The fragile male

**Feckless** · 25th-September-2008

The fragile male

Sebastian Kraemer, consultant child and adolescent psychiatrist.
Child and Family Department, Tavistock and Portman NHS Trust, London NW3 5BA
sebastian@kraemer-zurne.freeserve.co.uk.

The human male is, on most measures, more vulnerable than the female. Part of the explanation is the biological fragility of the male fetus, which is little understood and not widely known. A typical attitude to boys is that they are, or must be made, more resilient than girls. This adds "social insult to biological injury." Culture and class make a difference to the health and survival of boys. The data presented here have implications for the clinical management of male patients as well as for the upbringing of boys.

Summary points

The disadvantages of the male are usually seen as socially mediated
Even from conception, before social effects come into play, males are more vulnerable than females
Social attitudes about the resilience of boys compound the biological deficit
Male mortality is greater than female mortality throughout life
The causes are a mixture of biological and social pressures: we need to be aware of both in order to promote better development and health for boys and men

Downhill from conception to birthAt conception there are more male than female embryos. This may be because the spermatozoa carrying the Y chromosome swim faster than those carrying X. The male's pole position is, however, immediately challenged. External maternal stress around the time of conception is associated with a reduction in the male to female sex ratio, suggesting that the male embryo is more vulnerable than the female.1 From this point on it is downhill all the way. The male fetus is at greater risk of death or damage from almost all the obstetric catastrophes that can happen before birth.2 Perinatal brain damage,3 cerebral palsy,4 congenital deformities of the genitalia and limbs, premature birth, and stillbirth are commoner in boys,5 and by the time a boy is born he is on average developmentally some weeks behind his sister: "A newborn girl is the physiological equivalent of a 4 to 6 week old boy."6 The male brain is heavier, with a larger hypothalamus, probably from the influence of a surge of testosterone in the third trimester of pregnancy, which also promotes greater muscle bulk.7 Similar differences have been observed in chimpanzees.8 At term the excess has fallen from around 120 male conceptions to 105 boys per 100 girls.9

Male excess of developmental and behavioural disordersBy the time a boy is born the pattern seems set. Developmental disorders

such as specific reading delay,10 hyperactivity,11 autism and related disorders, clumsiness, stammering, and Tourette's syndrome12

occur three to four times more often in boys than in girls, although girls, when they have such a disorder, may be more severely affected.13 Conduct and oppositional disorders are at least twice as common in boys.14 Genetic factors are known to play a part, varying from low heritability in conduct disorder to high in autism,15 but why are they all commoner in boys? None of these conditions is sex linked in the classical sense. But Skuse et al propose that the X chromosome does carry some of the burden of the social and cognitive deficits that are common to many (but not all) of these disorders.16 They found that, of people with Turner's syndrome (XO), those with an X chromosome from their mothers (who would be boys if they also had a Y chromosome) had significantly more hyperactivity, attention deficits, and poorer social and emotional expressivity than those with X chromosomes from their fathers. These results are supported by the twin study of Scourfield et al, which shows a significant genetic influence on social cognition to the disadvantage of males.17 "Males are attempting something extra all through life."18

Social and cultural attitudes: danger and despairSince the sex of most fetuses is unknown to the parents until birth, social attitudes and prejudices about the sex of the baby cannot make any difference, but as soon as the child is born these can amplify pre-existing biological disadvantage or indeed, in traditional patriarchal societies where males are strongly favoured, reduce it. In rural Bangladesh, for example, more girls than boys die during infancy and early childhood.19 Cultural expectations about masculinity shape the experience of boys as they grow up. Most at risk are the "boys who don't talk."20 They become "ashamed of being ashamed,"21 and try to stop feeling anything. This makes them seem invulnerable, even to themselves. This is not a safe strategy.
The excess of non-fatal and fatal accidents among boys seems to be part of a pattern of poor motor and cognitive regulation in the developing male, leading to misjudgment of risk. In adolescence the nature of risk taking may change and lead to dangerous experiments with drugs and alcohol or to violence against self and others. As is now well known, the suicide rate in young men is several times higher than in young women and has risen alarmingly from the late 1970s until recently in Britain and several other Western nations.22 The dramatic rise in this statistic

which parallels a soaring rate in violent crime, also largely due to males23

implicates powerful environmental rather than biological factors. For example, the male to female ratio of suicides in the 15-24 age group varies from 7.1:1 in Ireland to 1.1:1 in Mauritius.24 There is similar variation in deaths from all causes within countries. In England and Wales the death rate in boys under 16 is 41% greater than in girls. Differences between social classes are even greater: the death rate for boys in social class V is more than twice that in social class I.25

(Credit: ANGELA SMITH)

The fragile male -- Kraemer 321 (7276): 1609 -- BMJ

This is great for writing a female privilege list. I guess this covers 23 points in health alone.

**Dylan MacVillain** · 25th-September-2008

The irony is that feminists will use this to mock us men further and celebrate female "superiority" even more. Yet, in spite of alll the feminist claims of empowerment and equality, when it is convenient, feminists utilize female fragility or vulnerability to get sympathy, state protection, government grants, convictions for (innocent) men, etc. Any man who doesn't kowtow to the matriarchy in the aforementioned ways is labeled a male-chauvinist pig.

Regarding the concept of the "fragile male ego," that is just an excuse for women to abuse us men. If they mistreat us, we are supposed to take it silently. If we speak up, instead of apologizing and behaving more maturely, women abuse us further by mocking us and saying that we have a "fragile male ego." It's called being human and not appreciating mistreatment. Maybe it is women who have the "fragile ego" as they are overly demanding as to how we men are supposed to treat them.

**Percy** · 25th-September-2008

The genetic difference between the Chimp and the Human is just a few percentages points. A small number of genes. Most of the differences are on the Y chromasome. The male one.

That means that humans are actually being born by a more chimp-like females and the male humans are less suited to the more chimplike female uterus.

**Incognito** · 25th-September-2008

Quote from Percy

The genetic difference between the Chimp and the Human is just a few percentages points. A small number of genes. Most of the differences are on the Y chromasome. The male one.

That means that humans are actually being born by a more chimp-like females and the male humans are less suited to the more chimplike female uterus.

Well if women are more "chimp-like" then why is it that men are so much more hairy?

**Feckless** · 25th-September-2008

Because...Because....DAMN...

**chevalier** · 25th-September-2008

Because we have spent more time outside than females and Testosterone promotes hair growth. Nice try though Tera.

**christianj** · 25th-September-2008

Those cowards have been promoting this sexist male-bashing drivel for years. This type of analysis is reminiscent of the DNA argument that feminists loved to promote and really got off on it until it was proved otherwise.
I see this as another "female supremacist" commentary and one that feminists love to promote..

The article is so anti-male, one wonders if it would be more suited to have ALL males aborted before birth to save our poor sex from all this agony and suffering..

It's just another load of biased irrelevance..

**Ragnar** · 25th-September-2008

Quote from Percy

The genetic difference between the Chimp and the Human is just a few percentages points. A small number of genes. Most of the differences are on the Y chromasome. The male one.

That means that humans are actually being born by a more chimp-like females and the male humans are less suited to the more chimplike female uterus.

Percy

As only men makes civilisations (logic, abstract thinking, inventions, et al) which actually is the main thing that distinguishes Man-kind from 'Animal-kind', it is actually only men who ar Mankind.
Hereof follows that Men has taken an evolutionary step, unseen among other species. Namely the males alone without the biological female part.

This also explains much of the chimpanzee like behavior we still see in 'homo sapiens females' (i.e. shopping; gathering fruits and roots; Thug loving; leaning towards the alpha-male only etc.)

Maybe we are witnessing a further evolutionary thing;
A biological species developing away from its biological basis!!!
Men are inventing all sorts medical and reproductive applications that in turn will render the females obsolete. (Everything from androids, humann cybernetics, artificial womb and arificial sexual entertainment.)

Just thought, but it actually bases itself on various scientifical writings allthough these are not explicit about this context.

In the present socialistic matriarchy we see the 'price' women tumble in all areas. What further degradation of female value will come with an economic crash and the following end of any kind of affirmative action due to lack of funding.

**Percy** · 26th-September-2008

Well if women are more "chimp-like" then why is it that men are so much more hairy?

Tera

Good one, Tera.

At least one person sees the humour.

As to why women are less hairy, not all the gene differences are on the male chromasome, just most. The girls got the less-body-hair gene; the more-head-hair gene; the bigger boobs gene; the nit-picking gene evolved a step or two to adapt to the less hair; and the blame-blokes gene quadrupled in effect.

**Incognito** · 26th-September-2008

There is no bigger-boob gene in my family...I'm pretty certain. You could go back several generations in the family photo albums and archives and never find any evidence of it whatsoever!

**BlueRanger** · 26th-September-2008

Great, now womn will have another reason to ridicule us, and stupid little girls will have a reason to make fun of their male classmates. But of course, the boys are going to be told to suck it up.

This really pisses me off.

**Incognito** · 26th-September-2008

If this is all true, there are many good reasons to invest great resources, time, and energy into men's health, from the pre-natal period to the elderly. While some may see this as "opportunity for more female ridicule directed toward men," I see it as great reason to re-double our efforts to invest in men's physical and psychological health. It is fuel for men's health issues which are an important part of the MRA movement.

**christianj** · 26th-September-2008

there are many good reasons to invest great resources, time, and energy into men's health

The three dollars they allocate won't go very far..

**Percy** · 26th-September-2008

If this is all true, there are many good reasons to invest great resources, time, and energy into men's health, from the pre-natal period to the elderly. While some may see this as "opportunity for more female ridicule directed toward men," I see it as great reason to re-double our efforts to invest in men's physical and psychological health. It is fuel for men's health issues which are an important part of the MRA movement.

And if it isn't all true, we still need to investa and rebouble efforts to bring men's health resources up to the level that the women have.