Galileo’s Middle Finger: Heretics, Activists, and the Search for Justice in Science by Alice Dreger isn’t actually about Galileo and his offensive middle digit, but the two make a powerful metaphor for what this book is really about: the power of facts and reason to make a more humane, democratic world and horrifying examples of that failure. Dreger, who holds a Ph.D. in the history of science from Indiana University, is a Professor in Medical Education-Medical Humanities and Bioethics at Northwestern University who has spent much of her academic career studying not sex, per se, but the spectrum of gender. She’s also a committed activist for intersex and transgender people, an area she first stumbled into while casting about for a dissertation topic. She comes by the activism—and the affinity for Galileo—through her Catholic childhood in which she was encouraged by her Polish émigré parents to question everything and embrace science.
Like Superman, Alice Dreger believes in truth, justice and the American way, especially in science and medicine. The Tuskegee Experiments, Henrietta Lacks, thalidomide, DES, and the infection of Guatemalans with STDs in the 1940s & 50s under the auspices of Johns Hopkins and the Rockefeller Foundation are part of the tradition of both the accidental and deliberate perversion of medical ethics Dreger explores in her book. Her personal example of that failure involves the treatment of children born what is now called intersex: with deviations from “normal” genitals, and/or genetic and developmental anomalies affecting sex characteristics. One of the mind-blowing stats that Dreger points out right off the bat is that “If you add up the dozens of kinds of sex anomalies—including incredibly subtle things you might never know you had without the benefit of a lot of fancy medical scans your insurance company probably doesn’t want to cover—the frequency of intersex in the human population comes to about one in a hundred.”
The logical question you have to ask after that world-rocking bit of information is, WTF do we mean by “normal,” then? Apparently it’s just a setting on the dryer, as the meme goes. Which is precisely Dreger’s point in this case. Until all too recently, intersex children were treated by “normalizing” their genitalia (“trimming” overlarge clitorises and removing “extraneous” male or female organs) and assigning them a sex that often turned out to be at odds with either their genetic makeup or what they felt themselves to be—and without them having any say in the matter. This is the core of the problem for both intersex and transgender individuals: their physical and psychological identities challenge social ideas of normalcy in an area Americans are especially touchy about: sex. (There’s a reason the first sex change operations occurred in Europe.) But if gender—who we feel we are and how we present ourselves to the world—is indeed more of a spectrum than a binary, why can’t biological sex also be a continuum?
Intersex activist Bo Laurent of the Intersex Society of North America felt the same way, and contacted Dreger after learning of her dissertation work, describing the involuntary and often horrific treatment many intersex individuals received as children. Here’s where Dreger’s Catholic and activist background came in: “Hearing Bo’s gentle plea [to help change medical treatment of intersex children], I also found myself remembering something my mother had said to me before I left for Indiana to study the history and philosophy of science: ‘I hope you study philosophy, because maybe then you can at least help people think more clearly. History is just about what’s already finished.’” And off Dreger goes with Laurent on her newfound crusade, with all the beautiful and heartwarming zeal and naiveté of the novice activist—which she freely admits. Nonetheless, the success of the crusade is evident in laws like those just enacted by Malta, forbidding surgery on intersex individuals and by the report of the UN Special Rapporteur on Torture condemning such surgeries.
For all the squirming sensitivity and embarrassment a topic like this could possibly generate (in the average American, at least), Dreger is refreshingly forthright and irreverent in a good way. One young man approaches her for advice after a talk she has given, describing his own experience being diagnosed with androgen insensitivity syndrome and discovering he had both ovaries and a uterus, and wondering if he should have a sex change. Dreger asks him if he thinks of himself as a woman and he confesses he doesn’t, but his doctor recommends a sex change because he has ovaries. “‘Look,’ I told him, ‘I don’t let my ovaries tell me what to do. I don’t think you should let your ovaries tell you what to do.”
Dreger is as passionate as activists come, and as meticulous about her data as any scientist, which is as it should be in the humanities too. Her investigative doggedness mirrors the best old-school long-form journalists and her communication style is blunt and engaging. These four qualities are what get her more deeply involved in first changing the medical treatment of intersex, then conjoined twins, then digging into the harassment of researchers investigating the factors that influence transgender identity. Behind Dreger’s activism is what drives most human rights activists: the desire to see everyone treated equally as human beings. That extends not just to people who don’t fit the social norms or the default characteristics of human, but those who are challenging those norms and asking questions that even the activists find uncomfortable. And here is where she runs into her first fear-driven backlash of the kind familiar to Galileo.
The bulk of the book is an exploration of what happens when researchers publish or hold uncomfortable or unpopular ideas, especially those that challenge our sense of identity as is sometimes the case in fields like psychology, sociology, evolutionary science and even women’s studies. Researchers who challenge our cherished ideas about ourselves can face ostracism and humiliation by their colleagues, and even career-ending punitive measures from professional societies and academic departments if they are accused of wrongdoing in their research. Dreger discuses in-depth the cases of what came to be called the Bailey Transexualism Controversy based on a theory called Blanchard’s taxonomy and anthropologist Napoleon Chagnon’s studies of the Brazilian indigenous Yanomamo, which were sensationalized and attacked by yellow journalist Patrick Tierney in his book Darkness in El Dorado. Both of these involved what can only be called persecution of the researchers by colleagues and members of the public, including death threats and stalking, as well as outright slander and frivolous lawsuits. She also mentions in passing the attempts to discredit Margaret Mead’s work, the continuing brouhaha over E.O. Wilson’s theories of sociobiology and circles back again to her intersex work with the very current promotion of a high risk drug regimen by Dr. Maria New of Cornell Medical College and Mt. Sinai School of Medicine, with disturbing parallels to the thalidomide disaster of the 1960s.
When I say “in-depth,” I mean absolutely exhaustive. She unpacks both the original research that sparked the controversy, the accusations against it and the researcher, and the evidence of lies, fraud, professional jealousy, personal vendetta, and sometimes just outright mental pathology behind the controversy. This makes for fascinating reading in part because Dreger really knows how to tell a story and in part because the narrative itself is as tangled as any good novel, with very human motivations far beyond pure scientific truth. And this is one of the most important distinctions she makes, especially in Dr. New’s case. Most of these cases involve people who are just trying to do good science (with some exceptions) but who don’t recognize their own very human emotional investment in what they see as truth. The major takeaway from her studies is that people need to do their homework. Most of the false accusations she uncovers only got as far as they did because nobody checked the sources before rushing either to publication or judgement.
I can’t think of a better illustration for the absolute necessity of interdisciplinary studies and mutual respect between the sciences and the humanities, and this is one of the points that Dreger herself makes, if obliquely. The scientific method is one of the most wonderful inventions of human reason—when it works the way it should. But it’s practiced by humans with confirmation biases, political biases, emotional needs, governmental pressures, career ambitions, financial problems, identity questions, and a boatload of other conditions that influence our thinking. We’d like to think that the search for knowledge is above that, but it’s not, and we need researchers like Dreger to help push the search back on track when it derails and before it totally derails the careers of innovative researchers.
More than that, and the driving idea beneath Dreger’s Guggenheim-funded study of academic malfeasance, is a vision of both the university and journalism as the bastions of the search for Truth, and how necessary both are to the practice of democracy. Terry Eagleton, in a recent article for the Chronicle of Higher Education, announced “the slow death of the university as a center of humane critique.” Eagleton goes on to describe the purpose of the proverbial “ivory tower” as providing enough distance from the mainstream to offer a nuanced and objective view of a society too busy and self-absorbed to critique itself. This is exactly what Dreger is concerned with too: turning the lens of science on our social constructs like identity, the practices of medicine and research, and the university itself.
Dreger bemoans the passing of an independent press and warns of the consequences of a university system where more than half of the faculty are in non-tenure track jobs and “easy to get rid if they make trouble” but also “loaded down with enough teaching and committee work to make original scholarship almost impossible.” More importantly, she links the search for truth with the search for justice. She also reminds us that the Founding Fathers were concerned with more than just freedom from tyranny. They were crafting their own social experiment. “These guys were rightly stoked about the idea that humans working together had it in their power to know and improve the world—scientifically, technologically, economically, politically.” So she has words of advice for both activists and academics. To activists, she says, “If you want justice, support the search for truth.” To scholars (academic and independent): “Evidence really is an ethical issue, the most important ethical issue in democracy.”
As educator John Dewey said, “Democracy must be reborn in each generation and education is its midwife.” Alice Dreger is definitely one of the midwives of this generation. Would that there were more.