Pill to "lessen" intersex may also reduce homosexuality

[Linus]

It's weird. This story, to me, says that we are born one way or another but at the same time, as a trans individual, makes me wonder if I could have been born without the thing that makes me who I am. But also heightens that I was born as is and it's not a mental condition. What is interesting that it only (from the article) seems to be targeted towards fetus' that are "female" but with both genital types.

Of course, this will cause the right-wing types to claim that homosexuality is a "disease" that "must be cured" and now there is a "cure".

Read more here: http://www.latimes.com/news/science/la-sci-adrenal-20100815,0,5576220.story

Thoughts?

[Nat]

If LGBTQ people are born this way, it's an excuse to attempt to medically eradicate us.

If LGBTQ people are "choosing" to be this way, then it's an excuse for moral condemnation, denial of full citizenship status and conversion "therapy."

As long as we are hated, they will try to eradicate us. Using a fetus as a guinea pig for hormone treatment is so risky. To risk a fetus's life, quality of life and lifespan in order to anti-gay it seems extraordinarily effed up to me. For all they know, their kid will die of cancer at the age of 30 because this type of experimentation.

[Nat]

In a 2008 study in the Archives of Sexual Behavior, New and her colleagues administered a sexual behavior assessment questionnaire to 143 women with congenital adrenal hyperplasia who were not treated prenatally. They found that most were heterosexual, but the rates of homosexual and bisexual women were markedly higher in women with the condition — especially those with the most severe conditions — compared with a control group of 24 female relatives without congenital adrenal hyperplasia.

"And, in a paper published earlier this year in the Annals of the New York Academy of Sciences, New and her colleagues reported on data from 685 pregnancies in which the condition was diagnosed prenatally, acknowledging the potential effects of the treatment for reducing traditionally masculine behavior in girls. Prenatally treated girls were more likely to be shy, they wrote, while untreated girls were "more aggressive."

Moreover, the authors said, failure to provide prenatal therapy seems to lead to traditionally masculine gender-related preferences in childhood play, peer association and career and leisure choices.

[Nat]

Bitch Magazine awarded Dr. Maria New the Douchebag Decree on July 1st (http://www.bitchmagazine.org/post/douchebag-decree-dr-maria-new-in-utero-gender-norm-enforcer)

http://www.nlm.nih.gov/changingthefaceofmedicine/img/portraits/234.jpg

You know how in Gattaca doctors used hormones to control the personalities of fetuses, ensuring a creepily uniform generation of "perfect" people, like the guy who plays Ethan Hawke's brother in the movie? Well, now there is a doctor who is attempting to do something similar by eradicating non-"feminine" traits in female fetuses—an "abnormal" disinterest in babies, not wanting to play with girls' toys or become mothers, "career preferences" that are deemed too "masculine"—and she's this week's Douchebag Decree recipient. Dr. Maria New, come on down!

That's right—Pediatric endocrinologist Maria New, of the Mount Sinai School of Medicine and Florida International University, is using a hormonal drug called dexamethasone, or "dex", to regulate prenatal androgens in female fetuses that may have a form of congenital adrenal hyperplasia (CAH). What this means in terms us non-endocrinologists can understand is that New is hoping this hormone therapy will eradicate female tendencies toward childlessness, masculine career choices, and even bisexuality or homosexuality. The real breakdown? New and her colleagues want to prevent females from being "too masculine" starting in the womb.

[Nat]

http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=4754&blogid=140

In a paper published just this year in the Annals of the New York Academy of Sciences, New and her colleague, pediatric endocrinologist Saroj Nimkarn of Weill Cornell Medical College, go further, constructing low interest in babies and men—and even interest in what they consider to be men’s occupations and games—as “abnormal,” and potentially preventable with prenatal dex:

“Gender-related behaviors, namely childhood play, peer association, career and leisure time preferences in adolescence and adulthood, maternalism, aggression, and sexual orientation become masculinized in 46,XX girls and women with 21OHD deficiency [CAH]. These abnormalities have been attributed to the effects of excessive prenatal androgen levels on the sexual differentiation of the brain and later on behavior.” Nimkarn and New continue: “We anticipate that prenatal dexamethasone therapy will reduce the well-documented behavioral masculinization...”

It seems more than a little ironic to have New, one of the first women pediatric endocrinologists and a member of the National Academy of Sciences, constructing women who go into “men’s” fields as “abnormal.” And yet it appears that New is suggesting that the “prevention” of “behavioral masculinization” is a benefit of treatment to parents with whom she speaks about prenatal dex. In a 2001 presentation to the CARES Foundation (a videotape of which we have), New seemed to suggest to parents that one of the goals of treatment of girls with CAH is to turn them into wives and mothers. Showing a slide of the ambiguous genitals of a girl with CAH, New told the assembled parents:

“The challenge here is... to see what could be done to restore this baby to the normal female appearance which would be compatible with her parents presenting her as a girl, with her eventually becoming somebody’s wife, and having normal sexual development, and becoming a mother. And she has all the machinery for motherhood, and therefore nothing should stop that, if we can repair her surgically and help her psychologically to continue to grow and develop as a girl.”

[UofMfan]

Dr. Maria New, a highly regarded pediatric endocrinologist at Mount Sinai Medical Center in New York, is among a handful of physicians worldwide who have studied the treatment. New does not offer the treatment in her position at Mount Sinai, but follows children she treated previously or who have had the treatment provided by other doctors. She declined to be interviewed for this report, but on her website and in publications, New says the data so far show that the treatment is safe and effective in preventing ambiguous genitalia.

However, New's more recent studies have caused more consternation, because — as she describes it — treated girls behave in ways that are considered more traditionally girlish.

In a 2008 study in the Archives of Sexual Behavior, New and her colleagues administered a sexual behavior assessment questionnaire to 143 women with congenital adrenal hyperplasia who were not treated prenatally. They found that most were heterosexual, but the rates of homosexual and bisexual women were markedly higher in women with the condition — especially those with the most severe conditions — compared with a control group of 24 female relatives without congenital adrenal hyperplasia.

And, in a paper published earlier this year in the Annals of the New York Academy of Sciences, New and her colleagues reported on data from 685 pregnancies in which the condition was diagnosed prenatally, acknowledging the potential effects of the treatment for reducing traditionally masculine behavior in girls. Prenatally treated girls were more likely to be shy, they wrote, while untreated girls were "more aggressive."

Moreover, the authors said, failure to provide prenatal therapy seems to lead to traditionally masculine gender-related preferences in childhood play, peer association and career and leisure choices.

"The majority, no matter how severe, are heterosexual," said Meyer-Bahlburg, who has collaborated with New on some of the studies. "But the rate of CAH women attracted to females increases with their degree of androgen exposure during prenatal life."

Studies have not yet been conducted to examine whether the hormone treatment would reduce the rate of lesbianism, Meyer-Bahlburg said.

"I would never recommend treatment in order to take lesbianism away if that is someone's predisposition," he said. "Any treatment can be misused. That could happen here. But this is not the focus of the treatment. The focus is to make surgery unnecessary."

shari.roan@latimes.com

OK so after reading this article I am thinking that a lot of bad can come from it, especially from the right-wing nuts and religious zealots that think homosexuality can be "cured"

It is scary to read this. The parts I highlighted form an excerpt of the article are the ones that are giving me food for thought. I am still priocessing.

[imperfect_cupcake]

sick woman that should have her license revoked. sick, sick fuck.

[UofMfan]

I was just saw that there is another thread where this conversation started taking place back in June.

http://www.butchfemmeplanet.com/forum/showthread.php?t=1682&page=2

Linus, I am wondering if we should merge them in the "Lesbian Zone" to include this newest article.

Just a thought.

[Linus]

I was just saw that there is another thread where this conversation started taking place back in June.

http://www.butchfemmeplanet.com/forum/showthread.php?t=1682&page=2

Linus, I am wondering if we should merge them in the "Lesbian Zone" to include this newest article.

Just a thought.

Ah.. I didn't realize that. However, I would argue that this is beyond just lesbians. Trans and intersexed individuals are affected by this as well.

[Nat]

It would affect any fetus whose parents did this - all sexes, genders and orientations.

[EnderD_503]

Once more with the idiocy. What's the point of all this? You can genetically engineer a fetus to have certain physical characteristics just as well...brown hair, green eyes, skin colour etc. Doesn't mean that a certain hair colour or eye colour is a disease that needs to be cured, just as homosexuality or being born intersexed isn't a disease that needs to be cured. The only "cancer" here is ignorance. The human species has evolved in a variety a ways, deal with it. I wish so-called scientists giving their field a bad name would stop trying to use science to suffocate the world with the idiotic morals and belief systems influenced by brainless religious fundamentalism.

[Soon]

It was I who chose to put it in the lesbian zone due to the title of the original article I encountered:

Doctor Treating Pregnant Women With Experimental Drug To Prevent Lesbianism (http://slog.thestranger.com/slog/archives/2010/06/29/doctor-treating-pregnant-women-with-experimental-drug-to-prevent-lesbianism)

I realize this drug/topic can affect other groups, and I wasn't sure which forum to put it in and hesitated but, due to the original article/title, I chose that zone.

No offense meant.

[UofMfan]

Ah.. I didn't realize that. However, I would argue that this is beyond just lesbians. Trans and intersexed individuals are affected by this as well.

I am sorry if you felt that I was implying that it didn't. Like HSIN, I was simply taking it from what the articled addressed.

I was only trying to get the conversation in one place, did not mean to step in any toes.

[Ebon]

It's weird. This story, to me, says that we are born one way or another but at the same time, as a trans individual, makes me wonder if I could have been born without the thing that makes me who I am. But also heightens that I was born as is and it's not a mental condition. What is interesting that it only (from the article) seems to be targeted towards fetus' that are "female" but with both genital types.

Of course, this will cause the right-wing types to claim that homosexuality is a "disease" that "must be cured" and now there is a "cure".

Read more here: http://www.latimes.com/news/science/la-sci-adrenal-20100815,0,5576220.story

Thoughts?

Yeah because this is way more important than curing AIDS or Cancer. This is some evil shit right here. Bad dark dense horrible energy. Makes me furious!

[Linus]

It was I who chose to put it in the lesbian zone due to the title of the original article I encountered:

Doctor Treating Pregnant Women With Experimental Drug To Prevent Lesbianism (http://slog.thestranger.com/slog/archives/2010/06/29/doctor-treating-pregnant-women-with-experimental-drug-to-prevent-lesbianism)

I realize this drug/topic can affect other groups, and I wasn't sure which forum to put it in and hesitated but, due to the original article/title, I chose that zone.

No offense meant.

I am sorry if you felt that I was implying that it didn't. Like HSIN, I was simply taking it from what the articled addressed.

I was only trying to get the conversation in one place, did not mean to step in any toes.


I take no offense or anything. I don't want to take away the discussion that exists already in the lesbian section. It is just as important as this is to the larger community. I do think it may be worthwhile to have the discussion separately as much as together.

[Leader]

It's not without health risks, but to its critics those are of small consequence compared with this notable side effect: The treatment might reduce the likelihood that a female with the condition will be homosexual. Further, it seems to increase the chances that she will have what are considered more feminine behavioral traits.

Yes, because we all know that women with more feminine traits won't be homosexual!

:|

What a quack. And a dangerous one at that...

[Ryobi]

I have to admit, this pisses me off, big time. It's just disgusting.

If these folks want to formulate pills to eradicate "undesirable" traits in people, why then, don't they start with finding pills that eradicate stupidity, ignorance, bigotry, laziness, the gimme gimme fucking look at me gene, bullying, serial killers/rapists, rapists and murders in general, and the list could go on for miles.

This Dr and her friends probably don't want anyone to find a pills to get rid of these things, some one might insist THEY take a fucking pill.

I might come back when I can think more civilly about the matter.

[Soon]

A Prenatal Treatment Raises Questions of Medical Ethic (http://www.time.com/time/printout/0,8816,1996453,00.html)



When Marisa Langford found out she was pregnant again, she called Dr. Maria New, a total stranger, before calling her own mother. New, a prominent pediatric endocrinologist and researcher at Mount Sinai Medical Center in New York City, is one of the world's foremost experts in congenital adrenal hyperplasia, or CAH, a group of inherited disorders of the adrenal gland.

Langford and her husband learned they were silent carriers of the genetic variation that causes CAH when their son was diagnosed with the condition after birth. Their son — like the 1 in 16,000 babies born with CAH each year in the U.S. — faces a lifetime of taking powerful steroid medications to compensate for his faulty adrenal glands. When Langford contacted New about her second pregnancy, New, who was not Langford's regular doctor, called a local pediatric endocrinologist. That doctor prescribed Langford a commonly used medication for CAH. "Dr. New told me I had to start taking dexamethasone immediately," says Langford, 30, who lives in Tampa. "We felt very confident in someone of her stature and that what she was telling us was the right thing to do."(See the most common hospital mishaps.)

The early prenatal use of dexamethasone, or dex, has been shown to prevent some of the symptoms of CAH in girls, namely ambiguous genitalia. Because the condition causes overproduction of male hormones in the womb, girls who are affected tend to have genitals that look more male than female, though internal sex organs are normal. (In boys, in contrast, the condition leads to early signs of puberty, such as deep voice, body hair and enlarged penis by age 2 or 3.) But while the prenatal treatment may address girls' physical symptoms, it does not prevent the underlying, medical condition, which in some severe cases can be life-threatening, nor does it preclude the need for medication throughout life.

Langford says also that neither New nor her prescribing physician mentioned that prenatal dexamethasone treatment is an off-label use of the drug (an application for which it was not specifically approved by the government) or that the medical community is sharply divided over whether dexamethasone should be used during pregnancy at all.

Is It Safe — or Even Necessary?

To date, there has been just one controlled, prospective, long-term trial of prenatal dexamethasone for the prevention of ambiguous genitalia, conducted in Sweden. The results, published in 2007 in the Journal of Clinical Endocrinology & Metabolism — more than two decades after doctors began using the medication in pregnant patients — found some mild behavioral and cognitive deficits in children whose mothers had been treated. But the study, with just 26 participants, was too small to be definitive. "We just don't know what we are doing to these kids," says Dr. Walter Miller, the chief of endocrinology at University of California, San Francisco. "It's not sufficient to say, The baby was born and had all fingers and toes, so it's fine."(See the top 10 medical breakthroughs of 2009.)

In animal studies, dexamethasone has been shown to cause birth defects, but proponents of the treatment note that no human birth defects have ever been associated with the treatment, and that it is uncertain whether findings in lab animals translate to humans. Meanwhile, the possible benefits are clear: the treatment can spare young girls the potential psychosocial problems associated with having ambiguous genitalia as well as the ordeal of surgery to correct deformities later. "I see potential for benefits and I don't see evidence there's any negatives to this. There are lots of risks associated with surgery, and if this can prevent surgery, then it's a good thing," says Dr. Ingrid Holm, a pediatric endocrinologist at Children's Hospital in Boston.

Research has also suggested that affected women who were treated with dex in the womb show more typical gender behavior than other women with CAH; the latter group tends to behave more tomboyishly and express little interest in having children. New told the Wall Street Journal in 2009 that the treatment further spares parents the "terrifying prospect" of not knowing whether their newborn is a boy or a girl.

It is these very benefits, however, that lead some researchers to question what, exactly, doctors are treating — and whether it needs to be treated at all. Miller believes that prenatal dex is being used to alleviate "parental anxiety," rather than the child's condition. Other doctors and researchers have criticized New for introducing gender behavior into the medical prognosis — in two recent presentations on CAH at medical conferences, New offered medical outcome data on prenatal dex alongside data on typical gender behavior. "Maybe this gives clinicians the idea that the treatment goal is normalizing behavior. To say you want a girl to be less masculine is not a reasonable goal of clinical care," says David E. Sandberg, a University of Michigan pediatric psychologist who treats and conducts research on children with CAH.(Read how postpartum depression can strike fathers.)

Perhaps most controversially, prenatal dex must be given as soon as a woman learns she is pregnant, which is usually several weeks before genetic tests can determine if the fetus is in fact a female affected with CAH — the chance of which is 1 in 8 for parents who already have an affected child or know they are carriers of the genetic disorder. If the baby is healthy, treatment is stopped, but at that point, the fetus has been exposed to the steroid drug for weeks. There is no data on how many mothers receive prenatal dex, but according to the odds, 7 of 8 may be taking medication unnecessarily.

Concerns over Patient Consent
Some critics strongly oppose prenatal dex in large part because of the way it is presented to patients. Guidelines issued by pediatric endocrine societies in Europe and North America recommend that doctors obtain written informed consent from the patient as well as ethics-committee oversight for the treatment, but it is not known how many physicians adhere to these guidelines. Langford says she was not made aware of them. In addition, 2010 practice guidelines from the international Endocrine Society suggest that prenatal dex be administered as part of clinical research, which requires informed consent and ethics-committee oversight.

However, prenatal dex is routinely given outside the research setting, as an off-label treatment. It is common — and perfectly legal — for doctors to use their own discretion when prescribing drugs off-label. Antiseizure drugs like topiramate are commonly prescribed to treat migraine headache pain, for example. The practice allows patients to receive valuable treatment for which the drug may not have been expressly approved and may never be — it takes money and drug-company interest, which are hard to come by, to conduct the large randomized controlled trials required for a new-use the Food and Drug Administration (FDA) approval of a drug that is already on the market.

But as doctors share information about a drug's perceived off-label benefits and lack of harm, it gets even harder to take a step back and launch a formal randomized controlled trial — considered the gold standard in medical research — because patients demand the treatment, and doctors say it would be unethical to withhold it from them or from control groups in clinical trials. "It's a risky and dangerous way to innovate," says prominent University of Pennsylvania bioethicist Arthur Caplan. "There's no systematic collection of information. So, yes, things do get proven this way, and it is a way to innovate, but it also can come at a cost of unnecessary expense and, sometimes, bad side effects."

It also enables doctors to do human research without gaining proper approval. All participants in human medical research are, by law, entitled to the protective oversight of an institutional review board (IRB), a committee that safeguards the interests of research volunteers and ensures they have been fully informed about the potential risks and benefits of an experimental treatment. If doctors are simply treating a patient with an off-label drug, they are not required to obtain written informed consent from patients. But if doctors give treatment with the intent to gain knowledge, they are technically doing research, which must receive IRB approval.

Ethicists say physicians may sometimes treat patients off-label, then decide later to launch a follow-up study; or, they do follow-up research on patients who have been treated by other doctors. In the process, they have converted these patients into unwitting research volunteers. Some doctors game the system this way, Caplan says, to avoid battles with IRBs.

Critics suspect that Mount Sinai's New, who has long championed prenatal dex and bills it as safe on her foundation website, has gamed the system. In a letter dated Feb. 2, 2010, a group of 36 bioethicists, including Alice Dreger, a professor of bioethics at Northwestern University, asked the FDA and the federal Office for Human Research Protections to investigate New's practices; the authors contend that the doctor has conducted follow-up studies on prenatal dex patients without receiving IRB approval for treatment trials. Dreger says she has also asked Weill Cornell Medical College, where New previously worked, and Mount Sinai Medical Center to investigate the matter.

New, who declined to be interviewed for this article, does not administer the treatment in her current practice — according to Mount Sinai Medical Center, she has prescribed it only once since joining the hospital in 2004 — but ethical concerns remain, Dreger says, if the doctor consults with patients, resulting in their being prescribed dex elsewhere, then follows up with them for research purposes. At a medical conference in January, where New presented data from her research on prenatal dex, the doctor refused to answer a fellow researcher's questions regarding her process of informed consent.

Clinical Trials vs. Legal Trials
For Langford's part, she says she is grateful to New for her help, even though her daughter, now 4 and healthy, was found not to have CAH.

But Jenny Westphal, 24, who took dexamethasone throughout her pregnancy at the recommendation of another doctor, says she feels misled. Like Langford she was not asked to give informed consent. Unlike Langford, however, her daughter, now 3, who has CAH, has also had serious and mysterious health problems since birth, including feeding disorders, that are not commonly associated with her adrenal-gland disorder.

In April, Westphal, who lives in Wisconsin, started doing research online and discovered there was some controversy over the treatment. "I was outraged, frustrated and confused. Confused, because no one had ever warned me about this. I wasn't given the chance to decide for myself, based on the risks and benefits, if I wanted the treatment or not," she says.

Westphal may never know whether her daughter's problems were caused by dexamethasone, though she will likely always believe they were. That is why so many similar situations, in which experimental drugs are prescribed off-label without informed consent rather than in clinical trials, wind up becoming case studies — not in scientific journals, but exactly where Westphal and her husband are considering taking theirs: to court.