Two academic heroes under 30

I have two academic heroes this week.

The first is U Mass graduate student Thomas Herndon, who replicated Rogoff and Reinhart's austerity paper and discovered a mistake.  Many social scientists encourage replication, but people arguably don't do it enough.

The second is a public high school sophomore Ria Chhabra who began performing experiments on fruit flies during middle school, and discovered that organic food results in better outcomes for fruit flies. 

Their examples can inspire and encourage all of us.  Their achievements are an important reminder of how capable students can be, given opportunity and encouragement, and how it doesn't take elite schools to inspire achievement.  And how important it is to question assumptions, design good work, and work hard to execute it. 

Young adults and the Boston marathon bombing

As a 10 year resident of Cambridge, I have been following the Boston marathon bombings, but it wasn't until I saw this tweet from a NYT reporter that I thought about the connection to young adults.

So far, everyone who has been killed in this -- marathon victims, MIT policeman, first suspect -- is under 30.
— Jess Bidgood (@jessbidgood) April 19, 2013

As the story unfolds, we will understand more about the motivations of the bombers:  nationalism, religion, or neither.  Right now we just have questions, such as which factors cause an adolescent to turn into the type of young adult who travels thousands of miles to Boston to become a statistics graduate student as opposed to a boxer or alleged bomber?   

We asked a similar question during my first year in college, when one alienated foreign student killed her socially-integrated roommate in a murder-suicide.  I remember that spring morning in 1995, wheeling a hand truck filled with boxes from my dorm to Dunster House and finding Dunster surrounded by police tape.  The rumors in the street were that a dozen people had been stabbed and the killer was on the loose; ultimately it turned out to be just 2, and the killer had hung herself an hour ago.  Meanwhile, I needed to figure out what to do with my boxes.  I threw them over the wrought iron fence into the side yard and hoped for the best.  Melanie Thernstrom researched the crime and published a book that included intriguing foreshadowing, such as the killer sending letters to strangers from the Boston phonebook asking for help with social skills, but no real answers. 

In this case, the alleged bombers seemed to be well-liked.  A photoessay of the older alleged bomber from 2 years ago is no longer available online, but this article has many photos from it and the key photo captions, such as saying that he has no American friends.

Whatever the reasons for these divergent paths, these patterns emerge during adolescence and young adulthood, although likely they are forged in childhood, infancy, and even before.  

Adolescents and young adults are at a turning point in life, and the uncertainty inherent in that transition is often stressful.  Here one 19 year old has put the entire city of Boston on lockdown.  He has made a huge negative impact on the world.  In the coming days, we will wonder what could have prevented him from taking such a destructive path.

We'll probably never know, but thankfully these extreme situations are rare.  More common are adolescents and young adults who destroy their and others' lives in more quiet ways.  UNICEF just released a report ranking the US at the bottom of rich countries in child well-being, below even Greece.  The entire nation is transfixed by a single demented individual, while entire sectors of US society are impoverished in ways that will increase their propensity for more mundane forms of violence, and we will feel the impact for decades.

Media coverage of "Cash, cars, and condoms" paper in Journal of Adolescent Health

Our newest paper on women getting money from their sexual partners was just published in the Journal of Adolescent Health, and covered by
ABC News, the
Health Behavior News Service (by Laura Kennedy), the
Empowerher blog (by Susan Cody), and in Latvian (?).

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.

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.

Origins of eating disorders among religious teens

This NY Times article about eating disorders among Orthodox Jews raises some theories about the origins of eating disorders in this population, but I think there are some other possibilities.

Modesty may make it harder to dress well for women who are even slightly overweight. Thin women look fine in a wide range of clothes, but slightly overweight women need to be creative in ways that don't always work with modesty restrictions --- showing cleavage is a good way for men not to notice extra fat elsewhere.

Also I suspect that being sexually involved is helpful for overweight women and their partners to feel good about their bodies. For religious women, that reinforcement isn't available. Religious men who have no experience either way may assume that thin women are better in bed. Alternatively, thin partners are more socially valued, and the social value may bring gratification pre-marriage. Likewise, religious women cannot feel sexy or sexually empowered by sexual activity. They may feel sexually empowered about how thin their bodies are, so they may seek thinness as their primary form of feeling sexy.

Because these alternative outlets for feeling desirable are not available to Orthodox teens, they need to find other ways of feeling good about themselves. I wonder whether the types of exercise that are incompatible with anorexia, such as weight lifting where it's important to eat minimum amounts of protein (0.5-1 g protein per pound of body weight) and to be moderate in quantity of exercise (every other day, at most), would be helpful. Gymnastics, dancing, rock climbing, and other ways of using that strength could also be helpful in helping teen women feel confident about their bodies, and also staying healthy.

Meanwhile, teen males also need to change their attitudes and how they perceive women of different sizes. That's harder, especially if they do not interact much with the opposite sex.

Thursday, July 1, 2010

13 year old girl performs abortion with a pencil

So many things wrong in this news story: in Pennsylvania, a state requiring parental consent for abortions, a 13 year old girl pregnant by her 30 year old "boyfriend" attempts to perform an abortion with a pencil, goes into labor, boyfriend buries the stillbirth or baby in a plastic shopping bag in the woods, and girl goes into hospital.

Things wrong:
1. Sexual coercion of minors often happens in families where parents just aren't paying attention. Parents are so out of the picture here that this 30 year old "boyfriend" has been with this girl for 1 year.
2. Even in the best of cases, adolescents have undeveloped judgement. Where teens will not involve their parents, doctors are the next best alternative. Not allowing doctors as an alternative, teens turn to their own judgement. Adolescents' brains aren't fully developed, so they may not see consequences of their actions.
3. Shady characters like pedophiles have poor judgement. This fellow may even be a murderer if baby was born alive, and yet the boyfriend is the only adult acting in this story. A legal abortion would involve doctors and nurses.
4. Finally and most importantly, illegal abortions are dangerous. On top of the trauma of pregnancy which is usually unsafe for a 13 year old, she had to be hospitalized.

Laws have to work at the borderlines. Most pregnant minors are 17 or so, many parents are supportive, and most teens tell their parents about their pregnancies, but 12 year olds do have sex and get pregnant, and often it's in crazy cases like this where the parents are just not paying attention. In my 8th grade class of 70 children in the best-funded school district in Illinois (at the time), we had 1 pregnant girl, and same in the year before us class of 60 children, a pregnancy rate of about 3% for those two years.

In Utah, a similar case of a woman asking to be attacked in order to induce abortion created a new anti-abortion law.

Could this case possibly cause Pennsylvania to alter its abortion laws so that parental consent was no longer required? I wish, but somehow it seems unlikely.

Do teens consider oral sex to be sex?

A recent study finds that only 20% of a convenience sample of teens consider oral sex to be sex. This finding has been documented anecdotally, such as in the classic scene from the 1994 movie _Clerks_, where the main character is described to hear the discrepancy in his girlfriend's number of sexual partners and number of oral sex partners. (3 vs. 37.) He had only been told about the former.

Of course there's the caveat that this convenience sample has no implications about US teens' norms in general since the sample wasn't random.

Quantifying and qualifying casual sex

A recent paper compares measure of "psychological wellbeing" between people whose most recent relationship was casual versus serious, and finds no difference. The paper motivates itself by the speculation in public discourse and the teachings of abstinence-only sex education that casual sex is harmful.

The qualitative research on the subject of casual sex seems pretty clear that, to the extent that they exist, the harms of casual sex would be unlikely to be found on a psychometric measure. Kathleen Bogle's qualitative study found that college-aged women feel frustrated and sometimes their feelings are hurt by differing expectations, which is also consistent with what Laura Sessions-Stepp reports in her journalistic book. I haven't ever seen anyone suggest higher rates of mental illness among people who have casual sex. It seems highly unlikely that casual sex poses a public mental health problem. (Casual sex does likely increase the total lifetime number of sex partners, so increases STD risk, but that's not the main issue here.)

The lack of a quantitative measure for romantic frustration doesn't make it unimportant. Just as quantitative research finds that married men seem to be in better physical and mental health than unmarried, but no difference for women, doesn't diminish the importance of the desire of many unmarried women to be in committed relationships. Likewise, quantitative research finds that people with children are more unhappy than people without, and yet there is an entire medical subfield dedicated to making people unhappy by helping them have children. (Likewise, my understanding is that US medical doctors stopped performing sex reassignment surgery after quantitative studies found no improvement after surgery, and yet qualitatively transgendered people who choose surgery report an improvement.)

Intangibles are important. Keep those qualitative studies coming.

Twilight books romanticize domestic violence?

The Twilight book series has been thought of as promoting abstinence, so I've followed it somewhat because of my work. I found it interesting to read this post, which goes through the checklist from the National Domestic Violence hotline for Bella and Edward's relationship, and finds 15 signs that their relationship is abusive. Fifteen! I have only read articles about the books and movies, not read the books or seen the movies myself, so I am frankly surprised to hear that Edward throws Bella through a glass table. But even the other signs, like repeated statements of jealousy, abandoning her in a dangerous place, threatening suicide. . . This is supposed to be romantic? Religious groups can't possibly approve of these books, abstinence message or no.

Also: the view from a school librarian (and member of my Cambridge synagogue).

Women's recurrent need for self-defense

We had three related stories in the news this week:

• India's women-only train cars, necessary due to extensive harassment and recent increase of women working outside the home;
  
• the murder of a Yale graduate student by a co-worker, which New Haven police emphasize is an issue of workplace violence, not domestic or street violence;
  
• a Hopkins undergraduate's accidental killing of an intruder using a samurai sword.
  

I'm glad that the New Haven police again emphasize that the primary risk to women is the people they know rather than strangers on the street. People have an easier time thinking about self-defense from strangers. Strangers are the least likely attackers, but the line between an attack and a non-attack is brighter, which may be why the Hopkins undergrad was able to take such decisive action; it's obvious that the intruder did not belong there and had already committed a crime. In the case of an acquaintance, it's harder to find the line between minor conflict and potential violence.

According to the National Crime Victimization NCVS survey, 2 million people are the victim of workplace violence on average each year, with homicide being only the extreme of the scale of violence. Workplace violence is the second highest cause of workplace death for women. I wonder how these figures compare with other countries, and what proportion are due to guns, or whether the US is somehow more violent due to inequalities.

Hearing these stories, I've been feeling grateful that my mother took me to a multi-week self-defense class when I was a young adolescent. The class was run by a Chicago organization Chimera that emphasized response possible at each level of escalation, and the realistic responses that women can make to each level appropriate to the situation.

Judging from the murderer's injuries --- "bruises and abrasions on his arms, a mark under his eye, a scratch on his right ear, and a bruise or deep scratch to his chest" --- the victim employed the most common ineffective self-defense tactics. If someone is intent on hurting a woman, the only way for her to stop them is to disable them somehow. Arms and chest are strong, especially on a man, but we learned that even strong people have weak parts and effective self-defense includes poking eyes, striking nose with the palm, using keys as weapons, stomping on tiny foot bones, and dislocating knees.

Of course it's impossible to know what really happened, and everything is much easier said than done especially given the judgement call necessary to realize whether one is really in danger. This attack reminds me to take a self-defense refresher course and makes me thankful that I learned self-defense from an active feminist group as an adolescent so that it became subconscious, reflexive knowledge. I hope that I never find out how well I learned this material.

May her family and fiance be comforted in their loss.

Bar mitzvahs as the Jewish Rainbow Party?

Brandeis sociologist Shulamit Reinharz writes in 614 magazine, the magazine of the Brandeis women's research institute, that Jewish girls are giving oral sex as a bar mitzvah present, a topic people have been speculating about since at least 2005 (for instance, this 2005 David Brooks column is skeptical of what sound like old rumors even then.) Without better substantiation than the vague assertion from an unnamed Brandeis student that oral sex at bar mitzvahs is "common", it sounds like another rainbow party urban myth.

As head of a research institute, I'm surprised Professor Reinharz couldn't spare even a work study undergrad to investigate whether this claim has any basis whatsoever before raising alarms about it, much less publishing it under the name of an institution that might be considered an authority on "Authentic Judaism."

So we're the majority, now what?

Now that it's official that there is no money allocated to abstinence-only sex education, reproductive health advocates are firmly in the majority. Two articles that came up on my news alert email show contrasting approaches.

The first criticizes the National Campaign to Prevent Teen and Unplanned Pregnancy, which is a moderate organization that summarizes research on which sex ed programs are effective. They don't rule out that there might exist abstinence-only programs that work, but they say simply that there's no evidence that they work, and that moderation is why almost everyone trusts them.
This article doesn't see that moderation as quite so benign, saying they are not much better than the abstinence-only camp, calling them sex negative and saying they engage in "slut shaming", and that relationships don't turn out better if you wait to have sex until the 50th date instead of the 1st. That last question is an interesting one; as far as I know, there's no academic research on it, but I'd love to see the grant entitled, "Maximizing romantic returns: An investigation of the optimal time in a dating relationship until young women should put out." (Naturally to avoid confounding, the project would need to use matched sampling.)

The second articletalks about how complicated young women's sexualities are now, perhaps summarized as too much information without enough knowledge and wisdom. Women who initiate sex early do so under coercion, even without actual coercion many adolescent women don't feel comfortable saying no, and that when they say yes it is hesitant; she puts this well, so I will quote her:

The "yes" to sex and sexuality I hear young women often express sounds like the way many of us who took other languages in high school and trying to speak them in the country of their origin in our later years. Like asking with a feigned confidence where the drivel is when we wanted to ask where the bathroom was.

BGLT culture is more available to BGLT teens, yet only in certain places; women's bisexuality is accepted only as men's entertainment; and transgendered teens feel pressure to transition young, before age 18. Uniquely, she also emphasizes that teens' relative lack of responsibility compared to past generations (e.g., delays in moving out and getting a job) does not prepare them to take responsibility for their sexualities when the stakes are higher. Overall a fantastic summary: lots of questions, few answers other than the suggestion of communicating to teens that we understand that things are complicated.

When reproductive health advocates are in the minority, we show the status quo's failures. Even if it were right, the first article is not constructive; engaging in such divisiveness is a waste of a valuable opportunity to improve the situation. By contrast, the second article is constructive by laying out current problems of teen sexality in all their complexity. Now to move on to address them.

Teen-written sex ed site: sexetc.

Teen-written sex ed site includes an article "Kissing: are you missing out on life's simple pleasures" imploring readers to slow down and smell the roses; another article covers what abstinent teens do. One quoted teen says, “Now that I’ve been in a relationship for over a year and we’re considering becoming sexually active, I realize that my sex ed experiences made me terrified of sex. My teachers made it seem like everyone had an STD, and that contraceptives are expected to fail. If it weren’t for my own reading, I wouldn’t know what kinds of contraceptives are available.”

It's neat to read a quote by a real teenager illustrating what the GAO talked about in how inaccurate and negatively slanted abstinence education is.

Decreased contraceptive use among teens

I was pleased that the NYT editorial board highlighted the recent study by John Santelli, Mark Orr, Laura Lindberg, and Daniela Diaz about decreased use of contraception in an analysis of the Youth Risk Behavior Survey. As the media reports it, Santelli and collaborators found that fewer teens are using contraception than previous highs a few years ago, and the speculation is that the decrease is from abstinence-only sex education.

Other research certainly indicates that abstinence is one plausible explanation for the decrease in contraceptive use. The trouble is that there are many other possible explanations, but the trend data on teen sexual decisions is so poor that we'll never know which explanation is responsible for this particular decrease in contraception use. The survey used by Santelli has at most a dozen relevant questions, and any information beyond that gets lost to the mists of time.

Some teens get pregnant because they want to. It's not a question of not knowing how to use birth control; they want someone to love them or to establish themselves as adults. Other teens get pregnant because they are in coercive relationships with older men who support them financially --- perhaps especially relevant in insecure economic times --- and the men want babies. I heard a story from a Maryland public school teacher about a 14 year old girl in her class who recently got pregnant because her 20+ year old boyfriend and his mother wanted her to; the boyfriend's mother wants to take care of the baby and the girl's mother is indifferent to the situation.

These stories represent more fundamental social problems than simply inconsistent or incorrect condom use, but the current data is so poor that if one reason for the lower contraceptive use was that more girls are being coerced by older partners to get pregnant, we would have no way of knowing. Such issues of teen pregnancy are not liberal or conservative, but some conservatives are opposed to funding surveys that would collect data to better understand the issues because they are uneasy about asking questions about sex to teenagers. If they could better understand the implications of their opposition, and what a good investment it would be to understand teen pregnancy better by funding an annual survey that monitors issues exclusively relevant to teen pregnancy and STD prevention, perhaps we could start to decrease the rate of teen pregnancy.

Forever relevant

A retrospective look at Judy Blume's Forever, a book about a couple's first love and decision to have sex. (The article was published 4 years ago, but is making the rounds again through reproductive health blogs.)

What the article does not mention is the issue of sex outside of romantic relationships which has become more normative in the past decade or two. What I like the most about this book is that having such a healthy relationship of communication portrayed in the book creates an ideal that might discourage teens from pre-relationship and non-monogamous sex. Adolescents have famously short time horizons, and will wait for marriage only extremely particular conditions and maybe not even then, but waiting for a devoted and loving girlfriend or boyfriend rather than just a sex partner may be attainable.

Life Values and Intimacy Education

I just finished reading
a paper about the new sex education curriculum sponsored by the Jewish Orthodox rabbinical seminary at Yeshiva University and was really impressed.

It's truly comprehensive: it goes from elementary school through 12th grade, follows the sex education guidelines of SIECUS (an advocacy group that is unfortunately dismissed by the evangelicals as a fringe liberal group), and teaches the students about masturbation, condoms, and that they're not allowed to touch or be alone with the opposite sex: really abstinence-plus. And they teach 11th graders about sexual ethics based on the Talmudic story of the yeshiva student who visits a prostitute.

I haven't seen the curriculum beyond this paper, but what I've seen is fantastic. (As when I look at evangelical books, I overlook the wording issues that seem overly normative.) I'm sure once I see the whole thing I will have a more mixed opinion.

My favorite part is the list of questions to ask about people you're dating:

1. Do I treat the other person as a person or a thing? If you go out
with him/her because he/she is good looking (a “prize” to be
with) or a way out (a ticket to the movies), that isn’t love.
2. Would you choose to spend the evening alone with him/her if
there were no kissing, no touching, and no sex? If not, it isn’t
love.
3. Are the two of you at ease and as happy alone as you are with
friends? If you need other friends around to have a good time,
it isn’t love.
4. Do you get along? If you fight and make up a lot, get hurt and
jealous, tease and criticize one another, better be careful, it may
not be love.
5. Are you still interested in dating or secretly “messing around”
with others? If so, you aren’t in love.
6. Can you be totally honest and open? If either or both of you are
selfish, insincere, feel confined, or unable to express feelings,
be cautious.
7. Are you realistic? You should be able to admit possible future
problems. If others (besides a parent) offend you by saying
they are surprised you are still together, that you two seem so
different, that they have doubts about your choice, better take
a good look at this relationship.
8. Is either of you much more of a taker than a giver? If so, no
matter how well you like that situation now, it may not last.
9. Do you think of the partner as being a part of your whole life? If
so, and these dreams seem good, that is an indication of love.

Good Morning America goes back to the 1950s

Yesterday was the National Day To Prevent Teen Pregnancy, so the issue got some coverage including Bristol Palin on Good Morning America.

The GMA segment on the subject reminds me of something from the 1950s or 60s where contraception and sex were only hinted at and discussed in veiled terms that only adults could understand.

Bristol Palin's last statement on abstinence a few months ago was incoherent and stumbling but included a statement that "abstinence is not realistic." That interview didn't seem to mention birth control either.

This time she has her talking points down and she gives a well-articulated message. "Abstinence is a hard choice, but it's the safest choice and the best choice." The interviewer asks what's the second line of that since teens might "roll their eyes" at abstinence (is that what they're calling it nowadays?) and her line is, "It's the safest choice, and it's something that kids should know about."

That is, the best choice is abstinence. And the second best choice is also abstinence. And the third best choice. And the fourth choice. Is that really what she means to be saying?

They also had a guy from an anti-teen pregnancy foundation started by a teenage shoe company who summed up the foundation's motto as "Just because you're wearing high-heeled sexy shoes, obviously you shouldn't have a baby."

The only discussion about birth control is impossibly muddled:

Host: "Do you think it has to be black and white, abstain versus protection, or do you think there is going to be some middle ground?"
Palin: "Yes I think definitely some middle ground."
Foundation guy: "Abstinence is obviously the best way, but being realistic you gotta talk to teenagers and say anyway, whether it be protection ... having a baby... a kid having a kid is just not right. Any way you can get through, we have to educate."

What exactly is this middle ground between abstinence and protection? Presumably they don't mean as in this joke site dedicated to "abstinence" from acts that can get women pregnant. It's a shockingly bizarre statement.

There is no getting around it: Teaching birth control is the middle ground.

Abstinence makes your brain stronger

"Abstinence Makes the Brain Grow Stronger" read the headline, but it turned out they were talking about abstinence from alcohol during adolescence.