Does testosterone make you mean?

The risk-taking male hormone is blamed for everything from sexual violence to the financial crisis, but some researchers are starting to question the supposed links

Charles Ryan has a clinic in San Francisco at which he regularly relieves men of their testosterone. This chemical castration, as it is sometimes known, is not a punishment, but a common treatment for prostate cancer. Testosterone doesnt cause the disease (currently the third most deadly cancer in the UK), but it fuels it, so oncologists use drugs to reduce the amount produced by the testicles.

Ryan gets to know his patients well over the years, listening to their concerns and observing changes in them as their testosterone levels fall. Because it involves the so-called male hormone, the therapy poses existential challenges to many of those he treats. They know that every day, millions of people from bodybuilders and cheating athletes to menopausal women enhance their natural levels of testosterone with the aim of boosting their libido, muscle mass, confidence and energy. So what happens when production is suppressed? Might they lose their sex drive? Their strength? Their will to win?

The fears are not always groundless. Side-effects can also include fatigue and weight gain. But Ryan has witnessed positives, too. As professor of medicine and urology at the University of California, he has noticed that the medical students who have passed through his clinic in the 18 years that he has been treating prostate cancer invariably comment: Dr Ryan, your patients are so nice. He replies, jokingly: Its because they dont have any testosterone. They cant be mean.

Could there be some truth in that glib reply? Ryan knew his patients hadnt always been so kind. Before being robbed of their testosterone, they might have been personable and adept at small talk, but they werent nearly as interested in other people. He could feel a hypothesis coming on: that as mens testosterone levels lower, their capacity for empathy will rise. In his new book, The Virility Paradox, he argues that the fact that reducing testosterone in these ageing men may lead to increased empathy, more emotional engagement in relationships and a softening of aggression could be something of a silver lining.

Ryan started measuring his patients empathy quotients, using a survey developed for studying autism. Its too early to release detailed results, he says, but we do see increases in the empathy scores in many patients on the treatment.

He also dived into the literature on testosterone, attempting to understand what exactly was happening to them. Try as he might, however, he found little conclusive evidence for many of the claims made about testosterone, such as a link between hormone levels and risk-taking or sexual violence. Theres so much ambiguity in the science, he says. Many of the studies had been carried out on disappointingly small numbers of people.

Ryan is one of several researchers who are questioning the accepted wisdom about testosterone. It is often wheeled out as an excuse for patriarchal society, in arguments along the lines of: women, with their lower testosterone levels, have evolved to nurture and multitask in the domestic sphere, while men are hardwired to take risks, compete and furnish as many women as possible with sperm, thus ensuring the future of the species. But, as Ryan points out, obviously behaviour and cognition are extraordinarily complex and dont pivot on one molecule.

The psychologist Cordelia Fine makes a compelling case that it is our culture rather than our hormones that most influences gendered behaviours. As she writes in Testosterone Rex (winner of the Royal Societys science book prize for 2017) testosterone has been blamed for the financial crash of 2007-08, yet studies show that, although women have lower levels than men, they can have a higher appetite for risk even when it comes to financial decisions. She uncovered similar stories when it came to the evolutionary need for more sexual partners (more babies get made if women sleep around, too) and competition for status.

Fines pluck in challenging the scientific status quo could itself be viewed as classic testosterone-fuelled behaviour. She has cojones, you might say. She asserts that many typically female behaviours, such as deciding to have babies, are riddled with risk, only womens risks dont seem to count when it comes to testosterone mythology.

While Ryan comes at the subject from a different angle, both authors highlight how little research there is into testosterone in women. And yet we know it is vital to them (for example, oral contraception reduces testosterone levels, which can lead to low mood and libido). It can also influence sexual orientation, Ryan writes, with studies showing that self-described lesbians are likely to have [indications of] higher foetal testosterone levels than women who identify as heterosexual.

The lack of research, meanwhile, hasnt prevented a fierce debate about testosterones role in womens sports, with high levels seen as conferring an unfair advantage. The athlete Caster Semenya, who won a gold medal in the womens 800m at the 2016 Olympics, has extremely high natural testosterone levels for a woman. She had to prove her gender, and medically suppress the hormone before competing (although this ruling is currently suspended). Meanwhile, in 2016, the International Olympic Committee ruled that transgender women could compete without having had surgery, on condition that their testosterone levels were no higher than cisgender womens.

Not that testosterone levels are consistent in anyone. They rise and fall all the time, according to season, health, relationship and parental status, age, time of day (higher in the mornings) and emotional responses. When a man hears a woman cry, his testosterone goes down. When a person cares for their child, the bonding or love hormone oxytocin rises, while testosterone falls. If a threat to status or territory is perceived, testosterone rises again. Its the situations, the culture even, that seem to pull the hormones strings. Testosterone, in both men and women, also works in a feed-forward system: when you win at something, you get a spike in testosterone that as well as making you feel dominant and confident, increases your sensitivity to the hormone encouraging further swagger and quests to win.

Another of the hazards when studying testosterone is that there are three significant measures of how strong its force is in you. You can check levels in the bloodstream, but we already know how they fluctuate. The second measure is the number and sensitivity of androgen receptors, which vary significantly from person to person. (Testosterone is one of three hormones known as androgens, and receptors are what allow them to act on the cells in our bodies.) Third is the amount of testosterone to which we were exposed in the womb, most of which is produced by the foetus itself. This exposure is harder to gauge, although the difference between the lengths of the index and ring fingers is often used as a marker. The smaller the difference, the theory goes, the greater that foetal exposure.

This complex web, says Ryan, means that responses to hormonal suppression therapy are highly variable, based on [individuals] intrinsic biology. I have patients whose testosterone I take away and they dont have any [unwanted] side-effects. In fact, they say: I feel better. My brain is less clouded with intrusive thoughts about sex and things like that.

In a sort of mirror-image experiment, the writer Ann Mallen recently told how she accidentally rubbed testosterone cream into her skin every day for a month due to a mixup at the pharmacy. She wrote in the Washington Post that her sexual appetite became a constant distraction, as did her new persistent bouts of irrational anger. She concluded that underneath the high-pitched whine of our sex hormones, we are neither [male nor female].

Because women are more responsive than men to supplemental testosterone, they were used in one of the key studies into how testosterone essentially removes the burden of empathy from moral decision-making. Its known as the trolley car experiment. Picture a runaway tram hurtling down the tracks towards five unsuspecting workers. Theres a lever that would divert the tram to another track, but theres someone working on that track, too. You have to kill somebody to save five others, says Ryan, and you have to act fast.

The researchers at Utrecht University gave some of the subjects a shot of testosterone the night before presenting them with the dilemma. The number of respondents who were willing to kill in order to save people, and their confidence in carrying out the act were enhanced, says Ryan. And the equivocation they demonstrated was significantly reduced.

This isnt to say that empathetic people cant make tough decisions. Hormones are a bit-part in a complex cognitive picture. Aaron, a high-flying lawyer treated by Ryan, was adept at suppressing his empathy in order to win a case. But as his testosterone dissipated, he grew more caring and started asking Ryan about his family. At one appointment he asked whether getting emotional was a side-effect of his treatment, after he had wept at the end of a long-distance visit to his elderly mother. Like many patients, writes Ryan, Aaron regards these developments with a measure of surprise. Hormonal therapy hasnt been as bad as he expected, and he admits he has actually come to appreciate some of the effects it has had on him.

However, this outcome posed one worry for Ryan. A major case is heading to trial and Aaron is the lead attorney. Will having a testosterone level at 10% of normal affect his performance? he writes. The answer, it turns out, is no: Aaron had not lost his killer instinct in the courtroom.

You get the sense that Ryan sees toning down testosterone as a force for social good. Take his patient Marcus, an octogenarian who is still a keen runner. When his cancer risk was sufficiently low, he came off hormone suppression therapy and started taking supplemental testosterone to counter its effects. He would come in and talk about his half-marathon, weightlifting, his younger girlfriend, says Ryan. He never talked about anybody but himself. Eventually, he had to quit the supplements because his markers for cancer rose again. He disappears for more than a year, and comes back and is now taking care of his daughter, picking up his grandkids and being a nice grandpa. I think it is misguided for ageing men to think they should necessarily want to have high testosterone levels, because they may pay a price for that in terms of their relationships. They may be more self-centred, lack empathy.

But again, its complicated and depends on the individual. Many men, as they age, feel sluggish and lose muscle mass, lose their self-esteem, so I dont say we shouldnt ever use supplemental testosterone.

Its estimated that one in 10 men aged over 40 in the UK have low testosterone levels, which is in a large part related to obesity. Fat tissues will produce an excess of oestrogen, says Ryan, which leads to reductions in testosterone. Artificially boosting the latter could help them lose the weight, but any other benefits, Ryan warns, could be transient. A study published in the New England Journal of Medicine found that while [their participants on supplemental testosterone] felt good at first and their libidos went up, there werent long-term beneficial effects.

And, of course, they may end up impairing their capacity for empathetic relationships. But there are non-medical ways to boost empathy. In Testosterone Rex, Fine cites a 10-year US study targeting boys at high risk of behaving antisocially later in their lives. Some of them were given coaching to improve their emotional resilience, relationships and educational performance, while their parents were trained to manage their childrens behaviour. The goal was to enable the boys to respond more calmly and less vociferously to provocation. Years later, when the participants had reached their mid-20s, about 70 were deliberately provoked by someone stealing points from them in a game. Not only were the group who had been given coaching as boys less likely to retaliate; their testosterone levels rose less.

Another way, according to Ryan, is to do more childcare. Testosterone levels are 33% lower in fathers of newborns than in non-fathers, making way for a good 25% more oxytocin. This hormone, says Ryan, induces men to spend more time with their children and respond more quickly to their needs. It enables fathers to play more closely with their children, and get less rattled if they cry. (One of Ryans patients started getting down on the floor to play with his grandkids for the first time during hormone suppression therapy.) Romantic love, friendship and pet ownership open the floodgates to oxytocin, too (even a dogs oxytocin rises when it stares into its humans eyes). Less testosterone, more oxytocin, more bonding, says Ryan. Thats another, perhaps more fulfilling, feed-forward system.

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AI Beats Humans At Emotional Recognition Test In Landmark Study

Artificial intelligence (AI) has the potential to bring about a technological renaissance. Although it can’t properly mimic human behavior or thought just yet, it is trouncing us in one particular area: pattern recognition.

We’re pretty good at recognizing patterns, sure – after all, that’s essentially what basic scientific thought is. AIs, however, are now able to detect breast cancer and pick IVF-suitable embryos more accurately than medical professionals, and a new study suggests that this could apply to recognizing emotions too.

A team at The Ohio State University have applied a method humans automatically seem to use to read emotions to an AI. Ultimately, the AI proved to be better at detecting emotional states in this way than humans – although, rather surprisingly, the AI isn’t even the key finding of the research.  

Cognitively processing emotional content is something else entirely, but when it comes to detecting how someone is feeling based on their facial expression, there are multiple visual cues.

One is the hue of someone’s face, which is partly controlled by localized blood flow – something technically known as “vascular response”. As the authors note in their study, these facial blood flow changes match up to the type of expression, and its “valence” – its nebulously defined inherent “good” or “badness”.

Writing in the Proceedings of the National Academy of Sciences, the team’s hypothesis went one step further. Can a person, using blood flow color changes alone, detect the type of emotion and its valence on another person’s face if their facial expression doesn’t change?

In order to test this, they took hundreds of images of 18 facial expressions of 184 people from different genders, ethnicities, and overall skin tones, and quickly found that, via digital analysis, emotions – from simple “happy”, “sad”, and “disgusted” to more nuanced “happily surprised” and “angrily surprised” – fit into color patterns influenced by facial blood flow.

They’re not simple or uniform across the face for each emotion, mind you. When someone feels disgust, for example, the hue around the lips is different from that around the nose and forehead.

In any case, using this complex emotional palette, the team then superimposed various hues corresponding to a range of emotional states onto neutral expressions, and asked a handful of participants to guess how the person was feeling.

Remarkably, most of the time, the participants guessed correctly, including for happy hues (70 percent), sad hues (75), and angry hues (65). This all strongly suggests facial hue is a strong indicator of emotions that we quickly and involuntarily register.

They upped the ante by applying mismatching hues to other expressions too; for example, adding a “sad” hue to a happy expression. Although more difficult, the participants picked the correct emotion most of the time.

“The emotion information transmitted by color is at least partially independent from that by facial movement,” the study concludes. Based on the fact that we have little facial hair compared to our far floofier primate cousins, the study authors suggest that “recent evolutionary forces” have allowed us to transmit emotions in this unique way.

Using this new database, the team generated a basic AI that had an understanding of this emotional palette, and it’s at least as good, and sometimes better, than humanity. According to a press release, it recognized happiness 90 percent of the time, with anger (80), sadness (75), and fear (70) also being frequently detected, based on hues alone.

Once again, all this is pattern recognition, but it’s hard not to be impressed by how easily humans are defeated in this regard. In fact, this AI is so effective that the researchers have already patented and commercialized it.

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Comedian Bashes ‘SNL’ For Not Casting An Openly Gay Man In Over 30 Years

Comedian James Adomian thinks it would be nice if “Saturday Night Live” put a gay man on the show ― something they haven’t done in more than 30 years.

“I’ve been out of the closet the whole time since I auditioned 13 years ago.” Adomian told The Daily Beast at SXSW. “You would think that they would have tried to put someone else on that was a gay man. It’s about time.”

Adomian is perhaps best known for his recent portrayals of Bernie Sanders, often playing opposite Anthony Atamanuik’s impression of President Donald Trump. He appears with Atamanuik on the latter’s “The President Show” that airs on Comedy Central.

Terry Sweeney was the first openly gay regular cast member from 1986 to 1987, but since then Kate McKinnon has been just the second openly LGBTQ cast member in the show’s 43 seasons.

Danitra Vance was the first African-American woman added as a regular cast member in 1985, but it’s unclear how public she was about being LGBTQ while on the show. Not until her death from breast cancer in 1994 was her relationship with another woman made public.

Adomian doesn’t believe it’s overt homophobia, but rather executives of the show being afraid of what their audiences might think. “TV executives are the slowest cowards.”

“It certainly didn’t help that I was openly gay,” Adomian said of his “SNL” auditions. 

Adomian said that we are currently in the “golden age of gay male comics” when it comes to live shows and festivals. “We are very well-represented at live shows and on the internet. Television? Not so much.”  

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Most Rigorous Study Yet Concludes Abortion Practices In US Are Safe, Restrictions Are Riskier

A groundbreaking report from the National Academies of Sciences, Engineering, and Medicine concludes – with no margin for rational disagreement – that the abortion procedures used in the United States are safe and effective.

The 186-page review, available online in its entirety or as a tidy summary, is based on a review of the available clinical and real-world data regarding the medical outcomes and quality of the four current methods – medication, aspiration, dilation and evacuation (D&E), and induction.  

Moreover, the diverse team of expert authors found no evidence to supporting the benefit of regulations, varying state-by-state, that require abortion-providing clinics to meet stringent facilities criteria, offer pre-procedure counseling, observe waiting periods, and limit which providers can perform the procedures. Their analysis proves that these laws, passed under the thinly veiled claim that they protect women’s wellbeing, accomplish the opposite instead.

“Abortion is safer when it’s performed earlier in gestation,” Dr Hal Lawrence, CEO of the American College of Obstetricians and Gynecologists, told NPR. “And so delaying and making people wait and go through hoops of unnecessary, extra procedures does not improve the safety. And actually by having them delay, can actually worsen the safety.”

The recent national decline in abortions has been attributed to the increasing use of long-acting contraceptives, historic declines in the rate of unintended pregnancy, and increasing numbers of state regulations that limit the availability of legal abortion services. Infographic credit: The Guttmacher Institute

Although all four methods are safe, undergoing an abortion before 10 weeks is the least invasive, as women can simply take one oral dose of the medication mifepristone combined with a vaginal suppository of misoprostol. Thus, any delay to accessing an abortion runs down the clock to a point at which she would need a more intensive procedure that carries a greater risk of complications (and is offered at fewer locations).

According to the report, about 17 percent of women had to travel more than 50 miles to obtain an abortion due to the scarcity of operating clinics. And 27 states mandate that women receive counseling and then wait a prespecified time (usually 24 hours) before they can return and undergo the procedure. When these logistical situations are combined, as is common in the middle American states, women in need of abortions who lack adequate time away from work/family obligations or reliable transportation (i.e. low-income individuals) may face unjust difficulty.

When examining what resources an abortion clinic truly needs, the authors determined that the equipment, personnel, and hospital availability necessary for patient safety are no different than what other outpatient medical centers that perform procedures of similar complexity offer. As the majority of abortions are simple, they estimate that 95 percent can be performed in an office setting.

Finally, the paper calls out the misleading nature of many states’ informed consent requirements.

“Some states require abortion providers to provide women with written or verbal information suggesting that abortion increases a woman’s risk of breast cancer or mental illness, despite the lack of valid scientific evidence of increased risk,” the authors wrote. 



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New Trial Vaccine Could Treat Ovarian Cancer, But Chlamydia Increases Risk Of The Disease

Two coincidentally timed announcements offer good and bad news on ovarian cancer. Despite not being one of the most common forms of cancer, ovarian cancer is particularly hard to treat, so it causes a disproportionate number of deaths. Now, a new approach to treatment has passed Phase I clinical trials, but the problem could become worse before it reaches the market, since a separate study found that chlamydia, whose frequency is rising, is a risk factor.

Although the ovaries are less susceptible to cancer than the breasts or bowel, 22,000 American women are diagnosed with the condition each year, with similar rates elsewhere. Moreover, the disease has fewer distinctive early symptoms than many of its counterparts, so by the time it is detected, surgery, chemotherapy, and radiation may all be required. With less than half of those diagnosed surviving after five years, even with good medical facilities it is a major cause of death. Even pre-emptive action, such as that taken by Angelina Jolie to have her ovaries removed, doesn’t totally guarantee protection.

In a webinar briefing on research to be presented at the American Association for Cancer Research (AACR) Annual Meeting in April, Dr Britton Trabert of the National Cancer Institute announced two independent studies reporting cancer rates are higher among women with Pgp3 antibodies, which indicate past chlamydia infection.

Antibodies for a variety of other sexually transmitted infections were not associated with increased risk of ovarian cancer. Given that chlamydia is the most common cause of pelvic inflammatory disease (PID), and PID has been associated with ovarian cancer before, the results are unsurprising, but still concerning as chlamydia rates rebound.

Hopes for better treatment options rose, however, with the publication in Clinical Cancer Research of a trial of an immune therapy to treat the disease. Like all Phase I trials, this was done on a small sample of people, in this case, just 14. Consequently, it’s too early to tell just how effective the TPIV200 therapeutic vaccine used in the trial really is, particularly since there was no randomized control group.

Nevertheless, the trial succeeded in its goals of generating a lasting immune response, and almost doubled the usual period before disease progression began. Only one patient experienced a serious side effect. The findings were sufficiently promising and a Phase II trial is already underway. The trial also tested the responses of eight breast cancer patients to the vaccine, with similar positive effects.

TPIV200 targets the Folate Receptor Alpha, implicated in ovarian and some breast cancers. It stimulates the immune system’s helper cells to attack tumors, which should, in theory, produce far fewer side effects than chemotherapy, and has the potential to be extended to many other types of cancer.

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