The Chronicle Review

Reluctant Crusader

Why Alice Dreger’s writing on sex and science makes liberals so angry

Susan Tusa for The Chronicle Review

March 10, 2015

Alice Dreger is feverish. On a wet, chilly Wednesday evening, in a high-ceilinged, beige ballroom at the Marriott in downtown Philadelphia, she is taking to task — eviscerating, really — the American Anthropological Association for its ham-fisted handling of allegations made in Darkness at El Dorado: How Scientists and Journalists Devastated the Amazon, a much-heralded but ultimately discredited book by Patrick Tierney, a journalist whose tales tended toward the fanciful. That controversy needn’t be chewed over again here, and besides, Dreger isn’t talking about just one misguided book or one feckless group of scholars. She is casting a wider net, diagnosing a disorder that she fears pervades too much of what passes for reasonable intellectual discourse. "Forms of scholarship that deny evidence, that deny truth, that deny the importance of facts, even when performed in the name of good, are dangerous, not only to science and to ethics but to democracy," she tells the Philadelphia crowd.

You’re not just hurting yourselves, people. You’re hurting America.

That was in December 2009. I happened to be in the room that night, scribbling in a steno pad, pleased to have something interesting to cover. The rebuttal to her rousing remarks seemed sniffy and weirdly muted, embarrassed almost. Perhaps Dreger had violated the bylaws by saying precisely what she meant.

Dreger writes about that skirmish, and many others, in her new book, Galileo’s Middle Finger: Heretics, Activists, and the Search for Justice in Science (Penguin Press), and reveals in passing that she was suffering from whooping cough that night and running entirely on adrenaline and a highly developed sense of outrage. The book is not about Galileo, except glancingly, and it’s not about anthropology, except in the section discussing the El Dorado debacle. Much of it is about gender and genitalia. There is a chapter on the motivations of rapists. There is an account of Dreger’s difficult, years-long and still-active campaign against a steroid sometimes given to pregnant woman, an effort that succeeded in "nearly crushing my reputation and my spirit."

There is swearing ("postmodernist horseshit") and drinking ("I ordered a gin and tonic for myself, and then another"). Insults are hurled. Enemies are made. Tears are shed.

And questions are raised, chief among them whether certain branches of science have become infected with a pernicious groupthink, the kind that exalts identity and politics over inquiry and evidence — a problem that often occurs, as Dreger puts it, when "liberal hearts bleed so much that brains stop getting enough oxygen."

She didn’t set out to be an activist.

In 1995, while working on her doctorate in the history and philosophy of science at Indiana University, Dreger published a paper in the journal Victorian Studies about how British doctors had, a century before, tried to make the case that intersex people really weren’t intersex. The fact that some human beings don’t fall neatly into the category "male" or "female" bugged doctors then just as it bugs plenty of people now, so they attempted to explain it away with "science."

While writing that paper, Dreger realized she should get feedback from intersexuals — the real, living variety rather than those pictured in the blurry black-and-white photos she ran across in her research — because her work was "in a profound way more about them than anyone else." She started e-mailing with activists like Cheryl Chase, founder of the Intersex Society of North America. What they wanted to know, not unreasonably, was how what she had learned from history applied to intersexuals today. In her 1998 book, Hermaphrodites and the Medical Invention of Sex, Dreger writes that she became intrigued by "how and why it is that scientists and medical doctors work to mediate the relationships between our bodies and our selves" and "why it is we often look to scientists and medical doctors to read or even alter our bodies."

That’s how — somewhat reluctantly, by her own telling — Dreger began to get dragged from the secluded study carrel of history into the rough-and-tumble alley of activism. This wasn’t entirely unfamiliar territory. Her parents are no-kidding-around Roman Catholics and pro-life activists (her older sister is a nun and a physician). "I was raised by a woman who said that if you saw a problem, you helped," Dreger tells me. "She didn’t allow us to develop a voice that said ‘Don’t get involved.’ " Dreger inherited the ethos if not the ideology, later ditching Catholicism specifically and God for good measure. "I felt the tension one surely must feel when simultaneously taught the importance of a specific dogma and the importance of freedom from dogma," she writes in the introduction to her new book.

In 2005, after a decade of dividing her time between her day job as a professor at Michigan State University and her work as an intersex advocate, Dreger felt that she couldn’t adequately serve in both roles. She had a young son to think about as well. So she dropped her tenured gig just as she was coming up for full professor — crazy, right? — and instead took a less demanding and much less secure adjunct position at Northwestern University, where she is a clinical professor of medical humanities and bioethics.

She continued writing for magazines and on her blog, pieces that are reliably funny and passionate and vulnerable. She obviously skipped whatever graduate-school course encourages writers to meander and vacillate on the assumption that whatever is turgid must also be learned. For proof read her short 2006 essay arguing against circumcision, "Proof That I Like Penises," a wry reference to the rumor that, because of her advocacy on topics of sexuality and difference, she must be a closeted lesbian. It’s a serious piece, even though it includes lines like the following: "With love and understanding, boys can survive the stigma of having a penis that wears what looks like a little turtleneck sweater."

Dreger considers herself a stay-at-home mom (her son is 14), though she does make a semiregular 220-mile commute from East Lansing, Mich., to Chicago, to teach at Northwestern, along with traveling for speaking engagements. She’s managed to create such a division between her professional and personal lives that many of her neighbors are unaware that she is an accomplished troublemaker. "They don’t know that I get involved in national controversies. They know me as the nice woman who will clear your sidewalks when you’re away," she says. "People locally are starting to hear about the book and they are saying ‘You do what?’ "

Not everyone knows her as the nice sidewalk-clearer. Spend a little time reading old blog posts and comments about Dreger and you will see that, in certain circles, she is the enemy — worse, the enemy who pretends to be an ally. Here’s a representative quote from a 2009 blog post titled "Has Alice Dreger Gone Neo-Con?" "What I do know is that Dreger is obsessed with unleashing a torrent of hatred against transgender women, women who have dared to speak out and who have dared to speak truth to power."

So how did Dreger, a person who ditched a tenured professorship to devote herself to full-time advocacy on behalf of those marginalized by the medical establishment, mutate into a torrent-unleashing hatemonger?

The short answer is J. Michael Bailey. Her support of his 2003 book, The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism, embraced a disputed theory of transsexualism that divides male-to-female transsexuals more or less into two categories: those who identify as female and wish to attract men (women "trapped" in male bodies) and those who are sexually aroused by being perceived as female and wish to attract women as well as men. The latter, the theory goes, inhabit a category called autogynephilia, a term that is offensive to some transsexuals who see it as creating a division between "real" transsexuals and those who are merely turned on by the idea. "When they felt that Bailey was fundamentally threatening their selves and their social identities as women — well, it’s because he was," Dreger writes. "That’s what talking openly about autogynephilia necessarily does."

Dreger’s defense of Bailey — and of transgender women who see themselves as autogynephiles — put her in the cross hairs of those who believe that the theory Bailey helped popularize is bigoted junk science. For the record, Dreger did ding Bailey for insensitivity, including for using a photo on the cover of his book that depicts a man’s muscled legs in a pair of pumps. But she defended him initially on grounds of academic freedom, and has since become persuaded that he’s right on the science of autogynephilia. That was sufficient for some to deem her a transphobic right-winger.

Susan Tusa for The Chronicle Review

The Bailey business was complicated by an accusation that he had slept with a research subject — though whether she was a research subject at the time and whether they actually slept together remain hazy. Dreger made an effort to pin down what happened, going so far as to examine emails sent on the night of their alleged congress and to contemplate whether it matters. The publication you’re reading now covered the hubbub back then, and it’s necessary to note that Dreger thought that the coverage missed the mark. Actually she hated those articles and thought they demonized Bailey, though I have to say, reading them now, I don’t see that. (Full disclosure: I’m friends with the reporter and think she’s extremely fair.)

Ancient quarreling aside, the over­arching theme of the Bailey episode for Dreger was whether or not a scholar should be allowed to present evidence for a theory that some find profoundly threatening and deeply offensive. The critiques of Bailey often revolved around whether his book was "invalidating to transwomen" — which seemed like a separate question from whether the argument itself had any merit, a question that continues to be debated.

In her new book, Dreger also empathizes with Randy Thornhill and Craig Palmer, authors of A Natural History of Rape: Biological Bases of Sexual Coercion (2001). They argue that rape is motivated at least in part by sexual attraction, a view that diverges from the widely held notion that it is solely about violence and control. Palmer and Thornhill see their work as contributing to an understanding of why rapists rape and therefore, ultimately, of help to victims. Their many irate detractors see them as rape apologists. What started as science devolved into name-calling and death threats.

This is where Dreger’s science-focused treatise intersects with a broader debate over whether fear of giving offense stifles a robust exchange of ideas. Jonathan Chait wrote a recent essay in New York magazine arguing that a virulent strain of more-liberal-than-thou rhetoric routinely shuts down useful conversations. That essay has been praised and despised and talked about to death, but his thrust — if not his examples — dovetails with Dreger’s thesis: "Political correctness is a style of politics," he writes, "in which the more radical members of the left attempt to regulate political discourse by defining opposing views as bigoted and illegitimate."

Dreger sees something similar going on. "I very much identify as a liberal feminist," she says. "That said, I get extremely impatient with liberals who want to rail about Republicans who won’t look at facts and then you get people who are making decisions based on identity and not on the facts. To me, that’s just a perversion of liberalism." That stance wins her fans among a crowd she’s not sure she wants on her side. "Believe me, it makes me uncomfortable that my last 20 Twitter followers are right-wingers," she says.

Yet she worries that partisan team-playing — making sure the progressive cool kids like you — is a hindrance to reasoned dialogue on tough topics. "I think we get lazy sometimes, and we let our politics rule what we’re doing, and as academics we can’t do that," she says. "There’s this whole branch of academe in which simply telling your story is taken as some sort of data beyond just telling your story. To me it’s just telling your story."

If you’ve followed Dreger’s career, you’d get the impression that she feeds on the friction. What you learn from reading her new book or speaking with her is that the friction feeds on her. "People who look at what I do assume that I like to pick fights, and that’s not really the case," she says. "My personality defect is that when I think I’m right, I can’t give up."

Also, she can’t resist going all-in. Take her most recent dust-up over dexamethasone, a steroid given to pregnant women to deal with a condition known as congenital adrenal hyperplasia, which can cause female fetuses to develop ambiguous genitalia and perhaps to exhibit typically male traits. Dexamethasone helps reduce the levels of excess masculinizing hormones and has been used for decades in children and adults with various conditions, though its prenatal use is still experimental and, according to Dreger, carries significant potential risks that have been unethically underplayed — she points to evidence suggesting that it may have an effect on the developing fetal brain. Dreger assumed, when she first heard about dexamethasone being given to pregnant women, that she would spend about three months researching and writing about it. She has spent three years, and even now it's not over.

Dreger argues that doctors tell pregnant women that dexamethasone is "safe and effective" while acknowledging in grant applications that its use is off-label and its long-term effects unknown. This is a fight that echoes her early intersex advocacy work opposing medical interventions that appear more concerned with enforcing cultural notions of normalcy than with what’s best for patients.

In 2010, Dreger started writing letters opposing the prenatal use of dexamethasone and published an article with the title "Preventing Homosexuality (and Uppity Women) in the Womb?" The pushback was immediate and forceful. The American Journal of Bioethics published an article accusing her of failing to meet "standards of evidence-based reasoning." An article on Big Think accused her of making a "sensational, politically loaded" allegation and engaging in "dishonest health writing." She thought those critiques were flawed and could be rebutted, yet still she worried about what they might do to her reputation and her ability to halt the prenatal use of the steroid.

The controversy exacted a toll on Dreger’s emotional health and on her relationship with her family. "I don’t think my husband would mind me saying that it drove us to marriage counseling because it was so stressful for both of us," she says. "There are many, many, many days and nights when I am curled up in a ball crying because I’m having an argument with somebody because they think I’m saying they’re a bad person, and I hate that." She writes frankly about the personal fallout in the book, though earlier drafts included even more details about her struggles. Her editor and agent prevailed upon her to excise some of the saga to avoid depressing her readers.

The epilogue to Galileo’s Middle Finger is less a spirited call to arms than a weary, resolute sigh: "I’ve met quite a few researchers who, like me, stumbled on an ethical travesty they tried to stop, and like many of them, I wish I could let it go but feel that doing so would be irresponsible."

While the book could have been titled "All The Craziness Alice Dreger Has Been Up to for the Past Decade," there’s one side project that doesn’t get a mention. She has started a nonprofit news website, called East Lansing Info, that features articles with headlines like "Lansing Area Women’s Soccer League: Still Kicking At 30." Dreger writes articles and edits those written by the 50 or so contributors. Her husband, a doctor, writes a nature column. Though the site has taken on some hot-button local controversies, it tends to not inspire the same level of rancor that her other writing does. Which is fine with Dreger. Last fall she wrote a piece about how, 20,000 years ago, a glacier carved East Lansing’s landscape. "The glacier story is my favorite," she says. "Because everybody loved it and no one got mad."

Tom Bartlett is a senior writer at The Chronicle.

Corrections (3/11/2015, 10:30 a.m.): This article has been updated to clarify that dexamethasone is given to pregnant women to deal with, rather than to prevent, congenital adrenal hyperplasia; and that Alice Dreger commutes to Chicago, the site of Northwestern's medical school, rather than to Evanston, where its main campus is.