s proven that sex is not binary — just look at the existence of intersex people, as well as the lived experiences of trans and nonbinary people — right-wing media coverage has gone into full panic-mode about this recommendation. Though the report has not gotten much mainstream media coverage, conservative outlets have been all over it, including The Federalist, Fox News, and The National Review. It marks a continuation of the ongoing right-wing fear mongering campaign against trans rights and inclusion. The AMA’s report notes that making this change “will not address all aspects of the inequities transgender and intersex people face, but such an effort would represent a valuable first step.” No word on whether it will stop cis people from continuing to stage gender reveals, though. Get the best of what’s queer.
Sign up for them.'s weekly newsletter here. Hospital
removes gender identification from bracelets -
11/14/18 The Bulletin newspaper in Bend reports the St. Charles Health System adopted the change last month. The ID bracelet is designed to provide caregivers an easy way to identify patients based on two distinct identifiers. “It was something that everybody felt had to be on there because it was always on there,” said Rebecca Scrafford, a psychologist at St. Charles who was involved in recommending the change. “It’s providing no benefit, but it’s causing harm.” The ID bracelet is designed to provide caregivers an easy way to identify patients based on two distinct identifiers. But staff generally check the patient’s name and date of birth, not gender. Until recently, the hospital’s record system did not distinguish between sex assigned at birth, legal gender and gender identity. The ID bracelet had been showing the patient’s legal name and sex assigned at birth. “For a lot of those patients, that didn’t match, and that was distressing for our patients,” Scrafford said. “This is one little baby step in providing affirming care that is probably the first visible sign of many efforts that are underway at St. Charles and communitywide.” Last year the hospital held a transgender health care training event for providers, and this year convened an internal sexual orientation and gender identity work group to guide initiatives around welcoming transgender patients. Meanwhile, the new Central Oregon Transgender Healthcare Coalition held its first meeting last month, establishing a goal of expanding capacity for transgender health in the community. The hospital has now trained its staff about when and how to ask about gender identity, and how to record that information in the patient’s record. “You can have the nicest provider in the world, but if the person at the front desk says the wrong name and gender, it’s not going to be the greatest experience,” Scrafford said. Surveys show many transgender people have had negative experiences interacting with the health care system and nearly half say they avoid medical care because of it. “Patients will access care first and foremost if they feel safe accessing care,” said Dr. Christina Milano, a professor of family medicine at Oregon Health & Science University in Portland, and an expert in transgender health issues. “Unfortunately, transgender and gender diverse individuals have a long history experiencing things like discrimination or inappropriate questions and comments regarding their gender when accessing health care.” Limitations in electronic health records, she says, often mean printed labels or ID bracelets don’t align with a patient’s gender identity. “A wristband that a patient is wearing in a hospital during a critical time, a scary hospital admission, that’s something that they’re staring at 24/7 during their waking hours,” Milano said. “So having that being gender affirming by either having the correct gender or having no gender marker — so avoiding the risk of the wrong gender marker — is a big positive.” But the limitations of the record system often mean transgender patients must sacrifice their privacy to get things corrected. “I’ve had to publicly out myself many times,” said Rob Landis, a transgender man from Prineville and a board member of the Human Dignity Coalition. “If I was any other transgender person, I could have gotten very offended and hurt by that.” Landis recounted a visit to one clinic where the woman checking him in for his appointment burst out laughing when she pulled up his records. “That’s so weird. There’s an F here on the screen where there should be an M,” he recalls her saying. “Yeah, it’s not really funny because I’m transgender.” Another time he had to explain why he was coming for an appointment with a gynecologist. “I had to out myself again, to say I had some female parts that needed to be removed,” he said. Still Landis says he has seen tremendous change in Central Oregon. When he started his transition six year ago, he had to research which providers locally were familiar with transgender health issues and if offices would treat him with respect. “I thought Central Oregon was like its own little island that has been kept from the real world,” Landis said. “But doing some research, there are a lot of providers out there locally. I don’t have to go to Portland.” The Human Dignity Coalition has served as a clearinghouse for transgender individuals seeking health providers, sharing word-of-mouth reviews of which doctors were knowledgeable and accommodating. It also holds training sessions for providers and staff on transgender issues. Coalition president Jamie Bowman has two transgender daughters and tries to pre-empt problems by informing the front desk when she checks in that her child’s legal name isn’t the name she now uses. “I just hope that the waiting room full of parents and other children didn’t hear, and then hope and cross my fingers that when the nurse comes to the door to call my child, she would call the right name,” Bowman said. “And just last week, they didn’t.” Two years ago, her daughter received an ID bracelet with the wrong gender at the emergency room at St. Charles Redmond. “I just looked at it and sighed. And then the admit person came back with a different bracelet, took the M off, and put an F on instead,” she said. “Even that little bitty thing, it just made all the difference to my child.” There are an estimated 1.4 million
transgender people in the United States, representing about
0.6 percent of the population, although those numbers may
represent an undercount. Remove Sex From
Public Birth Certificates, AMA Says - 6/10/21 Requiring it can lead to discrimination and unnecessary burden on individuals whose current gender identity does not align with their designation at birth, namely when they register for school or sports, adopt, get married, or request personal records. A person's sex designation at birth would still be submitted to the U.S. Standard Certificate of Live Birth for medical, public health, and statistical use only, report authors note. Willie Underwood III, MD, author of Board Report 15, explained that a standard certificate of live birth is critical for uniformly collecting and processing data, but the government issues birth certificates to individuals. Ten States Allow Gender-Neutral Designation According to the report, 48 states (Tennessee and Ohio are the exceptions) and the District of Columbia allow people to amend their sex designation on their birth certificate to reflect their gender identities, but only 10 states allow for a gender-neutral designation, usually "X," on birth certificates. The State Department does not currently offer an option for a gender-neutral designation on U.S. passports. "Assigning sex using binary variables in the public portion of the birth certificate fails to recognize the medical spectrum of gender identity," Underwood said, and can be used to discriminate. Jeremy Toler, MD, a delegate from GLMA: Health Professionals Advancing LGBTQ Equality said transgender, gender nonbinary, and individuals with differences in sex development can be placed at a disadvantage by the sex label on the birth certificate. "We unfortunately still live in a world where it is unsafe in many cases for one's gender to vary from the sex assigned at birth," Toler said. Not having this data on the widely used form will reduce unnecessary reliance on sex as a stand-in for gender, he said, and would "serve as an equalizer" since policies differ by state. Robert Jackson, MD, an alternate delegate from the American Academy of Cosmetic Surgery, spoke against the measure. "We as physicians need to report things accurately," Jackson said. "All through medical school, residency, and specialty training we were supposed to delegate all of the physical findings of the patient we're taking care of. I think when the child is born, they do have physical characteristics either male or female and I think that probably should be on the public record. That's just my personal opinion." Sarah Mae Smith, MD, delegate from California, speaking on behalf of the Women Physicians Section, said removing the sex designation is important for moving toward gender equity. "We need to recognize gender is not a binary but a spectrum," she said. "Obligating our patients to jump through numerous administrative hoops to identify as who they are based on a sex assigned at birth primarily on genitalia is not only unnecessary but actively deleterious to their health." Race Was Once Public on Birth Certificates She noted that the report mentions the race of a person’s parents used to be included on the public portion of the birth certificate and that information was recognized to sometimes lead to discrimination. "Thankfully, a change was made to obviate at least that avenue for discriminatory practices," she said. "Now, likewise, the information on sex assigned at birth is being used to undermine the rights of our transgender, intersex, and nonbinary patients." Arlene Seid, MD, ,an alternate delegate from the American Association of Public Health Physicians, said the resolution protects the data "without the discrimination associated with the individual data." Sex no longer has a role to play in the jobs people do, she noted, and the designation shouldn't have to be evaluated for something like a job interview, she said. "Our society doesn't need it on an
individual basis for most of what occurs in public life,"
Seid said. How
Hospitals Respond When It’s Uncertain If the Newborn Is
a Boy or a Girl Mike and Julie were eagerly counting down the days until they’d get to meet their baby girl, Emma. But hours after her birth, their joy turned to worry. Doctors had made a discovery that shocked them: Their newborn daughter had what appeared to be testes. The next 24 hours were a blur as Emma underwent several tests, and her parents were told that for unexplained reasons, she was born with XY chromosomes. “They told us ‘you don’t need to raise your baby as male or female. You can be gender neutral for the first year,’” Julie remembers. “It blew our mind. Maybe in a perfect world we could, but this isn’t a perfect world and society doesn’t allow you to raise a nongender child. How could we ever choose a gender for our child? My heart was just broken for her imagining how hard her life would be.” “At the time, we were just so uneducated about this topic. We felt extremely alone and isolated.” About 1 in 1,500 babies are born with a disorder, or difference, of sex development (referred to by some outside the medical community as intersex), in which development of the sex chromosomes, gonads or sex anatomy is atypical. While families are then often faced with the difficult and controversial decision of whether they should surgically reinforce a child’s gender, few hospitals are equipped with specialist teams highly qualified to treat these conditions. In fact, there’s significant difference in how institutions across the country respond to such cases — having a major impact on a family’s experience and decisions about sometimes irreversible procedures, according to a new study led by members of the DSD team at University of Michigan C.S. Mott Children’s Hospital. “A family’s experience and potential care for these conditions may be drastically different depending on where their child is born,” says senior author David Sandberg, Ph.D., a pediatric psychologist at Mott. “We found substantial variability across health care institutions in the ways that they organized and delivered care for these patients and families as well as how families were counseled prior to genital or reproductive anatomy surgery.” The study included 22 sites that offer DSD services and is the first to examine clinical practices for these conditions at U.S. medical centers. The findings were published in the American Journal of Medical Genetics, along with a second U-M-led study addressing the importance of psychosocial screenings in DSD care. “Our findings suggest the field has significant room to improve guidelines for diagnosing and treating disorders of sex development,” Sandberg says. “We need stronger collaboration among providers to determine the most effective practices to guide families as they make major decisions about their child’s well-being and future.” ‘Pioneering the way’ The first few days after Emma’s birth at a Grand Rapids-area hospital were brutal for Mike and Julie as they tried to educate themselves on Emma’s condition and determine the best next steps. “People were just flooding our room and we were putting on smiles when inside we were broken. We didn’t know who to tell,” Julie says. “We spent the first 10 months living a double life, having test after test done and still not knowing exactly what she had or what to do. “We had one endocrinologist actually tell us that we would know what gender to pick by age 2 or 3 depending on if our child played with Barbies or cars and dinosaurs. That made us lose faith in the system.” A year later, through their own research and a DSD support group, the couple connected with other experts and found their way to Mott, where their experience immediately changed. There, they found an interdisciplinary team of endocrinologists, geneticists, urologists, surgeons, gynecologists, social workers, psychologists and others who worked as a team to customize care for each family. Through further testing, the couple learned they each had rare genetic traits that increased the chance their children would be born with the specific DSD condition Emma had. And a few years later, her little sister was born with the same one. This time, they were more prepared and supported by their health care team and other families they had connected with who had similar journeys. “We felt more informed and had doctors who understood us and were on our team. We needed that big-time,” Julie says. “We felt so fortunate to have found them; it solidified that this was what it was supposed to be like. This team is pioneering the way it should be handled everywhere. Nobody should have to experience what we did the first time.” “We want to protect our children’s privacy but also want to share our story in order to raise awareness about DSD,” she adds. “There can be so much stigma and shame attached but mostly because people aren’t educated about DSD, just like we weren’t until it affected us.” Optimizing care in the future While most sites in the U-M study reported some degree of involvement of pediatric urology, surgery and endocrinology in the care of DSD patients, gynecology and neonatology were most frequently not represented. Sites were surveyed on multiple areas of practice, including the consent process for helping families understand potential risks of treatment, the possibility a child later identifies with a different gender, surgical complications, possible effects on sexual function and fertility,hormonal consequences of removing the gonads (accompanied by the need for lifelong hormone replacement) or psychological impacts. Sandberg says the survey suggests that sites would benefit from a network that facilitates the sharing of resources and strategies to improve care and patient outcomes. He notes that clinician perceptions of service may also differ from the experience of patients. “All institutions share the goal of optimizing care of patients with DSD, but delivering patient- and family-centered care for these conditions is often complex and challenging, requiring the input of multiple providers and families,” Sandberg says. “Many factors likely play a role
in why there is so much variability in practices, but we
need to better understand the reasons so we can establish
which practices and model of care are associated with the
best patient outcomes. We need to work together as providers
to identify opportunities for change that enhance health and
quality of life outcomes for patients and families affected
by DSD.” Disorders/Differences
of Sex Development The DSD Clinic at C.S. Mott Children’s Hospital is an interdisciplinary clinic designed to:
The birth of a baby with any physical difference is stressful. A DSD may be additionally overwhelming because of the rareness of these conditions and the possible initial uncertainty about gender, as well as how to explain this to family and friends. Often these are conditions that parents have never read about or encountered before. At conception, “we all start out the same.” DSD are differences in the typical path of sex development between conception and birth. These different paths may be influenced by the arrangement of sex chromosomes, the functioning of our gonads (i.e. testes, ovaries), and our bodies’ response to hormones. DSD can occur in both boys and girls. Since DSD are already present at birth, they are usually detected in infancy or early childhood. However, some DSD are not apparent until later in life. For example, the first sign of a DSD might be that a child’s body does not show signs of puberty at the expected age. Members of the University of Michigan DSD team at C.S. Mott Children’s Hospital understand that each child with a DSD is unique, and that each family has different concerns and needs. Our team of providers specializes in diagnosing DSD and providing clinical care for infants, adolescents and young adults and provides seamless transition to adult specialists. Our mission is to partner with our
patients and their families to provide comprehensive,
coordinated care that meets long-term physical, social and
emotional needs. Parent-infant
communication differs by gender shortly after birth -
Reuters Health - 11/4/14 Researchers also found that mothers may be more likely to vocalize back and forth with female babies compared to male babies. “We know that talking and playing with an infant improves cognitive and language skills,” said senior author Dr. Betty R. Vohr of the pediatrics department at Women & Infants Hospital in Providence, Rhode Island. “Early conversations start in infancy and infants appear primed to communicate shortly after birth,” Vohr told Reuters Health by email. “Both mothers and fathers can play an important role in their infant’s developmental progress.” The study included 33 infants born to two-parent households. The babies wore speech-activated recording devices in customized vests for 10 to 16 hours in the hospital at birth, again at about one month old, and again at seven months old. Researchers analyzed the recordings for adult word count, infant vocalizations and conversational exchanges. “The findings of female and male adult speech reflecting the actual mothers’ and fathers’ speech was based on logs the families kept for each recording,” Vohr and colleagues reported in Pediatrics. Even though very young babies do not yet speak, they do vocalize and can have reciprocal “conversations,” Anne Fausto-Sterling said. Fausto-Sterling, the Nancy Duke Lewis Professor of Biology and Gender Studies in the Department of Molecular and Cell Biology and Biochemistry at Brown University, was not part of the new study. The researchers found that infants were exposed to more speech from females than males at each time point. Female adults also responded more frequently to infant vocalizations than male adults. “It’s not very surprising because mothers are more involved in childcare,” Fausto-Sterling told Reuters Health by phone. “Infants hear women talk more than they hear men talk and learn to identify female voices first.” To newborns, adult females spoke an average of 1,263 words per hour on the recordings, compared to 462 words per hour for male adults. Mothers responded more to baby girl vocalizations at birth and at one month old, the researchers found. “This was an unexpected finding and deserves replication,” Vohr said. “We know that it is important for both parents to talk, play and be engaged with their infant.” “At the moment all we can say is that adult talk appears important for encouragement of infant vocalizations and conversation turns in early infancy,” she said. A previous study by Vohr and colleagues of preterm infants using the same recording software showed that the more parents talked and had conversation turns with their infant in the neonatal intensive care unit, the higher the child’s cognitive and language skills at 18 months of age, she noted. “At least within the standard psychological literature there has been a longstanding view that girls develop language skills more quickly than boys,” Fausto-Sterling said. Some researchers believe the difference in language development is innate, but this study suggests that adults may treat infant girls differently than infant boys at a very young age, which may help explain the difference, she said. “Not very many people have looked at children this young, preverbal kids, whether the input they’re receiving has a gender imbalance,” she said. To confirm that reciprocal vocalizations with adults in infancy are linked to langue aptitude later on, a new study would need to follow children from birth through when they are old enough to talk, she said. In the meantime, “it’s certainly not gong to hurt anything to tell dads to talk more to their kids,” Fausto-Sterling said. “Both parents and in fact all
caregivers need to be told about the importance of talking,
singing and playing with their infant or child,” Vohr
said. Do
we teach boys and girls differently? It can be uncomfortable to talk about boy/girl differences, especially in schools, because of the fear of being unfair or stereotyping. The classroom is a highly influential place for a young child, it being where they spend the majority of their time, and so the language they are exposed to in there is a vital part of their learning. In order to create environments that nourish all children and guide them to success, it is important to open up the conversation and explore whether there is a problem. So, do teachers teach boys and girls differently? If yes, how does this influence achievement levels? Is there a gender problem in class rooms? Research suggests that, subconsciously, teachers may be more likely to associate boys with underachievement and girls with high achievement. This can create misconceptions about the expected behaviours and characteristics of the respective groups, which may lead to these students being treated differently. Here are a few ways in which teaching may differ: The Language Used Using gender stereotypes such as “boys don’t like writing” and “girls settle down and get on with it” may not relay a positive message to students. This could lead to a tendency where boys are seen in terms of things they cannot, will not and do not do, whereas girls are seen in terms of the things they have achieved and their compliant behaviour. Being aware of our own gender biases will allow educators to take a step back and look at the bigger picture. Saying something like “girls are better writers” – a comment made by more than 8 teachers in a survey carried out at the English Department in a high school – can have more of an impact on students than it may seem. Girls who are underachieving may feel extra pressure to do well, and high achieving boys may feel that their efforts have gone to waste. Teachers are in a unique and privileged position to vocally challenge common stereotypes and show their students that they can be successful in every subject, regardless of their gender. Compliments in the Classroom Research on observations in the classroom have shown that teachers in that study gave 54 positive comments towards girls, and only 32 towards boys. Over the course of 36 classes, the girls received 22 negative comments with their male counterparts receiving 54. These figures are an indication of the type of support and responses students receive from their teachers on a day to day basis. Girls are praised much more often for their good work and behaviour, contributing to the continuation of it. If boys do not receive this same feedback, it is fair to expect them to be less likely to exhibit these behaviours. A fascinating report by the Department of Education, in 2009, suggested that positive interaction with the teacher in whole-class sessions kept students, especially boys, motivated and involved. That is one of many examples of the importance of good teacher-students relationships. Asking questions in class The under-achieving girl is the least likely to be invited to answer a question in class, and the under-achieving boy is the most likely to be called on to respond. This creates a hurdle in the path to improvement for girls as they may well be overlooked in the classroom. Due to the perceived norm of boys underachieving, the majority of the focus tends to stay on them. There is almost a whole branch of research dedicated to supporting boys in schools, whilst underachieving girls are often invisible. Not getting the same opportunities for improvement can have long-lasting detrimental effects. In order to combat these effects and get students more involved, teachers could divide the questions up equally or introduce a traffic light system which has shown to enhance learning. It is a simple and effective technique that gets students to use the colours of the traffic light to indicate their level of understanding. For more tips, check out our blog on how to help students raise their game. Pull, Don't Push Achievement levels are a good predictor of behaviour and interaction in the classroom, even more significant than gender. High-achieving students are often focused and disciplined, and underachieving students can fall into one of two groups: they are either quiet and disengaged, or loud and attention-seeking. This sometimes-disruptive behaviour can have negative effects on the other students and may hinder their learning. But remember: pull, don’t push. This means creating an environment that fosters motivation and entices students so that they feel a pull towards a goal, instead of using the pressure of looming deadlines and fear of failure to push them into something. If teachers aim to get students engaged and interested, they will be better in the classroom in every possible way, from completing tasks to interacting with their peers. Final Thoughts In order to boost achievement levels
and sustain those already outstanding ones, it is important
to create equal opportunities that allow all students,
regardless of their gender, to succeed and feel supported.
It is the subconscious biases that are often the hardest to
break, but they are also the ones that can yield the best
results if broken. ‘Troublesome
boys’ and ‘compliant girls’: gender identity
and perceptions of achievement and underachievement -
101910 Working within a methodological
framework that identified four focus groups, high-achieving
boys and girls and underachieving boys and girls, this
article presents teachers' perceptions of how gender
identity is seen to influence achievement levels. Beliefs
about gender identity informed the teachers' perceptions in
relation to each of the four focus groups, whereby the
underachieving boy and the high-achieving girl were seen to
conform to gender expectations; the high-achieving boys were
seen to challenge gender norms; and the underachieving girl
emerges as largely overlooked. The perceived characteristics
of the high-achieving girl are presented as describing all
girls. There appears to be a tendency to associate boys with
underachievement and girls with high achievement. The
gender biases that shape our brains - 5/24/21 My daughter is obsessed with all things girly and pink. She gravitated to pink flowery dresses that are typically marketed for girls before she even turned two. When she was three and we saw a group of children playing football, I suggested she could join in when she was a bit older. "Football is not for girls," she replied, firmly. We carefully pointed out that girls, though in the minority, were playing too. She was unconvinced. However, she's also boisterous and loves to climb and jump, attributes often described as boyish. Her overt ideas about what girls and boys should do were somewhat unexpected so early on, but considering how gendered many children's worlds are from the outset, it's easy to see how this occurs. These initial divisions may seem innocent, but over time our gendered worlds have lasting effects on how children grow up to understand themselves and the choices they make – as well as how to behave in the society they inhabit. Later, gendered ideas continue to influence and perpetuate a society which unknowingly promotes values linked to toxic masculinity, which is bad news for all of us, however we identify. So how exactly does our obsession with gender have such a lasting impact on our world? The idea that women were intellectually inferior to men was regarded as fact several centuries ago. Science has long sought to find the differences that underlined this assumption. Slowly, numerous studies have now debunked many of these proposed differences, and yet our world remains stubbornly gendered. When you think about it, this is wholly unsurprising due to the way we are socialised as infants. Parents and caregivers don't mean to treat boys and girls differently, but evidence shows they clearly do. It starts before birth, with mothers describing their baby's movements differently if they know they are having a boy. Male babies were more likely to be described as "vigorous" and "strong", but there was no such difference when mothers did not know the sex. Ever since it was possible to identify biological sex from a scan, one of the first questions asked of prospective parents is whether they are having a boy or a girl. Before then, the shape and size of a bump has been used to guess the sex, despite there being no evidence this works. More subtle are the different words we use to describe boys and girls, even for the exact same behaviour. Throw gendered toys into the mix and this reinforces the subtle traits and hobbies that are already assigned to male and female. The way children play is a hugely important part of development. It's how children first develop skills and interests. Blocks encourage building whereas dolls can encourage perspective taking and caregiving. A range of play experiences is clearly important. "When you only funnel one type of skill building toys to half of the population, it means that half of the population are going to be the ones developing a certain set of skills or developing a certain set of interests," says Christia Brown, a professor of psychology at the University of Kentucky. Children are also like little detectives, working out what category they belong to by constantly learning from those around them. As soon as they understand what gender they fit into, they will naturally gravitate towards the categories that have been thrust upon them from birth. That's why from the age of about two, girls tend to navigate more to pink things while boys will avoid them. I witnessed this first-hand when my then two-year old stubbornly refused to wear anything she perceived as slightly boyish, despite my futile attempts not to overtly gender her clothing early on. It's no surprise then that pre-school children learn to identify with their gender so young, especially as parents and friends tend to give children toys associated with their gender early on. Once children understand which "gender tribe" they belong to, they become more responsive to gender labels, explains Cordelia Fine, a psychologist at the University of Melbourne. This then influences their behaviour. For instance, even how a toy is presented can change a child's interest in it. Girls have been found to be more interested in typically boyish toys if they were pink, for instance. This has consequences though. If we only give girls and not boys dolls or beauty sets, it primes them to associate themselves with these interests. Boys can be primed to like more active pursuits by toy tools and cars. Yet boys clearly enjoy playing with dolls and buggies too, but these are not as typically bought for them. My son cradles a toy baby just as his sister did and likes to push it around in a toy buggy. "Boys in the first years of life are also nurturing and caring. We just teach them really early that that's a 'girl skill', and we punish boys for doing it," says Brown. Parents of boys often talk about how they are more boisterous and enjoy rougher play, while girls are more gentle and meek If from infancy, boys are discouraged from playing with toys we might associate as feminine, then they may not develop a skill set that they might need later in life. If they are discouraged by their peers from playing with dolls, while at the same time they see their mother doing most of the childcare, what does that say about whose role it is to care? And so we enter the realm of "biological essentialism", where we ascribe an innate basis to a behaviour that is, when you delve a bit deeper, highly likely to be learned. Toys are one thing, but traits are also prone to gendered stereotyping. Parents of boys often talk about how they are more boisterous and enjoy rougher play, while girls are more gentle and meek. The evidence suggests otherwise. In fact, studies show that our own expectations tend to frame how we view others and ourselves. Parents have attributed gender neutral angry faces as boys while happy and sad faces are labelled as girls. Mothers are more likely to emphasise their boys' physical attributes – even setting more adventurous targets for boys than for girls. They also over-estimate crawling abilities for their sons compared to daughters, despite there being no reported physical difference. So, people's own biases could be influencing their children, and so reinforcing these stereotypes. Language plays a powerful role too – girls reportedly speak earlier, a small but identifiable effect but this could be due to the fact that research also shows that mothers speak more to their baby girls than to baby boys. They speak more about emotions to girls too. In other words, we unknowingly socialise girls to believe they are more talkative and emotional, and boys aggressive and physical. Brown explains that it's clear why these misconceptions then continue later in life. We disregard the behaviours that do not conform to the stereotypes we expect. "So you overlook all the times the boys are sitting there quietly reading a book or all the times that girls are running around the house loudly," she says. "Our brains seem to skip over what we call stereotype inconsistent information." Parents will also buy their girls toys and clothes typically marketed for boys but rarely the reverse, often in an attempt to be gender neutral. This in itself gives an interesting insight into how we view gender. Males have always been viewed as the dominant and powerful sex, meaning parents, whether overtly or not, will discourage boys from liking girly things. As Fine explains, "we start to see manifestations of the gender hierarchy – boys seemingly starting to respond to the 'stigma' of femininity even in this early period [of childhood]." It reveals why parents are much more comfortable with girls in boys clothes than boys in girls clothes. Or why growing up as a tomboy attracted positive comments for me – I never liked dolls and loved climbing trees. The opposite occurs for boys who dress or act girly. To be seen as girly or exhibiting feminine traits diminishes status for men – those who do so even earn less. Gender scholars agree that these preferences are highly socially conditioned – but there remains disagreement about whether any gendered behaviour is innate, for instance, there is evidence that girls who have been exposed to higher levels of androgens in the womb, prefer toys we typically categorise as for boys. Even here Fine points out it could be the environment shaping their preferences. These girls do not consistently show better spatial ability either – a skill that is often said to be better in men. We also know that babies are extremely sensitive to social cues around them, they can spot differences early on. Regardless of how these preferences develop, it is adults as well as peers who continue to condition and expect certain behaviours, creating a gendered world with worrying consequences. Women will also do worse on a test if they are first told that their sex typically does worse For instance, when girls first enter pre-school – a gender gap in maths does not exist, but it later begins to widen as their teacher and self-expectations come into play. This is especially problematic because these reinforced gender stereotypes are "at odds with the contemporary gender egalitarian principle that your sex shouldn't determine your interests or future", says Fine. When specific toys are marketed to boys it could also be changing the brain to strengthen the connections that are involved in, for instance, spatial recognition. Indeed, when one group of girls played the game Tetris for three months, the brain area involved in visual processing was larger than for those who did not play the game. If girls and boys are presented with different types of hobbies, brain changes could naturally follow suit. As neuroscientist and author Gina Rippon of Aston University explains, the fact that we live in a gendered world itself creates a gendered brain. It creates a culture of boys who feel conditioned to behave in more typically masculine traits – they may get excluded by peers if they do not. If we focus on differences, it also means, as Rippon says, we begin to accept myths such as boys being better at science and girls at caring. This continues as adults. Women have been shown to underestimate their abilities when asked how well they scored on maths tasks, whereas men will overestimate their scores. Women will also do worse on a test if they are first told that their sex typically does worse. Of course this could and does affect school, university and career choices. Even more concerning is the idea that the way some masculine traits are emphasised early on and then conditioned, is linked to male sexual violence against women. We know for instance that the individuals who perpetrate sexual violence tend to be high in "hostile masculinity", says psychologist Megan Maas of Michigan State University. These are the beliefs that men are naturally violent, need to have sexual fulfilment, and that women are naturally submissive. Studies also show that girls who are heavily into princesses are more concerned with their appearance and more likely to "self-objectify – so they think of themselves as a sexual object," says Maas. The girls that scored highest on "sexualised gender stereotypes" also downplayed traits associated with intelligence. Early on, both girls and boys have been shown to view attractiveness as "incompatible with intelligence and competence" a study found. Brown and colleagues have now also argued in a 2020 paper that sexual assault by men against women is so common precisely because of the values we condition onto children. This socialisation comes from a combination of parents, schools, the media and peers. "Sexual objectification for girls starts really early," says Brown. One reason that these gendered ideas and self-assumptions continue to exist is, in part, because there are still regular reports of innate brain differences between men and women. However, most brain imaging studies that do not find any gender differences don't mention gender at all. Or still others are unpublished. This is known as the "file drawer" problem – when no effects are found, they are simply not mentioned or scrutinised. When we consider situations that might invoke empathy, women and men respond the same, it's just that from an early age, women have been socialised to act upon this apparently feminine emotion more And of those that do find small differences, it's hard to truly show how much culture or stereotyped expectations play a role. Adult brains cannot be neatly categorised into male brains and female brains either. In a study analysing 1,400 brain scans, neuroscientist Daphna Joel and colleagues found "extensive overlap between the distributions of females and males for all grey matter, white matter, and connections assessed". That is, overall we are more similar to each other than different. One study even showed that women acted just as aggressively as men in a video game when they were told their gender would not be disclosed, but less so when told the experimenter knew if the participants were male or female. It follows that women tend to be considered as less aggressive and more empathetic. When we consider physiological responses to situations that might invoke empathy, women and men actually respond the same, it's just that from an early age, women have been socialised to act upon this apparently feminine emotion more. This means that in order for there to be any significant change, people have to first understand their biases and be mindful of when their preconceptions don't fit into the behaviours they see. Even small differences of what they expect of girls versus boys can build up over time. It's therefore worth remembering why people are conditioned to think that boys are more boisterous and take note of the times this is not true. My daughter is certainly just as loud – if not more so – as her brother, while he also loves pretending to cook. While these are not necessarily representative examples, they also don't fit into our ideas of what boys and girls like. It would be easy for me to otherwise have highlighted my son's propensity to climb on everything and my daughter's preference for pink, glossing over the numerous times she plays with cars and he with dolls. When our children do inevitably start pointing out gendered divisions we can help by revising stereotypes with other examples, such as explaining girls can and do play football and that boys can have long hair too. We can also encourage a diverse range of toys regardless of what gender they are intended for. We need to provide as many opportunities as possible "for them to have experiences that go against this sort of avalanche of gendered play", says Maas. If we fail to understand that we are more alike from birth than we are different and treat our children accordingly, our world will continue to be gendered. Undoing these assumptions is not easy, but perhaps we can all think twice before we tell a little boy how brave he is and a little girl how kind or perfect she is. Melissa Hogenboom is the editor of BBC
Reel. Her upcoming book, The Motherhood Complex, is out 27
May 2021. She is @melissasuzanneh on Twitter. The
sexist myths that won't die - 9/30/19 When I meet the cognitive neuroscientist Gina Rippon, she tells me one anecdote that helps demonstrate just how early children can be exposed to gender stereotypes. It was the birth of her second daughter, on 11 June 1986 – the night that Gary Lineker scored a hat trick against Poland in the men’s Football World Cup. There were nine babies born in the ward that day, Rippon recalls. Eight of them were called Gary. Subtle cues about “manly” and “ladylike” behaviours, from the moment of birth, mould our behaviours and abilities She remembers chatting to one of the other mums when they heard a loud din approaching. It was a nurse bringing their two screaming babies. The nurse handed her neighbour a “blue-wrapped Gary” with approval – he had “a cracking pair of lungs”. Rippon’s own daughter (making exactly the same sound) was passed over with an audible tutting. “She’s the noisiest of the lot – not very ladylike,” the nurse told her. “And so, at 10 minutes old, my tiny daughter had a very early experience of how gendered our world is,” Rippon says. Rippon has spent decades questioning ideas that the brains of men and women are somehow fundamentally different – work that she compellingly presents in her new book, The Gendered Brain. The title is slightly misleading, since her argument hinges on the fact that it’s not the human brain that is inherently “gendered”, but the world in which we are raised. Subtle cues about “manly” and “ladylike” behaviours, from the moment of birth, mould our behaviours and abilities, which other scientists have then read as inherent, innate differences. Rippon’s writing bristles with frustration that this argument still needs to be stated in 2019. She describes many of the theories about gender differences as “whack-a-mole” myths that keep on arising, in another guise, no matter how often they are debunked. “We've been looking at this whole issue of whether male brains are different from female brains for about 200 years,” she says. “And every now and then there's a new breakthrough in science or technology, which allows us to revisit this question, and make us realise that some of the past certainties are clearly wrong. And you think that, as a scientist, you might have addressed them and put them right, and people will move on and not use those terms or conclusions anymore. But the next time you look at the popular press you find that the old myth has returned.” One of the oldest claims centres on the fact that women have smaller brains, which was considered evidence for intellectual inferiority. While it’s true that, on average, women’s brains are smaller, by about 10%, there are several problems with this assumption. “First of all, if you just thought it was a ‘size matters’ issue, then sperm whales and elephants have got bigger brains than men, and they're not renowned for being that much brighter,” says Rippon. Then there’s the fact that, despite the average difference in size, the overall overlap in the distributions of men and women’s brains is huge. “So that you get women with big brains and men with small brains.” It’s worth noting that Einstein’s brain was smaller than that of the average male, and overall, many studies find that there is next to no mean difference between men and women’s intelligence or behavioural traits. Yet the claims continue to persist in the media. Rippon argues that the apparent structural differences within the brain itself have also been exaggerated. The corpus callosum, for instance, is the bridge of nerve fibres that connects the left and right hemispheres of the brain, with some initial studies finding that this information highway is bigger in women’s brain’s than in men’s brains. This was used to justify all kinds of stereotypes – like the idea that women are inherently illogical, since their feelings from the “emotional” right hemisphere were interfering with the processing in the cooler, rational left hemisphere. As Rippon explains in her book: “Men’s more efficient callosal filtering mechanism explained the mathematical and scientific genius… their right to be captains of industry, [their ability to] win Nobel Prizes and so on and so on.” But such claims are often based on just a small number of participants, she says – and the techniques to measure the “size” of any region are still rather crude and open to interpretation, meaning that even the existence of such brain differences is on very shaky foundations. (And of course, the idea of the “left” and “right" brain is itself something of a myth.) Despite decades of research, it has been very difficult to reliably identify significant “hardwired” differences in the structure of the male and female brain. Raging hormones What about our sex hormones? Surely they, at least, should have a very clear impact on our minds and behaviours? Yet the evidence has been misinterpreted to denigrate women’s abilities, Rippon says. Women were initially barred from the US space programme, due to concerns of having such “temperamental psycho-physiologic humans” on board the craft The concept of premenstrual syndrome, for instance, first emerged in the 1930s. “And it became well established as a reason for women not being given positions of power.” As she points out, women were even initially barred from the US space programme due to concerns around having such “temperamental psycho-physiologic humans” on board the craft. While few today would hold this view, we still consider PMS to bring about a range of cognitive and emotional changes that are less than desirable. Yet some of the observed symptoms may be a psychosomatic response – the result of expectation rather than inevitable biological changes to the brain. In one study by Diane Ruble at Princeton University, for instance, women were given false feedback about where they were in their menstrual cycle. “They could give an approximate date about when they expected the period to start – but you could give them a fake blood test saying, actually, you are now in the pre-menstrual phase, or you're in the intermenstrual phase,” Rippon explains. And they were then asked to fill out a questionnaire on various elements of PMS. The study found that the women who were told they were in the pre-menstrual phase were much more likely to report the symptoms of PMS – even if they were not at that stage of the cycle, supporting the idea that some of the symptoms arose from their expectations. (Read about how the “nocebo effect” means our beliefs can produce real medical symptoms.) “I wouldn't want to underplay the reality of the hormonal changes that are associated with the menstrual cycle, or to deny that people do have changes associated with fluctuations in hormones – as they should, because the word hormone means stir to action,” Rippon says. “But if you actually look at things like menstrual diaries, or objective measures of mood changes, the effect is nothing like as profound as the person believes. So the very fact that you believe that [you are] experiencing a mood change, and that must be associated with the premenstrual cycle, becomes a kind of self-fulfilling prophecy.” There are positive cognitive changes about the time of ovulation. Yet I haven't come across an ‘ovulation euphoria questionnaire’ – Gina Rippon The perceptions of PMS also betray a certain confirmation bias among researchers studying sex and gender differences, who have tended to conduct studies that back up the stereotypes rather than looking for the evidence that may question prevailing assumptions. Rippon says that women may actually experience a cognitive boost at certain points in the menstrual cycle, for instance – but these have been largely ignored, thanks to scientists’ preoccupation with women’s perceived weakness. “We've done some studies showing that cognitively, there are fluctuations through the menstrual cycle,” she says. Verbal and spatial working memory, for instance, improve when oestrogen is highest. “And that there are very positive changes about the time of ovulation – improved responsiveness to sensory information, for example, and improved reaction time.” But Rippon says that while the standard tool to measure PMS is the Moos Menstrual Distress Questionnaire, “I haven't come across an ‘ovulation euphoria questionnaire’”. The focus, it seems, is always on the negative. Pink and blue tsunamis One of the challenges of studying sex differences has been accounting for the role of culture. Even when apparent differences in the structure of the brain can be observed, there is always the possibility that they arise through nurture rather than nature. We know that the brain is plastic, meaning it is moulded by experience and training. And as Rippon observed with the birth of her own daughter, a boy and a girl may have very different experiences from the moment they enter the world, as certain behaviours are subtly encouraged. She points to research showing that children as young as 24 months are highly sensitive to gender typical behaviours. They are, she says, “tiny social sponges absorbing social information”, and adopting those behaviours themselves will eventually rewire their neural circuits. “A gendered world produces a gendered brain.” This is why the gender stereotyping of toys is such an important issue to address. “A lot of people think that the idea that we should avoid gendering toys is actually a bit of PC [politically correct] nonsense,” she says. “But I think if we take a neuroscientific approach to this, we can see that there's quite profound implications of the toys that we play with when we're very young.” These moments of play can be seen as “training opportunities” that can mould a child’s brain into an adult one. Consider a construction toy like Lego or Duplo or games such as Tetris. As the child plays, rotating bricks and finding increasingly inventive ways to fit them together into new structures, they will be building the neural networks involved in visual and spatial processing. Then, as you get to school, you might perform slightly better at those tasks – and be praised for your abilities, meaning you’ll continue to practice them. Eventually, you may even find a profession that that asks you to spend all day, every day, strengthening those abilities. “Now, if all of those toys and training opportunities are gendered, then you can start getting what looks like a clear gender divide based on the biological sex of an individual, as opposed to the different training opportunities that individual has had,” says Rippon. The psychologists Melissa Terlecki and Nora Newcombe have shown that the apparent sex differences in spatial cognition diminish when you account for the amount of time someone has spent playing video games like Tetris, for instance. A few campaigns – like Let Toys Be Toys in the UK and Play Unlimited in Australia – have had some success in persuading retailers to change their gendered marketing, but in general, Rippon argues that children are still being pigeonholed in many other ways. “One of the problems we have in the 21st Century is that what I call gender bombardment is much more intense,” says Rippon. “There's much more in the social media, and a whole range of marketing initiatives, which make a very clear prescriptive list of what it's like to be male, or what it's like to be female.” And this is why Rippon is especially frustrated by the “neurosexism” out there. The more that tenuous conclusions, from weak data, reach the public, the more likely we are to pass on these messages to children, strengthening those self-fulfilling prophecies. “If we believe that there are profound and fundamental differences between men's and women's brains, and more than that – that the owners of those brains therefore have access to different skills, or different temperaments or different personalities – that will certainly affect how we think about ourselves as male or female,” says Rippon. It will also affect how we think about other people and what their potential might be, she warns. “So scientists need to be really careful,” she says.“Of course, we need to understand where there are sex differences and what they might mean. But we should be careful not to talk about fundamental or profound differences, because we're giving the wrong impression to people who are really interested to know what the answers are to the questions that we're asking.” Ultimately, we need to accept that each of us has a unique brain – and our abilities cannot be defined by a single label like our gender. “An understanding that every brain is different from every other brain, and not necessarily just a function of the sex of the brain’s owner, is a really important step forward in the 21st Century,” urges Rippon. *The video that accompanies this article is part of a BBC Reel Playlist called Re:Think, where you can watch more thought-provoking films about the human brain. David Robson is a writer based in the
London and Barcelona. His first book, The
Intelligence Trap: Why Smart People Do Dumb
Things, is out now. He is
d_a_robson on Twitter. Study finds some
significant differences in brains of men and women -
4/11/17 Do the anatomical differences between men and women—sex organs, facial hair, and the like—extend to our brains? The question has been as difficult to answer as it has been controversial. Now, the largest brain-imaging study of its kind indeed finds some sex-specific patterns, but overall more similarities than differences. The work raises new questions about how brain differences between the sexes may influence intelligence and behavior. For decades, brain scientists have noticed that on average, male brains tend to have slightly higher total brain volume than female ones, even when corrected for males' larger average body size. But it has proved notoriously tricky to pin down exactly which substructures within the brain are more or less voluminous. Most studies have looked at relatively small sample sizes—typically fewer than 100 brains—making large-scale conclusions impossible. In the new study, a team of researchers led by psychologist Stuart Ritchie, a postdoctoral fellow at the University of Edinburgh, turned to data from UK Biobank, an ongoing, long-term biomedical study of people living in the United Kingdom with 500,000 enrollees. A subset of those enrolled in the study underwent brain scans using MRI. In 2750 women and 2466 men aged 44–77, Ritchie and his colleagues examined the volumes of 68 regions within the brain, as well as the thickness of the cerebral cortex, the brain's wrinkly outer layer thought to be important in consciousness, language, memory, perception, and other functions. Adjusting for age, on average, they found that women tended to have significantly thicker cortices than men. Thicker cortices have been associated with higher scores on a variety of cognitive and general intelligence tests. Meanwhile, men had higher brain volumes than women in every subcortical region they looked at, including the hippocampus (which plays broad roles in memory and spatial awareness), the amygdala (emotions, memory, and decision-making), striatum (learning, inhibition, and reward-processing), and thalamus (processing and relaying sensory information to other parts of the brain). When the researchers adjusted the numbers to look at the subcortical regions relative to overall brain size, the comparisons became much closer: There were only 14 regions where men had higher brain volume and 10 regions where women did. Volumes and cortical thickness between men also tended to vary much more than they did between women, the researchers report this month in a paper posted to the bioRxiv server, which makes articles available before they have been peer reviewed. That's intriguing because it lines up with previous work looking at sex and IQ tests. "[That previous study] finds no average difference in intelligence, but males were more variable than females," Ritchie says. "This is why our finding that male participants' brains were, in most measures, more variable than female participants' brains is so interesting. It fits with a lot of other evidence that seems to point toward males being more variable physically and mentally." Despite the study's consistent sex-linked patterns, the researchers also found considerable overlap between men and women in brain volume and cortical thickness, just as you might find in height. In other words, just by looking at the brain scan, or height, of someone plucked at random from the study, researchers would be hard pressed to say whether it came from a man or woman. That suggests both sexes' brains are far more similar than they are different. The study didn't account for whether participants' gender matched their biological designation as male or female. The study's sheer size makes the results convincing, writes Amber Ruigrok, a neuroscientist at the University of Cambridge in the United Kingdom who has studied sex differences in the brain, in an email to Science. "Larger overall volumes in males and higher cortical thickness in females fits with findings from previous research. But since previous research mostly used relatively small sample sizes, this study confirms these predictions." Ruigrok notes one factor that should be addressed in future studies: menopause. Many of the women in the study were in the age range of the stages of menopause, and hormonal fluctuations have been shown to influence brain structures. That may have played some role in the sex differences noted in the study, she says. The controversial—and still unsettled—question is whether these patterns mean anything to intelligence or behavior. Though popular culture is replete with supposed examples of intellectual and behavioral differences between the sexes, only a few, like higher physical aggression in men, have been borne out by scientific research. For the moment, Ritchie says his work
isn't equipped to answer such heady questions: He is focused
on accurately describing the differences in the male and
female brain, not speculating on what they could mean. How
we inherit masculine and feminine behaviours: a new idea
about environment and genes - 8/18/17 Everyone, including Damore, acknowledges the role of our social environment in shaping gender differences. Ideas about which jobs are “women-appropriate”, the pressures placed on men to take up “manly” roles – these experiences, expectations and opportunities can impact how we perform our gender. But it is commonly believed that biological differences between the sexes create average differences in behaviour that even equal environments won’t overcome. In his memo, Damore drew on scientific ideas suggesting that average differences in interests between men and women (“things” versus “people”) and preferences (status and competition versus family and collaboration) are due in part to evolved, gene-directed biological differences. If you follow this view, which is a common one, even Silicon Valley’s liberal environment can’t overcome such a deeply embedded legacy. But what if thousands of years of gendered environments actually reduced the need to develop genetic mechanisms to ensure gender differences? This is the idea we suggest in our new paper. A richer inheritance Advances in evolutionary biology recognise that offspring don’t just inherit genes. They also reliably inherit all kinds of resources: a particular ecology, a nest, parents and peers. And it appears that these stable environmental factors can help ensure the reliable reproduction of a trait across generations. Take, for example, the apparently “instinctual” sexual preference of sheep and goats for mates of their own species. Remarkably, this adaptive behavioural trait seems to depend in part on early contact with animals from their own species. Sheep and goat newborn males fostered across species have been found to develop sexual preference for mates of the other species. In this case, genetics aren’t the only inherited resource for development: a stable environment where sheep are raised with sheep also matters. Rethinking genetic mechanisms We propose that a stable environment that teaches men to be men and women to be women could be making the need for genetics to enforce such differences in some ways redundant. This helps to explain what would otherwise seem very surprising: we can rear sheep that can be attracted to goats in a single generation. But perhaps it shouldn’t be so surprising, after all. Only regular cross-species-fostering would provide any selective pressure for sheep and goats to evolve genetic insurance for their sexual preferences. In fact, genetically determined traits may even be lost when some reliable feature of the environment makes them unnecessary. One example is primates’ loss of the ability to synthesise vitamin C, given this vitamin is readily available in their fruit-based diet. We make no claim that the examples we cite can be generalised across species or behavioural traits: this is a matter for empirical investigation. But the insight that stable environmental conditions can play a crucial role in the development and inheritance of adaptive behavioural traits is highly relevant to humans. The impact of human environments The human environment includes extensive cultural, behavioural, and environmental mechanisms for the transmission of gender-linked traits. We emphasise gender through names, clothing and hairstyle. We learn about gender from the beliefs, judgements, behaviour and claims of family, friends, celebrities, media, art and science. Humans have an unprecedented capacity for social learning, which means most of us easily soak up these lessons. In fact, recent research from Melissa Hines’ lab suggests that sex may affect who we learn from. This study found that girls with congenital adrenal hyperplasia (CAH), who are exposed in utero to unusually high levels of androgens (the group of steroid hormones that include testosterone), show a reduced tendency to mimic the behaviour of women and “obey” gender labels. This may explain the greater interest of girls with CAH in “boy toys”, a finding often taken to support claims that boys’ and girls’ toy preferences diverge in part because of higher prenatal testosterone in boys. Hines’ study supports the possibility that in some ways, sex, via testosterone, is affecting who we learn from, but the environment determines what we learn. If the environment is gendered, our toy preferences will be. The mosaic brain At first glance, the idea that sex isn’t necessarily the only way traits are transferred between generations seems incompatible with evidence. Studies show that the genetic and hormonal components of sex affect the structure and function of the brain. However, recent research in rats on the effects of sex on the brain reveal that these effects may vary and even be opposite under different environmental conditions, such as varying levels of stress. Are brains male or female? These interactions between sex and the environment, which can also be different in different parts of the brain, give rise to brains made up of idiosyncratic “mosaics” of features. Such mosaics were recently observed in humans. In other words, sex affects the brain, but this doesn’t mean that there are two distinct types of brains – “male brains” and “female brains”. Although you could predict a person’s sex with accuracy above chance on the basis of their brain mosaic, attempting the reverse prediction – predicting someone’s unique brain mosaic on the basis of the form of their genitalia – would be beyond difficult. Back to gender debates The possibility that a key role of our genetic inheritance is in learning gender from our surrounding culture supports organisational initiatives in favour of gender balance. The down side is that the prevalence of “gendering” environments means that many relevant aspects of the environment have to change in order for gender patterns to significantly shift at the population level. Those working to increase the representation of women in technology and leadership have a lot of work to do. Still, humans are unique in their capacity to transform their environments. A century or so ago, our gender debates focused on whether women were suited to higher education and voting. Today, such debates are laughable, thanks to the progression of social attitudes and science. Now the debate is around technology and leadership. As history has shown, when cultural
ideas of what roles women and men are “built” to
perform change, the Would
gender differences exist if we treated all people the same
from birth? 11/22/16 Gender identity is not a simple concept. It is usually defined as whether someone thinks of themselves as male or female, though it’s more than that. Even this is not a simple, binary division between all human beings. However, we do know that the hormones the brain is exposed to in early pregnancy have powerful effects on gender identity. For example, there’s a condition called androgen insensitivity syndrome. Girls with this condition are born looking just like other girls. Only at puberty do things start to change. This is because they are actually genetic males (they have the male XY chromosomes). They also have testes, hidden in their abdomen, but no uterus or ovaries. The condition is caused by a genetic insensitivity to the hormone testosterone, so that while these girls secrete male-type levels of testosterone, it doesn’t have any effect on their brain (or anywhere else). The important point is that their gender identity is female. Does that mean that testosterone is ultimately what makes someone masculine? The experimental evidence suggests as much. Giving little female rats testosterone during early life makes them very male-like, and the opposite occurs if little males are castrated. Testosterone seems to be important, but is it the whole story? Is the fact that individuals with androgen insensitivity syndrome look like women responsible for others treating them as female, thus influencing how they see themselves? In the 1960s, John Money, a prominent psychologist, convinced himself that gender identity was independent of early hormones. Put simply, if a parent thought their baby was a boy, and treated him as such, then he developed a male gender identity, and vice versa. This idea was put to the test: after a surgical accident, a one-year old boy was castrated and given a vagina. He was dressed as a girl and given a female name. But it failed. Eventually, the “girl” reverted to being a boy. You might think that was the end of the “parent” theory of gender identity. But a second case, which started when the baby was two months, succeeded. The “boy” grew up as a “girl” and accepted her gender identity, though she was bisexual. So why the different results? Note that single case reports are unreliable as evidence. But it seems likely that exposure of the brain to testosterone during development does influence various aspects of sexuality, including gender identity. We also know that the brain in early life is very susceptible to external events. So both testosterone and parental behaviour can influence gender identity. Beyond hormones But gender identity is also how a person expresses themselves in that society. In a society that represses expressions of sexuality, this will alter how women and men see themselves. The important point here is that gender identity is both “biological” and “social”. But none of these factors results in a simple binary division. So could we abolish differences in gender by altering upbringing? Schemes exist to minimise gender-stereoptypical play behaviour, for example some Scandinavian nurseries. While this may have some impact, research has nevertheless shown that little boys still prefer to play with trains, and little girls with dolls. Giving such toys to societies that have never seen them in real life has the same result. There are, of course, established gender differences in muscular strength and height that are not controversial. And yet there are women who are stronger or taller than some men: in other words, there is an overlap between the sexes despite the sex difference. Accepting that there may be gender differences in brain function has proved much more controversial. Many studies have shown, for example, that males are better at visuo-spatial tasks and females are better at languages and empathy. These differences are small and overlap, so sometimes they are not observed; but we should not discount their influence. There are also well-established but very small gender differences in the brain, such as men having a larger hypothalamus. The hypothalamus is responsible for initiating eating, drinking, sex and other behaviours essential for survival. Relating these differences to those in behaviour has not, so far, been very successful: this may reflect our ignorance of how the brain actually works. Soceity’s responsibility There are those who decry the small differences that have been recorded, or even consider that they do not exist. But why should we want to abolish them? It seems to me that these both reflect identity and contribute to it. It’s no secret that sex differences have been used as an excuse for gender inequality. But that just means we need to redress that inequality, not deny that gender differences exist. It’s opportunity that is crucial. A man’s job? Alfred T. Palmer If this were equal, would we see an even distribution of males and females across all occupations and activities? Not in my opinion. If a job requires physical strength, then it is likely that men will predominate. Also, in the branch of medicine dealing with brain disorders, about 50% of psychiatrists are female, but only about 15-20% are neurologists, and a mere 5% neurosurgeons. Is this gender-related prejudice, or individual preference? Should we insist on an equal gender distribution? Of course not, provided the choice was unfettered. It may be that males are attracted by more technical aspects of medicine, and females by the more person-orientated specialities for reasons that are not just due to upbringing or expectations, but genuine differences in the brain. But, of course, social norms also contribute to which professions we choose. So we have to make an effort to ensure that women are not hindered from a free choice of profession by social expectations, burdens of child-rearing or selective education. But ultimately, an unequal gender distribution is no longer controversial if opportunities are the same for all. If gender differences then remain, we should accept them. Thankfully we now see an increasing
number of women as distinguished scientists, CEOs of major
companies and world leaders. We don’t even bat an
eyelid when a woman plays King Lear, that most masculine of
roles. Gender identities are changing; but let us not muddle
the essential distinction between similarity and
equality. Sweden's
'gender-neutral' pre-school 7/8/11 On the surface, the school in Sodermalm - a well-to-do district of the Swedish capital - seems like any other. But listen carefully and you'll notice a big difference. The teachers avoid using the pronouns "him" and "her" when talking to the children. Instead they refer to them as "friends", by their first names, or as "hen" - a genderless pronoun borrowed from Finnish. Changing society? It is not just the language that is different here, though. The books have been carefully selected to avoid traditional presentations of gender and parenting roles. So, out with the likes of Sleeping Beauty and Cinderella, and in with, for example, a book about two giraffes who find an abandoned baby crocodile and adopt it. Most of the usual toys and games that you would find in any nursery are there - dolls, tractors, sand pits, and so on - but they are placed deliberately side-by-side to encourage a child to play with whatever he or she chooses. At Egalia boys are free to dress up and to play with dolls, if that is what they want to do. For the director of the pre-school, Lotta Rajalin, it is all about giving children a wider choice, and not limiting them to social expectations based on gender. "We want to give the whole spectrum of life, not just half - that's why we are doing this. We want the children to get to know all the things in life, not to just see half of it," she told BBC World Service. All the staff are clearly passionate about this. Teachers say the aim is to help both boys and girls "I want to change things in society," says 27-year-old Emelie Andersson who is fresh out of her teacher training, and specifically chose to work at Egalia because of its policy on gender. "When we are born in this society, people have different expectations on us depending if we are a boy or a girl. It limits children. "In my world, there is no 'girl's world' and there is no 'boy's world'," she says. Last year a Swedish couple provoked a fuss in the media by announcing that they had decided to keep the gender of their young child, Pop, a secret from all but their closest family members. There was a similar case recently in Canada with a baby called Storm. But is it not confusing for a young child to blur gender boundaries like this? It is a criticism that Egalia director Lotta Rajalin has heard many times before, but she contests it vigorously. "All the girls know they are girls, and all the boys know that they are boys. We are not working with biological gender - we are working with the social thing." The verdict of child psychologists and experts in gender is divided - with most supportive of the aims, but questioning the means. "The sentiments are excellent, but I'm not sure they are going about it in exactly the right way," says British-based clinical psychologist Linda Blair. "I think it's a bit stilted. Between the ages of three and about seven, the child is searching for their identity, and part of their identity is their gender, you can't deny that," she told BBC World Service. Gender obsessed? But Sweden takes gender issues seriously, and for a number of years now, the government has been taking its battle to the playground. Gender advisers are now common in schools, and it is part of the national curriculum to work against discrimination of all kinds. Sweden is often praised as being one of the most equal countries in the world when it comes to gender, but there are critics at home who think things have gone too far. "This equality idea, it has become so absurd, it has become a really stupid industry," rails Swedish blogger Tanja Bergkvist, who argues that the nation has an unhealthy obsession with gender. "Gender researchers have convinced politicians that the solution to all problems is a gender perspective. "That's quite dangerous because they spend money and resources on the wrong things." The Egalia school - which is state-funded - is proving popular though, and boasts a long waiting list. Pia Korpi, a metal designer, and her husband Yukka, a dancer and choreographer, have two children at the pre-school. Ms Korpi says she, and her husband in particular, had to battle to pursue their chosen interests because they sat uneasily with gender expectations, and they want their children to feel free from these restraints. She says most of their friends and family are 100% behind them, but admits some people might not understand their choice. "People who don't know what this is about - and especially in the countryside - they think it's brainwashing." Swedish way The idea of working with children in pre-schools - between the ages of one and five years old - is to help shape them from a young age, but many doubt there are any lasting effects. Egalia is the Swedish word for equality "It's a real world out there - we cannot isolate people from that real world," says clinical psychologist Linda Blair. Philip Hwang, Professor of Psychology at the University of Gothenburg - who has conducted long-term studies of children's development - chuckles slightly when talking about this scheme. "I don't think it's anything bad," he says. "But it is naive to say the least. It is a symbolic gesture. I find it a bit funny - who do they think they are fooling?" "It's very Swedish in a sense. Swedes have a tendency to think that if they institutionalise something, it will automatically change - it's the Swedish way," he told the BBC. "But lasting effects - when it comes
to issues embedded in our culture - that takes
generations." How parents
unconsciously treat baby boys and girls differently. -
12/10/16 Parents everywhere will tell you this. They will say their baby boys and girls develop differently—even the thoroughly modern type of parent who goes to lengths not to treat their boys and girls differently—proving nature trumps nurture every time. Except it probably still is nurture that makes your baby girl a faster talker, and your baby boy a better walker. Neuroscientist Lise Eliot first brought this to people’s attention in 2009 when she published a book based on a lot of scientific study in this field. She discovered that actually, even before a baby is displaying much of a personality, parents will unconsciously behave differently around boys and girls and altering their development in ways that conform to gender norms. Study after study found parents were attributing traits to their offspring based on their gender without even realising it. One study Eliot cited in her book took baby boys and girls, and disguised them as the opposite sex. Then it asked parents to observe the babies and make judgements about their behaviour. The “boys” were more often described as angry, while the “girls” were more often described as “happy” and “social”. Except the boys were really girls, and the girls were really boys. This was seven years ago, and yet we still see arguments every day about the “innate differences” between boys and girls as proof that men and women are suited to different roles in our society Would you buy your son a doll? Post continues after video. The thing is, a lot of our developmental “stuff” is happening in those early months. So if parents are ascribing behaviours to boys and girls without realising it, they are ultimately going to fundamentally alter the way those babies develop. If, as studies suggest, parents are more social with baby girls, then the baby girl’s language and expression are going to develop more fully and faster than the baby boy’s. Baby brains are elastic, suggestible
blank canvases. And how parents treat them really does
determine a lot. So next time you hear someone say girls and
boys are different because of nature, not nurture, you might
want to point them this way. Can
parents treat boys and girls differently without
realising? There are differences in girls and boys aren’t there? Girls are said to be more social, and love to talk and socialise, but boys are more introverted but physically stronger than girls, right? Not necessarily. In one study, scientists attempted to show how parents make a number of assumptions about their baby boy or girl. So they dressed newborns in gender-neutral clothes and told adults the boys were girls and girls were boys. The adults spent time with the newborns and described the ‘boys’ (actually girls) as angry or distressed more often than the adults in the study who thought they were observing girls. The adults spending time with the ‘girls’ (actually boys) described the babies as happy and socially engaged. Many other disguised-gender experiments have also noted that adults perceive baby boys and girls differently - choosing, to see the behaviour they expect from the sex. What these studies show is that how we perceive boys and girls—and how we treat them therefore affects experiences we give them. Much of our developmental behaviours form in the early months of life so if parents are encouraging certain behaviours amongst boys and girls without realising it; they are fundamentally affecting the way their baby develops. So, if parents are more social with baby girls, then the baby girl's language and expression is naturally going to develop more fully and faster than baby boy's. Baby brains are often described as little sponges. So the affect parents have on them does determine a lot. Whether consciously or not, it seems parents do make assumptions about the gender preferences of their little ones which have an effect on how they develop. Gender neutral parenting tips
Source: www.bounty.com/family/family-dynamics/boys-and-girls-differently Developmental
Differences Between Boys and Girls - 12/15/21 The difference between boys and girls is pretty obvious when it comes to anatomy. But what about developing gross motor skills, talking and meeting other major milestones? As it turns out, in many areas the disparities between the two sexes are actually pretty small. In fact, behavior and development have more to do with a child’s genetics and life experiences than they do with sex. And, of course, every child is an individual who will grow and develop at his or her own pace. So, in order for your tot to reach his or her full potential, your cutie needs lots of attention and encouragement from the get-go. Read on to learn about where (and how much) your child’s sex plays a role in development, from walking and talking to potty training. When it comes to boys versus girls in the walking department, this one is a draw. Anecdotally, many parents say boys reach gross-motor milestones like sitting up, cruising and walking earlier than girls, but some pediatricians swear the opposite. Yet both are wrong: Studies show no significant differences between boys and girls when it comes to these motor skills in infancy. Both sexes generally start walking independently after turning 1, often around month 14. Still, some parents believe boys start sooner. One study found that mothers of 11-month-old infants overestimated their boys’ motor skills and underestimated their daughters’. This belief could be related to physical size since boys tend to be heavier than girls between 8 and 12 months. How you can help Build up your baby’s muscles by giving your little guy or gal plenty of tummy time in the early months — and making sure your tot doesn’t spend too much time confined to the stroller, car seat or play yard. Physical size and growth Right from the start, boys tend to weigh more at birth and this trend continues as babies age, with girls measuring about a half pound less. But girls catch right up as the toddler years approach. Most of them reach half their adult height by 19 months of age. Boys, on the other hand, achieve this size when they’re closer to 2 years old. Of course, each child is different, from infancy to toddlerhood to puberty. Growth spurts vary, and in general, both boys and girls spend middle childhood about the same size. When adolescence begins, girls typically start outpacing their brethren. In middle school, girls are usually taller, though males catch up and typically measure taller than some girls in a year or two. How you can help No matter your child’s weight or height, make a point of offering healthy meals and snacks as often as you can. Focus on fruits, veggies, whole grains, lean protein and low-fat dairy products, depending on your child’s age, current weight and health status. Your pediatrician can offer important nutrition and allergy guidelines. Talking One milestone that consistently differs between boys and girls is talking. Some research has found that sons are more likely to be late talkers and that girl babies tend to have larger vocabularies than boy babies as early as 18 months. But sex only explains a small part of the differences in toddlers’ verbal skills. Other socioeconomic factors and opportunities also influence how soon they talk. Exposure to language and a child’s environment can make a huge difference in the number of words they learn — and science backs this up. Research has found an association between larger vocabularies by the age of 4 and the number and variety of words kids heard during the first three years of life. How you can help Talk, talk and talk some more! Parents should narrate the day, sing songs and read to their babies consistently, whether they’re girls or boys. Studies have shown that reading to your child helps him or her achieve strong language skills well into their school years. Avoid screens (including TV, phones, computers and tablets) as much as possible — except for video chatting with family and friends. Potty training If you’re wondering when the diaper stage will end, expect it to happen sooner with daughters than sons. Girls usually ditch their diapers faster. While most girls start toilet training anytime from 22 to 30 months, boys can take approximately six months longer. But a child’s desire and ability to potty train varies widely, so it’s helpful to try and spot the signs of readiness. For example, girls can often sleep through the night without having a bowel movement around 22 months of age, while boys often do so by 25 months. And when it comes to pulling up underwear or training pants, girls usually master it by 29 months versus 33 months for boys. How you can help Even if your little boy takes more time to get the hang of potty training, bring out the potty around his second birthday and just let him have fun with it. Set it up and let your tot sit in it, both with clothes and without. Offer loads of praise (or something tangible like stickers) when success comes, but be patient when those inevitable accidents occur. From the What to Expect editorial team
and Heidi Murkoff, author of What to Expect When You're
Expecting. What to Expect follows strict reporting
guidelines and uses only credible sources, such as
peer-reviewed studies, academic research institutions and
highly respected health organizations. Learn how we keep our
content accurate and up-to-date by reading our medical
review and editorial policy. Be Worried About Boys, Especially
Baby Boys - Psychology Today - 1/8/17
We often hear that boys need to be toughened up so as not to be sissies. Parents' toughness toward babies is even celebrated as “not spoiling the baby.” Wrong! These ideas are based on a misunderstanding of how babies develop. Instead, babies rely on tender, responsive care to grow well—resulting in self-control, social skills, and concern for others. A review of empirical research just came out by Allan N. Schore, called “All Our Sons: The Developmental Neurobiology and Neuroendocrinology of Boys at Risk.” This thorough review shows why we should be worried about how we treat boys early in their lives. Here are a few highlights: Why does early life experience influence boys significantly more than girls?
How are boys affected more than girls?
What can we conclude from the data? Boys are more vulnerable to neuropsychiatric disorders that appear developmentally (girls more vulnerable to disorders that appear later). These include autism, early-onset schizophrenia, ADHD, and conduct disorders. These have been increasing in recent decades (interestingly, as more babies have been put into daycare settings, nearly all of which provide inadequate care for babies; National Institute of Child Health and Human Development, Early Child Care Research Network, 2003). Schore states, “in light of the male infant’s slower brain maturation, the secure mother’s attachment-regulating function as a sensitively responsive, interactive affect regulator of his immature right brain in the first year is essential to optimal male socioemotional development.” (p. 14) "In total, the preceding pages of this work suggest that differences between the sexes in brain wiring patterns that account for gender differences in social and emotional functions are established at the very beginning of life; that the developmental programming of these differences is more than genetically coded, but epigenetically shaped by the early social and physical environment; and that the adult male and female brains represent an adaptive complementarity for optimal human function." (p. 26) What does inappropriate care look like in the first years of life? “In marked contrast to this growth-facilitating attachment scenario, in a relational growth-inhibiting postnatal environment, less than optimal maternal sensitivity, responsiveness, and regulation are associated with insecure attachments. In the most detrimental growth-inhibiting relational context of maltreatment and attachment trauma (abuse and/or neglect), the primary caregiver of an insecure disorganized–disoriented infant induces traumatic states of enduring negative affect in the child (A.N. Schore, 2001b, 2003b). As a result, dysregulated allostatic processes produce excessive wear and tear on the developing brain, severe apoptotic parcellation of subcortical–cortical stress circuits, and long-term detrimental health consequences (McEwen & Gianaros, 2011). Relational trauma in early critical periods of brain development thus imprints a permanent physiological reactivity of the right brain, alters the corticolimbic connectivity into the HPA, and generates a susceptibility to later disorders of affect regulation expressed in a deficit in coping with future socioemotional stressors. Earlier, I described that slow-maturing male brains are particularly vulnerable to this most dysregulated attachment typology, which is expressed in severe deficits in social and emotional functions.” (p. 13) What does appropriate care look like in the brain? “In an optimal developmental scenario, the evolutionary attachment mechanism, maturing during a period of right-brain growth, thus allows epigenetic factors in the social environment to impact genomic and hormonal mechanisms at both the subcortical and then cortical brain levels. By the end of the first year and into the second, higher centers in the right orbitofrontal and ventromedial cortices begin to forge mutual synaptic connections with the lower subcortical centers, including the arousal systems in the midbrain and brain stem and the HPA axis, thereby allowing for more complex strategies of affect regulation, especially during moments of interpersonal stress. That said, as I noted in 1994, the right orbitofrontal cortex, the attachment control system, functionally matures according to different timetables in females and males, and thus, differentiation and growth stabilizes earlier in females than in males (A.N. Schore, 1994). In either case, optimal attachment scenarios allow for the development of a right-lateralized system of efficient activation and feedback inhibition of the HPA axis and autonomic arousal, essential components for optimal coping abilities.” (p. 13) Note: Here is a recent article explaining attachment. Practical implications for parents, professionals, and policymakers: 1. Realize that boys need more, not
less, care than girls. Separation of mom and baby at birth is harmful for all babies, but Schore points out how much more harm it does to boys: “Exposing newborn male ... to separation stress causes an acute strong increase of cortisol and can therefore be regarded as a severe stressor” (Kunzler, Braun, & Bock, 2015, p. 862). Repeated separation results in hyperactive behavior, and “changes ... prefrontal-limbic pathways, i.e., regions that are dysfunctional in a variety of mental disorders” (p. 862). 3. Provide responsive care. Mothers, fathers and other caregivers should avoid any extensive distress in the child—“enduring negative affect.” Instead of the normalized harsh treatment of males ("to make them men") by letting them cry as babies and then telling them not to cry as boys, by withholding affection and other practices to “toughen them up,” young boys should be treated in the opposite way: with tenderness and respect for their needs for cuddling and kindness. Note that preterm boys are less able to spontaneously interact with caregivers and so need particularly sensitive care as their neurobiological development proceeds. 4. Provide paid parental leave. For parents to provide responsive care, they need the time, focus and energy. This means a move to paid maternal and paternal leave for at least a year, the time when babies are most vulnerable. Sweden has other family-friendly policies that make it easier for parents to be responsive. (This link is broken. Refer to the Sweden article in the index at the start of this page.) 5. Beware of environmental toxins. One other thing I did not address, that Schore does, is the effects of environmental toxins. Young boys are more negatively affected by environmental toxins that also disrupt the brain’s right hemisphere development (e.g., plastics like BpA, bis-phenol-A). Schore agrees with Lamphear’s (2015) proposal that the ongoing “rise in developmental disabilities is associated with environmental toxins on the developing brain.” This suggests we should be much more cautious about putting toxic chemicals into our air, soil, and water. That is a topic for another blog post. Conclusion Of course, we should not just worry about boys but take action for all babies. We need to provide nurturing care for all children. All children expect and need, for proper development, the evolved nest, a baseline for early care which provides the nurturing, stress-reducing care that fosters optimal brain development. My lab studies the Evolved Nest and finds it related to all the positive child outcomes we have studied. Next post: Why Worry About Undercared for Males? Messed up Morals! Note on circumcision: Readers have raised questions about circumcision. The USA dataset reviewed by Dr. Schore did not include information about circumcision, so there is no way to know whether some of the findings might be due to the trauma of circumcision, which is still widespread in the USA. Read more about the psychological effects of circumcision here. Note on basic assumptions: When I write about child-raising, I assume the importance of the evolved nest or evolved developmental niche (EDN) for raising human infants (which initially arose over 30 million years ago with the emergence of the social mammals and has been slightly altered among human groups based on anthropological research). The EDN is the baseline I use to examine what fosters optimal human health, wellbeing and compassionate morality. The niche includes at least the following: infant-initiated breastfeeding for several years, nearly constant touch early, responsiveness to needs to avoid distressing a baby, playful companionship with multi-aged playmates, multiple adult caregivers, positive social support, and soothing perinatal experiences. All EDN characteristics are linked to health in mammalian and human studies (for reviews, see Narvaez, Panksepp, Schore & Gleason, 2013; Narvaez, Valentino, Fuentes, McKenna & Gray, 2014; Narvaez, 2014) Thus, shifts away from the EDN baseline are risky and must be supported with lifelong longitudinal data looking at multiple aspects of psychosocial and neurobiological wellbeing in children and adults. My comments and posts stem from these basic assumptions. My research laboratory has documented the importance of the EDN for child wellbeing and moral development with more papers in the works (see my website to download papers). References Kunzler, J., Braun, K., & Bock, J. (2015). Early life stress and sex-specific sensitivity of the catecholaminergic systems in prefrontal and limbic systems of Octodon degus. Brain Structure and Function, 220, 861–868. Lanphear, B.P. (2015). The impact of toxins on the developing brain. Annual Review of Public Health, 36, 211–230. McEwen, B.S., & Gianaros, P.J. (2011). Stress- and allostasis-induced brain plasticity. Annual Review of Medicine, 62, 431–445. Schore, A.N. (1994). Affect regulation the origin of the self. The neurobiology of emotional development. Mahwah, NJ: Erlbaum. Schore, A.N. (2001a). Effects of a secure attachment relationship on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22, 7–66. ?Schore, A.N. (2001b). The effects of relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22, 201–269. Schore, A. N. (2017). All our sons: The developmental neurobiology and neuroendocrinology of boys at risk. Infant Mental Health Journal, e-pub ahead of print doi: 10.1002/imhj.21616 National Institute of Child Health and
Human Development, Early Child Care Research Network (2003).
Does amount of time spent in child care predict
socioemotional adjustment during the transition to
Kindergarten? Society for Research in Child Development,
Inc. Source:
www.psychologytoday.com/us/blog/moral-landscapes/201701/be-worried-about-boys-especially-baby-boys Why Worry About Undercared for
Males? Messed up Morals! - Psychology Today -
1/15/17 Males are more susceptible to early stress, resulting in higher rates of developmental disorders like autism, ADHD, early schizophrenia, and conduct disorders. As indicated by Allan Schore in his review, these are signals of early development gone awry. But they are mostly social disorders that end up harming everyone else. In fact, early undercare negatively influences capacities for ethics and morality. I have written about this in many publications, including my 2014 book, Neurobiology and the Development of Human Morality: Evolution, Culture and Wisdom. Unfortunately, we have come to expect a good number of adult males to be egoistic, aggressive and/or reactive (even when this is not the case in other cultures). But it turns out the causes may not be genetic but epigenetic—effects of experience on how genes are expressed and the very “plastic” young brain is shaped. We can think of moral development like Leo Tolstoy’s discussion of happy and unhappy families in his novel, Anna Karenina. He noted, to paraphrase, that happy families are all alike but unhappy families are all unique. Similarly, moral flourishing looks similar across individuals as a form of dynamic, high-minded, self-controlled, flexible selfless sociality with resilience (e.g., making amends) when setbacks occur. Harry Potter is a fictional exemplar of these capacities. Nelson Mandela exemplifies a real person who characterized this type of moral resilience. For example, he was able to move past his anger and forgive his enemies while continuing to work for justice in his country of South Africa. In contrast, as with unhappy families, there are multiple ways for individual moral development to “go wrong” (which perhaps makes them more interesting and more available as characters). There are individuals who are habitually low-minded (Al Bundy in Married with Children), un-self-regulated (Homer Simpson from The Simpsons), rigid in social relations (Archie Bunker from All in the Family), ruthless in treatment of others for his own ends (Francis Underwood of House of Cards), unable to take perspectives of others (Sheldon Cooper from The Big Bang Theory), or unable to forgive (George Costanza from Seinfeld). Why is it so easy to find disordered male characters? As noted in the previous post Be Worried about Boys, Especially Baby Boys, boys are more vulnerable to neuropsychiatric disorders that appear developmentally such as autism, early onset schizophrenia, ADHD, and conduct disorders (Schore, 2017). This may be the reason that boys make for more interesting characters in fiction. The roots for moral disarray often begin in early childhood, when toxic stress or poor care have greatest impact. Early experience initially shapes moral values by engraving neurobiology, setting one on a better or worse trajectory in terms of moral development and influencing one’s deep moral values. We will focus on two fictional characters, Sheldon Cooper from "The Big Bang Theory" and Francis Underwood from "House of Cards." Sheldon Cooper has been told rules for life by his mother and others, and has committed many to memory, but they do not match up with his own anti or non-social intuitions and reactions. Francis Underwood is not as autistic (socially awkward in perception, sensitivity and behavior) but he has similar antisocial attitudes. Both do not care much about other people, except instrumentally, using them to help get what they want. What happened? It looks like when they were babies they were smart enough as a baby to “go into their heads” when needs were not met, as a defense against trauma (Winnicott, 1965). Like those with avoidant attachment, they took an intellectual route to social development. At the same time the development of their emotional intelligence was thwarted, all during sensitive periods of brain development. Both Sheldon and Francis show how a person can learn rules from explicit instruction that don’t match up with implicit (subconscious) understandings of the world. While such a person may comply with others’ moral values when necessary, he has not internalized the values—does not internally believe, understand or know them. So then, what kinds of morality are Sheldon and Francis exhibiting? Morality based in enhanced survival systems. All of us are born with survival systems to keep us alive. They include the emotion systems located in the extrapyramidal action nervous system: fear, anger, panic/grief, and basic lust—all well mapped in mammalian brains and integrated with the stress response (Panksepp, 1998). When toxic stress takes place in early childhood, the survival systems are kept active, undermining capacities for sociality which are otherwise scheduled to develop at that time (Narvaez, 2014). Survival systems kick in under stress and promote such things as territoriality, imitation, deception, struggles for power, maintenance of routine and following precedent (MacLean, 1990). When survival systems take over the mind, they change perception of what seems good in the moment. If they trump other values and guide behavior, we can call them a self-protectionist ethic (Narvaez, 2008, 2014, 2016). Self-protectionism becomes apparent as a mindset when individuals hold themselves apart from others, unable to relationally attune as an equal to others, just what we see in Sheldon and Francis. Sheldon displays social withdrawal enhanced by intellect, what I call detached imagination. Detached imagination represents emotionally-detached intellectualism that does not attend to responsibility towards others, and plans without a sense of long term consequences on the web of life. Our studies have found detached imagination related to personal distress and social distrust (Narvaez, Thiel, Kurth & Renfus, 2016). Recent real-life examples of this mindset include the bankers and mortgage brokers who caused the 2008 USA financial crash (illustrated in The Big Short by Michael Lewis). More everyday examples are found in our fictional characters like Homer Simpson who regularly causes disasters for others by not thinking through possible consequences of his actions. Francis Underwood displays social opposition enhanced by intellect, a vicious imagination. Vicious imagination (inflamed by social opposition) represents planful control or harm of others. Our studies found it strongly related to insecure attachment and trait aggression (Narvaez, Thiel et al., 2016). We can note other examples. Crake in the novel, Oryx and Crake, by Margaret Atwood, exemplifies viciousness as he secretly develops both a new life form to inhabit the earth while at the same time a way to kill off humanity with a pill containing a virus with a delayed effect. But less extreme cases are found in everyday life with characters like George Costanza as he seeks to take revenge on those who he thinks slighted him. These types of protectionist ethics indicate a hierarchical mindset (dominance or submission) to which survival systems are oriented to promote self-safety. When the stress response is active, blood flow shifts towards mobilization for safety and away from capacities for openness. The shift can occur by situation and can happen so quickly that it is not apparent to the individual (Narvaez, 2014). Someone can shift into aggression under particular circumstances, as when George Costanza pushed everyone at a daycare out of the way to escape when he thought there was a fire in the building. Individuals can dispositionally favor aggressing or withdrawing, or shift between them opportunistically like George does. In my lab we have shown that individuals whose childhoods were more inconsistent with the evolved nest are more likely to have protectionist ethics and behaviors (Narvaez, Thiel et al., 2016; Narvaez, Wang, & Cheng, 2016). Those with protectionist ethics were more distrustful, less prosocial and had lower integrity scores. BUT But you might argue that it is normal for mothers to be unresponsive and foster the types of disorders the data show are more common in boys (autism, conduct disorder, schizophrenia, ADHD). To believe this is contrary to billions of years of evolution where disordered individuals just don’t make it—a poorly developed individual is not going to have descendants over the long term that can outcompete the well developed rivals. And this view is contrary to human evolution according to Darwin. We take these things up in the next post. Conclusion We now face a world full of males who have been undercared for. Look around at the leadership in fields like business or politics and you can see many self-centered males (perhaps more or less extreme than Sheldon or Francis). Sociologist Charles Derber contends that to get ahead in the USA you have to be sociopathic. People with self-protectionist ethics represent a danger to the rest of us because they lack the evolved "moral sense.". WHEN I WRITE ABOUT HUMAN NATURE, I use the 99% of human genus history as a baseline. That is the context of small-band hunter-gatherers. These are “immediate-return” societies with few possessions who migrate and forage. They have no hierarchy or coercion and value generosity and sharing. They exhibit both high autonomy and high commitment to the group. They have high social wellbeing. See comparison between dominant Western culture and this evolved heritage in my article (you can download from my website): Narvaez, D. (2013). The 99 Percent—Development and socialization within an evolutionary context: Growing up to become “A good and useful human being.” In D. Fry (Ed.), War, Peace and Human Nature: The convergence of Evolutionary and Cultural Views (pp. 643-672). New York: Oxford University Press. WHEN I WRITE ABOUT PARENTING, I assume the importance of the evolved nest, the evolved developmental niche (EDN) for raising human infants (which initially arose over 30 million years ago with the emergence of the social mammals and has been slightly altered among human groups based on anthropological research). The EDN is the baseline I use to examine what fosters optimal human health, wellbeing and compassionate morality. The niche includes at least the following: infant-initiated breastfeeding for several years, nearly constant touch early, responsiveness to needs to avoid distressing a baby, playful companionship with multi-aged playmates, multiple adult caregivers, positive social support, and soothing perinatal experiences. All EDN characteristics are linked to health in mammalian and human studies (for reviews, see Narvaez, Panksepp, Schore & Gleason, 2013; Narvaez, Valentino, Fuentes, McKenna & Gray, 2014; Narvaez, 2014) Thus, shifts away from the EDN baseline are risky and must be supported with longitudinal data looking at multiple aspects of psychosocial and neurobiological wellbeing in children and adults. My comments and posts stem from these basic assumptions. My research laboratory has documented the importance of the EDN for child wellbeing and moral development with more papers in the works (see my Website to download papers): Narvaez, D., Gleason, T., Wang, L., Brooks, J., Lefever, J., Cheng, A., & Centers for the Prevention of Child Neglect (2013). The Evolved Development Niche: Longitudinal Effects of Caregiving Practices on Early Childhood Psychosocial Development. Early Childhood Research Quarterly, 28 (4), 759–773. Doi: 10.1016/j.ecresq.2013.07.003 Narvaez, D., Wang, L., Gleason, T., Cheng, A., Lefever, J., & Deng, L. (2013). The Evolved Developmental Niche and sociomoral outcomes in Chinese three-year-olds. European Journal of Developmental Psychology, 10(2), 106-127. We also have a paper in press showing the relation of the EDN to adult wellbeing, sociality and morality. We also have a recent paper look at adult effects: Narvaez, D., Wang, L, & Cheng, A. (2016). Evolved Developmental Niche History: Relation to adult psychopathology and morality. Applied Developmental Science, 4, 294-309. http://dx.doi.org/10.1080/10888691.2015.1128835 See these for theoretical reviews: Narvaez, D., Gettler, L., Braungart-Rieker, J., Miller-Graff, L., & Hastings, P. (2016). The flourishing of young Children: Evolutionary baselines. In Narvaez, D., Braungart-Rieker, J., Miller, L., Gettler, L., & Harris, P. (Eds.), Contexts for young child flourishing: Evolution, family and society (pp. 3-27). New York, NY: Oxford University Press. Narvaez, D., Hastings, P., Braungart-Rieker, J., Miller, L., & Gettler, L. (2016). Young child flourishing as an aim for society. In Narvaez, D., Braungart-Rieker, J., Miller, L., Gettler, L., & Hastings, P. (Eds.), Contexts for young child flourishing: Evolution, family and society (pp. 347-359). New York, NY: Oxford University Press. Also see these books: Evolution, Early Experience and Human Development (Oxford University Press) Ancestral Landscapes in Human Evolution (Oxford University Press) Contexts for Young Child Flourishing: Evolution, Family and Society (ed. with Braungart-Rieker, Miller-Graff, Gettler, Hastings; OUP, 2016) Neurobiology and the Development of Human Morality (W.W. Norton) References MacLean, P.D. (1990). The Triune Brain in Evolution: Role in Paleocerebral Functions. New York: Plenum. Narvaez, D. (2008). Triune ethics: The neurobiological roots of our multiple moralities. New Ideas in Psychology, 26:, 95–-119. Narvaez, D. (2014). Neurobiology and the development of human morality: Evolution, culture and wisdom. New York, NY: W.W. Norton. Narvaez, D. (2016). Embodied morality: Protectionism, engagement and imagination. New York, NY: Palgrave-Macmillan. Narvaez, D., Thiel, A., Kurth, A., & Renfus, K. (forthcoming, 2016). Past moral action and ethical orientation In D. Narvaez, Embodied morality: Protectionism, engagement and imagination. New York, NY: Palgrave-Macmillan. Narvaez, D., Wang, L, & Cheng, A. (2016). Evolved Developmental Niche History: Relation to adult psychopathology and morality. Applied Developmental Science, 4, 294-309. http://dx.doi.org/10.1080/10888691.2015.1128835 Panksepp, J. (1998). Affective neuroscience: The foundations of human and animal emotions. New York: Oxford University Press. Schore, A. N. (2017). All our sons: The developmental neurobiology and neuroendocrinology of boys at risk. Infant Mental Health Journal, e-pub ahead of print doi: 10.1002/imhj.21616 Winnicott, D. (1965). The maturational
processes and the facilitating environment. New York:
International Universities Press: London: Circumcision’s Psychological
Damage - Psychology Today - 1/1/16 As psychologists, we are deeply concerned by the recently announced CDC guidelines promoting circumcision for all males, and in particular children. The CDC guidelines are based on a sharply criticized 2012 policy statement by the American Academy of Pediatrics. The 2012 statement was condemned by a large group of physicians, medical organizations, and ethicists from European, Scandinavian, and Commonwealth countries as “culturally biased” and “different from [the conclusions] reached by physicians in other parts of the Western world, including Europe, Canada and Australia” (Frisch et al., 2013). The new CDC guidelines highlight methodologically flawed studies from Africa that have no relevance to the United States. They chose to ignore studies that were conducted in the United States and show no link between circumcision and the risk of sexually transmitted diseases, including HIV (Thomas et al., 2004). Worse, the CDC has completely ignored the psychological effects of genital cutting on male children. This article outlines the psychological research that demonstrates the relationship between circumcision and psychological harm. The authors, along with other psychologists, have appealed to the CDC and Congress to reevaluate this policy in light of the psychological harm it will cause infants, children, and teens. Psychological Effects on Infants 1. Circumcision Causes Immediate Harm Circumcision is often performed on infants without anesthetic or with a local anesthetic that is ineffective at substantially reducing pain (Lander et al., 1997). In a study by Lander and colleagues (1997), a control group of infants who received no anesthesia was used as a baseline to measure the effectiveness of different types of anesthesia during circumcision. The control group babies were in so much pain—some began choking and one even had a seizure—they decided it was unethical to continue. It is important to also consider the effects of post-operative pain in circumcised infants (regardless of whether anesthesia is used), which is described as “severe” and “persistent” (Howard et al., 1994). In addition to pain, there are other negative physical outcomes including possible infection and death (Van Howe, 1997, 2004). 2. Pain from Circumcision in Infancy Alters the Brain Research has demonstrated the hormone cortisol, which is associated with stress and pain, spikes during circumcision (Talbert et al., 1976; Gunnar et al., 1981). Although some believe that babies “won’t remember” the pain, we now know that the body “remembers” as evidenced by studies which demonstrate that circumcised infants are more sensitive to pain later in life (Taddio et al., 1997). Research carried out using neonatal animals as a proxy to study the effects of pain on infants’ psychological development have found distinct behavioral patterns characterized by increased anxiety, altered pain sensitivity, hyperactivity, and attention problems (Anand & Scalzo, 2000). In another similar study, it was found that painful procedures in the neonatal period were associated with site-specific changes in the brain that have been found to be associated with mood disorders (Victoria et al., 2013). 3. Infant Circumcision has Psychological Consequences for Men Over the last decade there has been a movement of men who were circumcised as infants and have articulated their anger and sadness over having their genitals modified without their consent. Goldman (1999) notes that shame and denial is one major factor that limits the number of men who publicly express this belief. Studies of men who were circumcised in infancy have found that some men experienced symptoms of post traumatic stress disorder, depression, anger, and intimacy problems that were directly associated with feelings about their circumcision (Boyle, 2002; Goldman, 1999; Hammond, 1999). Psychological Effects on Children and Adolescents 1. Medical Procedures in Childhood are Often Experienced as Traumatic The CDC fails to consider that many medical procedures, even those that are described as routine, are often experienced as traumatic by children and adolescents (Levine & Kline, 2007). Circumcision, for example, clearly meets the clinical definition of trauma because it involves a violation of physical integrity. In fact, research has demonstrated that medical traumas in childhood and adolescence share many of the same psychological elements of childhood abuse, such as physical pain, fear, loss of control, and the perception that the event is a form of punishment (Nir, 1985; Shalev, 1993, Shopper, 1995). 2. Procedures Involving Children’s Genitals Produce Negative Psychological Effects The psychological consequences of medical procedures are even greater when they involve a child’s genitals. Studies have examined the psychological effects of medical photography of the genitals (Money, 1987), repeated genital examinations (Money, 1987), colposcopy (Shopper, 1995), cystscopy and catheterization (Shopper, 1995), voiding cystourethrogram (Goodman et al., 1990), and hypospadias repair (INSA, 1994). The studies found that these procedures often produce symptoms which are very similar to those of childhood sexual abuse, including dissociation and the development of a negative body image. The effects often persist into adulthood as evidenced by a study that examined the effects of childhood penile surgery for hypospadias. Men who had this surgery in childhood experienced more depressive symptoms, anxiety, and interpersonal difficulties than men who did not have the surgery (Berg & Berg, 1983). 3. Circumcision Causes Significant Psychological Harm in Children and Adolescents Circumcision in childhood and adolescence has significant negative psychological consequences. Following a traumatic event, many children experience anxiety, depression, and anger; and many others try to avoid and suppress these painful feelings (Gil, 2006). In addition, children often experience a debilitating loss of control that negatively affects their ability to regulate emotions and make sense of the traumatic experience (Van der Kolk, 2005). In a study of adults circumcised in childhood, Hammond (1999) found that many men conceptualized their circumcision experience as an act of violence, mutilation, or sexual assault. Kennedy (1986) detailed the psychological effects of circumcision in a case study describing the psychotherapy of a boy who was circumcised at three years of age. The sense of inadequacy, feelings of victimization, and violent sexual fantasies experienced during this boy’s adolescence were found to be both consciously and unconsciously linked to his experience with losing part of his penis (Kennedy, 1986). In a study examining the psychological effects of circumcision on boys between four and seven years of age, Cansever (1965) used psychological testing to measure boys’ level of distress. The results of the study indicated that circumcision was perceived as an aggressive attack on the body that left children feeling damaged and mutilated (Cansever, 1968). Cansever (1968) also noted that these boys experienced changes in body image (with many feeling smaller and incomplete), feelings of inadequacy and helplessness, as well as a tendency to withdraw psychologically. 4. The Majority of Boys Circumcised as Children and Adolescents Meet Diagnostic Criteria for Post Traumatic Stress Disorder (PTSD) The most comprehensive study available that assesses the psychological impact of circumcision on children after infancy was conducted by Ramos and Boyle (2000) and involved 1072 pre-adolescent and adolescent boys who were circumcised in a hospital setting. Using an adapted version of a clinically established PTSD interview rating scale, the study’s authors determined that 51 percent of these boys met the full diagnostic criteria for PTSD and noted that other variables such as age at circumcision (pre-adolescence versus adolescence) and time elapsed since the procedure (months versus years) were not predictive of a PTSD diagnosis (Ramos & Boyle, 2000). As a point of comparison, the rate of PTSD among veterans of the Iraq war is approximately 20 percent (NIH, 2009). 5. By Encouraging Circumcision, Medical Professionals are Shaming Boys’ Bodies If the CDC guidance is followed, medical providers will be communicating a psychologically damaging message to boys with intact genitals—that their penises are somehow “bad” or inferior. The negative effects of such communications have been studied with regard to intersex children and have been found to be frightening, shaming, and embarrassing to the child (Rusch et al., 2000). This is a particularly cruel message to send to adolescents, many of whom are already experiencing concerns regarding body image. Conclusion The circumcision of children has myriad negative psychological consequences that the CDC has failed to consider. Removing healthy tissue in the absence of any medical need harms the patient and is a breach of medical providers’ ethical duty to the child. We believe that all people have a right to bodily autonomy and self-determination and deeply respect this fundamental tenet of international human rights law (UNESCO 2005). As children cannot advocate for themselves, they need adults to understand the complexities of their emotional experiences and provide them special protection. We oppose the CDC’s circumcision recommendation and encourage all parents to do the same in order to protect their children from physical and psychological harm. Parents: For clear, easy and plain-language help making the circumcision decision, try the Circumcision Decision Maker. For more information, also read the following: Circumcision in childhood is linked to increased risk of autism. Practical Tips for Men Distressed by Their Circumcision References Anand, K.J., & Scalzo, F.M. (2000). Can adverse neonatal experiences alter brain development and subsequent behavior? Biol Neonate, 77, 69-82. Berg, R., & Berg, G. (1983). Castration complex: Evidence from men operated for hypospadias. Acta Psychiatrica Scandinavica, 68, 143-153. Boyle, G.J., Goldman, R., Svoboda, JS., & Fernandez, E. (2002). Male circumcision: Pain, trauma, and psychosexual sequelae. Journal of Health Psychology, 7, 329-343. Boyle, G.J., & Ramos, S. (2000). Ritual and medical circumcision among filipino boys: Evidence of post-traumatic stress disorder. Humanities & Social Science Papers, 114. Cansever, G. (1965). Psychological effects of circumcision. British Journal of Medical Psychology, 38, 321-331. Frisch, M., Aigrain, Y., Barauskas, V., Bjarnason, R., Boddy, S.A., Czauderna, P., de Gier, R.P., de Jong, T.P., Fasching, G., Fetter, W., Gahr, M., Graugaard, C., Greisen, G., Gunnarsdottir, A., Hartmann, W., Havranek, P., Hitchcock, R., Huddart. S., Janson, S., Jaszczak, P., Kupferschmid, C., Lahdes-Vasama, T., Lindahl, H., MacDonald, N., Markestad, T., Märtson, M., Nordhov, S.M., Pälve, H., Petersons, A., Quinn, F., Qvist, N., Rosmundsson, T., Saxen, H., Söder, O., Stehr, M., von Loewenich, V.C., Wallander, J., Wijnen, R. (2013). Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision. Pediatrics, 131, 796-800. Gil, E. (2006). Helping abused and traumatized children. New York: Guilford Press. Goldman, R. (1999). The psychological impact of circumcision. BJU International, 83, Suppl. 1, 93-102. Goodman, G.S., Rudy, L., Bottoms, B.L., & Aman, C. (1990). Children’s concerns and memory: issues of ecological validity in the study of children’s eyewitness testimony. In R. Fivush J.A. Hudson (Eds.), Knowing and Remembering in Young Children (pp. 249-294). NY: Cambridge University Press. Gunnar, M.R., Fisch, R.O., Korsvik, S. & Donhowe, J. (1981). The effects of circumcision on serum cortisol and behavior. Psychoneuroendocrinology, 6, 269-275. Hammond, T. (1999). A preliminary poll of men circumcised in infancy or childhood. BJU International, 83, Suppl. 1, 85-92. Howard, C.R., Howard, F.M., & Weitzman, M.L. (1994). Acetaminophen analgesia in neonatal circumcision: The effect on pain. Pediatrics, 93, 641-646. Intersex Society of North America (ISNA). (1994). Hypospadias: A parent’s guide. Kennedy, H. (1986). Trauma in childhood: Signs and sequelae as seen in the analysis of an adolescent. Psychoanalytic Study of the Child, 41, 209-219. Lander, J., Brady-Freyer, B., Metcalfe, J.B., Nazerali, S., & Muttit, S. (1997). Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision. JAMA, 278, 2157-2162. Levine, P.A., & Kline, M. (2007). Trauma through a child’s eyes. Berkeley, CA: North Atlantic Books. Money, J., & Lamacz, M. (1987). Genital examination and exposure experienced as nosocomial sexual abuse in childhood. The Journal of Nervous and Mental Disease, 175, 713-721. National Institutes of Health. (2009). PTSD: A growing epidemic.. NIH Medline, 4, 1. Retrieved from: http://www.nlm.nih.gov/medlineplus/magazine/issues/winter09/articles/wi…. Nir, Y. (1985). Post-traumatic stress disorder in children with cancer. In S. Eth R. S. Pynoos (Eds.), Post-Traumatic Stress Disorder in Children (p. 121-132). Washington, D.C.: American Psychiatric Press, Inc. Rusch, M.D., Grunert, B.K., Sanger, J.R., Dzwierzynski, W.W., & Matloub, H.S. (2000). Psychological adjustment in children after traumatic disfiguring injuries: A 12-month follow-up. 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Adopted by the General Conference of the United Nations Educational, Scientific and Cultural Organization on 19 October 2005. Van der Kolk, B.A. (2005). Developmental trauma disorder: Towards a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35, 401-408. Van Howe, R..S. (1997). Variability in penile appearance and penile findings: A prospective study. BJU, 80, 776-782. Van Howe, R.S. (2004). A cost-utility analysis of neonatal circumcision. Medical Decision Making, 24, 584 - 601. Victoria, N.C., Kiyoshi, I., Young,
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female rats. Psychoneuroendocrinology, 38, 3015-3028. Gender
stereotyping may start as young as three months, study of
babies' cries shows - 5/12/16 Adults attribute degrees of femininity and masculinity to babies based on the pitch of their cries, as shown by a new study by researchers from the University of Sussex, the University of Lyon/Saint-Etienne and Hunter College City University of New York. The research is published in the journal BMC Psychology. The study found:
Despite no actual difference in pitch between the voices of girls and boys before puberty, the study found that adults make gender assumptions about babies based on their cries. Dr David Reby from the School of Psychology at the University of Sussex said: "It is intriguing that gender stereotyping can start as young as three months, with adults attributing degrees of femininity and masculinity to babies solely based on the pitch of their cries. Adults who are told, or already know, that a baby with a high-pitched cry is a boy said they thought he was less masculine than average. And baby girls with low-pitched voices are perceived as less feminine. Professor Nicolas Mathevon, from the University of Lyon/Saint-Etienne & Hunter College CUNY, commented: “This research shows that we tend to wrongly attribute what we know about adults - that men have lower pitched voices than women - to babies, when in fact the pitch of children's voices does not differ between sexes until puberty. The researchers recorded the spontaneous cries of 15 boys and 13 girls who were on average four months old. The team also synthetically altered the pitch of the cries while leaving all other features of the cries unchanged to ensure they could isolate the impact of the pitch alone. The participating adults were a mixture of parents and non-parents. 'Sex Stereotypes Influence Adults'
Perception of Babies' Cries' is published in the BMC
Psychology journal. It is authored by David Reby from the
University of Sussex, Florence Levrero and Erik Gustafsson
at the University of Lyon/Saint-Etienne and Nicolas Mathevon
at the University of Lyon/Saint-Etienne & Hunter College
CUNY. California
Will Now Recognize Nonbinary Identities on Death
Certificates - 7/13/21 California passed two pro-LGBTQ+ bills last week (2021), and there’s plenty more to come. Governor Gavin Newsom signed Assembly Bills 439 and 378 into law on Friday, per the local LGBTQ+ publication the Bay Area Reporter. The former will allow nonbinary people to be represented in accordance with their lived identities on death certificates, while the latter will remove gendered language from a huge number of state codes relating to government positions. Currently, California state officials are referred to with “he” pronouns in these codes. Both bills were authored by Assemblywoman Rebecca Bauer-Kahan (D-16th District), who celebrated the move on Twitter. She said AB 436’s passage will ensure that nonbinary individuals “are respected in their death as they are in life.” Bauer-Kahan affirmed to the Bay Area Reporter that she was “beyond thrilled that Governor Gavin Newsom has signed these two bills into law.” “It's 2021 and our laws need to reflect that anyone, regardless of gender, can hold California's highest offices,” she said of the gender-neutrality bill In addition to affirming respect for the dead, a nonbinary designation on death certificates will strengthen the LGBTQ+ data available to public health researchers, according to the California Fox affiliate KTVU. Given that nonbinary people are only just now starting to be studied on a population level, this designation will better assist California in researching its nonbinary population’s health. It’s not an unprecedented move, either: New York City announced in 2019 that its Health Department would start including an “X” option on death certificates, and Oregon has been offering gender-neutral markers on such documents since 2018. Though the Golden State is often one step ahead of the rest of the country when it comes to trans equality, California is only the latest to revise its state laws to be gender neutral. Minnesota removed gender-specific language from its laws in 1986, according to Newsweek. A similar bill revising “archaic gender-specific pronouns” in California’s vehicle and insurance codes is still pending in the legislature. Californians, meanwhile, have been able to get “X” gender markers on state IDs since 2019. While the death certificate bill is the first pro-LGBTQ+ legislation that the governor has approved this year, it’s likely far to be the last. According to the Bay Area Reporter, lawmakers hope to put 10 other LGBTQ+ bills on Newsom’s desk before the end of the legislative session in September. That includes two bills sponsored by Assemblyman David Chiu (D-17th District), which aim to protect the privacy of trans people receiving gender-affirming care and prohibit public universities from deadnaming trans students in academic records. While California has some privacy protections for those receiving “sensitive services,” which encompasses mental health and gender-affirming care, the bill allows all patients to request increased confidentiality measures for their medical information. Other bills include the Safer Streets for All Act, which would repeal California’s version of the “walking while trans” law criminalizing “loitering for the intent to engage in prostitution.” As critics have noted, the enforcement of these laws is highly subjective and results in the disproportionate targeting of transgender women of color, especially Black trans women. Lastly, another bill would require large retail stores to remove gendered signage from toy and childcare aisles. A previous version of the bill included children’s clothing, but this stipulation was removed as a compromise in order to move the bill forward. The bills passed Friday will go into
effect on January 1.2021
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