Why Can't a Man Be More Like a Woman?

by Wolpert, Lewis;

  Deborah Cameron has written that some studies have found that women talk more in interactions with partners and family members in the home, as this is a woman’s domain. This may be related to the claim that in formal and public contexts, high-status speakers talk more than low-status ones. In informal contexts where status is not an issue, the commonest finding is that the two sexes contribute about equally. So why does this myth that women talk more than men persist, she asks. It possibly does so because it is based on long-established social prejudice. There are claims that women tend to communicate more effectively than men, using their abilities in deciphering non-verbal cues such as tone, emotion and facial expression as well as speech itself. Men, who have less empathy, find it more difficult to interpret these non-verbal clues and tend to rely on the spoken word alone. Such differences could help explain why men and women sometimes have difficulty communicating, and why male friendships are often based on common outside interests such as football or cars, and are different from more emotional and intuitive friendships between women. Whether such differences are cultural or biological is not known.

  Men and women differ somewhat in understanding the meaning of someone else’s remarks, as the normal female brain responds earlier and more widely to words and other signals. Women identify the emotional nature of a sentence, such as sad or happy, earlier than men. Individuals with higher empathising abilities, mainly women, pick up on details about the speaker, such as their demeanour or status, while taking on board what is actually being said, thus making use of the social aspects of language. So if they are told ‘I’d rather you left’ they are probably able to assess if their partner really means the words he is saying. However, in circumstances where language is totally explicit such as ‘Get out of my house!’, sex-based differences unsurprisingly disappear.

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  Health

  There is one thing women can never take away from men. We die sooner.

  P. J. O’Rourke

  Among the most dreaded fatal diseases are several that involve anatomically sex-specific structures as sites for cancer: the male prostate and testis and the female breast, uterine cervix and ovaries. But there are many other diseases that for various reasons are strongly associated with one or the other sex. Diseases that are more common in women include certain mental illnesses like depression, eating disorders such as anorexia nervosa and bulimia, panic attacks and phobias. Also more common in women are autoimmune diseases like multiple sclerosis and rheumatoid arthritis, chronic fatigue syndrome, and osteoporosis. There are higher rates of acute stress disorder and post-traumatic stress disorder in women than in men following exposure to trauma among civilians. In general females suffer more from internalising disorders such as depression, which result in them having difficulty functioning and more disabling long-term conditions such as arthritis, whereas males have more externalising illnesses like heart attacks and stroke, which can lead to physical disability and even death. Other diseases more common in men include neurological disorders such as Parkinson’s disease, autism, attention deficit syndrome, dyslexia, and addictions such as alcohol and drug abuse.

  Biological differences play a key role but lifestyle contributes as well to the differing incidence and manifestations of illness in men and women. There are explanations that highlight the influence of biological sex hormones and it has been proposed that oestrogen helps to protect pre-menopausal women from cardiovascular disease. But oestrogen has also been identified as a protective factor against diseases more prevalent in men, so its rapid decline after menopause may eliminate a woman’s advantage. Differences in the biochemistry of man and woman must also play a role, significant biochemical differences having been reported for 102 out of 131 key compounds. Since men have a higher incidence of cardiovascular events than women of similar ages, this led to the belief that testosterone is a risk factor for this illness in men. But this hypothesis is no longer tenable according to Guarner-Lans and his associates, as low testosterone levels are associated with multiple sclerosis, diabetes mellitus, heart disease and erectile dysfunction.

  Several genetic illnesses are more common in males because of their having only one X chromosome. If a gene does not work properly on one of a female’s X chromosomes, then the spare gene on her paired X chromosome can compensate. The absence of a spare X chromosome explains why certain disorders, known as X-linked disorders, are more common in men. For example, more boys and men suffer from autism than do girls and women–thus the condition probably involves genes on the X chromosome, of which there are over a thousand. Another example is haemophilia A, a bleeding disorder which affects only males and which is especially famous because of its prevalence in intermarrying European royalty. Duchenne muscular dystrophy, a form of muscle degeneration, is another X-linked male disease.

  Abnormalities may be caused by variation in the number of sex chromosomes. Klinefelter syndrome, which gives males an extra X chromosome, is a cause of male infertility. It also results in small testes, a body with abnormally long limbs, wide hips which are equal to the size of the shoulders and sometimes abnormal breast development. Turner syndrome in females results in a failure to develop normal female sexual characteristics and is the result of having just one X chromosome instead of the normal two, with physical abnormalities such as short stature, swollen hands and feet and a webbed neck. Women with Turner syndrome are typically sterile because their ovaries do not function and they have no menstrual cycle. Other health problems are also frequently involved, including congenital heart disease, and cognitive deficiencies.

  Although there is no doubt that biological factors contribute to gender differences in health, there is also general agreement that these do not explain all the differences between men and women. Social factors are involved as well. Women are more likely to use preventive health services, whereas a typical man will go for years without ever seeing a doctor because, unlike women, he is not trained to think about the early detection of disease. Unhealthy behaviour can also play a role. Needham and Hill have observed that men have generally been more likely to smoke and to be heavy drinkers, which may explain the male excess of kidney and liver disease. Then there are some environmental hazards associated with male-dominated occupations, such as mining and construction, which may contribute to cancer and respiratory disease, while jobs that involve repetitive tasks such as data entry or garment stitching are more commonly held by women and may give them a higher likelihood of arthritis. Women may contract infectious diseases more frequently than men because they have more contact with children. In a study in the United States it was found that each person carried an average of about 150 species of bacteria on their hands, but that women carried twice the number of species as men did, even though women wash their hands more often and are more sanitary. The reason for the difference is not known.

  We now look at mental illnesses. Clinical depression is twice as common in women as in men, and is predicted to be the second leading cause of global disability by 2020. The lifetime risk of major depression in women is about twenty to twenty-six per cent, compared to about eight to twelve per cent for men. This risk is unrelated to race or ethnicity. A symptom of severe depression is total negativity about one’s life. But the symptoms in men and women can be radically different; for example, men tend to blame others while women have a tendency to self-blame. Given that depressive disorders in women tend to be more prevalent after puberty and are more frequent in their reproductive years, between the ages of twenty-five and forty-four, hormonal factors probably play a role. Bereaved women are also more likely to suffer from depression. The underlying molecular mechanisms responsible for heightened female vulnerability are not known. Postnatal depression tends to develop within four to six weeks after childbirth, although in some cases it may not develop for several month and hormonal changes are not the only explanation. Menopause may lead to depression. Depressed women performed significantly worse on cognitive tests than depressed men. The female pr
edominance in psychological disorders diminishes with age and with regard to treatment, and as we have seen, women seek help more often than men.

  A study by Maguen and her colleagues of the mental health of 330,000 United States veterans returning from conflicts in Iraq and Afghanistan found that female veterans were more likely to be diagnosed with depression, and at an earlier age, than their male colleagues. Male veterans were found to be more prone to suffer from post-traumatic stress disorder and alcohol abuse.

  Bipolar disorder, also known as manic depression, involves depression and mania alternating, sometimes rapidly, and develops in men and women in about equal numbers, but there are gender differences in how the illness affects them. Men typically develop bipolar disorder earlier than women and suffer more severe symptoms, particularly in the manic phases. They are more likely to display manic symptoms such as, for example, going on spending sprees. Women with bipolar disorder tend to have fewer manic episodes and more depressive ones than men do.

  Suicidal behaviour linked to depression shows a clear sex difference for both fatal and non-fatal suicidal attempts. Females contemplate suicide more frequently than males, but deaths from suicide are typically higher for males. Women who attempt suicide tend to choose drug overdose or self-wounding as the suicide method, while men more frequently use hanging or asphyxia. Women are more frequently found to attempt suicide rather than to actually commit it, whereas men are more likely to complete their attempts. Older men have a higher risk of suicide than older women.

  Women have a higher risk of developing Alzheimer’s disease and other forms of dementia than men. At the early stages of Alzheimer’s disease, the most commonly recognised symptom is memory loss, especially for recently learned facts. Objects are misplaced or lost, and sufferers may repeatedly ask the same questions. The sufferer has difficulty in finding words to complete a sentence, and comprehension is poor, as is performance on complex motor tasks. There are also non-cognitive symptoms–delusions, depression, anxiety and verbal and physical aggression. Men, more than women, tend to become aggressive and to develop physical, verbal or sexual problems as the disease gets worse, while women become more reclusive and emotionally unstable. A longitudinal study on Swedish twins found that engaging in intellectual and cultural activities helps women to avoid the risk of developing Alzheimer’s disease, but does not help men. Moreover, more women than men benefit from the protective effects of regular physical exercise.

  Schizophrenia affects men and women to about the same extent, but women tend to be older at onset, and to suffer a more benign course of illness. The disorder in men peaks between the ages of fifteen and twenty-five years, whereas in women two peaks are seen, one at about thirty and another around menopause. Silvana Galderisi and her co-authors found that schizophrenic female patients, compared with male patients, showed fewer negative symptoms and less frequent alcohol abuse. But no significant difference was found between female and male patients in the rate of remission. Verbal memory is better preserved in women than in men. Female patients are more heavily paranoid, while male ones tend to display a subtype of the illness, characterised by disorganised behaviour and speech and inappropriate emotion.

  The brains of healthy men and women differ in some ways from those of the mentally ill. Certain common differences between men and women are found to be reversed in mental illness. For instance, healthy men score higher than women in a task involving mental rotation of a three-dimensional image, as mentioned earlier, but schizophrenic women invariably outperform schizophrenic men when tested on this task. Differences in testosterone and oestrogen levels may explain these results, since in men and women who are mentally ill, as in schizophrenia, the women have higher levels of testosterone, while men have much lower levels than their healthy male counterparts. A history of childhood trauma is associated with a worse prognosis in male patients but not in female patients, or female controls.

  Hypochondria is seen about equally in men and women, but this somatisation disorder characterised by recurring multiple clinically significant complaints about pain, stomach, sexual and neurological symptoms, for which no cause can be found, is more common in women. Women constitute the majority of chronic pain patients, and they are more sensitive to pain and differ in how they sense it and in their response to analgesics, so that they may require higher doses of morphine. Jenny Strong and her colleagues point out that women are also more willing to disclose pain, to complain of more symptoms and to be more emotional about them. Men’s descriptions of pain are typically based on recounting facts and observations as well as their thoughts and emotions. Women tend to use more descriptive and evocative language, while men use fewer words and less graphic language, and take a more objective stance on their observations and recollections of the painful event. Women also suffer from chronic pain conditions such as headache and migraine more than men, and differences in pain threshold and tolerance have been demonstrated experimentally. That most patients with these conditions are female suggests that female hormones play an important role in the occurrence of the disorder. The finding that sixty per cent of women sufferers related attacks to their menstrual cycle supports this view. A placebo response to treatment was observed only in men.

  But why are women more sensitive to pain than men? Women report pain more often and more severely than men in situations varying from recovering from surgery to arthritis. Experiments have been made where pain was induced to an equal degree in both men and women, and although there was similar activity in some brain regions of both sexes, several areas of male and female brains reacted differently. There was greater activity in the emotion-based centres of the women’s brains, but in men it was the cognitive centres which showed greater activity. So maybe women’s better empathy increases their perception of pain. Since women score higher than men on empathy, as we have seen, this could explain the findings that psychiatric disorders which are often characterised by a lack of empathy, such as antisocial behaviour, are far more common among boys and men.

  Twice as many men as women are diagnosed with Parkinson’s disease, the main symptoms of which are tremor, rigidity and slowness of movement. There is a link between Parkinson’s disease and a loss of neurons using the chemical messenger dopamine in the substantia nigra of the mid-brain. A separate population of these neurons plays an important role in processes of reward and addiction, and sex differences have been seen in the development of dopaminergic neurons. The fact that women get Parkinson’s later in life and less often than men may be explained by higher dopamine levels, possibly due to the activity of oestrogens. Men and boys are also more vulnerable to various other disorders with a major impact on movement such as Tourette’s syndrome, which is characterised by multiple physical and verbal tics. It is three to four times more common in boys than in girls.

  More than twice as many men as women become alcohol dependent during their lives. This may be due to women’s physiology, which makes them more vulnerable than men. Even if they drink only the same amount of alcohol as men, women acquire higher concentrations of alcohol in their bloodstream and thus become drunk more quickly. They are also more likely than men to suffer organ damage. Many women may take this as a warning to limit how much alcohol they drink. There are more male drug abusers than female; for example, the male rate of marijuana smoking is twice the female rate.

  Autism is a lifelong developmental disability that affects males more than females. It leads to difficulties in communication and relationships, and gives the individual severe problems in understanding the feelings and thinking of other people. It is a condition that begins before the child is three years old and has a strong genetic basis, and Cheslack-Postava and Jordan-Young have charted the changes. An infant with autism may not respond to their name, and when a little older may have delayed speech, and may fail to engage in pretend play with other children or may line up toys obsessively. An older child or an adult with autism may have difficulty understanding jokes, engaging in
conversation and forming friendships. There is an impairment of mental skills in a substantial proportion of cases. The male incidence of autism is five to ten times higher than the female and is considered by some to be an extreme manifestation of the ‘male brain’, as males on average have a stronger drive to systemise, and autistic traits are often found in mathematicians, engineers, scientists, and their families. Such findings have led Simon Baron-Cohen and colleagues to suggest that high-functioning autism represents simply the high-systemising, low-empathising extreme of the population. There is a possible biological explanation for the disproportionate numbers of males who become autistic which is the effect of foetal testosterone, as there is a positive link between testosterone levels in the womb and the early signs of autism. There are brain differences too. The amygdala in males with autism is more enlarged than that of typical males early in development. As pointed out earlier, there are differences in brain functional connectivity which may also contribute to sex differences in diseases like autism, since the male brain has decreased local connectivity compared to the female.