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Caroline Ford and Angela Saini

These categories and the reasons we think about femininity and masculinity in the way that we do is not because of biology, it's because of the ways in which cultures have taught us to think about these things and these ideas have been used to hinder women much more than they’ve been used to free us.

Angela Saini

As we move beyond the pseudoscientific ideas of the past, what mistakes are scientists and doctors still making when they think about sex and gender?

On International Women's Day 2021, British science journalist and author, Angela Saini, joined leading cancer researcher and founder of the STEMMinist Book club, Caroline Ford for a conversation about bias in science, medicine and the public understanding of gender, and how to build a more accurate picture of human difference.

The Centre for Ideas’ international conversation series brings the world to Sydney. Each digital event brings a leading UNSW thinker together with their international peer or hero to explore inspiration, new ideas and discoveries.


Ann Mossop: Welcome to the UNSW Centre for Ideas podcast, a place to hear ideas from the world's leading thinkers and UNSW Sydney's brightest minds. I'm Ann Mossop, Director of the UNSW Centre for Ideas. We're coming to you from UNSW Sydney campus, and I'd like to acknowledge the Bidjigal people, the traditional custodians of the land and pay my respects to their elders past and present, and to Aboriginal and Torres Strait Islanders people who are with us this evening. On International Women's Day, our conversation titled, Inferior, from Angela Saini’s book of the same name, is about gender in science and medicine. Our host is Caroline Ford, a cancer researcher who leads the gynaecological cancer research group at the Lowy Cancer Research Centre at UNSW. Caroline is a brilliant communicator about science and medicine, an avid reader and the founder of STEMMinist book club. Welcome, Caroline.

Caroline Ford: Thank you Ann, and welcome everybody, to my conversation tonight with the absolutely brilliant Angela Saini and Happy International Women's Day. So Angela is a science journalist and author of three prize winning and highly regarded books on science, sexism, and racism. Geek Nation, Superior, and Inferior. Angela is one of my heroes, and I know she already has many fans in Australia from some of her visits here for writers festivals. But I am so delighted to actually have the opportunity to introduce her to perhaps some of you that have not heard of her work before. So I'm thrilled about tonight, I'm pleased that she's gotten up bright and early in chilly London. So Angela, welcome and Happy International Women's Day.

Angela Saini: Oh, thank you so much, happy International Women's Day to you too.

Caroline Ford: So for those of us here in Australia, where many of us are wrapping up, you know, a busy International Women's Day with events and panels and, and all sorts of different things, discussing women. But I'm really curious as to your opinion on International Women's Day, as it becomes, sort of, increasingly corporatised with inspirational breakfasts, sort of, goodie bags, cupcakes for everybody. What do you think the relevance of International Women's Day is in 2021?

Angela Saini: This is a hard one. I agree with you. I mean, I've been to one of those breakfasts myself, last week. The ones that feel like they're a bit more about the goodie bag than they are about actually moving forward the conversation. I do think it means different things to different people. I think that's true of feminism as well. I think for many women, feminism is about solidarity, about coming together, about having spaces where they can discuss their issues. For many of us, it's also about moving forward on quite fundamental issues around girls' education, domestic violence, abuse, you know, smashing the patriarchy, gender gap, pay gap around gender, and other issues. But I don't think that's a bad thing. I mean, you know, it's going to mean different things for different people, because we're all different in our aims and what we care about, and that I guess that's just how it is.

Caroline Ford: Yep. So the title of this evening's event, Inferior, is also the title from your book of a number of years ago. And it actually comes from an exchange you uncovered in your research for the book between Charles Darwin and the feminist, Caroline Kennard. So can you tell our audience a little bit about that story? Because I find it so fascinating and enraging.

Angela Saini: Well, it was interesting, I first saw this, kind of, body of literature that… so online, the University of Cambridge have been collating correspondence between Darwin and other people. And I saw a snippet of an exchange that he had with Caroline Kennard who lived in America. And she was a women's rights activist there in the 1800s. I think it was around 1880 that she first wrote to him. And so I went to the library to look at it, so I could actually see what they had written and the way that they had written it. And I think that was illuminating because when you just see text written on a screen, transcribed, you don't get a full sense of how that person was feeling. And, and the way that it was written, their penmanship really did reflect the way that they were feeling. So Caroline Kennard’s first letter to Darwin is very neat and beautiful and quite concise. And essentially what she's asking him is, I've heard people say to me, that you think that women are not the evolutionary equals of men, that, you know, that we're not as smart as men, please, can you correct this misconception that people have about your work because it's doing a lot of damage to movements for equality or, you know, something along those lines. And Darwin writes back, and his writing is a bit scrawling, and in fact, if you look in the library, someone has had to transcribe the interview onto another piece of paper. I don't know when they did it, in history, but they've done it, because it's very difficult to read otherwise. And he's written back and said, well, actually, this is what I think, I do think women… actually, I've got it here. I certainly think that women, though generally superior to men, in moral qualities are inferior intellectually – slightly patronising. And then he goes on at length to explain how if women were to catch up with men, they would have to enter the workforce, and work in the same way that men do. And that wouldn't be a good thing, because it would disrupt the family harmony, that would disrupt homes. So it's patronising on so many different levels, but also reveals… actually what is also written in his published work, so in the Descent of Man as well, he also talks about women being the intellectual inferior of men, intellectually, in moral qualities, different, but intellectually, not the same, that we are somehow less evolved. And in her reply, Caroline Kennard, her penmanship is completely different. It's much longer, it's angrier, you can see how enraged she is by this. And essentially, she says to him, and again, I'm going to quote here, let the environment of women be similar to that of men, with his opportunities before she'd be fairly judged intellectually inferior, please. And that is such a wise and perfect thing to say, because, of course, what Darwin was doing at that time, what many scientists were doing at that time, because of the way that the science of human difference had been constructed, in a way within the west, to assume that women were the intellectual inferiors of men, was to ignore what was going on in the world around him. How were women and you know, Darwin is judging women based on what he can see in the society that he's in, how are women supposed to be doing the same as men, when they're not allowed to go to university, when they're barred from the professions, when they don't have the vote, when they are judged for every little thing that they do outside the home? How on earth are they supposed to be proving themselves the intellectual inferiors of men, and this is what Kennard really brings up into sharp relief for him is that how, how dare you judge us before you really know who we are?

Caroline Ford: Yeah, so without knowing what women are doing and are capable of, and the work they were doing in homes and in other spheres, but also that without equal opportunity how could they possibly be at the same level. For me as a scientist, so I am a scientist, you know, I've done my bachelor and my PhD and worked in research for over 15 years, when I read that in your book, it was, it was so shocking, because for me, and those of us trained, particularly in biological sciences, and medical science, Darwin has this unparalleled, sort of, legendary status, as, you know, as this absolute, you know, pillar of reason and, and, you know, absolute expertise. And so, to realise that he too, this man of such brilliance was actually shaped by his environment, and the attitudes of the time, just totally cut through for me and clarified the idea that science is not neutral in any way, as we are really led to believe. And so that is the central tenet to me of both of your books, Inferior and Superior, really, that science is performed by scientists who are people that are, of course, bringing their own politics and bias to everything that they do. So can you expand a little bit on that to our audience, because I think it's not necessarily the public view of science, a lot of people will think of science as neutral and governed by the scientific method and apolitical.

Angela Saini: Yeah, and I think to some extent, the scientific establishment over centuries has tried to nurture that impression, because like any powerful institution, it wants to believe that it has authority and objectivity, perhaps, that even though it doesn't have it in, in real life, but right at the birth of modern Western science, from the Enlightenment onwards, there were certain assumptions made about human difference that came to shape the way that human difference will be studied for centuries, and even up to this day. I mean, the fact that we still worship Darwin, you know, within science, we still worship Darwin, is really a product of this. But one of those assumptions was that women were not the intellectual equals of men. So it was quite normal in Western Europe, as the scientific establishment was starting, so as universities were starting to proliferate, and certainly, when the first scientific academies were developed, and these were the gateways to professional science, this is what they became, as science stop becoming a kind of amateur thing, something that rich people would do in their spare time, and started to become more established, and started to have gatekeepers. The scientific academies like the Royal Society here in London, were crucial. And they as a matter of course, from the beginning, barred women. In fact, there were some universities that wouldn't even allow professors to marry because it was thought even the presence of women in their lives would somehow disrupt the intellectual work that they were doing. And that didn't really change until well into the 20th century. So the Royal Society here in London, for instance, they didn't start admitting women as members until 1945. So this was, that was the year my dad was born, so it's well within living memory. So we have to remember how much these political assumptions at the start, you know, not at all informed by anything other than prejudice. We didn't have molecular evidence, we didn't know how brains were structured, we didn't have any ways of judging intelligence, this was just based on people's prejudices in the West. And, you know, mainly upper class men who were making, devising these things, that that came to shape the way that human difference would be studied. And the same goes for race. I mean, another assumption that was made was that perhaps we weren't one human species, that we were different breeds, or different races. And that's how scientists came up, naturalists came up during the Enlightenment with racial categories that we use now. They didn't exist before. So these colour coded black, white, yellow, red, brown, very crude racial categories that we still use today, were developed at that time, and came to be shot through with so much meaning, so naturalists like Linnaeus, for instance, didn't just talk about skin colour as a superficial, skin deep quality, but something that told you a lot about someone's psychological makeup, or their intellectual makeup. So he is marrying cultural observation and prejudices about what people were capable of, with their skin colour, and tying that all together. And those stereotypes are still affecting us to this day, you know, by the 19 century, these ideas were so ingrained within the sciences. And this kind of helps us understand why Darwin thought the way he did, because it was so shot through the whole science of human difference in the West, was completely shot through with this idea that these fundamental differences between groups existed.

Caroline Ford: So fascinating that it's such recent history, but also how pervasive these ideas remain. And this idea of race, which we know to be a social construct, is still being perpetuated in lots of fields of Medicine and Genomics, and lots of different areas to this day. So, yeah, for anyone that's interested in this do read Angela's book Superior, which clearly explains, sort of, the history of race science, but also how it is rising again now, and it's, it's a shocking read, but it's also really important, I think that people learn about it. Which actually, sort of, leads me a little bit to one of the other questions I was going to ask you, is, again reflecting on my own science education, there was very little history of science that I was taught, I was taught about DNA, and about structures, and chemistry, and maths and, and we learned about, yes, these great men – and they really were primarily men – of science, but I didn't learn at depth about the history of science, the problematic history of science. Do you think we should be teaching undergraduate medical and science students this type of history? And if we did, What difference do you think it would make?

Angela Saini: I think the difference would be profound. I mean, I couldn't agree with you more that when we contextualise scientific knowledge, then it takes on a completely different… the stories are completely different. You know, we just don't see those ideas in the same way. For me, I studied engineering at university and I, like you, I didn't get really any training at all in the history of science. I learned concepts, I learned the formulae. I learned how to build bridges and understand how things worked, but didn't understand why things were named after the people that they were, and why they came up with these concepts in the first place. For example, there are lots of concepts within statistics, statistics itself, a field that emerged out of eugenics in the late 19th, early 20th century, in order to be able to understand human difference better, in order to be able to pick out who are the weaker, so called, weaker elements in society, and who are the so called stronger elements in society who should be encouraged to breed and who shouldn't. And we have to understand that, because otherwise, it's very easy to fall into those same traps in the 21st century. I still see it happening. You know, it's only December 2019 that a paper was published in Nature Communications, trying to find genetic… using public data, so this is public DNA data donated to the UK Biobank, trying to find genetic loci associated with income. I looked at that, many of us looked at that and thought, are we in the 1920s again? What are people trying to prove here? Trying to marry social differences, you know, and we already know how fraught, that is, trying to look at social inequality, and find genetic basis for it. It's so devastatingly dangerous. And yet, I think it's because we don't understand these histories that we find it so easy to fall into these traps. We haven't interrogated the problems in the past as much as we should have. And now we're in this awkward situation where institutions, and I work with a number of scientific institutions and museums here in the UK, and in some other countries, and because of Black Lives Matter, and because of this huge reckoning that's coming, you know, you go on social media, everyone is digging up these histories and revealing facts to us that we should have been taught when we were growing up, but we're only just learning them for the first time, many of us, and now thinking, oh, my goodness, we now need to think about who this is named after, and understand the legacy of this person, and rename this eugenics fund, or rename our lecture theatre. And it's very hard because it feels so it's very sudden, it feels like a culture war – it's been described as sometimes – but really, it was inevitable. You know, as soon as this information was made available to everybody, then of course, we, you know, we were going to recognise those historic injustices and try to think about, actually, then how do we want science to move forward in the future?

Caroline Ford: I think I absolutely agree. I think people need to learn about the history, and I think we need to be very careful about who we set up as our heroes of science and who we celebrate, and not just dismiss it. As I often hear people say, oh, it's just because they were men of their time, it was, you know, those were the predominant views of the day, and therefore, you need to accept the fact that while in 2021, it might feel like they have, you know, frankly, hideously sexist and racist views that was predominant at the time. So we will excuse that and we will just recognize their brilliance. And I find that difficult. What about you?

Angela Saini: Well, I was just going to say that we have to… I do take that time argument because you know, entire societies, eugenics, for instance, was popular right across the spectrums, it drew in prominent politicians, intellectuals, writers, scientists from the left and the right. But we also have to remember that there were huge arguments also at the time around these questions, that there were scientists that push back, there were thinkers that pushed back, and unless we understand those debates, I think we don't really, you know… that kind of, they will people have their time argument doesn't really make any sense in that context, because we have to understand, why did people push back? Why were there counter arguments, even at that time? And why did they not win that argument at that time? And I think sometimes that's what we leave out. And it's not just about, you know, male scientists, it's also about white feminists. I mean, there were Marie Stopes was a eugenicist, who is again a feminist icon, Elizabeth Cady Stanton, who is, you know, a huge symbol, pioneer of the women's suffragists movement in the US was quite happy to throw black women and men under the bus in the fight for women's rights. We need to understand those complexities and understand why they existed at the time in the way that they did.

And I think, I mean, that's one of the wonderful things about social media and, sort of, the opening up of spaces and media, to more voices and diverse voices in that we are having this conversation, increasingly, but I still don't see that being integrated in to, sort of, education. And I think, you know, many of us come to that realisation later in our careers. And it would have been so helpful, I think, particularly for me to have known this history 20 years ago. I think the other, sort of, discussion I wanted to have was around, you know, where do these ideas come from? And where do these myths around men and women and around race come from? And obviously, a lot of that has to do with how science is interpreted and how science is discussed, in the media predominantly. So I wanted to ask you, sort of, specifically what implications you thought this had had for how we think about men and women, the reporting of the science that's been done on biological sex? And do you think, therefore, that the view that some women are inferior, in some aspects, does that persist in society and have you seen any recent examples of ways scientific research is reported that perpetuates this myth?

Caroline Ford: Without a doubt, I think depending on where you look, so there's so many different layers to this, I think, for the book that I'm writing at the moment, one of the interviewees told me that every wave of feminism bring brings with it certain arguments and certain debates around female specialness. And that female specialness idea does play out, I think. It feels positive, it feels as though these positive stereotypes are a good thing. You know, when people, for instance, I've heard a number of times recently that women leaders have done particularly well during the pandemic, and then people speculating about whether this is a quality, particular to women leaders, that they have more empathy, or a certain feminine quality that make them better leaders. And we have to ask ourselves, why do we do this? Why do we look at women leaders as a group, number one, and then assume that they have some kind of shared characteristics that make them better? Number one, this is problematic, because what if they hadn't done better? What if these women leaders do worse, during the pandemic, would we then ascribe their femininity in some kind of negative way, about their performance? And, you know, most importantly, of all, maybe it has nothing to do with their woman-ness at all. I mean, that is the part of the equation that we never hear, maybe they are just, as individuals, very, very good leaders. Maybe they're just very skilled, capable people, independent of whether they're men or women. And even if even if they do have some qualities, you know, as women, as a group that makes them better in a pandemic, I have heard this, this kind of essentialist argument that they have, perhaps is something, you know, innate to women, that that creates empathy, or gives us his certain feminine qualities, when of course, this is heavily mediated by gender. And you can see in books like Cordelia Fine’s Delusions of Gender, are in Gina Rippon’s book, The Gendered Brain, you can see how dangerous it is to assume that there are certain inbuilt biological differences between men and women that manifest in the, kind of, social differences or environmental differences that we see out in the world. Because we are so shaped by our upbringing, you know, we are taught so many loaded things about who we are from the second that we're born. I know that one of the reasons that I studied engineering, and yet I was the only girl in many of my classes is entirely because I happened to grow up in a very egalitarian family, where I wasn't exposed to these issues, where I wasn't told that girls can't do this, or boys can't do this, I was given the same toys as everybody else. You know, I played with meccano. Meccano was my favourite toy when I was growing up. And I wasn't at any point, given the message that I couldn't be an engineer, even though my dad was an engineer. I was given the message that I could be an engineer because my dad was an engineer. And I know that girls aren't getting those messages as they're growing up, in the same way that boys aren't getting the message, that they're allowed to cry, or they're allowed to be empathic, or they're allowed to show their emotions, or they don't have to show that stiff upper lip, for example, in certain, you know, depending on the culture that you're in, we have these certain gender stereotypes. So I think we need to be so much more careful in the way that we pick apart what we say about men and women and the generalisations that we make, and not fall into the trap of biological essentialism. Because as I said, these categories and the reasons that we think about femininity and masculinity in the way that we do is not because of biology, it's because of the ways in which cultures have taught us to think about these things. And these ideas have been used to hinder women, much more than they've been used to free us in the past. We have to be so cautious about saying that we need equality because women bring something different to the table. Yes, we may bring something different to the table because of our experiences, because of our social experiences to the world. But that doesn't mean that men can't also be empathic or that women can also be tough and cruel. And, you know, all the other negative qualities that we also associate with humans, we are individuals, I think, first and foremost. And sometimes I think that gets lost in these debates. 

Caroline Ford: I agree, and I think, often from very well meaning people, as well, and very well meaning feminists that sort of, you know, highlight amazing leaders like Jacinda Ardern, and will say, you know, isn't it fantastic the COVID response in New Zealand, let's compare that to Donald Trump in the US. But maybe the reality is not that it's anything to do with the sex of those individuals, but maybe that Jacinda Ardern is exceptional, and Donald Trump is an example of a mediocre man. I think we need to think about it a little bit more.

Angela Saini: And also, sorry, I was just gonna say that, you know, society, many societies, particularly the US remains so sexist, that they would rather hire an incompetent man into leadership than a very competent woman, or a very competent black person, you know. Look how brilliant Barack Obama had to be, how exceptionally overqualified he had to be to get the position of president, and how spectacularly under qualified Donald Trump could be and still become president. 

Caroline Ford: Yeah, shocking, and I think probably resonates with many Australians thinking about politics here at the moment, but we weren't talking about that too much. So that does lead us on to this idea of kind of biological essentialism, I think is really important. I'd like to try to unpack that a little bit with you, in regards to the impact of sex and gender on modern medicine. So, you know, it's well established that the history of medicine has been dominated by men and that this patriarchal system has led to a reduced focus on some women's health conditions. So, things like ovarian cancer, or endometrial cancer, which I research, or endometriosis, which is getting a lot more attention these days, or really any number of conditions that deal with women's pain. But I'm cautious about some of our conversations around the differences between sex and gender. And so, I guess, my question to you is really, how do you think we can more clearly separate out the difference between a lack of focus on women's health, which is really due to a consequence of structural sexism, from a very different argument of a binary idea that men and women are inherently different biologically, and should be treated as such and studied as such? How can we separate those ideas?

Angela Saini: This is such a brilliant question, and this is why I love you. You think about these things so carefully. But yes, I absolutely share in your concerns, and I've noticed it over the last few years. And again, I think this is in some ways a product of identity politics in an age of social media. I'm in favour of identity politics, I think we need it because otherwise how do you address historic wrongs and give rights to people who have been oppressed as a social group? The problem is when you start to treat that social group as though it is kind of biologically distinct, in some ways, special in some way, in the way that I've just described. And certainly, I've seen this in the literature over the last few years. I reviewed a book for the telegraph last year, called, I think it was called, The Biological Superiority of Women, or at least that was the subtitle. And that was written by a doctor in the US. And he essentially made this argument that women are better than men in every way, in every way, not just in a half term, but in every way stronger because of this, the Double X chromosome, and that men are disadvantaged by their x, y, which puts a lot of weight on that single x chromosome. 

Caroline Ford: So much on DNA. 

Angela Saini: A huge amount of weight!  Because there are so many other chromosomes out there, number one, that give us our individual differences. But I think, part of it is to do with the fact that, of course, we can see these gender disparities out there in the world, especially within health, we know that women's pain is neglected, and what we want to be able to do is say that the differences that we see are a product of the fact that we don't understand women's bodies enough, and we don't understand men's bodies enough in relation, you know, as a different set. And yet, when you look at the actual data that we do have, because we do, sex difference research is not taboo, it's been done for many, many decades. And like I said, it's been very popular right throughout history because of this assumption of a distinct binary between men and women. In the 1920s, when the sex hormones were first isolated, and discovered, scientists were shocked. In fact, they were very reluctant to accept that a sex hormones that they associated with men and women actually didn't exist only in men and women, that men also have oestrogen, women also have testosterone, that the levels can vary very much between individuals. And they didn't think that was possible because of this concept that the binary was so distinct, and so strict between men and women, and that somehow underpinned all the differences that we see out there in society, you know, the social and behavioural ones. And I worry sometimes that we slip into that, again, even though we know from the data that most drugs work in everyone, regardless of race, or sex, we know that. There are certain drugs, and I wrote about this in Inferior, a very small number of drugs that the FDA found had more adverse reactions in men than women, a handful of drugs. And yet in most of those cases, it was to do with size, rather than sex. So it's not to do with genetic issues. It is because of size and we know that there is an average size difference between men and women, we have to also remember that that average size difference is exacerbated by the way we treat men and women. So for example, in many societies, women will not eat as much as men, they will not bulk themselves up as much as men do. You see in very egalitarian hunter gatherer societies, in fact that men and women actually look quite similar. They can actually look physically quite similar and that's because you don't always see these kinds of distinctions. So the size differences are sometimes artificially created. Sometimes they are biological, there are average differences. I'm not denying that there aren't some hard differences between men's and women's bodies… or harder differences between men's and women's bodies, in our reproductive systems, in our hormone levels. But we have to, kind of, balance that with an understanding the individual difference, when it comes to most diseases, actually plays a much higher impact on health outcomes, especially when you look at the things that kill us the most, things like heart disease, heart attacks. So for instance, in Inferior and Inferior came out in I think, 2016, or 2017. When I was writing that book, it was quite orthodoxical to assume that women suffered different heart attack symptoms from men, that we are more likely to suffer atypical heart attack symptoms than men are, and that could possibly explain why women are less likely to be diagnosed with a heart attack even when they're having one. And actually, I was corrected in 2019, when I think it was 2019 or 2018 – sorry I've got it written down here somewhere – when a study was published – yeah, 2019 study – that was funded by the British Heart Foundation, carried out at the University of Edinburgh, that actually looked at the data around heart attacks, and found that women are just as likely to experience typical heart attack symptoms as men. One of the issues is that even when we experience typical heart attack symptoms, we are less likely to be believed, because we associate heart attacks with men, socially, you know, that's a gender difference. And because of that sexist attitude around who is likely to have a heart attack, even when a woman has typical heart attack symptoms, she's not diagnosed, as quickly or as effectively. So I really think we need to, kind of, like I said, with nuance and care, balance this idea of sex difference and gender difference with the disparities and differences that we see out in society, and understand how they interplay with each other. And I would just say here, actually, if anyone is interested in this topic, I would heavily, highly, recommend Gendersci Lab, which is run out of the US, Sarah Richardson and Heather Shattuck-Heidorn whose work is absolutely brilliant on this, members and head up that lab. But if you type in Gendersci Lab into Google, and you can see their work, and they just navigate this with absolute wisdom. And that is my first place to go. When I'm thinking about these topics.

Caroline Ford: It's so interesting, because I think, often I hear this myth of women's heart attack symptoms being completely different. I think that message came through loud and clear about four years ago, and it did get a lot of media coverage. But then the follow up science is not always as widely reported, and these myths don't get corrected. So, I think the point for me is, that without the actual research and ability to do sex disaggregation of data, to run clinical trials where you actually have equal amounts of men and women to run clinical trials in women that might be menstruating, in women that might be pregnant. Unless we have that data and information, we won't actually know the answers to these questions. And if there are differences, I tend to agree with you that I think there will be more of a range, across men and women, then there will be two completely different categories. But as a women's health researcher, right? I strongly believe that we just need more attention and focus and funding into all of these areas so that we don't, you know, relive the past history where drugs were only tested in male rats or only tested in male clinical trials. And then we get to a situation where women are concerned about if that's going to be effective, in them as well. Because it's, you know, that's the history and it may be poorly communicated.

Angela Saini: Yeah, I think it's a, it's a very tough line to tread because I completely agree with you that we do need to include so many more variables when we're thinking about clinical research, and when we break down the people that we include in clinical trials, but that shouldn't bleed into this assumption that these groups are somehow so distinct, that drugs tested on men won't work in women. And that is just nonsense, really, there's no reason to assume that just because a man is a man, a drug will work on him if it’s tested on him then won't work on a woman. Because things don't work like that, you know, I, for example, I'm allergic to penicillin, it's nothing to do with the fact that I'm a woman. My dad is also allergic to penicillin. It's just a quirk of, you know, individuals. These individual quirks happen and they map out in humans in quite complex ways. The problem is we don't have a science of human difference that looks at us as individuals, it looks at us in groups. And this is something we also see play out. With regards to race. I have, you know, I myself have heard people say to me, can I take the vaccine, this new COVID19 vaccine, if I'm black, and it hasn't been tested on black people? And I have to remind them, no, it's absolutely fine. We are not so different underneath that drugs will not work in you. The reason that most drugs don't work in everybody is because of that individual difference. Take statins, for instance, a few years ago, a statistic came out here in the UK that showed that something like half of people taking statins are getting no benefit from them, or very little benefit from them. And that has nothing to do with the group that they belong to. It's about individual difference, and the fact that we will vary at that individual level. So I think it's a very careful line that we have to tread. When we pick the variables that we do, the way that we desegregate things, that invites comparisons. So, for example, age, age is by far the biggest factor in this pandemic, in terms of, who gets severely ill and who doesn't. We know it has nothing to do with genetics, because your DNA doesn't change between you being five and you being 75, at least, as far as I'm aware, not profoundly. And so we have to, kind of, think about the variables that we're looking at and understand why we're looking at the variables that we are.

Caroline Ford: And I guess a different example that I'd like to discuss, really, kind of, covers some of this issue that we've been talking about is actually menopause. So you discuss in your book Inferior, the pretty, actually, kind of, wonderful grandmother hypothesis, as it's called. And, sort of, how this idea about menopause came to be. And so perhaps some in the audience may not know that menopause actually only occurs in homosapiens. And it also occurs in orcas, killer whales, I think, but most other species, once the woman goes through menopause, then that's almost the end of the life essentially. So your book Inferior really discusses this so nicely, about the impact that the person doing the research has on the hypothesis that they come up with for the science and the data they see before them. I'm not putting that very eloquently. But can you tell us a little bit more about how menopause has been interpreted in history?

Angela Saini: Well, you know, this is how I got into this topic in the first place. Like I said, I studied engineering. And as a science journalist, I tended to cover engineering and physical Sciences stories. So I didn't look at biology very much, until I came back to work after maternity leave. And an editor asked me to write a story on the menopause. And I didn't, you know, at that point in my career, I wasn't in a wasn't in a position to choose so I had to say yes. And it just so happened that back then, a paper had just been published out of Canada, by three male scientists arguing that one possible evolutionary reason why women experience the menopause, is because right throughout human evolutionary history, no man of any age has found a woman, an older woman sexually attractive. They just weren't having sex. And so that's why, you know, we have the menopause, it’s because we're just not having sex, so we don't need the sexual… we don't need to be fertile anymore. And what was interesting to me was that, you know, I'd grown up in this tradition, that had told me that science is objective, and it doesn't matter what your background is, it doesn't matter if you're male, female, black or white, because science is science, we're looking at empirical evidence here, and the theories are objective. And yet here are these male scientists with this hypothesis, and I have to say, critiqued at the time, heavily critiqued because it was, in many ways, difficult to stand up, you know, as, as is the case with much of evolutionary biology, it’s difficult to stand things up. But what was interesting was that there was a counter hypothesis, and actually, this was the prevailing one, the grandmother hypothesis that said that the reason women live so long into their infertile years, or humans lived so long into their infertile years, which is a more accurate way of thinking about it because most… in most creatures, most primates, for instance, lose fertility, they just happen to die around the same time that they lose fertility. We live so long, because older women are so crucial to the survival of their children and grandchildren. And we have a mechanism for this, because we can see from data that the presence of a grandmother, in many societies does increase the lifespan or likelihood of survival of her children and grandchildren. So that there's an actual mechanism there. That doesn't mean it's foolproof, that doesn't mean that's definitely what happened. We will never know what definitely happened. But the fact is that some of the leading researchers around the grandmother hypothesis are women. They just happen to be women. And I, you know, I was intrigued here because if science were completely objective and completely fair, then why would you have this gender difference around which theories get proposed and why some theories happen to be so sexist even when they have less evidence behind them? And when you look at the science of sex difference more generally, and I have to say, it's a very, you know, it's a heavily researched topic, sex differences, not as though it's ignored at all, it is heavily researched all over the world. You see, it shot through with sexism, right throughout history. Women's minds and bodies have been a battlefield in that sense, you know, people have argued over whether we are, you know, in the 1970s, one of the main textbooks on sexuality, argued that women's orgasm didn't evolve independently, that's a vestige of the male orgasm. You know, there are so many, there are so many crazy ideas about human female nature, who we are, all rooted again, I should say in this binary. So like I said, if you go back to the enlightenment, Western science was rooted in this binary, which doesn't exist universally I should add. You know, I'm not just talking about gender, I'm talking about sex. The sex binary does not exist in every culture. Because there are conceptions for instance that the way gender changes over age, you know, the conceptions of gender and sex change over age, but also that there is more fluidity and more multiplicity around these ideas. So within this western tradition, which is quite unique in some ways, because although these ideas of female inferiority do exist in many different cultures, the ways in which Western scientists thought about it have been particularly rigid, to draw ourselves out of that rigidity is very, very difficult, I've noticed. You know, people have been so reluctant to do it, and they remain reluctant to do it. Now, it's only relatively recently that researchers have started to think beyond that, and started to look beyond that and look at human beings in a more subtle and nuanced way and understand that human difference doesn't map onto our social ideas about who we are very well.

Caroline Ford: Yep. And so that sort of Western binary view of men and women and, I guess a different focus and attention on on different health problems, that also has to do, surely, with the people conducting the science and the research and the fact that the majority of research and leadership has been by white men, and the topics that they choose to progress and focus on. So we talked a little bit about this with COVID leadership. But my question is, in medicine, what do you think would actually change if we had more women and individuals from, sort of, different backgrounds in leadership in medicine faculties and in surgical departments across the world? And if and if women were leading medicine, do you think anything would change?

Angela Saini: I do think representation matters enormously. And this is something, you know, when I was writing Inferior I wasn't just writing about the things that we've got wrong, I was writing about how things have been corrected, and why they've been corrected. And a large reason why many of our myths and orthodoxies about female nature have been corrected is because women have entered the sciences in much larger numbers. So around the 1970s 1980s as women became professors and started to lead in their fields and challenge others within their disciplines, you see a complete rewriting of what it means to be a woman. So Sarah Blaffer Hrdy, for instance, the evolutionary biologist and primatologist – one of the most remarkable women I've ever met – I went to interview her at her – she's retired now – she runs a walnut farm in Sacramento with her husband… 

Caroline Ford: Of course she does. 

Angela Saini: An absolute force of nature, she was in her 70s when I interviewed her. Much stronger and active than I am. And she rewrote the book on women. She wrote it, I mean, one person described her work to me as making them cry. She said her work has made me cry. And he did exactly the same to me. It is so moving and so powerful to have these stereotypes challenged, from a biological standpoint, in the most thorough and rigorous way possible, you know, to really have someone take apart the biology around sex difference and say, actually, we need to start again when we think about these things. Same with Patricia Gowaty. Patricia Gowaty, another evolutionary biologist, also in California, and of Sarah Blaffer Hrdy generation, they're good friends with each other. In fact, I still communicate with both of them. And Patricia has just written recently a paper looking at gender and sex and why she so welcomes this, kind of, broadening out of the way that we think about sex and gender, now in research coming so late, as it does, in the 21st century. Now, we should have been thinking about these things this way 100-200 years ago. But like I say, we are constrained by the worlds that we're in, the social worlds that we're in, you know, the cultural boundaries of how we're allowed to think about each other and about ourselves. And as those boundaries widen because of society, because they are being challenged by society, as a whole, the the impetus is not coming from the sciences it is coming from the wider world, as people feel uncomfortable within the boundaries that they're in, as they start to ask, well, actually, why do these stereotypes still exist in the way that they do? As people do that, then science responds, and it widens its remit. And we see that happening right across the board, not just when it comes to gender, but in representation of all kinds. I'm very grateful, for instance, that now we're taking Indigenous knowledge systems more seriously, which we need, we needed to have done earlier. But there was an arrogance and hubris there that prevented people from doing that, too. So representation does matter. But like I said, it is only part of the equation, because as long as the systems stay the same, as long as we think in the same way, then it makes no difference whether you're a man or woman doing the research, because you're still thinking within those constraints. So it's about listening to each other, and really drawing out the, kind of, world of possibilities, that universe of possibilities around what we think could be true when it comes to human difference.

Caroline Ford: So, not only, sort of, tearing down the patriarchy, but tearing down all the systems of academia and research and, alright, let's get to it. I think we will turn to questions from the audience shortly. So just to remind you that you can enter in the comments field in Facebook and YouTube, or on Slideo with the event hashtag Inferior. While I just move to questions, I'm going to just ask Angela, for some book recommendations because I am always looking for new things to read. And I know Angela’s an avid reader as well. So what's your answer to the question of what is your favourite feminist book? When you get asked something like that.

Angela Saini: That is really hard. There are so many books I love. But like I said, Sarah Blaffer Hrdy’s work, Like Mothers and Others. I mean, her work is, she's prolific. There's so much work there that I think is so useful and relevant even now, many years after she wrote it. And Sexing the Body by Anne Fausto-Sterling which was just released last year in an updated edition, I think, is one of the best books for navigating sex and gender difference.  Anne Fausto-Sterling I was very honoured to do a talk with her in New York a few years ago, when I was there. And I remember in the audience, this question of transgender, you know, what are the biological differences that happen when you transition gender, and how do we navigate that? And Anne very wisely said, and this is also one of the reasons that I don't cover transgender issues so much in Inferior. We've only just started drawing up frameworks for how to research these topics, because we've been so deeply rooted in this idea that anything outside the binary is somehow aberrant, that we haven't wanted to look at these things. So Anne, I think, is a very wise thinker, and researcher on this topic, and I would urge everybody to read Sexing the Body. On race, The Lies that Bind by Kwame Anthony Appiah has really helped me in terms of understanding identity and what it means, and also Biased by Jennifer Eberhardt, who is a psychologist in the US, victim of police violence herself, but she works with police forces in the US to combat institutional racism. And she does it from a position of understanding, not one of division, or hatred, but saying we are all victims of this system that seeks to divide us, and make us believe that we are fundamentally different from each other, when we're not.

Caroline Ford: So, everyone's got to head down to their local bookstore tomorrow and pick up those excellent recommendations. We're going to turn to the questions on Slideo for now. The top question I'm going to begin with, so Angela, given your views on biological essentialism, how do you respond to the statistics on sexual harassment and assault as overwhelmingly perpetrated by men?

Angela Saini: And this is a very hard one because it's absolutely true. I mean, I'm writing a book on patriarchy at the moment. And the chapter that I'm looking at is on domestic violence and there is no doubt that rates of violence against women are, you know, absolutely, overwhelmingly high. You know, that men are the perpetrators. What's interesting, though, I think is also the ways in which societies are structured to make abuse like that, to trap women in situations like that, or to make it more likely. So I think we also need to look at that social environment. So for example, I've just been interviewing a domestic violence charity here in London, Hopscotch. They deal with, they work with immigrant women. So women who have often been brought into the country as the wives of someone who lives locally, and the experiences that they face and their stories are ones of isolation and alienation. That they feel trapped in the situations that they're in, one by language and the cultural differences, but also because the cycle, the system of abuse in which they're in is not just perpetrated by the men in their lives, it's perpetrated by the entire families. So mother in law's, for instance, there's a wonderful paper, written relatively recently in India, called The Curse of the Mummy-ji. So the Mummy-ji is a mother in law, in India. So when you get married as a daughter in law, it is often the mother in law, that is the instrument of the patriarchy within that family, who will, this study shows that the presence of a mother in law in a daughter in law's household severely restricts her freedom in ways that nobody else does. So we have to understand, what are we doing to support women, to help them feel independent and free, because it's freedom and independence that really allows women to free themselves from situations especially of domestic abuse and domestic violence. And we're not doing enough, as societies, you know, terming it as a biological problem that men can't help themselves. And women, therefore, are ultimate victims, really washes the hands, washes our hands of the blood of all these women, because then we're saying, then we can't do anything. Of course, there is so much that we can do. So much around how we behave, and what we feel is acceptable is mediated by the cultures and the societies that we're in. Look at ancient Greece, in ancient Greece, it was a hugely sexist society, possibly in Western history, one of the most sexist societies, misogynistic societies, that there were, and yet in Greece, according to the literature –  of course, we can't know how people really lived – but according to literature, domestic violence and violence, by husbands against women, at least in upper class societies, was completely frowned upon, you know, it was, neighbours would judge you, society would judge you, if you were known to have done this, a woman could leave her husband for this, you could divorce him, it was good grounds for divorce. And yet in Roman society, which was ancient Rome, which was, in some ways better for women on certain gender grounds, was terrible when it came to domestic violence. Men were allowed to beat their wives, they're encouraged to do it in order to keep them subordinate. So the frameworks that we put around each other, how we protect ourselves and how we, what we, the rules we put around behaviour really are decided by culture to some extent. So whether there is a biological component there or not – there may well be I don't know – and certainly, we need more understanding of how aggression plays out biologically. And I hope we get more research on that. But we'd need to pair that with the gender and cultural issues around how we live, and how we structure the relationships between men and women. It still angers me so much that we do not give enough protection and support to people who want to leave abusive relationships. We don't do that. 

Caroline Ford: Yeah, I think that's a hot topic of conversation in Australia at the moment as well. So I think it's very important to discuss it further. Looking at some more of the questions that we've received, something we discussed a little bit earlier, but I guess more directly, how do we get scientists to think critically about science, to go beyond assuming that it is impartial and objective? How can we as scientists rethink our field, I guess?

Angela Saini: I think what you were saying earlier about teaching history is crucially important. We need to… this is something I've been arguing for the last year, particularly when it comes to a better understanding of racial difference within medicine and health. But if every time you learn a concept, a scientific concept, or an engineering or medical concept, right from the beginning, so when you're at school, you are also taught the history of that idea, I just think many of the mistakes that I see happening… if you go to Retraction Watch, if everyone goes to the website, Retraction Watch, you'll see just how many papers get retracted, because they have racist agendas or sexist agendas. And the data turns out to be shoddy or you know, the process or methodology turns out to be shoddy. And I am convinced that those mistakes would not happen so much if we were given that kind of contextualised education from the beginning. I had it myself. You know, like I said, when I studied engineering, I didn't get it. But it was, as an adult, I was working at the BBC full time and part time I started taking a degree at the Department of War studies here at King's College London. And it's an interdisciplinary department, it doesn't sit within any particular discipline, not the social sciences, not the sciences or anything. And people there come from very different backgrounds. In fact, one of my tutors was a former Iraqi weapons inspector, you know, very broad range of people who'd worked on very different aspects of science and technology. And that was where I got my first taste of Popper and Kuhn and Foucault and I started to learn about feminist critiques of science and technology, all these different disciplines that have so much bearing on the questions that we ask within the sciences, and I wish that every single one of us would get that, kind of, broader, more liberal education when it comes to the sciences.

Caroline Ford: Yes. And actually, there's a second question here, asking both of us actually, which books we would recommend science students read to better understand the history of science. I think for me, a book that I often give students that come to my lab is, well, as well as Inferior, which gets trotted out as the end of your present to everybody in my lab. But also for me, because we work particularly with a lot of women with cancer, and we collect bio specimens from those women. The Immortal Life of Henrietta Lacks is a book that describes the taking of cervical cancer cells from an African American woman without her consent, and, sort of, the history and the impact that has had on her family. That to me, I think, is crucial reading for anyone working in medical research. But Angela, do you have any other recommendations for, sort of, accessible books that could be used in a science curriculum?

Angela Saini: Do you know, I think writing Superior has actually broadened my understanding of gender so much. And I think the reason for that is that within the field of critical race theory, there are critiques of science that sometimes you don't get in feminist critiques of science. And if you compare and contrast and start to understand how essentialism works, and the ways in which it is used to define people and categorise people and restrict what people can and can't do, or define human nature, it is enlightening. So I’d urge people to engage with critical race theory. There are a couple of recent books that I think are particularly good. There was, Is Science Racist? by Jonathan Marks, which is very thin and very easy to read. There's Fatal Invention, which is a bit older by Dorothy Roberts, which looks at race and medicine. And I think the value of engaging as a feminist scientist with critical race theory is it really does bring a new dimension to the way that you understand gender, it really does. It broadens it up immensely. And in fact, this book I'm writing now on patriarchy, I'm not looking at it through just a gender lens now, because of the understanding I have on things like race and class and other aspects of that question,

Caroline Ford: I cannot wait to read it. I'm looking forward to your new book, Angela. I think we're almost out of time. So my final question is, you know, it is International Women's Day. I'm always curious for great ideas that include actions that individuals can take. So if you had some sort of magical wand on International Women's Day, Angela, what's the one sort of thing you would immediately fix that would help us with the, sort of, challenge of gender inequity?

Angela Saini: You know, that the answer to this question will probably change depending on the day that you asked me. But like I said, I've been writing a lot about domestic violence recently. And the one thing I think I would do is make it so much easier for a woman to be able to leave, to be independent, to make it easier for women to be financially independent, because I think economic dependence on men compounds, the problem of domestic abuse, but also just create support networks that make it easy for a partner to leave an abusive person to leave an abusive partner. And make sure that society was there to support that person with whatever they needed in order to feel themselves free of that situation. So I would urge people on International Women's Day, and this is what I will be doing, donate to refuges and domestic violence charities.

Caroline Ford: I think that's a wonderful recommendation. So sadly, we didn't cover a quarter of the things that I wanted to discuss tonight. But I really enjoyed the range of topics we've been able to cover. So I'd like to thank, obviously, you Angela for getting up early. And I know it's the day that your son is heading back to school. So congratulations to you, primarily, for saying goodbye to your son. And thank you everyone for tuning in tonight to what I hope you will agree has been a really fascinating discussion. I'd also like to thank the Centre for Ideas team in hosting this event and this new series that they're running. Particularly Ann Mossop and Meredith Hall who have done an incredible job organising this event. And also the team here in the studio with me who have been very good at calming my nerves in preparation for tonight. So Ethan, Seb and Nick, thank you very much. So thank you, everybody, and Happy International Women's Day. Good night, everyone.

Angela Saini: Thank you so much, Caroline.

Ann Mossop: Thanks for listening. For more information, visit, and don't forget to subscribe wherever you get your podcasts.

Angela Saini

Angela Saini

Angela Saini presents science programmes on the BBC, and her writing has appeared in New Scientist, The Sunday Times, National Geographic and Wired. Her 2019 book, Superior: The Return of Race Science, was named a book of the year by The Telegraph, Nature and Financial Times. Her previous book, Inferior: How Science Got Women Wrong, has been translated into 13 languages. Angela studied Engineering at the University of Oxford and was a Fellow at the Massachusetts Institute of Technology. 

Caroline Ford

Caroline Ford

Caroline Ford is passionate about science communication and enhancing the health literacy of the wider community. In 2017 she was named as an inaugural ‘Superstar of STEM’ by Science & Technology Australia. She is a cancer researcher at within UNSW Sydney’s School of Women's and Children's Health at the Lowy Cancer Research Centre. She leads the Gynaecological Cancer Research Group which aims to understand why gynaecological cancers develop, how and why they spread throughout the body, and how best to treat them.

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