The human mind loves nothing more than to build mental boxes -- categories -- and put things into them, then refuse to accept it when something doesn't fit. Nowhere is this more clear than in the idea that there are men, and there are women, and that's it. Alice Dreger is an historian of science, specializing in intersexuality and the relationship between bodies and identities. She is also a successful activist, working to change the way that doctors deal with newborn children who are born intersex. We talk about human sexuality and a number of other hot-button topics, and ruminate on the challenges of being both an intellectual (devoted to truth) and an activist (seeking justice).
Alice Dreger received her Ph.D. in the History and Philosophy of Science from Indiana University. She has worked as a faculty member at Michigan State University and Northwestern University. She has been a Guggenheim Fellow, and was the Founding Board Chair of the Intersex Society of North America. She is the author of a number of books, including Galileo's Middle Finger: Heretics, Activists, and One Scholar's Search for Justice, and most recently The Talk: Helping Your Kids Navigate Sex in the Real World.
Click to Show Episode Transcript
0:00:00 Sean Carroll: Hello, everyone, and welcome to The Mindscape Podcast. I'm your host, Sean Carroll, and today, we'll be talking about truth and justice. It's very hard to say that phrase without thinking of Superman, right? "Truth, justice, and the American way." "The American way" part never quite made sense. Superman was from a different planet, after all, he came from Krypton, he should be about truth and justice for everybody. In fact, "the American way" was tacked on when the Superman radio serial was being broadcast during World War II and people thought it was really important that the superheroes be on America's side in this conflict. It was later dropped and then it was picked up again when we entered the Cold War, and ever since then, Superman has, for some reason or another, thought that America was the best country.
0:00:42 SC: But today's guest, Dr. Alice Dreger, is all about the truth and the justice parts of this motto. And that's a non-trivial thing to say because truth and justice, although both virtues, are two different things. It may happen in the course of human events that the search for truth and the search for justice come into conflict, either apparent conflict or real honest-to-goodness conflict. And Dr. Dreger's specialty as a historian and author is in human gender and sexuality, and more generally, how our bodies relate to ourselves. As you might imagine, this is a set of hot-button issues when it comes to humanity, bodies, and sexuality, so, perhaps it's not surprising that Dr. Dreger has been involved in all number of academic controversies. Her controversies and her research involve things like intersexuality, transgenderism, academic censorship, and so on.
0:01:38 SC: Dr. Dreger is the author of a wonderful book called "Galileo's Middle Finger: Heretics, Activists, And One Scholar's Search For Justice." As we'll talk about in the podcast, Galileo's actual honest-to-goodness finger is on display in a museum in Florence. You can go see it, well worth it, at the Galileo Museum. While everyone else is looking at the art, you can go see the Galileo relics there. But it's also a symbol. Galileo was an ornery kind of person who fought for both truth and for justice. He didn't back down under political pressure. And that's what we'll be talking about today. We'll be talking about the various ways in which you can try to get to the truth, you can try to get to justice, and even though we would like to think that the ultimate goal of truth and justice coincides, that the most just world is one in which we're also telling the truth, it can sometimes happen that the road to truth and the road to justice don't always run on parallel tracks.
0:02:36 SC: It's a fascinating story, no matter what your actual substantive beliefs are about any of the controversies, the goal of trying to be a good intellectual and honest scholar, finding out the truth about the world, while also being an activist in the sense of trying to make the world a better place, is one that we can all strive to uphold. So, let's go.
[music]
0:03:15 SC: Alice Dreger, welcome to The Mindscape Podcast.
0:03:18 Alice Dreger, PhD: Thanks, Sean.
0:03:20 SC: So you were in the news recently, even the news a lot, okay, but there was a recent episode. There was a story in The New York Times by Bari Weiss about something called "the intellectual dark web," and it was accompanied with moody photographs of the members of this dark web, all of whom are... It was hard exactly to figure out what the commonalities were, but there was something about saying forbidden, scary truths in a certain set of venues that might not be the most obvious, intellectually common ones. And you were invited to be part of this article and part of the dark web, and after some consideration, you declined. You let your picture get taken, if I understand, but then, you asked not to be included in the article and you wrote a little piece in The Chronicle of Higher Education about that. So, could you explain just a little bit what your thoughts were on that? Maybe that will lead us into the bigger picture here.
0:04:18 AD: Yeah, I'm not sure I can explain the dark web, because... I mean, what I know the dark web, as is the other dark web, right, the place where nefarious things happen off of the visible Internet, but the intellectual dark web, as I understand it, is supposed to be some sort of connected group of people who say things that in particular piss off progressives, as far as I can tell. And I've certainly said things that have pissed off some progressives, but the reason I asked to get out of this article profile was because it struck me as increasingly silly, the more I learned about it.
0:04:55 AD: The fellow who came out to take my picture... And if you've seen these pictures, I think "moody" is a good way to describe it. They were all done exactly at a particular moment with relation to sunset, and when the photographer called me and told me that's how it was gonna be and we needed to be outside at a very particular time 'cause it was gonna be this very particular moment at sunset, I was like, "Fine." I mean, this guy is a Pulitzer Prize-winning photographer, his photographs are amazing. So, whatever. I know for features, they sometimes do particular types of photos. But then having gone through that and talked to him, I became increasingly... I mean, I was already worried before that because I kept saying to Bari, "I don't know what this intellectual dark web is, and I don't even know of half the people you're talking about," so she would name names like I'm supposed to know who these people are. And it's not that they're not important or famous, I just don't spend a lot of time making a point of connecting with big names. And so, I like connecting with ordinary people and smart people, especially. And so, it just struck me as something that I had no idea what she was talking about, and then this photo struck me as something where I felt kind of silly doing it and so...
[laughter]
0:06:08 AD: I was very nervous. And I remember, right after the photographer left, I said to my husband, "I gotta get out of this, because I just don't think I'm meant to be in this." And I said, "I think I'm going to feel silly if I'm part of a group that I don't even know who half these people are, and I certainly don't have a good sense of what makes us a category." And then the piece came out, and I was rather relieved that I wasn't in it because as far as I could tell, there didn't seem to be any logical categorization in which I belonged. There are people in that group that I really respect, I mean, people like Bret Weinstein and Heather Hague who are academics in exile, which they say so am I although... I don't know, we all chosen at some level to be out of academia at the moment, but I really respect the two of them and the work that they do and all of that. But I couldn't figure out otherwise what I was supposed to have in common with these other people, other than Bari's interest seemed to be a lot about the idea that those of us in this alleged group sometimes say things like yes, sex does matter in rape, sometimes. It's not just about power; it may also be about sex or in some circumstances for the rapist. That's not to say it's a good thing, it's just to say talking about it simply as power doesn't really makes sense of some of what we see.
0:07:25 AD: And we say things like there are some inborn sex differences on average, or we say things like evolution matters. And these are supposedly things that you're not allowed to say. Only, we are all saying them, so, what's the claim that you're not supposed to say these things? Is it the case that people push back? Yeah, sure. Sorry, my mail just got delivered, that's what that clunk was.
0:07:49 AD: Is the case that we're not supposed to... That we say these things and people push back? Yeah, certainly, people push back, but I mean, people have been pushing back at things I've been saying for 30 years, that's nothing new. Social media makes it more intense and it catches fire faster, but just by virtue of irritating people, I don't think makes one special as an intellectual.
0:08:10 SC: I've certainly had no trouble hearing people say that biological differences do matter. It's not exactly a completely silenced point of view out there in the world.
0:08:19 AD: Not at all, I mean, I... It may be the case that among a certain set of progressives, saying biology matters is verboten, but within a large segment of academia, people are researching it and we talk about it, and we talk about how do we think about that in terms of how we approach equality, and how do we think about it in terms of how we support people. So, I don't think that that's really something you're not allowed to say.
0:08:47 SC: I really like the thing in your Chronicle article, you pinpointed this idea that the goal should not be to piss the right people off, right, that... It's a tempting thing, and I think that it speaks to the larger trajectory of your career, trying to balance a back-and-forth between saying true things and resisting kind of being funneled down to an obvious comfortable spot, and thinking that you are an oppressed minority saying uncomfortable truths. That's a slightly flattering way to think about yourself that is indeed very tempting.
0:09:21 AD: Yeah, I think it also... It becomes an easy way to get out of responsibility. And by that, I mean, if I get to say, "Oh, I'm so oppressed and misunderstood," I'm sort of not having to be responsible to the fact that maybe what I've said really is very threatening to somebody, and maybe what I'm saying really is disruptive to their worldview, potentially dangerous for them. So, I don't like that way of thinking about it in part because I think it's really important that those of us who say things that are politically intense take responsibility for that and address the challenges and the questions that arise from that. And that definitely is part of what bothered me about the approach, was like, "Oh, you piss people off, therefore, you're magic." I don't think I'm magic.
0:10:03 SC: Right, right. Yeah. Yeah, there's a... Yeah. It's a... Like I said, it's a comfortable place to be for a certain kind of personality, but it's not exactly supposed to be what intellectuals or scholars signed up...
0:10:15 AD: I am bummed I never got to see my picture.
0:10:18 SC: You didn't get a copy of your picture? Come on, you could ask. I'm sure they'll...
0:10:22 AD: Well, Bari said she's gonna send it to me, and then I published that piece in The Chronicle, then she stopped talking to me, so I think I'm never gonna get to see my picture. It's gonna be the famous playing card nobody ever got to see, and someday, it will be worth million dollars, don't you think?
0:10:35 SC: You should do a parody of it, just standing out field in the with your boots all muddy, right, like taken on an iPhone. You could... I think that should be your cover photo.
0:10:43 AD: I should totally do that.
0:10:47 SC: So, I'm suspecting that when you started off the academic path as a graduate student as a historian, you didn't suspect that this is how your career trajectory would go. Is that safe to say?
0:11:01 AD: I guess I didn't know where it was gonna go. I mean, the thing is I dropped out of college, so, I never really expected to go to graduate school. I never expected to become an academic. So, I never... When I was becoming an academic, I didn't have a firm sense of what that was gonna mean for my future. And I don't mean that I didn't know what it involved, I didn't know what it involved, but I also know... My husband jokes that I change careers every two pi years, so...
[laughter]
0:11:30 AD: That would be approximately...
0:11:31 SC: Two pi has its own letter.
0:11:33 AD: 6.2... Yeah, that's right, it's tau, right?
0:11:36 SC: Tau. That's right. Yeah, every tau years. Good. So you can be hip to a whole 'nother audience by saying it that way.
0:11:42 AD: I change careers every tau years. So, I was a very high-achieving high school student and I was very burned out and I said to my parents, "I should not go to school right now, I'm too burned out." And back then, there was no such thing called a "gap year" so I couldn't say I need a gap year, it wasn't named anything; it was just calling... It was being a student drop out, right? So my parents begged me to go to school, which I did for a year, I went to Georgetown University for a year, and I was still totally burned out, so I dropped out and I became a mortgage broker for five years on Long Island, and I only finished my degree because I was getting tired of mortgage brokering, and I thought maybe I'd go into real estate law. So I finished my degree at the state university down the street and my advisor told me about graduate school, and it sounded really great. You could read and people would pay you to read. That sounded really, really good to me.
0:12:33 SC: It is kind of awesome, I have to admit.
0:12:35 AD: I was also in therapy, and my therapist declared me cured, and he was like, "Get out of New York so that you don't relapse." Like, "Get out of here, just leave. Leave your boyfriend, leave your cats, leave your parents, leave everything." So, I thought, well, going to graduate school is a good way to leave everybody. So I did that and the truth is my graduate department lost my application and they admitted me out of embarrassment, I found out years later.
[laughter]
0:13:00 AD: So I was admitted by accident and... But I was good at it, and I also worked really hard 'cause I was used to working full-time and going to school full-time, so I was a really hard worker. And so when I got to graduate school and everybody else had gone a normal path, they were used to being kinda, frankly, lazy 'cause they were used to sitting around and doing nothing but school. And so I whipped through graduate school and graduated in record time for my department, and went on and got an academic job and everything. But I guess I always... To think, "Well, this is the direction my career go... " Eh, I don't know, I had a sense of I should know what I'm doing next in order to pay the rent, and that's what I've always done. And then when I had a kid in the year 2000, I realized I really liked him, and I really...
0:13:46 AD: Enjoyed being with him. He was very interesting, he was much more interesting than I expected having a child would be. And so I gave up tenure in 2004 to be with my son more and also to do more mainstream writing and do more activism of the type I was doing, which was for patient rights in the field of intersex, which is when people are born with not the standard male or standard female anatomy. So I dropped out of tenured life, and I took a part-time job at Northwestern Long Distance, and... So, I've never really had an organized life around the standard systems, just 'cause I... I guess I get bored easily, and so I stick with things, my husband's right, around six years is as long as I stick with things. Except with him, I've stuck with him much longer.
0:14:32 AD: And I've kept my son, who's now 18, so...
0:14:36 AD: So the idea that like now I'm in some intellectual dark web, I'm just like, "What?"
[laughter]
0:14:40 SC: Yeah. You're just doing your thing.
0:14:43 AD: It just strikes me as weird. So.
0:14:46 SC: But you did start... There was a point at which, in grad school, you were gonna be a historian in a fairly conventional way, and you were studying...
0:14:54 AD: No, I was gonna be a philosopher. No, I was gonna be a philosopher.
0:14:56 SC: Oh, you were gonna be a philosopher, I'm sorry.
0:14:58 AD: The department I was in was History and Philosophy of Science, and I went to graduate school thinking I'd do philosophy of science, but I didn't like the kind of philosophy of science being done at my program, which was this very intense, theoretical type of philosophy. And so I switched over to doing history, and I really liked it. I really like the concreteness of history, and I really like the detective work of history, so then I became a historian. But I didn't set out to graduate school... I really went to graduate school to get out of New York. But I became then a historian. Yeah. And now I'm a historian, except now I'm a journalist 'cause I gave up doing academic life a couple of years ago, so.
0:15:34 SC: But even as a historian, it's not like you were studying shipping routes; you decided to study hermaphrodism in the 19th century, is that about right?
0:15:43 AD: Yes, 'cause I was and am a feminist, and I was interested in the question of how medicine and science coped with biological blurriness when they were insisting that there were only two sexes. So, in the 19th century, so the late 1800s in particular, there was this big political movement that had begun among women for their rights, so that was the early part of feminism, and there was also a movement among people we now would call "gay and lesbian" people to demand their rights. And so, these were people who were challenging gender norms very strongly. And I was curious to know what doctors did when they were faced with the fact that biology is blurry, because all their claims about gender were that there's only two sexes, and there's no in-between. And in fact, there is in between. So I was curious about that. So I started publishing on what had happened in the late 19th century and then people who were intersex living then, which was the mid-1990s, started contacting me and asking me to look at what was going on today in the medical system and to help them change the medical system. So then I got into contemporary intersex treatment, and that led me into bioethics by accident. So some people think I'm a bioethicist, but I'm not, really; I'm really a historian who does patient advocacy work sometimes.
0:16:57 SC: Right. So the whole idea of intersex is fascinating, and I think, for me, the best way to get into it is you have a page on your blog about the question, can a person be born with two sets of genitals, with one male and one female set of genitals? And you have a very definitive statement about this.
0:17:16 AD: No.
[laughter]
0:17:20 AD: But you can absolutely be born with parts of both sexes. So, males and females start off with all the same parts. And if you have a high level of androgens and you're sensitive to that, so that's a kinda masculinizing hormone, you'll go the male route, and a low level, typically, you'll go the female route, but it turns out there's a hundred different ways besides that that can go in between or can mix things up. The reason you can't have both sets of genitals is because people are only born with one set of parts, so they'll either go left or right or in between, or they'll be mixed up in terms of the types, but you can't have genitals of both types. Unless what you mean is, can you have a vaginal opening with a penis? Yes, you can have that, but you can't have, say, a penis and a clitoris 'cause they're the same organ in development. And you can't have the labia majora and the scrotum 'cause they're the same organ in development, so they're gonna go one way or another or in between. So, people tend to have this sort of weird imagination that there's like, you could be completely male and completely female. You can't, you only have one set of parts, so you can go one way or another or blend 'em up.
0:18:22 SC: Yeah, and I think that this is just an underappreciated fact about human anatomy and development, but it makes perfect sense from an evolutionary point of view. Evolution uses what it has and tries to solve problems in a relatively simple way, but the fact that the male and female genitalia, sex organs, are two different versions of what starts out as the same thing, and that the male scrotum is just the female labia that developed in a different way, that's an amazing fact, I think, that is not very well-understood.
0:18:54 AD: No, that's right, and there are some nice animations now online that show genital development in fetuses that shows you can sort of slide a thing back and forth and see what does it look like, if it develops as female or as male or in between. And this is stuff I didn't know, certainly, when I went to graduate school; it was stuff I only found out pretty much by accident. And then I was fascinated to learn like, "Well, why have I not heard about this? Because this seems really interesting and really kind of important to know about sex development." And I realized, well, that's because the medical system had suppressed it for generations and kept the knowledge from us because of the idea that this was disruptive, frankly, to the social order, and that telling people about it was just gonna confuse people and create a kind of discomfort, which it does. It often does create discomfort for people.
0:19:38 SC: And this fact helps explain why there is this idea, this concept, of intersex, intersexuality. And you already alluded to the fact that in addition to simply having XX or XY chromosomes... By the way, it's not the only possibilities, right, there's more complicated things you can have, but there's also more to it than that. There's how these things get expressed because of the hormones that you have, and the hormones you're sensitive to, and how they develop over time. So as you say, there's all sorts of different specific ways in which you can be something other than the standard stereotypical male or female.
0:20:12 AD: There's also randomness in the process. So just like you can be born missing a finger, you can be born missing a penis and have everything else in terms of male development. So there's lots of variation in the system. And you're right, evolution... This makes sense in terms of evolution, because sex development is a key part of evolution. That's how we mix up our genes. And so sex turns out to be very important in terms of evolution. And whenever anything is important in terms of evolution, then there's gonna be a complex developmental process and there's gonna be variation, and that's where you get these variations. And variation happens through randomness, but it also happens sometimes because of genetic conditions running in families. So there are at least 30-something different ways you can develop in terms of sex. And that... Far more than that if you count them a different way, but there's plenty of different ways you can develop in terms of sex development.
0:21:03 SC: And I know you've written on the question which is extraordinarily important in certain circles, but what about when we have the Olympics and we have men's sports and women's sports, how do we decide? What is the right criterion for dividing up people according to that classification?
0:21:19 AD: It's really hard to figure out the answer to that, and the answer to that depends on what you're trying to achieve. So if what you're trying to achieve is a sort of mythical level playing field, then you're gonna be stuck. And the reason you're gonna be stuck is because humans vary a tremendous amount. And if you start making the decision, "Well, in terms of sex, we're gonna sort of draw the line right here," you've got to justify why you're drawing the line right there. And what the Olympic Committee would say is that women... People playing as women can't have too high a level of androgens because it gives them an unfair advantage. The thing is women naturally make androgen. So I think I'm a typical female based on what I know about my own biology, I've never had my chromosomes checked, but I'm pretty sure I'm a typical female. And I'm making androgens right now in my adrenal glands in the back of my body, just like other women, and I'm also making some androgens in my ovaries right now because that's where we make 'em. Males, meanwhile, make estrogen in their testes.
0:22:19 AD: So, all the sex hormones, we're all making all of them. It's just males make more of them than the average female will make. And so to make the claim, "Well, we're gonna cut off where it's supposedly unfair for a female to have," is a difficult argument to make, because we're making 'em, so why should we be told we're not allowed to have a certain high level of them? We don't do that when it comes, for example, to people's height. We don't say, "You're too tall to play basketball." We don't say to people, in terms of their ability to process oxygen, "Well, you were born with a genetic advantage, so you're not allowed to use that genetic advantage, you're not allowed to play." No, we say, "Look, if you're born with it, you're allowed to play with it." But where women are concerned, where intersex gets involved, that's where the Olympic Committee tries to cut things off, and it becomes very difficult to do that.
0:23:09 AD: My own feeling is, and I've written about this most recently for The New York Times, basically the rules they've come up with are pretty absurd because they declare certain sex hormones to be sort of the property of men, even though women do make them. And then they also have a system where they're setting up a system that has to measure something that can't really yet be measured, so they're trying to measure not only do you make these hormones, but do they affect you? And we don't have a good system for understanding to what degree they're affecting one's tissues, and the effectiveness of hormones on our tissues varies according to people. So, it's kind of a crazy system, it doesn't... They may have the data to show that testosterone improves performance in certain events, and they do have that data, and I believe that data, I believe testosterone absolutely gives you an advantage in certain events, certain running events, but they then leap to a policy that I think is very hard to justify. And that's where they keep falling down on their faces.
0:24:06 AD: And when I advised the Olympic Committee in I think it was 2012, I was there in Switzerland, basically what I said to them is, "You're making the same mistake that the Olympic committees made over and over again every time it's tried to adjudicate sex according to biology, and you're running up against the problem where biology is complicated and genders come in two categories for purposes of the Olympics. Why don't you just admit you've got two gender categories and stop trying to police the biology?" But the answer is they're afraid the Chinese will raise their sons as daughters, and they're afraid that they'll have boys playing as girls in the Olympics.
0:24:45 SC: I mean, it's almost as if nature and the natural world is very complicated and fluid and full of all kinds of crazy things, but we human beings really like to impose on nature these orderly categories, and then we get upset when nature does not conform to that order we wanna impose on it.
0:25:04 AD: We certainly do, and we get even more upset if money's involved.
0:25:07 AD: And where the Olympics is concerned, there's a crapload...
0:25:09 SC: And there are winners and losers.
0:25:11 AD: There's a crapload of money involved, so there's a lot of money at stake in terms of these decisions, and that's part of what's going on. What cracked me up is when I went to that meeting, there was an advisory meeting, they had a series of advisory meetings and I was one of many people that they invited to comment and critique and have a conversation about this, but what became clear to me is that it was mostly men making decisions about women's sports, and I was curious what would happen if women were actually in charge of women's sports and what decision women would make. And I suspect it would be different, because I suspect women who have been athletes are very sensitive to the idea of having your body policed. That's happened to them over and over and over again. And I think they would have more sympathy for the people getting caught in that policing, but I don't know, because right now, men are largely in charge of women's sports at that level.
0:26:00 SC: And this policing in some sense in a different context was what led in you to go on the journey from being a historian to an activist because you stumbled across the fact that surgeons were policing maleness and femaleness of infants as soon as they were born. They would notice that someone was intersex one way or the other and try to fix them. And number one, that was historically interesting, 'cause it started happening, I guess in the 1900s, but you'll tell me, but then it was still happening even today.
0:26:30 AD: Yeah, we started to see the beginnings of that approach in the 1800s, the late 1800s, but when surgery got better, then surgeons got more aggressive. And part of what has occurred is the idea that anybody who's left sexually in between will grow up to be miserable and depressed and rejected and therefore they will kill themselves, and so you have to fix every baby to look closer to a standard male or standard female type. Now intersex, by the way, sometimes occurs where on the outside of the body, you look very clearly like one sex, but on the inside, you have the organs of the other. So when we're talking about the early intersex interventions done by surgeons, we're talking about cases where there's visible sex anomalies on the outside of the body, and in those cases still today, what happens is most surgeons say, "Well, you don't wanna leave a kid in between, and therefore, we should either surgically make this child look more male or more female." In many cases, that means female because surgeons have a sort of high standard when it comes to what a male should look like and a rather low standard when it comes to what a female should look like.
0:27:35 SC: Male surgeons, we're talking about, presumably.
0:27:39 AD: Yeah, largely.
0:27:41 AD: Largely male surgeons, they think penises are very fancy organs and vaginas are just holes. And vaginas are not just holes, they're actually very fancy organs, the vaginal tube, the thing that is the vagina, the tube that goes from the opening on the outside up to the uterus is actually a very fancy organ, but they don't treat it as such; they treat it as something that can be replicated by creating a hole, basically, a hole that is... Medically safe hole. So that started happening in earnest starting in the 1950s, and there's an entire... There're generations now of people who grew up that way, who were lied to about their medical history, who have surgical problems resulting from what happened, some of whom had their fertility taken away from them because any chance of fertility was removed in the sex assignment process. And those people became activists, many of them became activists in the intersex rights movement starting especially in the 1990s.
0:28:34 AD: And it was a pretty active movement at the point which I was contacted by some of those people and I joined the movement as well because I could see that what they were describing was absolutely in the medical literature and it was going on, and to me, it was really disturbing to see what was going on. It wasn't that the doctors had bad intentions; they really wanted what was best for these kids, but they had a very narrow idea of what was possible and they had a very bad science, extremely bad science, when it came to following up whether or not this was actually working.
0:29:01 SC: And did you... Is it safe to say that you and your friends had actually had an effect on the practice, that the surgeons now were a little bit more aware of what's going on?
0:29:11 AD: They're certainly much more aware, whether or not we've changed the practice is an open question, I'm afraid we haven't changed it nearly enough. What has changed is now doctors say, "Well, it's the parents' decision," and so the parents are kinda pressured in many cases to make those decisions and are told, "Well, everybody's fine if you just do what we tell you." And parents tend to follow with their pediatricians tell them to do, so there are a bunch of clinicians now that I know that are reformists who strongly feel as I do, that you can raise kids as boys or girls, but leave their bodies intact if there's no medical emergency. Let them decide for themselves later whether or not they wanna take the risk of changing anything about their body, let them have bodily autonomy. And for those clinicians, they find parents are comfortable with what they're recommending, and I think that's because they're... In those circumstances, their pediatricians are telling them it's okay and to wait, and it's okay to let this child decide for him or herself how do they wanna handle their body. So for some places, it's better, but in a lot of places, it's the same old system, it's just now the parents are blamed for the decision-making rather than the surgeons taking responsibility for the decision-making.
0:30:19 SC: And what was it like for you sort of lifestyle-wise and intellectually to become an activist while you were also being an active scholar and a professor?
0:30:31 AD: Well, since I was in the humanities, it wasn't that hard because unfortunately, the humanities has largely gone in the direction of doing politics. I didn't think of myself as being in the... What I see often as the lazy versions of that within the humanities and academia in some circumstances. But for me, it was exhausting, mostly, because I was helping to run a national and international movement from my house and at the same time, doing a full-time academic career, which involved publishing in peer-reviewed journals, which I like doing, but it was... You know, that's intense work, doing the kinds of teaching that was intensive teaching 'cause I really liked teaching, and also doing service work. So I was doing full-time academic work and also basically full-time helping to run the Intersex Society of North America's cause, and at the same... And then I had a kid on top of it all, and that just became untenable in terms of the lifestyle. So, when I made a list of what I enjoyed doing, the things I didn't enjoy doing involved my academic job...
0:31:32 AD: So I gave that up and switched what I was doing at that point.
0:31:37 SC: And then you got involved in, I guess, a related but different controversy about transgenderism, which is different. Let's just get all the terminology on the table here. There's a lot going on when we talk about sex and how sex plays out in the world. There's sort of, at the very least, our biological sex; our gender identity, how we think of ourselves as male or female according to the standards of the world we live in; our gender expression, what clothes we wear, our mannerisms and so forth; and our sexual orientation, who we are attracted to. And all of these things are going on at once. And the intersex is about more or less our biological sex, as it were; and transgenderism, more about our gender identity, is that correct? Did I get that right?
0:32:28 AD: Yes. Congratulations, you have it exactly right.
[laughter]
0:32:32 SC: Well, I will just mention that before I got into this controversy over transgenderism, I expanded my work outward and looked at what else was happening to children born with norm-challenging bodies. So I looked at things like conjoined twins and the way they were treated in society and in medicine, and I looked at people with dwarfism, people with giantism, and those sorts things. In the book, I did that, and topic was called "One of Us: Conjoined twins and the future of normal," and that's a very... It was published by Harvard, but it's a very readable book basically designed to be used for freshman undergraduates sort of getting into this question of what do our bodies have to do with who we are, and when should we change our bodies, and when should we hold back and think about changing society instead.
0:33:15 AD: So yes, so, intersex is about how our bodies are when we're born, and transgenderism or gender is about how we feel about ourselves. So, I often tell people that intersex people and transgender people had opposite problems, but for the same core reason, historically. So intersex people were getting sex-change operations they didn't ask for, and transgender people historically had a hard time getting sex-change operations they did want, but they were both suffering for the same reason, which was a patriarchal medical system that said, "We get to decide what you'll look like and we'll get to decide what sex you are." So that's finally changing, and it certainly changed a lot more on the transgender side, and today, it's fortunately much easier for people who may benefit from hormonal changes and from surgical changes to go ahead and elect those for themselves, and that's a very positive development.
0:34:09 AD: We're actually swinging very far in that direction, and now we're starting to see some problems with sending people down that route without actually doing an adequate work up to see if that's really what's gonna help them in terms of their own personal situations. But it's certainly better than it used to be when it was very, very difficult for people to get access to legal sex change or gender change and social gender change and then also surgical changes to their bodies to match the way that they felt.
0:34:36 SC: And a similar issue comes up with the conjoined twins, right, there was this surgical idea that it would help them to separate them, that would make them more normal. We have categories, we have a view of what a person should be like, and that view doesn't have another person attached to them. And you found that in fact, lots of conjoined twins would prefer just to remain conjoined if they're healthy in that condition.
0:35:00 AD: Yeah, I was shocked by that. When I came to the subject of conjoined twins, I fully expected that anybody who could be separated would elect to do so, that nobody would be doing okay conjoined. And instead, when I looked historically at all the cases I could find, there's not as many of them as other types of variations in the world, so that was a little bit easier. When I looked at that, what I found was that there was only one single case in history where conjoined twins old enough to do so for themselves chose separation, and both of them died from it. And that historically over time and throughout different cultures, conjoined twins said the same thing if they grew up together. They said, "I know this isn't normal for the rest of the world, but this is normal for us, and I wouldn't wanna live the way you live." So what was really surprising to me was they consistently said, "The way we live is superior to the way you live because you must get lonely and you don't have anybody with you all the time. And we have somebody with us all the time." So the thing that we see as a terrible disadvantage is seen by them to be a huge advantage.
0:36:06 AD: And when I thought about it, I realized that shouldn't have surprised me so much because... So, speaking, for example, as somebody who was born female and has grown up as a girl and then a woman, I know that I'm discriminated against in terms of wages, in terms of political representation. I'm much more likely to be sexually assaulted than a male is. All of these things, but my solution to that is not, "Well, I wish I was a man," right?
0:36:31 AD: Even though I know that that would eliminate the discrimination I experienced. So conjoined twins were saying basically the same thing, they were saying, "I know I'm subject to a lot of discrimination, but I don't think I'm the problem. I think the problem is the discrimination system." So, as I began to look at that and then look at what the surgeries did to people, in some circumstances, separation surgeries are very simple, they're practically outpatient surgeries, in some cases, and in some cases, they're just a little bit complicated but not a big deal. But in many of the cases we hear about, they're enormously complicated and they leave people really damaged. If they're joined at the head, they leave them brain-damaged; if they're joined, say, sharing a body in the middle part, they are left without organs, it often disrupts their sexual sensation and function, it will disrupt their ability to have normal bowel movements to have urinary function. They'll have problems with pulmonary function, in some cases, if what we're doing is separating the upper part of the body.
0:37:25 AD: So, really, it's not the case that it's simple, that they're always better off if you separate them. And so I started to question that, and that became an interesting period of my life because I ended up talking to surgeons who were doing conjoined twin separations who started to hear of my work and read my work and began to ask the question, "Am I really helping?" Which I really appreciated, that they would ask that question. "Am I really helping?" Not all of them were thoughtful. I remember when I was talking to... I could hear him opening his mail in the background while we're having this discussion about whether or not's gonna separate these two boys who were joined at the head, who I was sure he was gonna kill. So not all of them were so sensitive and sensible, but many of them were.
0:38:07 SC: It's very sobering, how deeply ingrained this idea is that we want other people to become normal by our lights rather than asking them what they want. It's... This kind of a relationship is a little bit different, but everyone grows old, right? And people get sent to assisted care facilities, senior centers and whatever, and there's... Studies have shown that the elderly really would like to have much more autonomy than we give them. Well, we try to give them the safety, the caregivers or whatever try to protect them, and they tend to want to do risky things to give them a feeling of freedom, but we don't want to let them. It's not exactly the same set of issues, but it's the same human desire to sort of control other people's lives and make them normal by our own standards.
0:39:00 AD: We do the same thing with people with disabilities, and we do the same thing with children. And it's a real problem because in all those circumstances, you think you're helping, but if you actually bother to listen to the people whose lives you're limiting, they often do not feel you're helping; they feel that you are oppressing them. So I think it is something that we have to think about much more carefully. Certainly, for example, there are circumstances, of course, where people are in nursing care facilities who still wanna have sex, and we have the attitude, "Well, that part of your life is over." Well, why the heck should that part of your life be over, right?
0:39:37 SC: Yeah.
0:39:38 AD: And for adults with disabilities, including cognitive disabilities, many of them do still wanna have access to sex, or access to going out and having a good time. And so the Independent Living Movement within the disability rights community has been very positive in that way, but there's been a lot of de-funding of a lot of systems that allow independent living. And certainly for children, we infantilize our children for a very, very long time. So, compared to other nations, the United States, for example, has much higher drinking ages, is slower to permit things like control of your own medical decision-making. Many places, you could be younger and make decisions about your own medical care before you can in the United States. Age of consent is lower in terms of many other places. So there are many ways in which I think we just infantilize our children in this country in ways that do not empower them and also don't really protect them, because the fact is 15- and 16- and 17-year-olds will do what they will do anyway, and claiming that...
0:40:41 SC: Well, there's that reality to deal with, yeah.
0:40:44 AD: Yeah, no, so, my own feeling is that it's terribly important to empower your kids. I did... I mean, more recently, I wrote a book about talking to your kids about sex because a few years ago, my son invited me to his sex ed class where they were teaching abstinence which he knows drives me up the wall, and I ended up live-tweeting it which became viral, so then I was asked to write a book about talking to your kids about sex. So, that's a book called "The Talk." And in there, I just sort of modelled what I have done in my own parenting, which is trying to take seriously children as real people in the world and to address their actual questions with real answers, not namby-pamby around stuff. Tell 'em the truth.
0:41:25 SC: Yeah, it's kind of amazing to me, sex and death, two of the very fundamental features of human life, and yet two of the things that, at least out there socially, we're afraid to talk about as grownups. We'll joke, we'll sort of nervously teeter about this or that and we'll get a laugh, but the idea of just sort of talking about it as a real thing that's going to happen, and let's be honest about it, and even with children or the elderly, it's just remarkably hard for the society to catch on to.
0:41:58 AD: It is, and this leads naturally into the conversation of how I got in trouble by doing the history of that controversy over transgenderism. Part of what I was doing was I was taking seriously the idea that transgenderism also implicates issues of sexuality. And for many years, people in the transgender rights understandably kind of de-sexualized transgenderism, made it all about gender, never about sex, even though one of the things that often happens for people who are transgender is they change their genitals. So it has something to do with sex, right? It has something to do with self-presentation and genital feeling, how you wanna interact in terms of your sexual encounters. But a lot of the mainstream doesn't wanna talk about sex, just as they don't wanna talk about death.
0:42:43 AD: And so, to push for transgender rights, it became necessary to sort of de-sexualize it, just like when gay lesbian people were actively working on marriage equality, they often stopped talking about sexuality; they talked about adopting children and about cooking dinner together and watching TV together, but nobody was mentioning what's happening in terms of sex because the straight population is more comfortable with the idea that we're not gonna talk about sex. And so it's easier to access your rights in that way.
0:43:11 AD: And so this controversy that I got into had to do with one particular area of sexuality studies around transgender where I was looking at transgender women who transition because of sexual orientation issues. And this was extremely dicey a thing to talk about politically, and so the researchers that I was tracking the history of got attacked for talking about this, and then I became attacked as well for having tracked out what happened to those researchers when they crossed the line.
0:43:42 SC: So in particular, the idea that at least some people who want to transition from male to female do so because they find it sexually arousing or sexually interesting or that's part of their motivation, not all people and that's not the only motivation, but at least it's there.
0:44:01 AD: Right, that for some people, transition isn't it just about gender identity; it's also about sexual orientation. And I don't think that should be that surprising because I think for many of us, our sexual orientations are connected to our gender identities. So when I'm having sex as a woman, I think I'm doing it as a woman. I've paused to think about it sometimes 'cause I'm interested intellectually in this question. But I think for a lot of us, when our gender feelings become most vivid is actually when we're having sex, so I don't think there's anything unusual in that a transgender person might have that interaction going for themselves as well in terms of their orientation and their gender identity. But to talk about that was to be seen as going back to a really nasty old conversation about transgenderism that saw it merely as a fetish, and merely as a kink, and merely as something that was sort of something perverted and inappropriate. And that's not what these researchers were saying, they were saying, "No, this is actually a legitimate way to be transgender." And they would say there's absolutely no reason to deny people access to transition because of this; it's just sometimes sexuality is part of the equation. That's not to say...
0:45:10 SC: That's a lot of interesting material for your Tinder profile here, I think...
[laughter]
0:45:14 AD: Some of the researchers said these things in ways that were sort of cold or even outrightly offensive, and so that's how they got in trouble. But what happened to one of them, Michael Bailey, is what I traced in the book Galileo's Middle Finger, and that was that he was beset upon by a group of transgender activists who basically made up a whole bunch of lies about him. And when I came to that part of my research and I decided to look into this... 'Cause I knew people on both sides of this controversy, I was rather curious to know what really had happened, I really like questions, were like, I've been told one thing and everything else seems to be true. So I looked into that for about a year, I looked to a thousand sources and interviewed about a hundred people, and at the end of it, what I found was that the charges about Bailey were simply made up and that the people who had made them probably knew that these were false charges but had basically tried to just shut him up because they didn't want his view of transgenderism getting out into the popular realm. So, when I did that, they came after me, and that was very, very, very unpleasant and that was in around 2008 when it was easier because of Google's algorithms to take over a person's identity, and that's what occurred.
0:46:23 AD: And actually, I'll tell you. So, literally yesterday, I was going to a local coffee shop that I go to a lot. And the woman who owns it came up to me and said, "Alice, I was wondering if we could have coffee some time soon," I said, "Yeah, sure, of course. I'd be happy to have coffee with you." And she said to me, "Because people are telling me that you hate transgender people." And I was like, "Oh, my god," and this was... This traces back all the way to that stuff and this claim that's out there, that I somehow hate transgender people, even though I've agitated for transgender rights in sports, I've worked on national projects to improve the care, the medical care, of people who are transgender. I mean, but what happens is if people want to defame you in the social media world as it exists today, it can happen pretty easily, and then it takes on a life of its own and people and cannot figure out what's true about you. So it's... And what can I do, right? There's a whole bunch of stuff out there online about me that's simply not true, and there's nothing I could do about it.
0:47:21 SC: And this showed up on your webpage, you had the very vivid story of what you recently gave a talk at... Welsley, was it? And...
0:47:28 AD: Yes. Mm-hmm.
0:47:29 SC: Certain opinions about you have been shared and people came with protests, and as far as you could tell, they were protesting a completely different person than you would think of yourself.
0:47:37 AD: Which is a very surreal thing when you've spent your whole life studying the relationship between anatomy and identity, and you're standing there, you're bodily standing there right in your own flesh, and people are yelling at you about an identity that they swear is yours, that you don't recognize at all.
0:47:53 AD: It's a very strange experience. And the picture I put up of that moment where I faced these hundred-something people, young people, protesting me, only protesting a version of me I don't recognize, I'm just standing there listening to them and thinking to myself like, "How do you even begin to get a foothold here? Because at the end of the day, their politics and my politics, I think, exactly align, but they think I'm the enemy." So...
0:48:19 SC: That's what I thought... That's what I felt very strongly when reading Galileo's Middle Finger, this sense of heartbreak, in some sense, because you and the people who are coming to attack you in some sense want what is best for transgender people. Neither of you are trying to shut them down or not let them live their lives, but there is a mismatch because you are trying to be an intellectual, be a scholar, trying to say what is the truth about the situation as best we understand it right now, and of course, it's always subject to change if more studies come along or whatever, and they have a certain strategy for winning a fight for justice that they think that this particular point of view that you say might be right gets in the way of. And it's almost an impossible dilemma to address in some sensible way.
0:49:14 AD: It is, and I... I mean, I've largely given up on that front and have talked to other people who unfortunately have done the same. The good news is there's a lot of really fine clinicians now who are working on changing the system within medicine for transgender issues. There are a lot of terrific lawyers working on the legal and social issues, so... There are a lot of people in politics changing the laws, so there's real progress happening. And that's why I don't feel like I'm needed too much. But it is nevertheless disappointing that we can't have conversations that go beyond sort of screaming around about who is a bigot and who is not a bigot and it just... It feels very frustrating. But that's the whole social media experience on everything these days, so, this area is not special in that way, it's just... It's just a little disconcerting when somebody you've known for years has heard that you're a Nazi basically and feels the need to ask you, "Are you a Nazi?", and you're like, "Well, I'm gonna tell you I'm not a Nazi," but what's my proof? What is gonna... So I just...
0:50:13 SC: That's just what a Nazi would say.
0:50:15 AD: I know, exactly, right? No, and so I brought a stack of my books and I'm like, "I hate to give you a lot of homework, but I'm gonna give you what I've actually written and what I've actually done, and if you wanna look at it, you can look at it." So I gave her a whole stack of stuff and said, "This is what I've actually written and actually said, and some of it does irritate some people, but I think if you read it, you're not gonna find any evidence here that I, as people have claimed, wanna send intersex people to the gas chambers or want to stop people from transitioning who will benefit from transition." None of that is true. It's a very surreal situation.
0:50:48 SC: It's kind of the flip side of this human desire to categorize people, like, "Okay, you're either male or your female," full stop. "You're either an ally or you're an enemy," full stop. "And if you're an enemy, you're the worst kind of enemy. That's all you could possibly be."
0:51:03 AD: Mm-hmm. You have it exactly right. And I've always sucked at categories.
0:51:08 AD: I mean, I just... I mean, look at like what I study, right? I've always been interested in people who don't fit categories, and in that sense, I think it's something I've always related to; I don't... You know, I was at the top of my class in high school. I was not supposed to be a college dropout, you know? I got tenure early, I was not supposed to give up tenure, but I'm not satisfied with the world's categories. I don't find it interesting to live in those categories. So, that's why the people I study often are people who are challenging those categories, whether intentionally or unintentionally, through their bodies. But it does drive me crazy, 'cause I keep running up against people who wanna say, "Well, are you X or are you Y?", and I'm like, "I don't recognize that set of categories," like, "Really? You don't think there's any other way to be in the world?" So, for example, I mean, I'm a progressive, but I run a non-profit, non-partisan newspaper now for East Lansing, Michigan, which is where we live, and there are people who wanna say to me, like, "I don't understand it. You're a progressive, but you're taking developers seriously." And my attitude is, "Why should I not be interested in the thoughts and the actions of people who are not like me?" Right? But it's very, very frustrating.
0:52:20 SC: But the thing about these categories is that they are, in some sense... There is a landscape of where you can live intellectually and gravity pulls us down to some certain valleys, and that's where the categories live. So this makes you literally Sisyphus trying to constantly push the ball back up the hill and try to say, "Well, there's all sorts of places you could live."
0:52:41 AD: Well, and I hate to sound like I'm anti-capitalist 'cause I'm not really anti-capitalist but I will say money does matter here, again. So, if you are online, the way that people will make money off of you is if you feel strongly about categories. So, if they can convince you that a particular brand is absolutely the type of running shoe that you want, or the type of underwear you want, or the type of politician you want, or the type of law you want, whatever it is, if they can convince you that you have a particular category that is the only category you want, they will figure out ways to monetize that. So, when we look at places that are conventional newspapers, they have largely become opinion pages because opinion pages cause people to click and clicking means that you can sell out.
0:53:31 AD: So, there is a strong bias in our world today towards convincing people to be narrow-minded. Being broad-minded is not a good way to sell products. Getting people to be narrow-minded is a very good way to sell products because they will narrow what it is they're gonna choose, and they'll pay more, because there's not very much in that category, so they will pay more to purchase within that category. And that's how we end up in the situation we do politically, in terms of the undermining of newspapers becoming pure opinion pages. That's how we got here, and it's really problematic. So, if you go on YouTube and you click on what you like on YouTube, it'll draw you down in ever more particular path because that's when you end up with the ads. If you're actually pretty broad, and you click on this and that, and you're not really interested in number of views, and you're just watching whatever, there's no money to be made off of you. But there is money to be made off of you if we can convince you, "You are really into X and you're not into Y."
0:54:32 SC: So I conclude from this that you are a rabid anti-capitalist and you would like to collectivize the farms and institute five-year plans. That's just a logical consequence of what you just said.
0:54:41 AD: Yeah, with my retirement money invested in Wall Street. Yeah, that's me...
0:54:47 AD: Yeah, no, I mean, it's... I don't know how to solve that problem other than trying to convince people that living within categories is actually not very interesting or satisfying. But that said, I will recognize I'm much more comfortable with change and ambiguity than most people are. And so I think part of what we have to do is think about how can we cultivate a value of volatility and ambiguity among our populace and make them realize it doesn't have to be scary. But a lot of people are very scared of ambiguity. But they don't have to be.
0:55:25 SC: I think it... I think it's... It is scary. I think it... You're not gonna get rid of the scariness. I think that the best you could hope to do is to say embrace the scariness of it all.
0:55:34 AD: I think that's right, and there are limits to what we can embrace. I mean, when we have a bat in the house, the...
0:55:41 AD: Every now then, we get a bat in the house, 'cause we live in... Part of Michigan was... We had big trees in our neighborhood, and that means we have a lot of bats. And every now then, we get a bat in the house. And there is this otherworldly sense of ambiguity that there is some creature that will not communicate with us that is in our space, and we have to figure out where the hell it just went and get it out. And that is the moment which I realized I am not comfortable with certain kinds of ambiguity.
0:56:10 AD: I am not comfortable when there's another creature that will not communicate with me that is in my space, it freaks me the hell out. And so, yeah, no, we all have our limits and I'm not different from people that way. I mean, I definitely have my limits in terms of the ambiguity I can tolerate.
0:56:27 SC: Well, there's one sentence in Galileo's Middle Finger that I thought really pinpointed, for better or for worse, the dilemma that is faced by people who would like both truth and justice in the world. You say, "We didn't know of any successful rights movement that wasn't based on an essentialized shared identity, even if just constructed in politically expedient ways." So that's kind of pinpointing the difference between this anti-category, live in fear, that's the complexity and the subtlety of the world intellectual point of view, and the idea that, well, we wanna make the world a better place, we wanna improve things, and maybe that means bringing people under an umbrella of a certain shared identity even if it's not a completely perfect fit to how to the world actually is.
0:57:17 AD: Yeah, no, there are times when it's very useful to do that. I mean, we do that as families, for example, right, the way we define who is in the family or is not in the family will depend on the immediate need of the kin, and we'll change the boundaries on that as necessary. We do that within our own communities, whether there's a... If there's a threat, for example, communities may form that are not logically their own communities, but they'll form temporarily in response to a threat. So, certainly, we all do that, and the challenge to me is, how do we not make the borders of that so strong that we can't be flexible and allow change to occur when it's time for change to occur again? That can be really difficult.
0:58:00 SC: Up to a couple days ago, I was a huge LeBron James fan because it looked like he might join the Philadelphia 76ers, which is the best basketball team in the world, but now he's joined the Lakers so I think he's a terrible, terrible person, and he's the enemy. What can I do? Sorry, he's in the wrong tribe.
0:58:14 AD: Change with the sport you watch, I don't know. [laughter]
0:58:16 SC: No, I can't do that. So...
0:58:17 AD: No, 'cause you're still in that category.
0:58:21 SC: Oh, yeah, no, not very happily in the category of crazy Phil W 76ers fan who thinks that all other teams are morally failures. But you didn't stop, you didn't... Despite the transgender controversy and the emotional toll it have taken. I am a conflict-averse person, I don't think I could have stood up to what you had to put up with, but you've managed to get into a couple of new controversies since then. There was the Maria New controversy on, I'm not gonna say it right, dexamethasone steroids, is that right?
0:58:54 AD: Oh, you said it right. Yes. Yeah, that related to the intersex rights work, so, this is a researcher, a physician who... The short version of it was that she was convincing women at risk for having daughters born with intersex genitals to take a steroid when they were pregnant with these fetuses and to try to prevent the intersex development. And the problem with it was not only that this was ending up affecting fetuses who could not benefit because only seven out of eight of the pregnancies identified would actually involve a child of that type; the bigger problem was she was telling the families that this had been found safe for mother and child, when in fact, she was at the same time getting money from the National Institute of Health claiming that she needed to study these families to see if it was safe or effective. So she was using the same population she had brought in with a sales pitch that it was safe to say, "Oh, I need grant money to see if this had been safe," and that was extremely disturbing to me from an ethics point of view, and a moral point of view.
1:00:00 SC: And this was not some fringe figure; she's like the grand ol' lady of the field, right?
1:00:03 AD: She's a member of the National Academy of Sciences, she's a highly distinguished pediatric endocrinologist, one of the top people in her field. Yeah, so I tried to get the government to intervene in that case with a bunch of colleagues, and that failed. The government doesn't function very well in certain ways.
1:00:19 AD: Shocker! Shocker, the government doesn't protect you like it's supposed to protect you.
1:00:23 SC: Never before has this been realized.
1:00:25 AD: Exactly. So, that took a couple years off my life, both at the time and probably at the end of my life, a little shave off a few years. I got into a fight with the Food and Drug Administration, with the American Journal of Bioethics, and the medical schools of Cornell and Mount Sinai. I have to tell you... This is another reason why, I think, if we can go back to the beginning of our conversation, why I think I don't fit in the intellectual dark web, because a lot of those people spend a lot of their time sort of dealing with hot-button controversy issues out in the mainstream. I dig my feet in a lot of the time and take on small but, I think, morally deeply important projects and work on them for years. And the kind of stuff I do is hardcore historical investigations. I take on projects that literally take years at a time in order to try to figure out what happened and to try to bring some justice. And so, I just don't think those people are doing that. They're doing a different kind of political punditry that doesn't really... I do a little bit of political punditry, but a lot of what I do is hardcore research in historical areas involving science and medicine. So...
1:01:38 SC: Yeah, a few years ago, John Brockman has these collections, these edge questions of the year that he then collects into books and he asks... He's a literary agent, he asks his stable of writers to write something pithy and small in response to some question. And the question was, what have you changed your mind about? And I've changed my mind about a million things but most of them wouldn't be that interesting, so what I wrote up was, "Being a heretic is hard work." And I think...
1:02:06 AD: That's true.
1:02:07 SC: Yeah... Well, being a good heretic, right? Being a heretic at all is actually no work whatsoever. And I think that when I was a college student and I was first learning about physics and so forth, I had this romantic idea of having some heterodox view of mainstream physics and I was going overthrow to it and change the world, and having a view that is both correct and widely disparaged is really hard. You have to do a lot of work. It's easy to just be contrarian; it's hard to do the dirty work of establishing the truth of something that is not considered to be already pretty obvious.
1:02:50 AD: Exactly. And that... I mean, I also find that work really satisfying because it... Maybe it's gonna show that I was raised Catholic. It's very thankless. And I really like that about it because you're not doing it for any kind of conventional reward system; you're really doing it 'cause it's hardcore work. To me, it's like when I go running, and I'm not a natural runner, but when I go running and I push myself really hard and there's nobody with me and I'm not tracking the run or anything, I'm just doing it 'cause it's hard, I really like that. And I think a lot of intellectuals are like that, where they really like a difficult problem and they really wanna tackle it. And that's where, by the way, a lot of activists are very different from intellectuals, because I think a lot of activists really want the easy way out. If they could flip a switch and get what they wanted, they would do it. I would never be interested in flipping a switch if I didn't understand what was behind the switch and what all the implications are of flipping the switch, and can I think about the unintended consequences? Can I think through that, and can I figure out what the switch is... You know? Like you, I really... I really wanna... Really wanna get my feet into it, but that it is... It is really hard work.
1:04:00 SC: Well, the categories of activist/intellectual are hard to straddle equally, right? I think they both are important, it's important to make the world a better place, it's important to find the truth and be objective about it, but one tends to have a value that is more important. And if you're an intellectual, if finding the truth regardless of its consequences is the most important thing to you, then that leads you to certain practices and certain things that you're gonna consider to be enjoyable and having a good time, and it might not be the same as those who are juiced up by the activist lifestyle, by just changing the world for the sake of changing the world. The world needs to be changed.
1:04:41 AD: Yeah. I think you're right, we need both, but they often feel very different. There are, though... I mean, there are pockets of places where people are intellectuals and activists, and those, to me, are very exciting places. For example, the ACLU at its best is a place that joins intellectualism and activism. There's a lot of legal groups where really cool stuff happens, but then there's also some medical activist groups. For example, some of the medical groups around trying to bring evidence-based clinical practice into being, so for example, the Lon Institute that tries to look at what we really know in terms of the data and tries to avoid over-intervention over treatment in medicine and tries to pull back and say, "We don't need to over-medicate, we don't need to over... Send too many people in for procedures that don't actually help." Those kinds of places, I think, that join that heavy intellectualism with a real activist strategy of trying to improve people's lives, those are really exciting places.
1:05:38 SC: Well, you mentioned in The Chronicle piece that despite the fact that you are no longer, strictly speaking, a professor, you love the professoriate, academia, walking across the college campus. It's a space that is kind of unique in our culture, where trying to figure out hard questions and answer them deeply is valued. But nevertheless, you quit your job. You had a tenured faculty job, so why don't you tell us that story?
1:06:07 AD: So, after I gave up tenure, I was working at Michigan State University for... Where I got tenure. My friends at Northwestern's Medical School in the program of Medical Humanities and Bioethics offered me a long-distance part-time job, which I took. I had a big name by then, and they were interested in having my company and having my name, and in exchange, I would have their name, and it would all be lovely, and it was. I loved my colleagues there, and I ended up working there for 10 years. The job sort of swelled and set back depending on what was needed in terms of my home life, 'cause I was raising a kid at home 200 hundred miles from my job at the same time. So it all depended on, like, did I have a big speaking year? If I had a big speaking year, I laid back on the Northwestern job, et cetera, et cetera.
1:06:49 AD: So, about a year and a half before I ended up giving up that job, I was asked to edit the annual magazine/journal of our department which is a journal called "Atrium." And Atrium published short, intense, interesting pieces that were on a particular theme for each issue. So these are medical humanities themes. So we had themes like power, and the liminal, and good and evil. I mean, these are interesting themes within medicine, and we would invite people to submit proposals in terms of what they wanted to write. And some people were physicians, or historians of medicine, or philosophers, or bioethicists, or nurses, or patients. Whoever it was, you could submit on the theme and we would choose a certain number of them and publish them. It's a very high-gloss, beautiful production, and we edited it very carefully. It was very well-respected. It was subscribed to by the 3,000 people, and it was also read very widely online for free.
1:07:48 AD: So the year I was invited to be the editor of it, the theme that the editor-in-chief chose was bad girls, which was perfect 'cause it was about gender, it was about morality, stuff I do. So I solicited... We put together a call for proposals as a group and sent it out as we always did, and people sent me about 33 different proposals, and out of that, we could pick about 13 of them. And one of them I chose was a piece by a cultural anthropologist named William Peace at Syracuse University, and Bill Peace was writing about his own experience. He does culture anthropology and disability studies. And Bill was born with a neurological condition that meant when he was 18 years old, he became paralyzed from the waist down and he was in a long-term rehabilitation facility at that point, and he was wondering about his own sexuality. This was in the late 1970s. And you know, it was the sexual revolution, he is a young man, he wants to have sex, of course, someday, he wants to be a father, so he's asking his doctors about this and none of them are really willing to talk with him about it.
1:08:50 AD: So he talks about the fact that he's in this institution where basically, these men were there for a very long time and they got to know the nurses really well, and sometimes there were relationships that blossomed between nurses and patients, in this circumstance. 'Cause this was not like a hospital, it wasn't like people you just meet once and then they're disappearing; these are people they knew for months and years at a time. And in his circumstance, he tells the story in this piece that I published where one night, he was thinking he finally got bladder control and he wet the bed again and was very depressed and crying, and he hits the nurse call button. And this nurse that he had become very close friends with comes, and basically she reassured him by giving him oral sex. And he writes about it as a moment of compassion and a moment which really gave him hope that he could go on to have a positive sexual life. It still makes me tear up when I write about it 'cause I think it's one of those moments where somebody really reaches out to you and meets you where you are.
1:09:44 AD: And sure enough, he did go on to have a good sex life, he ended up becoming a father, he's had a really good life. And so he wrote this piece for me, and part of what he was doing in this piece was asking the question: Do we yet take care of the sexual needs of people who are nearly disabled? Are we addressing this at all? And he didn't say this should be what should happen in rehabilitation facilities. In fact, he called it "the wild West period" of medicine and rehabilitation medicine, which it was it was. It was a very crazy period, it's when infection control got good enough that people were surviving at levels they never had survived before. But what happened was after this was published, a few months after this was published and had gone out with a bunch of other intense articles, frankly, articles about transgenderism in Samoa and articles about women who give birth without a medical system, I'm very... Articles about abortion, one of which made me really uncomfortable, and I'm pro-choice. Very intense stuff as we always published, my dean, Eric Nielson, the Medical School at Northwestern saw the issue and saw Bill Peace's article and flipped out and apparently said that he was worried that it would violate a branding agreement with Northwestern's Hospital Corporation...
1:10:53 AD: So he ordered it censored. He ordered it taken down offline. This had been published; this was not like he prevented it from... It was already published, and he took a down. I was told, "Shut up, don't say anything. We're gonna try to work this out." And I'm not very good at shutting up to anything, but I was worried about my colleagues, so I shut up and did nothing. And then it went on and on and on, and one of my other colleagues started really questioning it. That was Christie Kirshner who's a physician and a disability study scholar in rehabilitation medicine herself. She had written a piece for me for that issue about women in... Women with disabilities and how they take back their own sexuality.
1:11:29 AD: So Christie was increasingly disgusted with the censorship, as was I. I'm in the middle of publishing Galileo's Middle Finger, I literally brought to the dean's office the book jacket as it had been designed, with all these people praising me for advocating for academic freedom, and here I am being censored in my own medical school, and I'm supposed to stay quiet about this, right? So, they keep telling me, like, "Well, there's nothing we're gonna do about it because we pay for it, so we have the right to decide." And I just kept saying, "Have you Googled me? Do you know who I am?" I cannot put up with censorship, right? Like, "I have spent the last several years fighting for academic freedom, and I'm not gonna put up with this." So, finally, what happened was Christie resigned, and then I ended up trying to go to the provost office and get them to reverse the decision. They did finally put Bill Peace's work back up, but they didn't say that it had ever been censored and they never explained why it disappeared for a while.
1:12:21 AD: They also required that from then on, that the journal had to be approved by the dean's office and by the PR department, and we would have to get permission on the themes, permission on the call for proposals, permission on what we were gonna publish, they were gonna approve everything. And that's not academic freedom in the least. So I couldn't put up with that, so I resigned quite publicly over it and called them out on it, and they never disagreed with my version of the events in public. They never challenged it, they basically admitted that what I was saying was true, and they never apologized for it. So, clearly, that was the wrong place for me to be. So in the great sweep of irony, if you know... If you know who Northwestern's chief rival is, Northwestern thinks that their chief rival, the other side doesn't think they should bother having a rivalship with Northwestern, but that is the University of Chicago...
1:13:08 AD: And...
1:13:09 SC: I used to be on the faculty there.
1:13:10 AD: As it turns out, that's where my son is going in the fall as a college student, and I will say that when I was there with him last and I was walking across the green with him, I was incredibly jealous of him, I just...
[laughter]
1:13:25 AD: I was so jealous because that wonderful intellectual life that exists there is something I really do miss. It was a beautiful thing, and that's why in that piece on the dark web, I say to people, "You are where you need to be. You don't need to be in the dark web, you should be in the light web." And that, I think, is true.
1:13:42 SC: You are kind of the Taylor Swift of academic controversies. At some point, do you worry, is it you?
1:13:50 AD: I think what's... The reason I get into these things is both because I'm kind of fearless and I don't mind being uncomfortable a little bit. But the other thing is that I'm articulate, and when you're articulate and willing to fight, that gets you in a lot of trouble. So, in the book Galileo's Middle Finger, I talk about the Galilean personality, and that's not to say I'm anywhere near of the intellect Galileo is, but it is to say I have this similar personality to him as do the other people I track in the book who get in trouble, and that is this personality type that is unafraid of fighting when they believe that something they know to be true is being denied, they will fight and fight and fight to try to get people to see what they see. And there are people who believe that eventually, the truth will save them, and they're stupid that way, 'cause it's not going to.
1:14:40 SC: Yeah.
1:14:41 AD: The book is named after a literal digit of Galileo, his middle finger, which is mounted on a stone pillar under a glass jar pointing forever more at the heavens, that is in the Galileo Museum in Florence. And to me, that's a story of like, well, yeah, technically, he won, but look what's left of it, right? It's like a middle finger pointing to the sky.
[laughter]
1:15:07 AD: He died under house arrest. It sucked. The truth is it sucks. So, that's the reality.
1:15:11 SC: I'll confess, I was one of the people that your publisher worried about. I thought that the book was about Galileo when I saw the cover and the title because I knew about the finger, I had been in Florence, and Jennifer, my wife, had gone to the museum and was raving about this little relic, sort of the closest we have to...
1:15:28 AD: It is really cool.
1:15:29 SC: Secular version of the Catholic relics of the saints, right?
1:15:33 AD: It is.
1:15:33 SC: So...
1:15:34 AD: It's fantastic. I love the relic, and I tell the story in the book that when I came upon it in graduate school, I just started laughing hysterically, 'cause I thought it was so incredibly funny, right, that of all the things left of Galileo, we have his middle finger pointing up at the sky. It was just so incredibly funny. But it's also a metaphor for, there's just so much you can do as an individual. I mean, there is just so much you can do as an individual; you have to hope that you can move people to look with you at what is true, and if you're right, then they will find what you found. Hopefully, there won't be mass hysteria, you'll find what you find.
1:16:09 SC: And one of Galileo's many virtues was that in some sense, he was a public intellectual, in our current sense, right? He wrote...
1:16:16 AD: He was.
1:16:16 SC: In the vernacular, he tried to reach people other than his academic colleagues. Just sort of finishing up here, how do you view the role of the public intellectual these days? I know that in science, there is a whole separate category of science popularizers, people who write books and have TV shows and so forth. And if you write a book or appear on a TV show that popularizes science, then there's certain segments that remove you from the list of active intellectuals doing work. So clearly, you've gone over to a different side, and the idea that you're both doing research and doing your work and trying to reach a bigger audience is not a category that they quite accept. But I suspect that in the communities, it's a little bit more established that this is something we can at least aspire to do.
1:17:10 AD: No, I think there's the same suspicion. I'm guessing you're talking about yourself running into it since you like to take both sides.
1:17:17 SC: No one I know personally, but I've heard of people this has happened to.
1:17:20 AD: Asking for a friend. Asking for a friend, yeah.
1:17:22 SC: Yeah, asking for a friend.
1:17:25 AD: So, yeah, no, there is that bias, and I've always assumed what that really is is jealousy, that that's some form of, "Well, you can do that, but you can't do what I do well." And in fact, there are people, there are some people who can do both really, really well, and I think that's really okay, if they do both really well. And you know, is it the case that some people dumb stuff down too much in order to sell books? Yes, and that's regretful, and that should not happen, but there are some folks who stick with it, stay in the field they actually know, don't wander into fields they have no clue what they're talking about, and some of the stuff that comes out of that is really very good. So... I try hard when I'm contacted by newspapers or broadcast venues or whatever it is and they say to me, "We want you to talk about X, 'cause you speak so clearly on this." And I say them, "That's not really my field. You need to talk to this person or that person." And they're always surprised, but my own feeling is if we're gonna do public intellectualism well, we should be very careful to talk about what it is we actually know, and where the danger zone comes in is when you have people who are wandering into fields that they really don't know what they're talking about. That is not good for intellectualism. That becomes mere punditry.
1:18:40 SC: It does seem, though...
1:18:41 AD: It's easy to do that, too, though, because the places will let you publish wherever you want, they need content now because of the Internet, they need so much content. There's so much crap published.
1:18:50 SC: And they don't know who to ask. In my field, there is the famous example of Bill Nye, The Science Guy showing up on CNN as an expert on climate change. They fired all their real science reporters, that's what they were left with. And Bill Nye's extraordinarily articulate and a good champion of science, he knows nothing about climate change, he's certainly not a researcher in that field, so I have mixed feelings, like, good for him but he could have said no and pointed them at somebody who was a better choice.
1:19:17 AD: And there are plenty of people who are very articulate, yeah.
1:19:19 SC: Yeah, exactly. It's worth making a little bit of an effort, if there are news producers out there. But I think I'm hardened, maybe I'm reading in, so, you should verify or fix this misimpression. After all of this, after all the controversies, after all the back-and-forth, you still seem to cling to something that seems like an optimistic view of the intersection or union of being an intellectual and being an activist, of seeking both truth and justice. It's hard, it's not linear, but it's worth the fight. Is that fair to say?
1:19:56 AD: Yeah. I think that is. I've often called myself a bitter optimist. Yeah, no, I think that's right. I like doing intellectual work, but I also feel like we have a limited amount of time on Earth and we should spend that trying to help improve the lives of others as we are able.
1:20:11 SC: I think that's a perfect place to stop. Alice Dreger, thanks so much for joining us on the podcast.
[music]
Mindscape is my new favorite podcast. Thank you for spending the time and effort doing this. Every episode so far has been amazingly informative, thought provoking and enjoyable. Keep up the great work!!
Amazing woman, great listen
Regarding the discussion (starting around 42:00) about the idea that some people transition from male to female in part because they find it sexually arousing, I have not read Dreger’s book, but I am familiar with the controversy in general, and I thought I’d write a few notes to help people better understand the background. For more information I recommend this video: https://www.youtube.com/watch?v=6czRFLs5JQo
In the podcast Carroll and Dreger are quick to emphasise “some” and “in part”, but the same is not true of the researchers Dreger is talking about and whose voices she is critised for amplifying. They really do argue that in the case of male to female transitioners who are attracted to women, sexual arousal at the thought of being women is the *dominant* motivation — and have a history of insinuating that people are lying/deluded when they report that their own experience says otherwise.
If we dismiss the universality claim (that the typology accounts for all or most transitioners in the relevant category), that leaves us with the causality claim: that the relationship between sexual arousal at the thought of being a woman and the decision to transition, is a causal/motivational one. This can be contrasted with the idea that both might stem from a common cause. These two claims — universality and causality — are what people find so offensive and invalidating.
The fact that some people *do* experience arousal at the thought of being a member of the opposite sex is well established (and I should know, but this comment is not about me). A partial correlation with gender dysphoria, and hence the decision to transition, is also well established. It is even sometimes the case that a person’s earliest awakenings of gender dysphoric feelings take the form of exactly this type of arousal. All these things are openly discussed within (parts of) the transgender community, but do not indicate that the arousal is what motivates the transition. The alternative explanation — that both, when present, stem from a common cause — respects the reported experiences of transgender people themselves.
(It is also highly unlikely that arousal could be anyone’s primary motivation to transition, because given the way hormones mess with the libido, even if one started out with that motivation one would need another to see it through.)
Dreger herself hints at a non-causal relationship when she says “I don’t think that should be that surprising because … I think for a lot of us, when our gender feelings become most vivid is actually when we’re having sex. So I don’t think there’s anything unusual in that a transgender person might have that interaction going for themselves as well”. Precisely so, and if you listen to transgender people’s rebuttals of the work Dreger describes, they often make very similar points. But Dreger does not acknowledge that it is a rebuttal, because she does not seem to understand that the causality claim (along with the universality claim) is at the heart of the controversy.
The research Dreger mentions is extremely shoddy scientifically. One way in which it is shoddy is the lack of a control group, and another is that, in the case of trans women, “sexual arousal connected with the thought of being a woman” is defined so broadly as to be unfalsifiable, whereas the same standard is not applied to cis women at all (that would be the mythical control group). I am reliably informed that arousal associated with thoughts of being a sexy woman is common among cis women as well, even if (as you’d expect) it is manifest differently.
I hope this helps people get a broader perspective on the controversy discussed in the podcast, and the video I linked to will fill in a few gaps.
Thanks, Adrian, that background is useful.
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Kudos, Sean, for being a pleasant and gracious host, and yet still willing to ask challenging questions, like after your well-spoken guest talked for a while about her natural resistance to categorization, you quote from her book that political advocacy requires an identified constituency.
It’s great to have smart guests, but even better when you ask those guests smart and insightful questions based on real study of their work. Thanks again, and looking forward to future episodes.
“my colleague Michael Bailey was set upon by a some radical transgender activists that made up a bunch of lies about him… so I looked into it because I really like things where we are all told one thing, but all the evidence says its not true…and it turned out that they knew they were lying to discredit him and prevent his ideas from getting out into the public…. So when I did that, they came after me too… It was really unpleasant.”
“What happens is, if people want to defame you, on social media its really easy, it takes on a life of its own and then people can’t figure out what’s true about you. And what can I do? There is a bunch of stuff out there about me that’s not true and I can’t do anything about it.”
And then you draw large protest crowds at your speaking events. “yeah its a very surreal thing…standing there in your own flesh and people are yelling at you about an identity they swear is yours, that you don’t recognize at all.”
WELCOME TO THE INTELLECTUAL DARK WEB ALICE DREGER!
She thinks The IDWs unifying principle is about trolling liberals or something? No, its about being lied about at having your character smeared and defamed by radical activists because the easily verifiable truths you speak somehow threaten the myths of an utterly anti-empirical dogma they hold. And the irony is that most of the Dark Webbers getting attacked are liberals themselves, speaking for liberal principles of equal rights and anti-oppression, while their radical defamers are unwittingly acting on the behalf of the Far Right and the theocrats.
I wish you could have at least gently guided her back to, “I think this kinda’ of a stuff is what they mean by the Intellectual Dark Web, Alice, but that’s just semantics, please continue…”
Apart from that nitpick, I absolutely love the new podcast Sean, I have been a super fan of your since the release of From Here to Eternity. The Big Picture is one of my all time favorites, and IS my girlfriend’s all time favorite book. (just ever so slightly edging out Max Tegmark’s Mathematical Universe.) Neither of us can wait for the new one to drop.
Keep up the fantastic work. Ever since we heard you school Sam Harris about, “not mixing terminology from different levels” as it applies to free will and moral responsibility, we were both like, “Sean seriously needs his own podcast.”