Mar 08 2012

# Digit length ratios and overinterpreting the data

Jen mocked this argument that Dave Futrelle highlighted on his blog. Some wacko MRAs have been diagnosing Sandra Fluke as being a lesbian with higher than normal levels of testosterone because, they say, she has “man hands”: they’ve looked at some photos of her hands and have subjectively determined that her ring finger is too long.

her ring finger is quite a bit longer than her index. It’s almost as long as her middle finger. In general, a low 2d:4d ratio in women indicates a greater proclivity towards homosexuality or bisexuality and greater tendency towards aggressiveness and assertiveness. So, yeah, pirate fits.

I hate this shit.

It’s really bad science — it’s not even science — and reflects a very poor understanding of the evidence. Yes, it is true that there has been an observation that men have relatively longer 4th digits (ring finger) compared to 2nd digit (index finger) than women. But let me show you the actual, real, quantitative raw data on this metric.

There is a statistically significant difference between those two distributions. You’ve gotta trust the math: P=0.0002. The male average ratio is 0.98, or that the index finger is 2% shorter than the ring finger, and the female average ratio is 1.0, or the two fingers are essentially identical in length.

But look at the variation! If you were given a blind assortment of ratios, you would not be able to reliably estimate the sex of the individuals. Yeah, sure, if it were a game in a casino, over many trials you might be able to make money at it, but as a guide for one on one sex determination, it sucks.

But, you say, isn’t there a reported correlation between digit length ratios and testosterone? Yes indeed there is, in men. Not in women, obviously. And here’s the raw data on that:

There is a statistical bias in the distribution, but really, if I told you the lengths of my fingers, you would not be able to use that to make significant estimates of my testosterone levels…and these differences are tiny relative to age-related changes anyway. We do not turn into women in our old age, though.

It’s a peeve of mine, though, that too often it’s considered sciencey to ignore the variation, when that’s the most interesting and important part, and reduce everything to a mean or a trend. There are morphological differences between men and women — you may have noticed — and since they’re driven to a large extent by systemic differences in hormones that regulate growth and metabolism, it’s not surprising at all that there are subtle variations in details. The question is whether they are at all significant functionally or selectively, and there’s no evidence for that at all in these ridiculous digit length studies.

Manning T, Scutt D, Wilson J, Lewis-Jones DI (1998) The ratio of 2nd to 4th digit length: a predictor of sperm numbers and concentrations of testosterone, luteinizing hormone and oestrogen. Human Reproduction 13(11):3000-3004.

1. 1
##### Thomas Sea

I always find this rizzable, if it were a reliable indicator of hormone levels it would be simple to diagnose so many conditions that are in reality difficult to find without blood tests.

2. 2
##### Becca Stareyes

My first thought wasn’t about trying to guess someone’s sexuality from tiny differences in hands, but ‘She could be a lesbian… so?” I mean, granted, lesbians generally don’t have to take birth control for pregnancy prevention, but they still might have gynecological conditions that are best treated with changing sex hormones around. And Ms. Fluke’s testimony was supposed to be about a friend, anyway.

3. 3
##### James C.

Phrenology redux.

4. 4
##### ChasCPeterson

I always find this rizzable

by all means, then, rizz it!

5. 5
##### iain

And how the hell would you correlate a physical difference, even if it were statistically significant (which it isn’t) to sexual orientation? This is not even bad non-science. Phrenology’s about right.

6. 6
##### kirklarson

Oh, so now they are saying homosexuality IS biologically determined and NOT a choice. Real consistent.

7. 7
##### unbound

Sadly, what PZ has essentially debunked above is actually better than the statistical evidence that dietary fat is bad for you. So while the length of the fingers is easily distinguishable as not even science, you might be surprised to know that dietary “science” in regards to fat intake is even less impressive…

8. 8
##### Richard Smith

So… She has so much sex that she needs the government to pay for her birth control and, because she’s clearly a lesbian, she doesn’t need to take birth control. If she doesn’t need it as birth control, then maybe she has an actual medical condition that would be alleviated by-

NO! NO! ERROR! DOES NOT COMPUTE! EMERGENCY RESOLUTION PROTOCOL ACTIVATED.

Lesbians can’t get pregnant! She’s not just a lesbian slut (I mean, is there any other type, guys? Huh? Huh?), she’s a stupid lesbian slut!

(Oooh. I think I sprained my brain with that one. I need to soak my head in Purell for an hour or two. The keyboard could use a good dunking now, too.)

9. 9
##### marcus

I’ve been going over multiple photos taken of the various aspects of her brain-pan and as phrenology and my unerring scientificalness tells me boop de boop hotcha derp! “So, yeah, pirate fits.” Please don’t question my science.

10. 10
##### lesleebeldotti

What does Sandra Fluke’s sexual orientation have to do with her testimony?

What difference does it make whether she’s gay, straight, bi, whatever? That has no impact on the legitimacy of her testimony.

11. 11
##### Thomas Sea

by all means, then, rizz it!

It must be very difficult for believers in digital-phrenology to date one another, as the question of when to bring out the calipers and compare each others’ 2 and 4 has not been settled by modern etiquette.

Most restaurants aren’t adequately lit for the activity, and waiting until both participants have retired to a hotel room, or if they’re old fashioned, the home of one or the other persons, can result in some red faces, difficult conversations, awkward goodbyes, etc.

A small pocket-light is advisable, and can be discretely concealed, without arousing suspicion.

Modern smartphones are also useful to digito-comparators, since they can store tens of dozens of characters, allowing everyone to take with them their latest measurements.

Yes, practitioners of finger-lingering may be called things like ‘weirdos’ and ‘sad obsessives’, but ultimately they are only doing what they believe is right. And who can stop them?

12. 12
##### Thomas Sea

Blockquote inversion and bolding AARRGH! (yes I know exactly what I did wrong.)

13. 13
##### What a Maroon, Applied Linguist of Slight Foreboding

This is so stupid on so many levels that it reaches a degree of meta-stupidity that can’t be measured by the normal metrics of stupidity. We need a new metric.

14. 14
##### zb24601

If we accept their point that Ms. Fluke is a lesbian (I don’t know, or care either way) for the sake of argument, what is their point? It would not invalidate what she said to Congress. It is nothing more that an attempt at a personal attack. People sometimes resort to personal attacks when they cannot argue against the facts or the logic of their opponent. I take it as an admission of their defeat.

15. 15
##### Tualha

Vivent les différences morphologiques ;)

16. 16
##### Tualha

Whoops, I spoke French. There go my chances of getting elected President…

17. 17
##### marcus

lesleebeldotti @ 10 What does Sandra Fluke’s sexual orientation have to do with her testimony?
Well obviously nothing. Except that now they can have the satisfaction of labeling her a “bull dyke” and imply that she is “not really” a woman. Simple.

18. 18
##### Glen Davidson

But it’s digital analysis. Must be at least as good as Dembski’s mathematics!

Glen Davidson

19. 19
##### Markita Lynda

Oops! It seems I’m a guy–funny how no one has noticed.

Racists used to pull this crap with other measurements, e.g “proving” that African-Americans were more “primitive” because they had had longer arms–on the order of 0.01 mm longer, that is, which can easily be accomplished unconsciously.

20. 20
##### Markita Lynda

…or maybe it was 0.1 mm–I don’t want to exaggerate!

— dimly remembered facts from my teens courtesy of Ashley Montagu and his book about the myth of race

21. 21
##### ChasCPeterson

And how the hell would you correlate a physical difference, even if it were statistically significant (which it isn’t) to sexual orientation?

It is statistically significant.
It’s the biological/functional significance that’s in doubt.
And to answer your question, it’s not a causal relationship that’s proposed, but rather that both phenotypes share a causal influence: genetic, perhaps, or the prenatal endocrine environment.

22. 22
##### ChasCPeterson

you might be surprised to know that dietary “science” in regards to fat intake is even less impressive…

I might indeed, had you supplied a link or reference to back up your anonymous internet assertion.

23. 23
##### Amphiox

Of course this criticism (that the variation between individuals easily overwhelms the differences in any between-group averages, regardless of statistical significance) applies to virtually every gender-based comparison of anything and everything, except presence of genitalia subtype and ability to give birth.

This is a case of something that is statistically significant, but clinically insignificant.

Sometimes I wonder, though, if the inability/reluctance to appreciate the significance of variation in comparison to means is an inbuilt feature of human brains, so often is this category of error made. And I wonder if some of the resistance to evolution in some quarters is partly contributed to by this.

24. 24
##### What a Maroon, Applied Linguist of Slight Foreboding

I might indeed, had you supplied a link or reference to back up your anonymous internet assertion.

Well, I certainly took it as an excuse to have a butter-and-bacon sandwich for lunch.

25. 25
##### F

Even assuming any or all items in this faulty reasoning are true, it still doesn’t make sense. Chain fail. (Or fail chain, whichever or both.)

What I see = true finger length. Finger length = testosterone. Testosterone = lesbian. Lesbians = PIRATES + SLUTS. (And lesbian pirate sluts have sex five time a day (apparently with men), which requires lots of contraceptives for which they demand that everyone else pay because pirates = freetards.)

This is a Well Reasoned Argument from Facts, my friends. Feel my WRAF!.

26. 26
##### Markita Lynda

It was not *testimony.* She was not sworn in to testify! She made a statement in front of a panel of Democrats. She did not speak before a Congressional committee.

Thank you for your attention to this detail.

I have already encountered one Dimbulb supporter frothing at the mouth with indignation because Ms. Fluke “LIED before a Congressional Committee in her sworn testimony by saying that she had seen the faces women affected by their lack of insurance as they walked across campus, and therefore she should be disbarred!!!!”

I pointed out that since 40% of the students said that they had difficulty paying for those prescriptions, she had undoubtedly seen some even if she didn’t know who they were, and that furthermore she had spent three years working with a group trying to get the university to allow the students to have the insurance and interviewing people affected by it, she may well have seen someone. I didn’t bother to say she also came with a group of supporters who–guess what–probably got involved because they were affected. I did say that it could be a rhetorical statement and it still wouldn’t be a disbarring offence. Some people are just desperate to find mud to fling.

27. 27
##### Markita Lynda

Since Ms. Fluke’s point was that a substantial proportion of women who need hormonal pills are not using them for birth control, if she were a lesbian it would just help to prove her point. Otherwise, it’s irrelevant.

28. 28
##### Kevin

Ahem…why do lesbians need contraception?

Some dumbasses are dumber than other dumbasses, but this is probably the Holy Grail of dumbassery. The most perfect dumbassed contention in the history of dumbassery.

Books will be written in the future about how this level of dumbassery could never be achieved again.

The Platonic Ideal of dumbassery.

29. 29
##### Richard Smith

The best metric to use against the sorts who (ab)use this sort of statistics is actually the length of the finger between the index and ring fingers. We should all extend this digit to these worthy statisticians so that they may measure them!

30. 30
##### Ms. Daisy Cutter, Gynofascist in a Spiffy Hugo Boss Uniform

My next band will be called the Lesbian Pirate Sluts.

What a Maroon:

This is so stupid on so many levels that it reaches a degree of meta-stupidity that can’t be measured by the normal metrics of stupidity. We need a new metric.

The MRAU (Men’s Rights Asshole Unit).

Example: “Last night’s speech by Santorum topped out at 4.7 MRAUs, handily beating the current 3.5 record achieved by Michelle Bachmann.”

31. 31
##### ruteekatreya

This is so stupid on so many levels that it reaches a degree of meta-stupidity that can’t be measured by the normal metrics of stupidity. We need a new metric.

…Like the Imperial System?

*Hides*

32. 32
##### daniellavine

Hmm, my soft-spoken introvert decidedly non-athletic definitely straight mother has an incredibly long ring finger relative to her index, as do I, her soft-spoken introvert decidedly non-athletic sexual-orientation-ambiguous son. By like a full inch in both cases. We can haz moar tosterone now?

33. 33
##### daniellavine

Also, I’m not sure testosterone levels are the least bit correlated with sexual orientation. This American Life did a whole episode on testosterone (here, listen, it’s awesome) and the person with the most testosterone — by a VERY wide margin — was the only gay guy in the group. (The guy with the lowest testosterone was the only sports-watchin’ gender-conformin’ male in the bunch.)

34. 34
##### Susannah

Markita Linda # 19

Oops! It seems I’m a guy–funny how no one has noticed.

Same here. Most definitely a man. And not even my kids noticed.

These days, when I look at my hands, I see my mom’s; they’re a close match, especially in the length and proportion of the fingers. Which means my mother was a man, too. And at least one of my daughters.

35. 35
##### ikesolem

Actually, what scientific evidence there is on the topic of genetic determinants of sexual orientation points towards pheromones. See for example:

In contrast to heterosexual men, and in congruence with heterosexual women, homosexual men displayed hypothalamic activation in response to AND [a testosterone derivative, 4,16-androstadien-3-one]. Maximal activation was observed in the medial preoptic area/anterior hypothalamus, which, according to animal studies, is highly involved in sexual behavior.

The finger length business is just more phrenological Bell Curve-type nonsense.

36. 36
##### Ing: I Have No Mouth and I Must Scream So I Comment Instead

Actually, what scientific evidence there is on the topic of genetic determinants of sexual orientation points towards pheromones.

You sure? Last I heard humans do not have ‘pheramones’ like that.

37. 37
##### ikesolem

P.S. P.S. On this association-based claim:

Sadly, what PZ has essentially debunked above is actually better than the statistical evidence that dietary fat is bad for you.

As compared to non-dietary fat? What is that, the kind you rub all over your body? What the science actually says is that certain kinds of fats are not so healthy – trans fats and saturated fats, particularly in large quantities – i.e. animal fats and hydrogenated fats. Unsaturated vegetable fats are the easiest to digest – sunflower oil and olive oil are good choices.

Furthermore, a biochemist would tell you that the ratio of fats to carbohydrates (and to proteins) in the diet is also important, along with the ratio of overall caloric intake to physical activity, when it comes to health. Incidentally, this also points to high-protein weight-loss regimes being very unhealthy.

38. 38
##### Blattafrax

#22

you might be surprised to know that dietary “science” in regards to fat intake is even less impressive…

I might indeed, had you supplied a link or reference to back up your anonymous internet assertion.

http://jama.ama-assn.org/content/288/20/2569.full.pdf
p<0.05 for every study reviewed – I’ve not looked at them all, but that generally means 0.05>p>0.01.

It never ceases to amaze me that fate is so random. About the only things that are really certain to make you more ill than when you started are aging and smoking. Not being female (as in an absence of estrogen) is not so good for lots of ways of dying as well, but even this isn’t all that predictive.

39. 39
##### Ing: I Have No Mouth and I Must Scream So I Comment Instead

About the only things that are really certain to make you more ill than when you started are aging and smoking.

Would you care for some Cyanide Chip Cookies?

40. 40
##### Blattafrax

@Ing:
Show me the double blinded mortality/morbidity trial results and I’ll concede your point.

or alternatively I’ll have another espresso and go “ARRRRGH!”

41. 41
##### Lynna, OM

So what if the two digits in question are the same length on one hand, but different on the other hand?

Does this mean I taste especially good when slow baked?

42. 42
##### Ing: I Have No Mouth and I Must Scream So I Comment Instead

Show me the double blinded mortality/morbidity trial results and I’ll concede your point.

Just to be sure. You are joking right? You’re not actually questioning the high toxicity of cyanide?

43. 43
##### neogeshel

Nobody thinks that it’s inherently interesting that 2D:4D is slightly sexually dimorphic. The reason that psychologists are interested in it is that it might be sexually dimorphic because of differences in prenatal androgen exposure, so some people want to use it as data in trying to understand how other traits are related to prenatal androgen exposure, like sexual orientation and gender-atypicality. When you’re dealing with human beings you regularly have to deal with data that someone with a more general interest in mechanisms irrespective of species wouldn’t wipe their ass with.

44. 44
##### neogeshel

We’d like to dissect human babies, really we would, but we can’t, so we do what we can…

45. 45
##### Richard Smith

Just did the math, measuring from mid-knuckle to uncompressed fingertip, and got a ratio of 0.9. This, of course, means that I have tons of testosterone! I know this is true. It’s in three boxes of little foil packets I keep forgetting to apply nightly.

I can haz bigger pituitary?

46. 46
##### daniellavine

@neogeshel:

Sure. First of all, what does that have to do with the sort of irresponsible claims based on this data as highlighted in the OP?

Second of all, how much evidence is there that the 2D:4D is actually the result of prenatal androgen exposure?

Finally, how much evidence is there that prenatal androgen exposure affects sexual orientation?

47. 47
##### mnb0

Just checked. I have to stretch my index finger a bit, but then it’s as long as my ring finger. So apparently my penis notwithstanding I am female.

48. 48
##### rrainsmd

Since Ms. Fluke’s point was that a substantial proportion of women who need hormonal pills are not using them for birth control, if she were a lesbian it would just help to prove her point.

Hmm… but the rational for covering contraception without co-payment is that it is preventive medicine and cheaper than pregnancy, so contraception gets special status. If they aren’t using it for contraception, why should they get special status? Why can’t women pay the same amount as, say, a heart failure patient?

As a physician, I certainly have nothing against contraception, but there are a lot of medications I’d rather see available for free than birth control pills.

-RR-

49. 49
##### daniellavine

As a physician, I certainly have nothing against contraception, but there are a lot of medications I’d rather see available for free than birth control pills.

As a physician you may want to defer to your colleagues who specialize in women’s health on this issue.

And why not both?

50. 50
##### Jerry

As a scientist, I am offended at this misuse of biology and statistics. As a native Noo Yawkuh, I got the finguh dey’re lookin’ for right heah. *waves digitus impudicus* (Richard in comment 29 already make this point, but I felt that I must add my own. Let’s give them more finger length “data” to analyze.)

One cannot use and abuse scientific data that supports the case that Futrelle and others are making, but ignore the data which utterly refutes you. The variation of digit length ratios within genders is greater than the difference between them. This is the exact same kind of blinded mindset that accepts scientific claims for racism but ignores the fact that genetic diversity within races is greater than the genetic difference between races, i.e. we overlap more than we diverge. (Not that the term “races” is very useful when speaking of human diversity. See http://en.wikipedia.org/wiki/Race_%28classification_of_humans%29#.22Within.22_versus_.22between_group_variation.22)

51. 51
##### Blattafrax

@Ing:
I was more concerned if you washed your hands before you started baking.

Yes, I was joking.

52. 52

can someone explain to me what Jerry thinks he’s arguing against?

53. 53
##### daniellavine

He’s arguing against Futrelle’s spurious argument and comparing it to spurious race/IQ arguments.

54. 54
##### daniellavine

“Specious.” I meant “specious.”

55. 55

what specious argument did Futrelle make, exactly?

56. 56

daniel, could it be that you and Jerry are shooting the messenger because you didn’t actually follow the link? is that what’s going on?

57. 57
##### SallyStrange: bottom-feeding, work-shy peasant
Since Ms. Fluke’s point was that a substantial proportion of women who need hormonal pills are not using them for birth control, if she were a lesbian it would just help to prove her point.

Hmm… but the rational for covering contraception without co-payment is that it is preventive medicine and cheaper than pregnancy, so contraception gets special status.

What special status? Is “preventative medicine” a special status now? I thought it was just a designation for the type of medicine you take regularly to… you know, prevent thing rather than deal with things that already happened.

If they aren’t using it for contraception, why should they get special status?

Because they’re using it to prevent OTHER health problems, as in the case of Ms. Fluke’s lesbian classmate, ovarian cysts.

Why can’t women pay the same amount as, say, a heart failure patient?

I don’t even know what you’re trying to say here. Women do pay the same amount (as men, I presume? men is the default here?) for their policies. Why should they be forced to essentially pay twice, just because their employer has some weird ideas about morality and sex? Are there treatments that, when taken every day, prevent heart failure? Well, those should be free as well. Also, note the interesting juxtaposition of “women” vs. “heart failure patients”–apparently this physician has never heard of a female heart failure patient.

As a physician, I certainly have nothing against contraception, but there are a lot of medications I’d rather see available for free than birth control pills.

As a physician, you should be embarrassed by your ignorance. I’m not a physician and apparently I’m more informed than you.

58. 58
##### cbailey

Phrenology pure and simple.

That aside, I have no problem with Fluke humping herself to exhaustion as she would then be too tired to hump us. She is a moocher who wants the government to take from us and give to her.

Taking is not giving. Not giving isnt taking. Defining ‘denying access’ as a refusal to pay for something for someone else is ludicrous.

One thing is for certain, if you are a politician who has created a giant \$h!t-mess, you can easily distract people by yelling ‘sex!’. All heads will instantly turn away from real problems.

59. 59
##### daniellavine

daniel, could it be that you and Jerry are shooting the messenger because you didn’t actually follow the link? is that what’s going on?

I did follow the link, actually, but I have never read manboobz before so I mixed the names up. Sorry.

60. 60
##### curtisnelson

It’s encouraging at least that these people are acknowledging that sexual orientation has a biological basis.

61. 61
##### daniellavine

That aside, I have no problem with Fluke humping herself to exhaustion as she would then be too tired to hump us. She is a moocher who wants the government to take from us and give to her.

Taking is not giving. Not giving isnt taking. Defining ‘denying access’ as a refusal to pay for something for someone else is ludicrous.

Where do you idiots come from? And why is it so hard for you to do the two minutes of googling required to figure out that this is has nothing at all to do with what Fluke was testifying about?

The government does not pay for Fluke’s insurance. Fluke does. So when she gets birth control covered by health insurance she is getting what she has already paid for. She is not wrangling any money from you or the “gummint”. Cripes, dude, educate yourself.

62. 62
##### rrainsmd

As a physician you may want to defer to your colleagues who specialize in women’s health on this issue.

Why should I? Do you think they have some special expertise in how overall healthcare dollars should be spent?

Certainly if the healthcare pot were bottomless, I’d like to see all medications given away for free, but I don’t expect to see that in my lifetime. In the meantime, the gynecologists shouldn’t get the final say, and my opinion is probably no more valid than yours. It’s really a political issue, not a medical one. In the meantime, someone has to decide how to spend the money and I haven’t seen a good explanation for why contraception should go to the top of the list. It’s a perfectly legitimate question and I suspect the answer has more to do with women’s votes than their health.

-RR-

63. 63
##### daniellavine

In the meantime, the gynecologists shouldn’t get the final say, and my opinion is probably no more valid than yours. It’s really a political issue, not a medical one.

So casually mentioning you’re an MD was a non sequitir? I agree.

In the meantime, someone has to decide how to spend the money and I haven’t seen a good explanation for why contraception should go to the top of the list. It’s a perfectly legitimate question and I suspect the answer has more to do with women’s votes than their health.

Or you could google “birth control health care” and figure out for yourself whether that’s the case. Hint: it’s not. (You can kinda tell because this issue didn’t come up as an election issue in the first place.)

64. 64

so contraception gets special status.

what “special status”? it’s preventative medicine (medicine used to prevent other pedical conditions from arising) as other kinds, so whence the “special”?

If they aren’t using it for contraception, why should they get special status? Why can’t women pay the same amount as, say, a heart failure patient?

what is this incoherent crap? contraception used to prevent the appearance and growth of cysts, is preventative medicine.

As a physician, I certainly have nothing against contraception, but there are a lot of medications I’d rather see available for free than birth control pills.

rather obviously, all medicine should be “free” at the point of use. but since the US is a backwater on this issue, better to make all preventative medicine free, since it’s cheaper and improves quality of life a lot more than after-the-fact medicine

65. 65

Certainly if the healthcare pot were bottomless, I’d like to see all medications given away for free,

honeybunch, do you know that medical systems where “all medications [are] given away for free” are cheaper than the US system? and that the US system will be cheaper if all preventative medications are given away for free?
Your hypothetical is backwards. BECAUSE the pot isn’t bottomless, preventative medicine, all of it, needs to be free to access.

In the meantime, someone has to decide how to spend the money and I haven’t seen a good explanation for why contraception should go to the top of the list.

it isn’t “at the top of that list”, it’s simply in exactly the same spot as all other preventative medicine, in that it lowers medical costs and improves health and wellbeing of people by minimizing the occurrence of bad medical conditions.

66. 66
##### Geral

Wait. Does this mean we lost our chance to question the sexuality of the men who spoke in front of the congressional panel??

67. 67
##### michaelbusch

@unbound: Citation needed. Also a more precise definition of what you mean by “dietary fat” and “bad for you”. Clearly, a diet of nothing but fat would be very bad for you, as would a diet with no fat at all. The question is what the optimal diet is.

68. 68
##### carlie

Women ARE taxpayers. Women ARE workers. Women EARN their health care every day of the year. If you think for a hot second that a health insurance package is a mere courtesy bestowed on you by a kindly employer, I pity you for sipping the antifreeze so willingly. Do you realize who is really benefiting from that freedom of conscience you so raucously defend? It isn’t you, that’s for sure. You have just given away your rights to decent employment, by framing health insurance as a sort of largess sprinkling down from the corporate king. How easily you sell away your own labors, your own bodies, pretending you haven’t given up your choices because you pay “out of pocket.” Thinking you’re the harder worker because you’ve agreed to accept less than what you’re due. No, I’m afraid that doesn’t make you heroic. It makes you dreadfully, painfully gullible.

69. 69
##### Dr. Audley Z. Darkheart, purveyor of candy and lies
Oops! It seems I’m a guy–funny how no one has noticed.

Same here. Most definitely a man. And not even my kids notice

Damn it, me too. *sigh* I guess I’ll have to check the contents of my pants later.

rrainsmd:

In the meantime, someone has to decide how to spend the money and I haven’t seen a good explanation for why contraception should go to the top of the list.

So a relatively safe, relatively cheap-to-produce, extremely effective AND cost-saving drug should be more expensive/difficult for women to access, yes?

If you’re a really real real MD, I’ll eat my hat.

70. 70
##### rrainsmd

“What special status? Is “preventative medicine” a special status now?”

Yes. When the current plan is fully implemented, you won’t be allowed to charge a co-payment for it. That is different than treatments for heart failure or cancer or multiple sclerosis. It’s special status. (And just to head the next ad hominum off at the pass, the co-payment wouldn’t go to me. I have no financial interest in this issue.)

“Because they’re using it to prevent OTHER health problems, as in the case of Ms. Fluke’s lesbian classmate, ovarian cysts.”

In general , if she has a history of ovarian cysts, it is considered a therapeutic, not a preventive use of the medication. Please trust me on this.

“Also, note the interesting juxtaposition of “women” vs. “heart failure patients”–apparently this physician has never heard of a female heart failure patient.”

And now you’re just being silly. Of course I know of female heart patients. And they have to pay \$10 or \$20 a month for each medication while women who have absolutely nothing wrong with them can get their meds for free. Does this really make sense to you?

“As a physician, you should be embarrassed by your ignorance. I’m not a physician and apparently I’m more informed than you.”

Ah no… apparently you’re not

-RR-

71. 71
##### Alethea H. Claw

(Fluke) is a moocher who wants the government to take from us and give to her.

Wait, what? When did the US get a public health system?

72. 72
##### Dr. Audley Z. Darkheart, purveyor of candy and lies

Carlie,
I love the implication of that article– that someone else* is paying our healthcare costs and women are just apparently getting shit for free. I hadn’t thought about it that way before.

*You know, men. ‘Cos men are still the breadwinners or some shit.

73. 73
##### daniellavine

In general , if she has a history of ovarian cysts, it is considered a therapeutic, not a preventive use of the medication. Please trust me on this.

You’ve already admitted that on this particular issue your opinion isn’t necessarily worth more than any of ours. And you specifically said that gynecologists shouldn’t be making this sort of decision.

Which leaves me a little confused. Who do you think should make these sorts of decisions? Bureaucrats at health insurance companies? Should we freeze medical experts out of these discussions entirely?

Did you bother doing any research into why it might make sense to cover birth control as preventative medicine? Or are you just here to offer your opinion “as a physician” regardless of whether it’s actually based on anything?

74. 74
##### A. R

Oh, fun. Now the MRAs are throwing their bullshit into this shitshow.

75. 75
##### robro

I’m confused. Somehow these MRA wackos got from some pictures of Fluke’s hands (really? how good were they?) to some statistical woo doo about finger lengths of men, and therefore…Ms Fluke is a Lesbian? It would be one thing if they said she’s a man, but their conclusion doesn’t follow from the evidence assuming you accept the evidence and the questionable use of the statistics. Are they assuming that women with “male characteristics” (whatever that may be) must be Lesbians? I gather they haven’t known many Lesbians, or women.

But really, the question is…so what? What difference could it possibly make to her testimony or the subsequent incident if her fingers aren’t the right length or she’s a Lesbian or even if she’s a biological male. That doesn’t undermine what she said and it doesn’t make what Rush Limbaugh and others have said about her OK. They are still rude and they are still lying.

And, these MRA guys are sounding a lot like Rush, except instead of “slut” they’re saying “Lesbian” and they’re pretending to have “evidence”…of something or the other.

76. 76
##### keithpeterson

I’m more interested in how fingers and toes are formed, and what protein interactions cause them to form.

Oh man, I’m such a nerd.

77. 77
##### SallyStrange: bottom-feeding, work-shy peasant

“What special status? Is “preventative medicine” a special status now?”

Yes. When the current plan is fully implemented, you won’t be allowed to charge a co-payment for it. That is different than treatments for heart failure or cancer or multiple sclerosis. It’s special status. (And just to head the next ad hominum off at the pass, the co-payment wouldn’t go to me. I have no financial interest in this issue.)

Ah, so when you said, “special status,” you meant “preventative medicine. Jadehawk already laid out the reasons it’s a good to provide preventative care for free. You seem to be trying to convince me that hormonal therapy (AKA birth control) is not preventative medicine. Yes, it is different from treating heart failure or multiple sclerosis. Treating heart failure or multiple sclerosis after the fact is, by definition, not preventative care. Make your case or shut up.

“Because they’re using it to prevent OTHER health problems, as in the case of Ms. Fluke’s lesbian classmate, ovarian cysts.”

In general , if she has a history of ovarian cysts, it is considered a therapeutic, not a preventive use of the medication. Please trust me on this.

I’m having trouble trusting you on this, because as the story went, the classmate was at risk of ovarian cysts, and was prescribed hormonal therapy to prevent it, but was not able to afford it and stopped taking it, and thus developed a cyst, which resulted in having to have her ovary removed. If that’s not preventative medicine, then I have severely misunderstood the meaning of “preventative medicine.”

“Also, note the interesting juxtaposition of “women” vs. “heart failure patients”–apparently this physician has never heard of a female heart failure patient.”

And now you’re just being silly. Of course I know of female heart patients.

No, I’m not being silly. I’m pointing out your implicit bias for men and against women, which leads you to speak of men as the default setting for human being, and women as a deviation.

And they have to pay \$10 or \$20 a month for each medication while women who have absolutely nothing wrong with them can get their meds for free. Does this really make sense to you?

Yes, it does, because failing to provide those medications will lead to lead to more expensive, intensive medical complication later down the line. That’s why they’re called “preventative”–because you give them to healthy people to prevent them from developing medical complications or illnesses. Like I said, if there were a medication you could give to people at risk of developing heart failure to prevent heart failure, that were far cheaper than the cost of treating heart failure, those medication would be classed as preventative too and would be provided without a co-pay.

You aren’t coming off as too bright here. I have to agree with Audley, your claim to M.D.-hood isn’t sounding super convincing right now. Feel free to demonstrate otherwise.

78. 78
##### 'Tis Himself, OM

I’m more interested in how fingers and toes are formed, and what protein interactions cause them to form.

Me too.

79. 79
##### 'Tis Himself, OM

This is one of my bêtes noires: the word is “preventive”, not “preventative”. There’s no need even for a Brit to put an extra, extraneous syllable in the word preventive.

80. 80

while women who have absolutely nothing wrong with them can get their meds for free

um yes, that’s what “preventative” means. it prevents them from having something wrong with them. if you can’t make all medicine free at the point of access, then yes, preventative medicine should be the kind to be prioritized

81. 81
##### Gregory Greenwood

her ring finger is quite a bit longer than her index. It’s almost as long as her middle finger. In general, a low 2d:4d ratio in women indicates a greater proclivity towards homosexuality or bisexuality and greater tendency towards aggressiveness and assertiveness. So, yeah, pirate fits.

Not only does this anti-scientific blather tell us nothing about Sandra Fluke’s sexuality, her sexuality is also totally irrelevant to the topic she was discussing.

I get the distinct impression that these cretins put forward this tripe in the belief that a ‘charge’ of lesbianism was the most damning indictment possible, something that would automatically destroy Fluke’s credibility – and in the eyes of their fellow backward bigots it probably does.

It is bad enough that they are so repugnantly misogynist and homophobic, but it is even worse that they are trying to subvert the authority of science by seeking to breathe a vague semblance of life back into the rotting, pseudo-scientific corpse of phrenology in order to try to gloss their hatred with a veneer of credibility.

But the thing that bothers me the most is that, in much the same way as Deepak Chopra’s quantum woo, some people will inevitably buy into it because it sounds vaguely ‘sciencey’, no matter how little sense it makes.

82. 82
##### alwayscurious

LOL! OMG, just looked up in pubmed “Manning JT” beings he was the lead author on the paper. According to him, the 2:4 digit length ratio explains everything from athletic success and homosexuality to autism & migraines and more! I call BUSHLLIT!!!

Next off, mandated coverage doesn’t imply that it’s free to anyone: benefits are paid for by premiums (newsflash, that’s how insurance works). Premiums are paid for by the people who will eventually receive this care.

–AND–

Coverage doesn’t imply free to patient (co-pay, deductibles, and partial coverage may all come into play).

Federal & State governments mandate health insurance companies to offer all kinds of coverage, under varying circumstances:

Some states specifically list professions whose work must be covered such as optometrists, dentists, and chiropractors (sic),

Some states specifically list certain services be covered such as home health care, organ transplant, and diabetes treatment,

Some states (maybe the fed?) specifically require that certain types of plans must also cover children (biological & adopted) up to a certain age.

So now that we’ve barely begun to scratch the surface of what government already requires of the health insurance industry–including rare & common conditions, cheap & expensive ones, Why are we crying over covering birth control?!? (already mandated in a number of states)

–Because Congress is full of moral blowhards who want to oppress women and this is one easy thing they can do to make that happen.

OR

–Because Congressmen want to get reelected and expect that religious bigots will reelect them because of this well-publicized stunt

OR

????? (I’m convinced nothing positive or progressive could possibly explain this situation)

I think Sandra Fluke has grounds for a lawsuit over the needless abuse she’s suffered. She’s handling it all very well and should get commended for such.

http://oci.wi.gov/pub_list/pi-019.pdf

83. 83
##### alwayscurious

OOoh, also WI requires that all plans offering prescription coverage must include coverage for HIV meds for HIV patients. Much more expensive & not the least bit preventative. And a very good idea!

84. 84
##### A. R

rrainsmd: I must say that for an MD, your grasp of the concept of preventative vs. therapeutic medicine is somewhat tenuous.

85. 85
##### StarStuff, an uppity feminist

The Republicans and the religious right can make all the fuss they want, but in a year I’ll be getting ALL the free contraceptives!

If you ever want to really piss of a Republican, tell them that you already get birth control pills for free from the government (aka, the health department). I’ve done it before. You should see their faces :D

86. 86
##### alisonstreight

To think I have reached senior citizen status, and based on my hands, I am a lesbian. What a shock! Since I’ve always been very attracted to men and find women a bit icky, something doesn’t compute. Maybe I should have been a gay male. That’d fix it.

87. 87
##### Aquaria

I wonder what the resident “physician’s” license number is, so I can lodge a complaint about his utter incompetence. He’s a danger to female patients, just breathing.

I mean, my good ol’ GP knew to give me BCP when I was having a rather bad problem with menorrhagia, but this fuckfaced quack arguing against contraception coverage would prefer that someone like me in that situation bleed to death rather than making sure I had access to a medication through insurance THAT I FUCKING PAY FOR and that would save my if. I mean, I was only bleeding so much that I was going into hypovolemic shock from the blood loss, no big deal, right, you fucking quack?

rrainsmd, you’re either a fucking lying piece of shit fraud who is no doctor, or you’re the worst doctor in America needing your license pulled right fucking now before you kill someone–if you haven’t already.

88. 88
##### A. R

Aquaria: I’m not sure if I would use your language, but I do agree with the sentiment. rrainsmd is acting like those idiotic fundies who think that oral contraception exists for the sole purpose of allowing “sluts” to avoid their “punishment” for enjoying sex. I mean, it’s not like it can be used to treat polycystic ovary syndrome, endometriosis, adenomyosis, menstruation-related anemia, painful menstruation, estrogen related migraines, and acne, and may have some effect in preventing cancer. No of course not, it’s just for sluts and whores who want to have tons of sex without getting pregnant.

89. 89
##### A. R

Correction of my above: may have an effect in preventing certain> cancers.

90. 90
##### carlie

Why wasn’t there any fuss raised at all when Viagara and Cialis came out and were immediately covered by almost all prescription plans?

91. 91
##### carlie

Funding birth control could save the US 1.32 billion dollars a year.

92. 92
##### A. R

carlie: Yes, one does wonder, considering that they are almost never used for any other purpose than to allow men to have sex. (Granted sildenafil (the active compound in Viagra) can be used to treat pulmonary hypertension and altitude sickness, and tadalafil (Cialis) can be used to treat BPH in men with ED)

93. 93
##### A. R

Vardenafil (Levitra), however, is totally useless for any other purpose other than given men erections as far as I know.

94. 94
##### rrainsmd

I’m having trouble trusting you on this, because as the story went, the classmate was at risk of ovarian cysts

The only way I know of to be “at risk” for ovarian cysts is to have had ovarian cysts. She either had chronic anovulation or polycystic ovarian disease. If you have never had a cyst, there is no test that predicts your risk of getting one down the line. The birth control pills in this case were a treatment for a known disease. My original point was that free contraception was originally justified as “preventive” but when they realized that meant actually endorsing sex, they switched to the argument that hormones have therapeutic uses as well. They are talking out of both sides of their mouths.

Yes, it does, because failing to provide those medications will lead to lead to more expensive, intensive medical complication later down the line. That’s why they’re called “preventative”–because you give them to healthy people to prevent them from developing medical complications or illnesses.

We are still talking about contraception here, right? I don’t consider pregnancy an illness.

Sure, pills or depo provera save the system money by preventing some costs of pregnancy care. But by the same token, treating CHF saves money by preventing unnecessary hospitalizations. On a patient by patient basis, I’m betting CHF care saves way more money than OCPs. Yet we expect our elderly to share the cost of their medications. Why is it wrong to expect the same of young, healthy women?

Look… I have nothing against contraception. I don’t even object to free contraception. If patients want it and it sells insurance policies, fine. But I don’t exactly understand why we need a federal mandate for free contraception. My question is not why Lo-Ovral is a good thing. My question is why is Lo-Ovral more important than carvedilol.

-RR-

95. 95
##### A. R

rrainsmd: Think of it as a one at a time approach. Eventually (perhaps very soon if we can get Democratic majorities) we can strengthen the health care bill to a point where medications are indeed free at point of use. Saving insurance companies and the government money on prenatal and pregnancy care is one way of proving that health care reform is good for everyone.

96. 96
##### A. R

Bisoprolol is better in some cases anyway.

97. 97
##### DLC

Yes, because anyone with long fingers must be a Pirate ?
And how did we conflate Pirate with Lesbian ?
What, now all Pirates are Lesbians ? You mean I have to give up sailing the seven seas, raiding Spanish ships for booty, or be a lesbian ?
In other words: this is the stupidest damn idea I’ve seen since Ross Perot ran for President.

98. 98
##### rrainsmd

honeybunch, do you know that medical systems where “all medications [are] given away for free” are cheaper than the US system? and that the US system will be cheaper if all preventative medications are given away for free?

honeybunch? really?

I don’t claim to be an expert on the world’s medical systems, but I’m pretty sure it isn’t the giving the drugs away that makes them cheaper. The fact that pharmaceutical companies sell meds to Mexican pharmacies for a fraction of what they sell them for here is a whole ‘nother issue.

But within our system I don’t think you can show that giving away preventive meds is cheaper. I don’t have any figures, but I have abounding faith in US health insurers to look after their own interests. If giving away contraceptives made them more money than charging a co-payment for them, they would already be shipping them for free. I guarantee it.

-RR-

99. 99
##### Dr. Audley Z. Darkheart, purveyor of candy and lies

A. R:

rrainsmd is acting like those idiotic fundies who think that oral contraception exists for the sole purpose of allowing “sluts” to avoid their “punishment” for enjoying sex.

Even so, planned pregnancies are a healthier option for women and I’m surprised that a (*snerk!*) medical doctor would refuse to see that.

I know that Ms Fluke’s testimony would have been about the dangers of not treating ovarian cysts*, but (to me, at least), that’s kind of beside the point. Women’s health and well-being in general is dependent on being able to access reliable birth control. Family planning is absolutely essential to women’s physical, mental, and economic health.

In all honesty, we need to demand to have the freedom to be “sluts”, because that’s the fucking point. If the Pill was only used to treat ovarian cysts and the like, chances are we wouldn’t be having this conversation. The jackasses who would limit access to the pill are terrified of women’s sexual freedom, because if we’re not barefoot and pregnant, we’re so much harder to control.

But whatevs. RR can continue to be completely deluded. It’s not like 99% of women in the US have used some sort of birth control or anything.

*Which I have suffered. And they’re totes not fun. But I do have cool surgery scars, so there’s that.

100. 100
##### A. R

Audely: Very true, but given the conservative climate that we find ourselves in (whether artificially created or not) it is understandable why some would choose to focus on the therapeutic factors. Naturally, this isn’t the best long-term strategy, as the fundies are eventually going to have to face the fact that normal women can like sex, just like it took them awhile to realize that women like sex at all. (Remember hysteria)

101. 101
##### SallyStrange: bottom-feeding, work-shy peasant
I’m having trouble trusting you on this, because as the story went, the classmate was at risk of ovarian cysts

The only way I know of to be “at risk” for ovarian cysts is to have had ovarian cysts. She either had chronic anovulation or polycystic ovarian disease. If you have never had a cyst, there is no test that predicts your risk of getting one down the line. The birth control pills in this case were a treatment for a known disease.

Okay. Well, you’re the doctor, so I’ll take your word for it. Nevertheless, the upshot of the whole thing was that this woman, who was paying hundreds of thousands of dollars per year to attend an elite law school, which provided health insurance for her, paid for with the money she put into tuition, ended up having her ovary removed because she could not afford the cost of hormonal therapy, because Georgetown refused to include BC coverage, all because of the stupid Catholic fixation on ladybits. Are you saying this is a desirable outcome?

My original point was that free contraception was originally justified as “preventive” but when they realized that meant actually endorsing sex, they switched to the argument that hormones have therapeutic uses as well. They are talking out of both sides of their mouths.

So, it seems you think there’s something wrong with endorsing sex. Care to explain why?

And no, there was no switch, no talking out of both sides of anyone’s mouth. There are the facts: first of all, BC is important to prevent pregnancy. Second of all. BC is important to prevent AND treat a number of other medical conditions and/or illnesses. The debate was being framed as dirty sluts wanting a financial reward for slutting around. To demonstrate the falseness of that framing, Ms. Fluke talked about ovarian cysts. You call that hypocrisy; you’re wrong.

Yes, it does, because failing to provide those medications will lead to lead to more expensive, intensive medical complication later down the line. That’s why they’re called “preventative”–because you give them to healthy people to prevent them from developing medical complications or illnesses.

We are still talking about contraception here, right? I don’t consider pregnancy an illness.

I didn’t say I did, either. I specifically used the phrase “medical condition,” because idiots like yourself like to use this idiotic turn of argument: “You’re not saying pregnancy is a DISEASE are you???? *shock horror*” No, it’s not a disease. But it is a medical condition that requires regular medical attention and puts women at risk for many actual illnesses up to and including death. I find it misogynist in the extreme to discount the discomfort and medical risk that pregnancy entails. Privileged much?

Sure, pills or depo provera save the system money by preventing some costs of pregnancy care. But by the same token, treating CHF saves money by preventing unnecessary hospitalizations. On a patient by patient basis, I’m betting CHF care saves way more money than OCPs. Yet we expect our elderly to share the cost of their medications. Why is it wrong to expect the same of young, healthy women?

Um… are you missing the fact that these young, healthy women are also paying for the insurance packages we’re talking about here? If you want to make the case for some other medicine being classified as preventive (h/t ‘Tis) then have at it. But nobody’s getting a free ride here, as you seem to be insinuating.

Look… I have nothing against contraception.

I don’t even object to free contraception. If patients want it and it sells insurance policies, fine. But I don’t exactly understand why we need a federal mandate for free contraception.

We need this because certain religious groups are framing it as their constitutional right to force women to pay twice for birth control: once when they purchase their insurance policy, and again when they go to the doctor and discover that the policy doesn’t cover it because of their employer’s “moral” objection. I guess you haven’t been paying much attention to this debate, have you?

My question is not why Lo-Ovral is a good thing. My question is why is Lo-Ovral more important than carvedilol.

Because some stupid Catholic bishops took issue with facilitating the distribution of one and not the other. Do try to keep up.

102. 102
##### SallyStrange: bottom-feeding, work-shy peasant

If giving away contraceptives made them more money than charging a co-payment for them, they would already be shipping them for free. I guarantee it.

Gawd, this is so dumb. No, obviously charging money is more profitable than giving it away. But let’s keep in mind that the BC is bought and paid for already because people pay money to buy insurance packages. So stop saying that anything’s coming for free here, because that’s just a dirty fucking lie.

103. 103
##### tapetum

rrainsmd – Pregnancy may not be a disease, but it’s sure as fuck a medical condition. A normal, healthy delivery with no complications at all, and minimal amounts of intervention was priced at \$3000 – 13 years ago. I have no clue what it is now. And that’s the absolute best case scenario for price.

My deliveries ran well over \$50,000 each, covered by medical insurance. That would pay for one hell of a lot of contraception. And I think I can count my IUD as preventive medicine. It prevents me from having a nervous breakdown, facing a potential third pregnancy and a repeat of malpresentation, massive hemorrhage, and lovely crash surgery without benefit of anesthesia (which only happened once, and will only happen once, no matter what I have to do to end up in that situation again).

Do most pregnancies end up with that kind of drastic intervention and expense? No. But it’s always a possibility. Even perfectly healthy women, with perfectly normal pregnancies can have horror show deliveries. Women who were perfectly healthy before pregnancy can develop diabetes, joint pain (which can last well after the end of the pregnancy), pre-eclampsia or other metabolic issues. Frankly, if the health insurance companies were looking at their bottom line here, the way they seem to with every other thing under the sun, they’d be handing birth control out like candy. It’s a tremendous bang for the buck.

104. 104

I don’t claim to be an expert on the world’s medical systems, but I’m pretty sure it isn’t the giving the drugs away that makes them cheaper.

actually, that IS part of why they’re cheaper. the other part is that a government has a better position to negotiate for good prices, and has no profit-motive.

I don’t have any figures, but I have abounding faith in US health insurers to look after their own interests.

HAHAHAHAHAHAHA
all businesses are shortsighted by default. if they weren’t, we wouldn’t have had to bail out the car businesses, because they’d have been capable of thinking far enough ahead to make high-mileage cars the new col thing, instead of SUVs, even if the latter is more profitable in the short-term.

secondly, not paying for anything at all is most profitable, and plenty of insurance companies just go that route, refusing to pay for the consequences of not paying for preventive care. that’s where the taxpayer ends up having to pay for a lot of it.

If giving away contraceptives made them more money than charging a co-payment for them, they would already be shipping them for free. I guarantee it.

free market worshippers are so fucking naive. if businesspeople were capable of making rational business decisions, we wouldn’t be in a recession.

My original point was that free contraception was originally justified as “preventive” but when they realized that meant actually endorsing sex, they switched to the argument that hormones have therapeutic uses as well. They are talking out of both sides of their mouths.

pointing out ALL the ways in which it’s a good thing to cover contraceptives is not “talking out of both sides of their mouths”, it’s making a thorough assessment of the situation.

We are still talking about contraception here, right? I don’t consider pregnancy an illness.

it is a medical condition, and one that’s expensive and often quite detrimental to a woman’s health. for some women, with some other conditions, it can even be deadly.

Why is it wrong to expect the same of young, healthy women?

wrong question. the correct question is why we’re forcing the elderly to pay for their medication.

105. 105
##### Azuma Hazuki

Finger-length is barely better than astrology. My indices are longer than my rings by a huge margin, almost 1 cm each…by that logic I should be super-straight right? Well, someone at the front desk seems to have messed up :)

106. 106
##### hotshoe

Frankly, if the health insurance companies were looking at their bottom line here, the way they seem to with every other thing under the sun, they’d be handing birth control out like candy. It’s a tremendous bang for the buck.

Exactly, that’s why the insurance companies did not cry bloody murder when Obama made the “compromise” with the Catlicker bigots that the church wouldn’t pay the insurance premiums for contraception, the insurance companies would just throw it in for free with every plan as the price of getting their hands on all those new customers which the Health Care Act promises them. (And the insurance companies want to look like – at least sort of – reasonable good guys here, to avoid the insurrection which should have already occurred in America when we were denied any public option … an Obama and Dem landslide could at least potentially reopen the public option battle if the insurance companies are uncooperative now.)
Why didn’t they give out BC pills like free candy before ? Well, why would they, when at that time they had the chance to make money on both sides of the transaction ? Charge the premium-payers for a plan which “covered” birth control, then keep the profit when they forced a sizable co-pay on each prescription, plus if the woman couldn’t afford the co-pay or if BC failed, the insurance company still made some profit on the maternity policy (on average, even though it risked unhappily high pay outs when births don’t go smoothly). Win both ways for them.
So, now, with the Health Care Act about to go into full effect, they’ll only win one way. That is, to give out as much birth control as the customers want, and save themselves the greater risk of pay out on the maternity policies.
I wouldn’t be surprised if the top insurance guys had approached Obama behind the scenes that they would volunteer to provide BC for free rather than let the Catlickers back them into a corner where they had to cover too many pregnant women who had been cut off from BC by the church meddling. Bang for the buck, like you say.

107. 107
##### tapetum

Apropos of the OP – count me as another man and/or lesbian here, which will be a heck of a surprise to my husband and kids. Also, my second toe is longer than my big toe – does that mean anything in bizarro-world?

108. 108
##### Markita Lynda

Suzannah @34. My son has my hands–only bigger. I find that sweet.

Humans do have pheromones, they’re just not much studied. Babies scalps give off soothing pheromones.

one experiment of putting underarm pheromones on a washroom door found that no one would use that stall–they would all “coincidentally” veer away–except for one guy who was oblivious. No linkies, sorry; it’s all from my reading science books over the years.

109. 109

oh, and I forgot one more thing: conflating the cost to society with whether something is profitable to insurance companies is pretty fucking rich. The government needn’t and shouldn’t mandate things that would force companies to become more profitable in the long-term. but it absolutely needs to and should regulate those things that come at a high cost to society as a whole; and the lack of preventive care (including contraception) in this country is massively expensive.

110. 110

lack of affordable preventive care

111. 111
##### rrainsmd

Gawd, this is so dumb. No, obviously charging money is more profitable than giving it away.

No, it’s not obvious at all. That’s the whole argument isn’t it? That if you charge money for birth control women are either too cheap or too poor to buy it and will just go-ahead and get pregnant. That’s why it has to be supplied without charge and the argument made here repeatedly is that giving away contraception instead of charging for it should significantly decreased the cost of healthcare which means it would make the insurance companies money if it were true. But it’s not true. Contraception is relatively cheap in the grand scheme of things and most women that want to use contraception will use it even if they have to pay all or part of the cost.

So, it seems you think there’s something wrong with endorsing sex. Care to explain why?

Not me. The Democratic Party. The Republican started whining about encouraging sexual promiscuity and the Democrats, rather than standing up to them, started babbling about alternative uses for birth control pills. Hell, I’ll endorse sex all day long.

all businesses are shortsighted by default. if they weren’t, we wouldn’t have had to bail out the car businesses

I never said I had faith in car companies. Health insurers, on the other hand, are among the most profitable businesses in America and they know how to read an actuarial table. I suspect they know exactly how many dollars they can charge before the pregnancy rate starts to significantly rise and if that number were \$0, that’s what the co-payment would be.

-RR-

112. 112
##### SallyStrange: bottom-feeding, work-shy peasant

Uh huh. But RR, if you’re an insurance company and your customers have no way to access contraceptives except through you, then it’s still more profitable to charge them a small fee for getting it, even if giving it away would save you money. That’s what I was getting at.

Indeed, the Democratic party is too hesitant to defend sex for its own sake. So? That doesn’t make it untrue that hormonal birth control has a number of other health benefits, both therapeutic and preventive, and it isn’t hypocrisy to point that out. What exactly is your issue again? At first it seemed like you cared about something or other, but now you just look like a Professional Critic, one of those annoying people who sits on the sidelines taking potshots at all parties because it’s amusing, as if he’s above all the messy, dirty passion and politics and caring and stuff.

113. 113
##### SallyStrange: bottom-feeding, work-shy peasant

free market worshippers are so fucking naive.

Ah, so he’s dinging your libertarian warning bells too eh?

114. 114
##### SallyStrange: bottom-feeding, work-shy peasant

Contraception is relatively cheap in the grand scheme of things and most women that want to use contraception will use it even if they have to pay all or part of the cost.

In a recent Guttmacher survey, eight percent of women reported that they sometimes did not use birth control in order to save money. This cost-cutting behavior was more common among those financially worse off than among others (12% vs. 4%). According to our study, 18% of women using the pill reported inconsistent use as a means of saving money. Pill users said they skipped pills (4%), delayed getting a prescription filled (12%), went off the pill for at least a month (11%) and obtained fewer pill packs at one time (8%).

115. 115
##### love moderately ॐ

To add to SallyStrange’s #144: “The Impact of Subsidized Birth Control for College Women: Evidence from the Deficit Reduction Act”

With the passage of the Deficit Reduction Act of 2005, Congress inadvertently and unexpectedly increased the effective price of birth control pills (“the Pill”) at college health centers more than three-fold, from \$5 to \$10 a month to between \$30 and \$50 a month. Using quasi-difference-in-difference and fixed effects methodologies and an intention-to-treat (ITT) design with two different data sets, we find that this policy change reduced use of the Pill by at least 1 to 1.8 percentage points, or 2 to 4 percent, among college women, on average. For college women who lacked health insurance or carried large credit card balances, the decline was two to three times as large.

116. 116
##### love moderately ॐ

Somehow I grossly exaggerated the comment count.

117. 117
##### tapetum

Thinking about it a little more closely, the most profitable price point for an insurance company for contraception is going to be somewhere just beyond the point where a small percentage of women can’t afford it. (The following numbers are entirely theoretical, and largely based on the numbers I know best from a decade ago.) If they charge \$30/month and 98% of the women who want it can afford it, then for every 100 women, they’ll be getting \$2940/month. The remaining 2 women are only likely to get pregnant once per year, at a maximum, which leaves the insurance company with \$35,280 to pay for 1-2 births. If those births go smoothly, which they are more likely than average to do, since women with known birth/pregnancy difficulties are willing to go much further to obtain birth control, then that leaves the company a nice profit of well over \$20,000, with the only damage being the couple of women they just screwed over, or the occasional loss of the coin flip when someone with no risk factors goes expensively south.

I don’t happen to think the minor increase in company profits is worth screwing over even a few women. But what do I know? I think companies in health care ought to actually be providing appropriate care.

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##### kemist

I don’t claim to be an expert on the world’s medical systems, but I’m pretty sure it isn’t the giving the drugs away that makes them cheaper. The fact that pharmaceutical companies sell meds to Mexican pharmacies for a fraction of what they sell them for here is a whole ‘nother issue.

An expert you certainly aren’t.

I live in Canada and I pay less for my medicines because of our freaking public healthcare system. I am covered under our public medicines coverage plan, which doesn’t cover everything at 100% rate but has a maximum yearly patient spending limit for medicines according to income. A person with no or low income does not pay for medicines. The logic behind this is that when you’re very sick, there’s very little way for you to even have a sizable income. Duh.

Our government has used its status as a big buyer to get an agreement over prices with pharmaceutical companies.

The only reasons that keeps yours from acting the same are the lobbies in place in your government and the sheer stupidity, selfishness and stuborness of a majority your population when it comes to healthcare.

People from your country even come here to buy their medicines cheaper. And get treated and then stick our healthcare system with millions in unpaid medical bills. If our public healthcare system is so freaking bad and yours is so much better, why do they do so ?

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##### pyrobryan

Seriously? Long finger = lesbian? /facepalm

http://www.smbc-comics.com/index.php?db=comics&id=2540#comic

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##### Anri

But within our system I don’t think you can show that giving away preventive meds is cheaper. I don’t have any figures, but I have abounding faith in US health insurers to look after their own interests. If giving away contraceptives made them more money than charging a co-payment for them, they would already be shipping them for free. I guarantee it.

(bolded for emphasis)

I do too.

I just understand that the interests of health insurance companies (which, like all companies, is to maximize profits) and the interestes of state health policy (which should be to provide the best health care for as many people as possible) are not congruent.
In fact, they are often opposed.

Do you disagree that providing free, accessable health care to as many women as possible is a good thing, public-health-wise?
If you do not, why do you believe that insurance company profits – or Middle Ages interpretation of Iron Age sky-daddy books – should be allowed to override that?

If your point is that (let’s say) my Lisinopril should be as covered as much as Ms. Fluke’s birth control then I say, good on ya! I agree!
But that’s not the question we’re having governmental hearing on right now. It’s not the issue we’re trying to keep the throwbacks from answering stupidly right now.

The economics on this issue are a red herring. This is being targeted as a morality issue. What Rush said was more unvarnished than usual for that side, but it’s the essence of the Right’s position on this issue.

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##### Anri

kemist:

People from your country even come here to buy their medicines cheaper. And get treated and then stick our healthcare system with millions in unpaid medical bills. If our public healthcare system is so freaking bad and yours is so much better, why do they do so ?

One of the most enduring myths in regards to this issue is that the USA has ‘the best healthcare in the world’. It is my understanding that there are pretty much no metrics under which this is true. Infant mortality, childhood mortality, lifespan, hours of work lost, cost, even citizen satisfaction – in no metric does the US top the charts. The idea that another country’s system might be better, even in some limited area, is because they’re ‘cheating’ in some obscure way.
As far as I can tall, so long as the idea that we’re the best in the world remains intractible, change will be virtually impossible.

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##### FilthyHuman

#104

free market worshippers are so fucking naive. if businesspeople were capable of making rational business decisions, we wouldn’t be in a recession.

They are making rational business decisions!
It leads to their own pockets being full of money!
Those that made the BEST decision gets mountains upon mountains of cash from the government!

Y’all just jelling!

@tapetum
#117

I don’t happen to think the minor increase in company profits is worth screwing over even a few women. But what do I know? I think companies in health care ought to actually be providing appropriate care.

Meh, nothing wrong with letting a couple un-important slutty wimmin die each year if I can sail in my gold-plated yacht!

@kemist
#118

People from your country even come here to buy their medicines cheaper. And get treated and then stick our healthcare system with millions in unpaid medical bills. If our public healthcare system is so freaking bad and yours is so much better, why do they do so ?

Funny enough, I heard the EXACT same arguments, except in regard to Mexicans by Americans.

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##### FilthyHuman

@Anri
#121

One of the most enduring myths in regards to this issue is that the USA has ‘the best healthcare in the world’.

It is the best!… at making truck-loads of money for shareholders.

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##### rrainsmd

Our government has used its status as a big buyer to get an agreement over prices with pharmaceutical companies.

The only reasons that keeps yours from acting the same are the lobbies in place in your government and the sheer stupidity, selfishness and stuborness of a majority your population when it comes to healthcare.

I believe this is more or less correct but the previous implication was that giving medicines away somehow intrinsically lowers the cost of medical care by making people healthier. That is not correct. What lowers the cost of pharmaceuticals in Canada is that the government has used its power to set the wholesale prices of medications. But Obama care has not done this. It simply mandated that certain medicines have to be supplied for free at the consumer level. That manifestly will not lower the overall cost of medical care.

Pharmaceutical companies, the last time I checked, were the most profitable companies on the planet and are huge political contributors to both parties. People who think a big Democratic victory in November will solve the drug cost problems in this country are kidding themselves. And if that ever happens, you can expect to see your drug prices going up. I believe the pharmaceutical companies have shifted a lot of their costs onto the backs of American consumers. If we ever stop letting them do that, they are going to become more intractable when they arrive at the Canadian negotiating table.

-RR-

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Apparently, she has a very long middle finger, because she metaphorically flipped it at Rushbo, he’s still crying about how badly his feelings have been hurt.

Although, lately, he’s been taking the “losing all my sponsors hasn’t hurt me a bit…*sniff*” line…

126. 126

I never said I had faith in car companies. Health insurers, on the other hand, are among the most profitable businesses in America and they know how to read an actuarial table. I suspect they know exactly how many dollars they can charge before the pregnancy rate starts to significantly rise and if that number were \$0, that’s what the co-payment would be.

ROTFLMAO

in any case, you are conflating cost to the company with cost to society again, and are ignoring the part where plenty of insurers actually make that calculation by taking into account all the lack-of-contraception-related medical conditions that will result but that they won’t have to pay for because they’re good at weaseling out of fulfilling their part of the bargain.

I believe this is more or less correct but the previous implication was that giving medicines away somehow intrinsically lowers the cost of medical care by making people healthier. That is not correct.

it is in fact correct, it’s just not the only variable that does so.

127. 127

Contraception is relatively cheap in the grand scheme of things and most women that want to use contraception will use it even if they have to pay all or part of the cost.

even if this were correct (and it’s demonstrably not), this would be backwards reasoning. most people will cover essentials even if they technically can’t afford them. such essentials include food and rent, for example. the fact that people will do their very best to pay for these things is not an argument that they should not be subsidized though; quite the contrary actually, hence food stamps and HUD

128. 128

though, I will admit that solely arguing on the basis of cost-saving was very uni-dimensional of me. the cost-savings are one thing (especially in the US, especially among poorer populations. preventive care could cut down on ER-based healthcare massively, if done right); but most importantly, preventive care is very cost effective.

and both apply to contraception, specifically: it’s both cost saving and cost effective.

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130. 130
##### SallyStrange: bottom-feeding, work-shy peasant

But Obama care the Affordable Care Act has not done this. It simply mandated that certain medicines have to be supplied for free without a co-pay at the consumer level. [Note: use of the word "consumer" indicates that RR is at some level aware that these medicines are bought and paid for, not free.] That manifestly will not lower the overall cost of medical care by making it more likely that consumers will make use of preventive medicine (which they pay for) rather that post-facto, more expensive therapeutic medicine (which they also pay for).

FIFY

Seriously dude, get honest.

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##### kemist

People who think a big Democratic victory in November will solve the drug cost problems in this country are kidding themselves. And if that ever happens, you can expect to see your drug prices going up. I believe the pharmaceutical companies have shifted a lot of their costs onto the backs of American consumers. If we ever stop letting them do that, they are going to become more intractable when they arrive at the Canadian negotiating table.

It’s going to be that way because you let it happen.

You’re a fucking superpower. You think it’s your given right to tell Iran, Afganistan and other countries what to do, and you’re telling me you’re afraid of pissing off Pfizer and Merck ? You know what will happen if they refuse to do things the way your government will tell them ? Smaller, leaner, hungrier companies will do it for less. Pharma start-ups are a dime a dozen. Isn’t it how this free-market thing is supposed to work ?

This is my former field, and I’m quite familiar with it. By the way, one of the reason I left is because the existing pharmas are too fat with profit to do anything new or interesting anymore. They just live with their existing profits, and fire their star researchers all over the world.

You keep yammering about democracy-this and freedom-that, and you don’t even thrust the government that you elect. Instead you selfishly yearn to make it smaller and smaller, while corporate power gets bigger and bigger. One of these days you’ll wake up as serfs to your runaway corporations.

132. 132

People who think a big Democratic victory in November will solve the drug cost problems in this country are kidding themselves.

missed that one. hilarious, considering nothing in this thread warrants such a silly-ass claim of what people here are thinking on the topic of the 2012 elections.

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##### crissakentavr

Oh, I used to get horrible migraines when I didn’t have prescribed estrogen. That wasn’t why I began taking it, but it was a really nice change. Now that happens less than once a year. Still nasty, but much better than the once every month or so that it was happening.

134. 134
##### Ms. Daisy Cutter, Gynofascist in a Spiffy Hugo Boss Uniform

rrainsmd may very well be a physician. Training in medicine does not make you a decent human being or particularly knowledgeable and intelligent about anything outside your narrow focus (if that). A lot of doctors in the U.S. these days come from highly privileged backgrounds and go into the field to make even more money.

Lurking on medical-resident fora is both enlightening and depressing.

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##### kemist

Oh, I used to get horrible migraines when I didn’t have prescribed estrogen. That wasn’t why I began taking it, but it was a really nice change. Now that happens less than once a year. Still nasty, but much better than the once every month or so that it was happening.

Once a month ?

Lucky you. That was my normal migraine rate, back when Maxalt still worked.

These days I get them every other day. Had to start a preventive medicine (which is a beta-blocker, incidentally) before my consumption of NSAID’s starts giving me ulcers.

I tried the pill for those and the excruciatingly painful cramps I get, but unless I took it continually and had no period at all, the migraines and cramps were there, as bad as ever every month. Taking it continually had weird effects on my mood, made my skin hypersensitive to sunlight and made me continually thirsty (and needing to pee every 20 minutes). Tried a few, and all of them had some of these side-effects. Not worth it.

136. 136
##### bryanpesta

Sorry to bump a zombie– was out of town.

I concur, the older study featured above looks very weak, effect-wise. I suspect removing the outlier would make the correlation non significant.

However, a recent meta-analyses shows a moderately small (g=.29) relationship between female finger ratios and orientation.

Seems like self-reporting ratios introduces error that masks the true effect.

Some in field see value in 2d4d differences. The journal PAID recently devoted a whole special issue to just it.

BP

137. 137
##### bryanpesta

Sorry to bump a zombie– was out of town.

I concur, the older study featured above looks very weak, effect-wise. I suspect removing the outlier would make the correlation non significant.

However, a recent meta-analyses shows a moderately small (g=.29) relationship between female finger ratios and orientation.

Seems like self-reporting ratios introduces error that masks the true effect.

Some in field see value in 2d4d differences. The journal PAID recently devoted a whole special issue to just it.

BP

http://www.putslab.psu.edu/pdfs/grimbos_10_behneuro.pdf

138. 138
##### PZ Myers

Swoosh, the point goes sailing right over Bryan Pesta’s head.

139. 139
##### Nerd of Redhead, Dances OM Trolls

Swoosh, the point goes sailing right over Bryan Pesta’s head.

As always. This one can’t learn, which requires it to shut the fuck up and listen….

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##### John Morales

[OT]

kemist, that sounds rough. :(

You can’t use both NSAIDs and PPIs?

141. 141
##### bryanpesta

The 2010 meta-analysis I linked shows just the opposite: ratios predict orientation for women, but not men. It cites the Manning study you feature here (but did not include it in the analyses, as it used self reports of finger ratios).

What point am I missing?

1. Is it that the sex difference in the ratio is too small to have practical significance. If so, how can the ratio predict orientation to g = .29? From my link:

“We found that heterosexual men had significantly lower 2D:4D than
did heterosexual women: This sex difference was highly robust…”

In fact, g here is -.55, where .60 is considered “large”.

2. Is it that g=.29, itself, has no practical value? Using established guidelines for effect sizes, it is medium-small (I’d bet it’s larger or similar to the effect size of stereotype manipulations). I’d have to look, but I also think it’s similar to the effect size of Viagra versus placebo in creating wood.

You are wrong above with the casino analogy. By definition, the .29 effect means one can use ratios to predict female orientation– not perfectly, but better than chance. In the field, results would likely be poorer as the base rate for lesbianism is non-optimal.

Consult someone conversant in stats 101 and rebut. And, colleague, if I’m still missing the point, please illuminate?

BP

142. 142
##### neogeshel

@daniellavine

oh, i was just responding to the point that pz made about it being “sciencey” to be interested in means. variation is fantastic if the science has matured to the point that it is possible to be specific enough to be able to address variability in a concrete and rigorous way. it’s certainly the case the it is an immature field of research that has to dally around with means.

as it happens, sexual orientation research is progressing, and there are a number of current research programs that are far more interesting than the kind of large-scale correlational studies done by the 2d4d people. but i’m willing to take any part of the puzzle i can get as a researcher, and one day a network of weak correlational studies may hang together in a way that suggests something interesting. meta-analyses will have to sort through the chaff, and have already pretty convincingly demonstrated that something is going on related to sexual orientation. that it’s sex-atypical levels of prenatal androgen is just an inference.

as i understand it there are two primary competing hypotheses to explain the sex difference. one is the organizational effect of prenatal androgens, and the other is sex differences in fat distribution that have nothing to do with prenatal androgen. they may be both going on. a guy named kim wallen is the main person arguing for that.

http://endo.endojournals.org/content/150/11/4819.full

there is more direct evidence from amniocentesis that circulating androgens in amniotic fluid are correlated with later infant 2d4d, which doesn’t nail it but certainly makes progress.

http://www.sciencedirect.com/science/article/pii/S037837820400012X

of course it’s not correlated with other sexually dimorphic traits like mental rotation ability, so whatever it’s tapping into isn’t anything simple, of course. anyway, even the main proponent of 2d4d relating to sexual orientation, marc breedlove, has said repeatedly that he thinks that 2d4d isn’t a very good measure of prenatal androgen, he just argues that the effect is real and deserves to be investigated.

regarding the last point about prenatal androgen in general, the evidence is largely variety of traits on which sexual minorities tend to be gender-atypical. there are always competing social hypotheses to explain these differences, but for a lot of things they’re not very plausible. for example, echo-like waveforms emitted by the cochlea in response to short sharp sounds tend to be stronger in women than men, and gay men have been found to be intermediate between heterosexual men and women. there’s just a huge array of these kinds of small effects that are out there.

not entirely related but there’s an amazing study by nalina ambady at stanford demonstrating that people can guess people’s sexual orientation well above chance from seeing a persons face for a second or so. there’s another study that demonstrates that judgements of gender-atypicality of children in home videos predicts the children’s adult sexual orientation, etc.

the inference of course is that it is prenatal hormones that are involved in sex-typing the brain by shaping the initial conditions that shape the range of adult phenotypes that are possible.

“Sure. First of all, what does that have to do with the sort of irresponsible claims based on this data as highlighted in the OP?

Second of all, how much evidence is there that the 2D:4D is actually the result of prenatal androgen exposure?

Finally, how much evidence is there that prenatal androgen exposure affects sexual orientation?”

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##### neogeshel

anyway, the MRA in question is obviously an idiot. i took that to be a given.

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