The fragile male

'It's a man's world' according to James Brown but 'would mean nothing without a woman or a girl'.

Mr Brown may well portray it as a man's world, but according to this paper from a few years back, us chaps are fighting an uphill struggle right from our very earliest days. The paper, from child and adolescent psychiatrist Sebastian Kraemer who is no stranger to gender research, reviews in quite some detail the many reasons why we men are more vulnerable than our female counterparts. 'Vulnerability' might seem a little at odds with our social models and conditioning of the genders (men not crying when watching Watership Down, but crying when your favourite football (soccer) team is relegated), but unfortunately men face a greater likelihood, throughout all stages of life, for adversity and an early death compared to women.

I touched briefly upon such gender discrepencies in a previous post on risk. I would in this post like to explore the male 'fragility' bit a little further and hopefully discuss some important issues along the way. It's funny but when I think about male fragility the first thing that comes to mind are our friends in the spider world, and those David Attenborough moments showing how female spiders tend to be bigger than males and after the je t'aime moment has finished have been known to eat their Mr Right too. Nature had possibly only a peripheral role for the male of the species in mind?

There are some interesting points raised in the Kraemer paper which I didn't know about previously. I have listed a few which include:

• At conception, there are quite a few more male than female embryos but for one reason or another this advantage is cut when it comes to live births (the ratio being somewhere about 105 boys : 100 girls).
• A newborn girl is more physiologically advanced that a newborn boy.
• There is a male excess in most developmental and behavioural conditions. (OK I knew this one).
• There is a male excess in fatal and non-fatal accidents.

Added to the fact that males on average die quite a bit younger than females and show a greater risk of death throughout their lifetime than females and I get the distinct impression that our Maker might have a soft spot for women.

Searching the literature it does seem to be quite apparent that males are somehow 'hard-wired' for more serious potential issues than females. When I say 'hard-wired' I don't necessarily just mean genetics being the be all and end all, although genes may very well be a primary factor. From conception to early infancy, males fare significantly worse than females. Things don't really get any better from there afterwards. Men don't take to gastrointestinal surgery as well as women according to a recent paper described here. Take also for example the concept of addiction, and the gender splits on who is more likely to become addicted to things like alcohol and drugs of abuse. One could argue that alcohol addiction is to a large part mediated by social factors and the norms of society but still there might be some underlying tendency for men to more likely become addicted and show alcohol problems if not only because of overall gender differences in the way that alcohol is metabolised. I think back also to an older post on theory of mind and its links to things like alcoholism bearing in mind the gender and cognitive styles debates on-going in several domains including autism. It's potentially the same pattern when it comes to illicit drug use also, and opens up some potentially interesting research into brain differences and gender.

The male domination (but not exclusivity) of developmental and behavioural conditions is never more stark than when looking at the overall sex ratio in autism. Autism is perhaps the condition which shows the most gender disparity (maybe alongside ADHD) when it comes to development; the figures for reading disorder for example, tend to be slightly less skewed. A good overview comparing the various data on sex ratios in childhood developmental conditions can be found in this recent paper from Prof. Simon Baron-Cohen and colleagues. The precise reasons for the gender disparity are as yet unknown but likely multiple.

I think that there are some interesting issues raised from this area of research although as always, one has to treat such generalised associations with some caution. It does seem almost contradictory to the way modern society has modelled itself that males, as a group, may be the 'weaker' sex from a biological perspective.  Kraemer in his conclusions makes some interesting comments about how many of the variables which contribute to the fragile male hypothesis may have had good evolutionary reasons at one time or another. He may be right although let's not get carried away with ourselves.

I opened with James Brown and his 'man's world'. After reading about the fragile male, and in the words of that dino-favourite Laura Dern, perhaps it is destiny that 'woman [not man] inherits the earth'?