SHEMALE

I’m not sure if you are familiar with this term, but you definitely will after a visit to Thailand. Despite the huge ethical controversy it raises, the “shemale culture” is the cornerstone of Thailand’s tourist industry. Many tourists travel all the way from Europe only hoping to have a look at real shemale.
In Thailand, there is a whole system to produce shemales, who have full male bodies yet also female breasts. Shemales are from poor families that hope to make more money by turning their boys into shemale performers. There are special schools in Thailand that turn two-to three-year-old boys into shemales, and then train these shemales on their performing skills.

I’m appalled at the fact that such derogatory practice goes on without being banned from outside pressure. I’m also surprised by the fact that millions of tourists watch shemale performances and leave, getting entertained without a sense of guilty. Yes, the shemale industry is a commercial chain with managers leading their transsexual performers and putting on shows. However, thi s doesn’t justify people’s watching them for their own good feeling.
Almost all shemales lead a poignant life. Born as boys, they are raised as if they are girls. They are trained to dress, act, speak like girls. Meanwhile they take female hormone estrogen to stop the development of male genitalia and turn the metabolism towards the female side. After ten years, they look just like women with smaller muscle, thinner waist, larger breasts and extremely small genetalia. Because there are so many of them in Thailand, they are not discriminated in society, however, that doesn’t mean they are respected either. They just bear this “in-between” identity until they die in their forties or fifties, which is the life expectancy for shemales.
As the moral value of the whole world advances, one could only hope that the misconduct of turning boys into shemales can be banned.

Too Close to See Clearly

In 1965 David Reimer was born a boy. Eight months later during a botched circumcision his penis was burned off. Concerned about David’s psychological well being David’s parents went to Johns Hopkins Medical Center and consulted psychologist John Money. John Money, a bit of a maverick in his field, suggested that David undergo a sex change operation. Under his parents consent David was given strong estrogen doses, genitalia reassignment surgery, and raised as a female.
The more despicable aspects of the gender reassignment are prevalent in the details. Dr. Money’s main goal was not to help David but instead to prove his psychological hypothesis that gender roles and attributes result from nurture not nature. He thought that if David looked like a girl and was treated like a girl then he would become a perfectly normal girl. He did not inform David’s parents that he was treating David as an experiment. David had a twin brother to use as a control and he gained consent from the parents during a time of duress.
David discovered that he was born a male at age 14 and promptly decided to assume a male identity. Despite what Dr. Money’s published reports might say, the experiment failed miserably. David never felt like a female. His peers ostracized him along with experiencing suicidal depression. In 1997 he elected to reverse the treatment and married a woman.
In 1997 he also publicized the failures of the treatment with the help of sexologist Milton Diamond. Diamond published a book on David’s life with the intention of discouraging other family’s from using similar treatments on infants.
The general question of gender reassignment is a difficult topic to conquer in a blog post. However, I would like to focus on the circumstances under which these parents agreed to have gender reassignment surgery. Their son of eight months underwent a relatively common procedure (the means of circumcision were somewhat untested) that rarely had complications. My question is how did this unfortunate situation lead to a much more horrific one. Dr. Money obviously had a large role to play, but in this case the parents should have been able to protect their child. If gender reassignment surgery was a feasible solution for this case, then how is it that repairing the existing ‘equipment’ was not another solution? This would have been a much better solution to the problem that the parents should have seen, but they didn’t. Why not? The parents were not in a position to be making the decision for their child despite their legal prerogative. Sometimes parents can be too close to a situation to make an objective decision. Their views are distorted during times of particular duress as reported during this experiment. It’s a stick situation though. If an objective third party rules against the will of the parents, then who makes the final decision? I say that there are times in which a third party can make the final decision or, especially when time is not a factor, where decisions must be delayed for significant periods of time in order to give the family perspective on the situation lest they hastily make a rash decision.
The other important thing to note in this case is that it took over thirty years for this case to surface to the public. Why so long? I would say because the issue was particularly psychologically difficult. What does that mean? It dealt with sex and sexuality. Many advancements have been made in medicine, but an area that continues to lag behind are areas relating to sex and sexuality. There exists a social stigma in publicizing sexual matters. But should a social stigma prevent advancement? I do not think that anyone can force another person to publicize their private lives without their consent; however, there are few situations in the medical field in which sharing knowledge leads to bad consequences. Perhaps we should recognize and attempt to tackle some of the social issues stopping medical advancements. Tackling does not mean throwing aside, but it means that the issues must be met head-on instead of avoiding them.

Beauty Is Pain

Why do women go to extreme measures to look beautiful? Perhaps it’s to make them feel better about themselves, or to try and impress others. But are they actually making themselves feel better when they could potentially be hurting themselves in the long run? In an article written in the New York Times last week, the author discussed that women wore shoes that could cause harm over shoes that helped prevent damage. 60 percent of the 3,378 surveyed said that they chose to wear a less supportive shoe, such as a high heel or a sandal, over a sneaker. What might be the reasoning behind that finding?

I know that most women love to shop, and many have a weak spot for shoes. There is just something about a beautiful pair of five inch, pink jewel covered stilettos that make it hard to resist. The pain you may endure from wearing a shoe such as this seems well worth it when making the purchase, but potentially regrettable two hours into the cocktail party. Certainly everyone may be complimenting the shoes, but clearly they don’t experience the pain; moreover, they won’t be suffering the consequences.

When people seek out medical evaluation of injury, the doctor usually gives a diagnosis and a cure. If one has a broken arm, it goes in a cast. Should the problem be a swimmers ear, the pool becomes off limits. Foot and ankle pain? Supportive shoes are the answer. Why do most people continue to knowingly wear shoes that can cause potential injury? Perhaps the desire to pursue fashion overrides the pursuit of health. Certainly the time honored tradition of pursuing fashion over health has been with our culture for generations and is expected to maintain its position of importance for generations to come.

http://www.nytimes.com/2009/10/06/health/research/06patt.html?ref=research

Off-Label Drug Use?

In last Wednesday’s issue of the New York Times, an article titled “Botox Maker’s Suit Cites Free Speech” reported about a controversy that has arisen regarding drug marketing regulations. According to current Food and Drug Administration (FDA) regulations, drugs may only be marketed for the specific uses that the FDA has approved them for. However, while they cannot be marketed for other uses, doctors are allowed to use their “medical judgment” to prescribe drugs for other uses that have not been officially approved.

Botox makers would like to be able to market their product for uses other than treatment of crosses eyes, eye spasms, severe neck contortions and wrinkles, the only FDA approved uses. Currently, Botox is often prescribed by doctors for use in treating facial spasms, vocal cord problems, and migraines, but these are not FDA approved and thus cannot be used in marketing. Allergan, the Botox company that is suing the FDA for infringement of its freedom of speech, would like to be able to market Botox for these as yet not approved uses as well.

Two pieces of information brought up in this article disturbed me. First, I was not aware that doctors were allowed to prescribe drugs for uses that are not FDA approved (or approved by any official body at all). Although doctors do usually act under the Hippocratic Oath, and thus are unlikely to prescribe a treatment that will undoubtedly do the patient harm, the fact that doctors have this much flexibility does seem to open the door wide for unregulated and potentially risky experimentation. In addition, because drug companies cannot market off-label uses of drugs that doctors may prescribe to patients, doctors may not always have all of the relevant information that the drug companies have regarding the risks of the use of drugs for different purposes. In short, drug companies are banned from providing information regarding techniques (including correct doses) and risks in the use of the drugs for off-label treatments leading to a system of guess-and-check by medical professionals.

There are two methods by which this second issue of lack of information to doctors could be solved. First, drug companies could be allowed to market their drugs for off-label, non-FDA approved uses. This does not seem to be the best option as it could potentially lead to hazardous experimentation in the medical field. The second option would be to only allow doctors to prescribe drugs for FDA approved uses. This seems ideal. However, the FDA would have to work overtime to research the risks and benefits of each drug for each type of treatment that is proposed so as to not inhibit medical advancement by being slow to improve beneficial treatments.

Related links:

http://www.nytimes.com/2009/10/03/business/media/03drug.html?scp=2&sq=botox&st=cse

Poppin' Pills

It would be absurd for a major pharmaceutical company to make, package, and sell bottles of sugar pills as prescriptions for Parkinson's, schizophrenia, or depression. Absurd, possibly, until you consider that placebos have almost doubled in statistical significance in double blind tests of new drugs conducted by pharmaceutical companies since 1980. Even less absurd when you consider that long-standing and well-established drugs like Prozac are now coming up short when put to the test against a placebo. Somehow, the placebo effect is becoming stronger.

What is especially interesting about this is what the team of researcher William Potter and technician David DeBrota uncovered when they took a comprehensive look at the test records of Eli Lilly, a major pharmaceutical firm. They found that observers in lab tests had different ideas of success or improvement in their clinical results labsite to labsite. They found that the placebo effect could be huge even in trials that were tightly controlled. Perhaps most interestingly, he found that different drugs were found to be more or less effective as compared to a placebo based on geographic location. A certain drug tested in the United States may fail in double blind trials while it succeeds in France and Germany.

Is this really so surprising, though? In a culture where poor grades or hyperactivity are grounds for prescribing amphetamines to a ten year old, where feeling scared, lonely, or unhappy is a condition treated through medication, where pills are almost as ubiquitous in the average handbag as loose change, why wouldn't we put our trust in anything we're told to take? As we've come to rely more heavily on pills and pharmaceuticals for whatever ails us, we could be conditioning ourselves to respond more to the mere presence of the pill than to the pill itself. Something has to give: either drug companies need to begin pioneering new ways to test their products, or research has to be put into utilizing the body's natural propensity for self-healing as an alternative to pharmacological methods.

Relevant Sites:
"Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why." from Wired.com

Monsters Used to Test Children

Human experimentation studies an array of human responses to experimental stimuli—the psychological effects of experimental situations, the physical effects of new medications or therapies, etc. Such experimentation often aims to study unprecedented procedures and therefore often requires risk. However, risky experimentation quickly becomes unethical when it subjects unwitting participants to harm, especially when such harm has lasting effects. This sort of experimentation is exemplified in the “Monster Study.”

In 1939, a pathologist named Dr. Wendell Johnson posed a hypothesis stating that stuttering is an acquired trait that people can generate in children. In order to test this hypothesis, Wendell went to Iowa Soldiers’ Orphans’ Home and used twenty-two of the orphans in his research. Without their knowledge of the study, Wendell and his fellow researchers set eleven of the students aside as a control group and treated them with common respect. With the other eleven, the adults would be quick to criticize the children and were intentionally belittling and unkind to them. In doing so, they were testing to see if the children would begin to stutter. The researchers' actions likely seemed petrifying the children, which is why the experiment became known as the "Monster Study."

None of the terrorized orphans developed stuttering problems, but they were left with many lasting psychological problems, problems so trying that in their older age they sued the university at which Johnson had been experimenting. Johnson tested these young children without their understanding or consent, but even if they had known about the experiment, it would not have protected their sensitive emotions and malleable minds. Children’s minds are still forming, so constant bitter and belittling remarks can leave scars on their impressionable minds. Considering all this, one can conclude that it was extremely unethical for Johnson and his fellow researchers to subject these vulnerable children to psychologically detrimental treatment due to the lasting psychological harm on the children that was wittingly induced.

The procedure was indeed mentally harmful for the children, so why would Johnson and his fellow researchers find it necessary to perform such a procedure? What gain would anyone have from knowing that, yes, terrorizing children does in fact make them stutter? Perhaps one could claim that by investigating the cause of stuttering, stuttering can be prevented. In response to such a claim, I would say that it is acceptable to try to discover the cause of stuttering, but it is never acceptable to subject anyone to any form of harm, whether it be physical harm or mental. Perhaps if an adult knowledgably consented to be subjected to such stress, such treatment could possibly be considered acceptable, but children, who make up a vulnerable and impressionable population, should never be exposed to such consistent belittlement. In an experiment, when someone is subjected to any form of harm, and if they are exposed to such treatment by force or without enough knowledge, as these orphans in the “Monster Study” were, the experimental procedures should be deemed unethical.

Sites used:

http://www.cbsnews.com/stories/2003/08/06/health/main566882.shtml

http://www.msnbc.msn.com/id/20327467/

http://listverse.com/2008/03/14/top-10-evil-human-experiments/

Sorry, But You Can’t Live Because You Have Down Syndrome.

Technology has made it possible for pregnant women 35 and older to know beforehand if their fetuses possess the extra chromosome that causes Down syndrome. Recently, this screening procedure has been made available to all pregnant women. According to an article in The New York Times, a shockingly high percentage of women—a mind-blowing 90 percent—who receive a Down syndrome diagnosis opt for an abortion.

But who are we to judge who has the right to live? With Down syndrome comes mental retardation, dependence on others, and shorter life expectancies, but these handicaps and disadvantages do not necessarily outweigh the benefits of life itself. People with Down syndrome are human beings too; they are perfectly capable of possessing emotions, partaking in everyday activities, and expressing their individual personalities.

However, at the mention of the genetic condition, potential parents of a fetus with Down syndrome often shy away from the thought of raising a disabled child. I would be lying if I said that children with Down syndrome do not bring extra burdens and responsibilities, but in reality, since when has it ever been easy to raise a child? Children everywhere, with or without disabilities, require unconditional love as well as endless attention, devotion, and care. Children with Down syndrome are no different.

Relevant site: http://www.nytimes.com/2007/05/09/us/09down.html