Monday, December 18, 2006

"The Female Brain"

Cover of "The Female Brain"

During my clinical interlude in psychiatry, I had the honor of meeting Dr. Louann Brizendine, a faculty member at UCSF and author of the best-selling book "The Female Brain," which was released in August 2006. Dr. Brizendine is extremely approachable and intelligent, and it is impressive how she took a genuine interest in the activities of the third-year medical students on their psychiatry rotation. It is a privilege to learn medicine at UCSF and rub elbows with a star-studded yet down-to-earth faculty.

Dr. Brizendine's novel has ignited a fair amount of reviews and controversy. Do men and women have brains that are fundamentally different? Dr. Brizendine believes so. However, the entire gender controversy, and especially the excerpt pasted below, eerily reminds me of an anecdote told by a former president of Harvard (named Larry Summers) concerning his daughters who preferred to designate the toy trucks given to them as "daddy truck" and "baby truck" (1)

"Common sense tells us that boys and girls behave differently. We see it every day at home, on the playground, and in classrooms. But what the culture hasn't told us is that the brain dictates these divergent behaviors...One of my patients gave her three-and-a-half-year-old daughter many unisex toys, including a bright red fire truck instead of a doll. She walked into her daughter's room one afternoon to find her cuddling the truck in a baby blanket, rocking it back and forth saying, 'Don't worry, little truckie, everything will be all right.'"

Do men have more spatial intelligence and an affinity for math and science? Are women more interested in communication and writing? Dr. Brizendine may be right...maybe the brains of males and females are completely different...but we are walking a very dangerous line between biological determinism and biological fact. Over one hundred years ago, the "science" of phrenology supposedly "proved" that African-American slaves were inferior and less intelligent than Caucasians by measuring and observing the shapes of many heads (2).

My main concern is that the public imagination will seize upon the biological differences in male and female brains to justify subtle and overt discrimination.

For example, if a woman is supposedly more talkative, emotional, and empathetic -- would the public be more inclined to elect her as Commander-in-Chief?

Earlier this year, Dr. Ben Barres, a transgendered professor at Stanford University School of Medicine wrote a cogent summary of this concern in Nature: "I am suspicious when those who are at an advantage proclaim that a disadvantaged group of people is innately less able. Historically, claims that disadvantaged groups are innately inferior have been based on junk science and intolerance" (3).

Part of our curriculum at UCSF includes a class debate and required essay on the topic of "race-based drugs." Bidil, a drug for the heart, was found to significantly reduce mortality in African-Americans and was approved by the FDA for "self-identified black patients." Our class focused on the issue of designing and manufacturing drugs for specific races...might this be this racism sanctioned by science or an enlightened tailoring of drugs to our unique genetics?

The strongest argument for the promotion of race-based drugs and the idea that men and women have fundamentally different brain structures is that our knowledge of these differences will result in more effective therapies, targeted treatments, and "enlightened thinking." For instance, children were considered to be "miniature adults" in the 18th century, but the modern era considers children to be humans at a special and particularly vulnerable developmental stage. Women are not children, however, so are we opening a Pandora's Box of inequality and half-baked stereotypes? If there truly is a significant biological difference between the brains of men and women, then it is our responsibility to research, investigate, explain and support our findings in a responsible manner.


My footnotes in Blogger will be extremely barbaric, please see the links:

(1) Baby Truck

"Remarks at NBER Conference on Diversifying the Science & Engineering Workforce, Lawrence H. Summers. Cambridge, Mass. January 14, 2005."

(2) Phrenology and Racism

(3) Ben Barres, MD, PhD

For more information on Dr. Louann Brizendine:

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