Birth control and the sexual revolution

Birth control, something practiced by nearly 100% of women, was once uncontroversial. Now, almost inexplicably, opposition to birth control has exploded.

Once upon a time, there were pro-choice Republicans. Now, not only has this breed become extinct, but it's no longer enough to oppose abortion. Birth control is now considered suspect.

It seems baffling to see such a reversal so suddenly. Social conservatives accept the standard narrative about the sexual revolution --- oral contraception allowed premarital sex, which caused the sexual revolution --- and they oppose it. Next step will be to reduce condom access, not just in schools, but also in stores, such as requiring them to be behind the counter and perhaps having age limits.

Telling kids to act as though the sexual revolution had not occurred, and teaching them that contraception is dangerous and ineffective --- abstinence only sex education --- didn't reverse the sexual revolution. The Congressionally mandated evaluation found that abstinence-only sex education did not decrease premarital sex. That failure was particularly embarrassing because some comprehensive sex education programs that teach about birth control decrease premarital sex.

Social conservatives' assumption may be that if birth control caused the sexual revolution, reducing birth control access might reverse the sexual revolution.

Unfortunately, they're wrong. Even before the advent of birth control, attitudes began to favor sex within loving non-marital relationships in the late 1940s and 1950s, as documented by sociologist Ira Reiss in his 1967 book, The Social Context of Premarital Sexual Permissiveness. (The entire book is available online for free at that link, and I highly recommend it.)

Even if there had been no oral contraceptive, there would have still been a sexual revolution. After all, in a society where sex within loving relationships is accepted, certainly people will find a way. For instance, withdrawal is only slightly less effective than condoms. The modern IUD is safe and effective. Diaphragms are safe and effective, if they are used without spermicide which could increase STI risk. And these methods may even be superior to hormonal contraception.

Elsewhere in this blog, I have spoken about shortcomings of oral contraception, according to my Second Wave feminist bias towards non-systemic, barrier methods of contraception. And I've spoken about problems with hookups, or as Reiss would say, permissiveness without affection.

Even if the conventional narrative were true, and birth control somehow caused the sexual revolution, it is not necessarily possible to reverse course and return to no premarital sex. How far will social conservatives go in attempting to reverse gains from the feminist movement?

Heterosexual-only sex education: next generation abstinence-only?

Rolling Stone tells of a rash of suicides among lesbian/gay/bisexual/questioning teens in a conservative town in Minnesota. They mention a next generation sex education program in public schools sponsored by evangelical organizations that questions same sex attraction. This heterosexual-only sex education program appears to be just another guise of abstinence-only sex education, and it seems to follow from the same motivation.

Both programs come from an assumption that both same sex attraction and premarital sex are brand new phenomena, and that it's possible to go back to the way things used to be. (Of course, plenty of evidence indicates that they're not new, and even if they were new, it's neither possible nor desirable to go back to a time when women's suffrage was unthinkable. None of the strong women evangelical leaders would agree to reverse feminist gains.)

Both programs attempt security via obscurity, and treat education as dangerous. Teaching a subject (contraception or same-sex attraction) is thought to encourage and legitimize the subject, and to advance an imagined liberal agenda.

Instead, the programs just delegitimize normal behavior and endanger teenagers. Abstinence-only sex education increased unsafe sex probably because it taught that pregnancy and STDs were unavoidable, so there was no point to avoiding them. Alternatively, it made teens so worried about the spiritual effects of sex that they never worried about the physical effects. That's dangerous and bad for public health, but probably no one would die from it. Hetero-only sex education is more insidious because it further marginalizes a population that is already marginalized, at high risk for educational and health disadvantages, and at high risk of suicide.

Right now these hetero-only sex education programs are coming into public schools using private funds. That's how abstinence-only sex education started in the early/mid 1990s. The next stage would be to slip funding for these programs into another bill, as abstinence-only began in 1996 with the welfare reform bill. I hope it doesn't get that far.

New experimental evidence suggests why weight loss is not just calories in vs. calories out

Exercise induces the release of a hormone called irisin, which converts white fat into thermogenic (calorie-burning) brown fat, according to a new paper published Wednesday in Nature. They motivate the paper by saying, "Exercise has the capacity to improve metabolic status in obesity and type 2 diabetes, but the mechanisms are poorly understood. Importantly, exercise increases whole body energy expenditure beyond the calories used in the actual work performed." The paper begins to explain how it may be that exercise burns more calories than those in the actual work: that is, much research in the exercise science literature finds that anaerobic exercise (like strength training and high intensity intervals) burns calories for 48 hours afterwards. Perhaps this hormone begins to explain why.

Meanwhile everyone is still despairing slightly because of the NYT Magazine article suggesting that body weight setpoints make permanent weight loss very difficult for almost everyone. The article mostly quoted people who used very low calorie diets that induce starvation conditions and steady-state cardio. As many have noted, steady state cardio doesn't work. People who stay away from processed food and use high-intensity intervals and strength training may have more luck maintaining weight loss.

If I understand the biochemistry, other research already found that high-intensity exercise increases a related protein (e.g., as found in Tabata's paper, famous for his intervals). We already know that anaerobic exercises burn more calories for longer and result in greater fat loss and less muscle loss. This paper suggests why: anaerobic exercise may be most effective in converting white fat into brown fat.

I am disappointed not to see a practical conclusion --- more weight lifting and intervals, less low-calorie dieting --- in the NYT Magazine article. The message is still "just walk more", which clearly doesn't work, but people say it because it seems realistic and attainable (never mind that it's cold outside.) Instead "do something hard" might result in people pushing themselves more and gaining more of the benefits of exercise demonstrated in this paper. I wonder what state the science would have to be in before the messaging on exercise changes.

After reading the paper, I did 3 simple Tabata intervals, and from this paper now I know that the irisin makes it worthwhile.

The importance of specific health communication

Often people speak in general terms about the negative effects of smoking. Here's a highly specific risk: smoking at the time of breast surgery can cause nipples to fall off. When the doctor warned his patient in general terms, she didn't really listen. When he told her specifically that her nipples might fall off if she kept smoking, she said she had the motivation to stop right away. That's a very important lesson for health communication in general, but also hard to implement because when public health campaigns do show very specific things that can go wrong, there can be accusations of scare tactics, whether it's showing very specific problems from STIs or very specific problems from smoking.

What's the line between a scare tactic and effective communication?

Emerging adulthood and medical subject headings

Emerging adulthood has been recognized as a concept in sociology for over a decade, and is generally recognized as extending to age 30. Adolescent health research often extends up to age 25 because brain development continues until about that age. Last year I asked Alan Guttmacher, the head of the National Institute for Child Health and Development (NICHD), about the definition of adolescents for the purposes of NICHD funding, and he said that it's reasonable for research to go past age 18.

In view of that, I'm submitting a new manuscript today, and as I was choosing keywords, I was surprised to notice how they classify ages.

Adults are ages 19-44. Young adults, a term added in 2009, are ages 19-24.

My study is about the transition to adulthood --- how people get college degrees in early 20s and develop professionally in their late 20s and early 30s --- and it doesn't seem to fit into either of these categories. The study examines how the subjects are in the process of becoming adults, socially and economically, but according to the medical subject headers, they are already. It's striking to be reminded of how our systems of thought have changed in such a short time, and an indexing system naturally didn't catch up.

Public sector layoffs among African-Americans

Kathy Newman wrote about how low SES minorities rely on public sector jobs for social mobility in her book, No Shame in My Game. Newman studied young adults in Washington Heights and nearby areas who were employed in fast food restaurants, as well as some young adults who had applied but were not hired for fast food jobs. Jobs were scarce in the neighborhoods she studied, so that even these fast food jobs had a great deal of competition. Many youth, particularly African-Americans, studied for civil service exams, and regarded these jobs as one of their only ways to achieve a middle class existence, but even these jobs were hard to get. The relatives of her study participants who got civil service jobs were able to build middle class lives for themselves, move to the suburbs, and be role models for the rest of their families. Growing up in a diverse community, I knew at least one minority family who had achieved upward mobility thanks to a federal civil service job.

The current backlash against government, combined with tight budgets, has meant that many African-Americans with these coveted civil service jobs are in danger of losing them. That conclusion was self-evident, or should have been, but I hadn't seen the issue raised (and the issue hadn't occurred to me), until seeing this NY Times article.

People like to mock the government for having exacting requirements to document the procedures followed to ensure that there is no measurable discrimination. I don't how how much time I've spent filling out the EEOC paperwork for the dozens of faculty jobs I've applied for in my life, for instance, and the extensive other measures to make sure that people get treated equally. As much as everyone might mock these efforts, and I'm sure that they are imperfect and clunky, they do seem to have produced more equal opportunity for minorities than the private sector has been able to offer. The private sector may be more "efficient", but they are also less likely to hire people with distinctly minority-sounding names, according to randomized experiments, such as "Are Emily and Greg More Employable than Lakisha and Jamal?".

Publication bias and the result that got away

An economist writes about his would-have-been dissertation: he gathered the data, did a regression, and found no relationship. So his dissertation was on another topic. 8 years later, he publishes the null relationship. It's refreshing to see someone talking about how publication bias affected their own research, as opposed to the studies published in epidemiology journals that suggest publication bias in macro.