How defining women as baby-makers backfired spectacularly on science

In Guynecology, Rene Almeling argues that moving away from gendered ideas about reproduction could improve our health and transform our societies

Guynecology: The missing science of men’s reproductive health

Rene Almeling

University of California Press

MALE bodies have long been seen as the norm when it comes to science. It is men and male animals that have been studied to understand what good and poor health looks like, as well as how to treat disease – except, that is, when it comes to reproduction.

Historically, baby-making has been viewed as the defining function of women’s bodies, so much so that other aspects of their health have been neglected. For example, heart attacks are less readily identified in women, who are 59 per cent more likely to be misdiagnosed despite the fact that cardiovascular disease is the leading cause of death in women.

Meanwhile, research into men’s reproductive health has lagged behind. Attempts to understand their contribution to fertility, miscarriage risk and long-term risk of a child developing some mental health conditions, for example, have only recently gained ground.

In Guynecology, Rene Almeling, a sociologist at Yale University, explores how attempts to kick-start the study of men’s reproductive health failed. Even now, as the role of health in sperm function and in the well-being of future children becomes clear, information is still scarce and gendered notions about a woman’s role in making babies persist, she writes.

Take the age-old notion of the coming together of “aggressive” sperm and “passive” eggs. The idea that conception is largely the role of the sperm cell is still a very popular one, but it isn’t true. We now know eggs release chemicals to sperm when they are ready to be fertilised, and recent research suggests that these might help select some sperm over others.

When it comes to men’s role in reproduction, the focus has been on sex rather than fatherhood, centring on sexually transmitted infections and conditions like erectile dysfunction. While women’s reproductive health has long been seen as key to their well-being, “men’s genitals were never seen as core to their health and psychology as women’s genitals were [to women]”, says Almeling.

“Shifts in how we understand gender might transform how reproduction and fertility are studied”

Her book tackles an important subject, but there are some dry sections. Best to skip to her coverage of recent research. One of the most important findings is how lifestyle choices significantly influence the health of sperm, and consequently of children. Men, too, have a “biological clock”, and their age, diet and smoking habits have been linked to issues such as miscarriage and risks of low birth weight.

These factors seem to have lasting “epigenetic” effects, conferring changes to the genome that mean new genetic risks of disease can be passed on to children. The field is still young, but there does appear to be a link between certain “paternal effects” and the risk of schizophrenia, for instance.

Yet while dietary advice abounds for women trying to conceive, men may be less aware of the dos and don’ts, warns Almeling. She points out that there is little to no information on paternal effects offered to these would-be parents by US federal bodies and health agencies.

Almeling rounds off her book with recommendations for scientists, healthcare providers and policy-makers. She thinks part of the problem is seeing gender as binary, with men and women as opposites, and that shifts in our understanding of gender might transform how reproduction and fertility are studied and treated.

A greater understanding of men’s reproductive health could also “reshape gender politics in surprising ways” and change gendered expectations of women about reproduction, she writes. Almeling suggests such changes may help reduce the gender pay gap and inequalities caused by the assumption that women (but not men) with children are less committed to their jobs.

Nice theory, but considering how long it has taken for women to get this far, I won’t hold my breath.