Sex affects absolutely every aspect of our lives," says neuroscientist Dr Karen Berkley from Florida State University. "The difference between the sexes is a continuing interplay between our physiological and hormonal processes and what is happening around us as we move through the lifespan. It's a continuous back and forth between physiology and sociocultural issues."
Over the years, the pendulum has swung to and fro. For a long time, it was ideologically fashionable to insist that sex differences were minimal. Aside from the reproductive apparatus, the thinking was that men and women were built equal. Talk about sex differences was taboo.
"Sexual politics has been up and down in my life," says biologist David Taylor, from the University Oxford, who recalls the hostility his lectures on sex differences triggered in the early 1970s. A 'feminine' upbringing was deemed to mould girls into gentle, caring women; 'rough-and-tumble' play chiselled boys into men.
Today, there is greater awareness of sex variation, and efforts to probe such questions have regained respectability.
Vive la différence
In humans, the default sex is female. Early male and female embryos are indistinguishable, and it is only when the male-determining SRY gene kicks in that developmental pathways diverge. SRY sets the embryo on course to be a boy, leading to the development of testes and production of male hormones.
The time spent in the womb is thus critical to the development of sex-related characteristics (after birth, puberty also drives extra sexual differentiation). But sex hormones do not just affect sexual organs; they bathe all organs in the embryo, establishing sexual differences that persist after birth. The key questions are how big these differences are, how strongly programmed they are, and what their actual impact is.
Sex biases could result from how the brain is organised. There are suggestions that female brains have a thicker corpus callosum, a body of nerve fibres connecting the two hemispheres, which would allow better communication between them, but the extent and significance of this difference is debated.
Dr Philip Shaw and colleagues at the National Institute of Mental Health in Bethesda, Maryland, recently showed that boys' brains take longer to mature than girls' brains. 1 "Girls have a smaller cortical volume and the thickness peaks at age ten, one or two years earlier than boys," Dr Shaw points out. Despite the initial delay, boys end up with a larger brain and possibly a thicker cortex than girls. Overall, males have larger brains – but allowing for body size, the inequality disappears.
What about that most incendiary of issues, IQ? A controversial paper in 2005 argued, by analysing a range of previous studies, that the average male IQ exceeded that of women. 2 A hard-hitting riposte pointed out numerous flaws in this theory (such as omitting the largest study, which found no evidence for sex differences in IQ). 3
This also illustrates a key difficulty in this area. An individual study, with a limited sample size, does not necessarily provide a definitive answer. To overcome this factor, researchers often pool several studies to see if statistical associations hold up over a range of different samples. Moreover, the nature of statistical associations raises further issues: at what point is an association seen as statistically meaningful?
So although some media coverage (and best-selling books) suggests that men and women are practically different species, the reality is quite different. A recent influential analysis of numerous studies found that the evidence for sex differences in psychology was weak at best, except in four areas. 4 Men tend to be better in visuospatial skills (they are more adept at mentally rotating an object in space or navigating a route). Females, on average, tend to excel in verbal fluency, verbal memory and language ability.
Medical impact
That said, there is strong evidence that disease and medicine are not sex-blind – though the reasons for this are not always clear. Developmental disorders of the nervous system tend to affect males more, while autoimmune disorders afflict women more often than men (see box below). The reasons are likely to be varied, from the impact of sex hormones to social factors.
At the bar, men are well known to enjoy an unfair advantage. Women get drunk quicker because they have less alcohol dehydrogenase to break down alcohol. The same male–female difference in physiology seems to apply to pharmaceutical compounds.
However, the jury is still out, because sex differences in drug metabolism have not been well studied. After thalidomide, women were not included in clinical trials in case they became pregnant. In addition, their inconveniently fluctuating hormones complicated analysis.
Men and women are known to respond differently to some drugs (low-dosage aspirin, for example, protects both men and women – but in different ways), and can also show different symptoms. Women with angina do not always experience the classic male symptoms of severe squeezing chest pain. Instead they are more likely to have 'silent' and diffuse symptoms. As a result, women are less likely to receive effective treatment for heart attacks.
Side-effects could be a further problem. Women are more vulnerable to medications that trigger abnormal heart rhythms, because the female heart has a longer QT interval (the time it takes to recharge between beats).
"We've known about the differences for 50 years but do we say: because you are female you get this, because you are male you get that?" asks Dr Anita Holdcroft, a clinician at Chelsea and Westminster Hospital in London. "No, we don't. I am concerned that we are missing a lot," she insists.
Pain is one area where clear sex differences have been identified, and are important clinically. 5 "As difficult as it is for many of us to acknowledge differences other than in reproductive function, there really are differences between men and women," says Dr Jon Levine, a clinical neuroscientist from the University of California in San Francisco. Dr Levine was first to discover that painkillers related to morphine, called kappa-opioids, give relief to women but are less effective in men (although not all subsequent studies have replicated these sex differences).
"In the clinic, we have more women than men with chronic painful syndromes," says Professor Ana Maria Aloisi, who studies the role of hormones in acute and chronic pain at the University of Siena. Women's pain threshold is lower than men's; on the other hand, they tend to be more sensitive to analgesics.
Whether these differences matter is still controversial. Variation is common in biology, and even where sex differences exist, there is significant overlap between males and females. Others believe that uncovering even subtle sex differences could be valuable. "The differences matter to me, as a clinician," says Dr Holdcroft. Distinguishing between a man and a woman could save lives now – and it does not take a high-tech gadget to make such a provision. When it comes to the brain and behaviour, though, exploring what makes men and women different will require some ruthless sociocultural stripping.
2006-09-21 18:34:03
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answer #9
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answered by Alen 4
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