Are Women Underrepresented In Medical Research?

Feminists have long claimed that women were underrepresented in federally-funded medical research, but as the National Center for Policy Analysis recently pointed out, new information has punctured this claim as yet another myth.

Although the National Institutes of Health proclaimed in 1997 that “women were routinely excluded” from federally funded research, it recently retracted that claim because it wasn’t supported by the evidence.

NCPA points to a Wall Street Journal op-ed by Sally Satel noting that in 1979, 268 of 293 NIH-funded clinical trials included female subjects, while in 1998 68 percent of subjects in all federally funded clinical trials were women.

When it comes to diseases such as cancer, women vastly outnumber men in clinical trials due to the vast overrepresentation of breast cancer research in such trials as compared to other forms of cancer. The NCPA cites Cathy Young, for example, as pointing out that from 1966 to 1986 there were more than three times as many clinical trials for breast cancer as there were for prostate cancer.


Women and Medical Research. National Center for Policy Analysis, March 21, 2001.

Should Abuse Victims Have to Pay for their Abuser’s Care?

Should children be forced to subsidize care for parents who abused them? A couple of adults in New Jersey have been ensnared by a law which requires them to do just that, and the media spotlight on their case will likely result in a much needed change in the law.

Passed in 1918, the state law requires relatives to pay for any hospitalization that is the result of a court order. As a result New Jersey plans to ask Michael and Chrissy McMickle to pay for the state-ordered hospitalization of their father, Nelden McMickle, who went to jail for sexually abusing them.

Under a 1993 New Jersey law, the state can commit some sexual offenders to a mental facility after their prison term is completed rather than simply release the offender back into the community, if the offender is deemed a threat to the community (such laws, by the way, should be unconstitutional, but have, unfortunately, been upheld by courts).

After Nelden McMickle finished his prison sentence, the state deemed him a threat to the community and committed him to a state hospital — and began sending Michael McMickle a letter asking him to pay part of the annual $90,000 bill for his father’s hospitalization. If Michael refuses to pay, the state could pursue him in court to force payment. Barring a change in the law, Chrissy McMickle, now 18, will not receive such letters until she has finished college, if she pursues post-secondary education.

The McMickle case will probably spur a change in the law. Michael McMickle has already hired a lawyer to challenge the law and says he won’t pay a single dime to support the father who regularly subjected him to physical and sexual abuse. Meanwhile as Chrissy McMickle sums the whole case up, “I didn’t think I would have to go through this again. It’s like being victimized again.”


Law could force siblings to pay for abusive father’s treatment. Amy Westfeldt, Associated Press, March 26, 2001.

Supreme Court Overturns Drug Testing of Pregnant Women

The Supreme Court ruled yesterday that a South Carolina program that administered drug tests to pregnant women without their knowledge or consent was unconstitutional. In the 6-3 decision, the Supreme Court said hospitals who wanted to test women for the presence of cocaine need to get either a warrant or consent from the patient to do so.

South Carolina had argued the testing program was part of a legitimate need to get drug addicts into treatment programs, but the majority opinion rejected that argument,

Here, the policy’s central and indispensable feature from its inception was the use of law enforcement to coerce patients into substance abuse treatment. Respondents’ assertion that their ultimate purpose — namely, protecting the health of both mother and child — is a beneficent one is unavailing. While the ultimate goal of the program may well have been to get the women in question into substance abuse treatment and off drugs, the immediate objective of the searches was to generate evidence for law enforcement purposes in order to reach that goal.

As a result the majority opinion holds that, “A state hospital’s performance of a diagnostic test to obtain evidence of a patient’s criminal conduct for law enforcement purposes is an unreasonable search if the patient has not consented to the procedure.”

The case now goes back to a lower court where South Carolina is expected to argue that the women did, in fact, consent to the drug tests which in turn might spawn another Supreme Court case.


US drugs testing ruled unconstitutional. The BBC, March 21, 2001.

Court: Consent needed to drug-test pregnant women. The Associated Press, March 21, 2001.

Is Puberty Really Starting Earlier for Girls?

I consider myself a pretty skeptical person, but I have to confess I accepted at face value claims that girls were reaching puberty. Surely such a claim, based on studies published in some relatively prestigious journals, had a lot of data behind them. Most of the debate in the media over this claim was what was causing early puberty. Environmentalists suggested manmade chemicals as a possible cause, some doctors suggested the high levels of obesity in children, while some feminists and conservatives suggested that the high level of sexual images in contemporary media might somehow be responsible.

It turns out, however, that the alleged evidence for early puberty is severely flawed and the quick acceptance of early puberty may be preventing some girls from obtaining the best health care available.

The New York Times‘ Gina Kolata, who has helped debunk other junk science issues in the past, reported on the debate over early puberty this week. The evidence for the phenomenon is appallingly absent. The claim is based entirely on a single study by Dr. Marcia E. Herman-Giddens that was published in Pediatrics in 1997. Herman-Giddens study looked at 17,077 girls aged 3 to 12. The girls had gone to a pediatricians office from July 1992 through September 1993. Herman-Giddens managed to persuade 225 health care providers at 65 private practices in the United States to evaluate any girls they saw for early onset of puberty.

As she reported in her 1997 article, of that sample population, Black girls began developing breasts at 8.87 years while white girls began developing breasts at 9.96 years. Many pediatrics textbooks, taking these numbers at face value, pushed back the lower end of normal puberty to age 6 for black girls and age 7 for white girls. But did they have a good basis for doing so? No.

The first major problem with the study is that the sample is incredibly biased. By focusing exclusively on girls who were brought to see a pediatrician, it is possible that Herman-Giddens is simply measuring the rate of premature puberty brought on by other health problems. After all, parents who are worried that their daughters are experiencing puberty early are more likely to bring their children to see a pediatrician about that problem. In statistics this is called a selection bias.

The second major problem is that the only marker of puberty for which reliable data exists for a long period of time — the onsent of menstruation — has remained steady for the last 50 years. There simply is no reliable long-term data on the average age that breasts start developing, but there is reliable long-term data for menstruation. That age has remained stable, even in Herman-Giddens study, at 12 years and 8 months for white girls and a bit earlier for black girls. If puberty is starting earlier and earlier it is very odd that the average age of menstruation has remained so consistent.

A group of pediatric endocrinologists wrote a letter to Pediatrics recently lamenting that doctors who believe this data are giving incorrect health advice to young girls. As they note, early puberty can be the result of serious health problems, such as brain tumors and other disorders, but parents who bring in girls who are experiencing early puberty are simply told that this is normal and no further tests or investigation are warranted. As Dr. Laura K. Bachrach told The New York Times, “You don’t just dismiss a child in that age range [under 7]. I think it is potentially medically dangerous.”


Doubters fault theory finding earlier puberty. Gina Kolata, The New York Times, February 20, 2001.