Deborah Rudacille: The Riddle of Gender

A larger, controlled study W. J. Dieckmann, M. E. Davies, L. M. Ryn-kiewicz, et al., “Does the Administration of Diethylstilbestrol During Pregnancy Have Any Therapeutic Value?” American Journal of Obstetrics and Gynecology 181, no. 6 (December 1999): 1572—3.

DES became a routine part of the quality care that practitioners gave their middle-class patients Apfel and Fisher, To Do No Harm, 25.

Methyl groups are entirely derived Sandra Blakeslee, New York Times, October 6, 2003.

DES also feminizes these patients Apfel and Fisher, To Do No Harm, 41.

A fact sheet on DES The reference to transsexual changes was removed from the online version of the NTP fact sheet in 2003. However, the reference to “transsexual changes particularly in utero” remains in the dictionary. Diethylstilbesterol entry, in J. Buckingham and F. Macdonald, eds., Dictionary of Organic Compouds, 6th ed. (New York: Chapman and Hall, 1996).

the fetus probably becomes sensitised to all estrogens by DES exposure Apfel and Fisher, To Do No Harm, 46.

If the timed sequence of hormone signals is disrupted Berkson, Hormone Deception, 89.

The term default sex has such a passive ring to it Natalie Angier, Woman: An Intimate Geography (New York: Anchor Books, 1999), 43.

began during weeks 5 and 6 of fetal life Apfel and Fisher, To Do No Harm, 47.

probably underestimates the number of in utero exposures Berkson, Hormone Deception, 64.

In April 1971, a paper published in the New England Journal of Medicine A. L. Herbst, H. Ulfelder, D. C. Poskanzer, “Adenocarcinoma of the Vagina: Association of Maternal Stilbestrol Therapy with Tumor Appearance in Young Women,” New England Journal of Medicine 284, no. 15 (April 15, 1971): 878-81.

This despite the existence of a 1939 editorial in the Journal of the American Medical Association Anonymous, “Estrogen Therapy: A faming,” JAMA 113, no. 26 (1939): 234.

lobbied for research funding to study its effects Not until 1992 did the National Institutes of Health convene a meeting on the long-term effects of DES. Shortly afterward, Congress passed the DES Education and Research Amendment, which provides funding for research and for a public and physician education campaign.

DES was one of the prime movers behind the nascent women’s health movement Author interview with Dana Beyer, September 2002.

For a very long time, we’ve been battling with the forces Author’s personal communication, Scott Kerlin, September 7, 2002.

says social scientist Scott Kerlin Kerlin is currently a counselor in private practice in Kingston, Ontario. From 1998 to 2000 he was a lecturing professor in social sciences and human development at Washington State University.

I’ve gotten advance looks at the CDCmatenaL Author’s personal communication, Scott Kerlin, September 12, 2002.

DES exposure causes imbalances in fetal hormone levels and impairment of normal functioning in hormone receptors See Robert Bigsby, Robert E. Chapin, George P. Dayston, et al., “Evaluating the Effects of Endocrine Disrupters on Endocrine Function during Development,” Environmental Health Perspectives 107, supp. 4 (August 1999): 613-18. See also John Travis, “Modus Operandi of an Infamous Drug: Mutant Mice Provide Clues to How DES Wreaked Havoc in the Womb,” Science News, February 20, 1999, retrieved from http://wwwsciencenews.org_sn_arc99/ 2_99/bob2.htm, April 12, 2003.

Hypospadias … and urethralmeatalstenosis … have also been noted in DES sons N. M. Kaplan, “Male Pseudohermaphroditism,” New England Journal of Medicine 261 (1959): 641-44; D. Hoefnagel, “Prenatal Diethylstilbestrol Exposure and Male Hypogonadism,” The Lancet 7951 (January 17, 1976):

152-53-

For a recent study on increased risk of hypospadia in DES grandsons (sons of DES daughters), see H. Klip, J. Verloop, J. D. van Cool, M. E. Koster, C. W. Burger, and F. E. van Leeuwen, “Hypospadias in Sons of Women Exposed to Diethylstilbestrol in Utero: A Cohort Study.” The Lancet 359 (2002): 1102-7. See also H. Klop, J. Verloop, J. D. van Gool, M. E. Koster, C. W. Burger, and F. E. Leeuwen, “Increased Risk of Hypospadias in Male Offspring of Women Exposed to Diethylstilbestrol in Utero.” Paediamc and Pennatal Epidemiology 15, no. 4 (2001): A19. 254 The DES Sons Online Network was also formed to expand awareness Scott Kerlin and Dana Beyer, M.D, unpublished paper, Scott Kerlin personal communication with the author.

About 50 percent of our two hundred people … exhibit some form of gender variance Dana Beyer responding to questions after a presentation at the International Foundation for Gender Education conference, March 22, 2003, Philadelphia, Pa.

In July 2004 “The vast majority of individuals whom I have allowed to join the [DES Sons] network had either ‘confirmed’ (i.e., directly through medical records access or indirectly through personal conversation with mother or other family members) or ‘strongly suspected’ (i.e., all evidence points in that direction, but medical records access and/or contact with mother not possible) prenatal DES exposure. However, a few (less than fifty since the network was formed) who had no way of confirming their exposure were also permitted to join in order to assist them with unanswered questions. (It is estimated that 50 percent of all DES-exposed XY males have never been told of their exposure.)” Scott Kerlin, personal communication with the author, July 9, 2004.

It seems that the entire focus of any ongoing “cohort” tracking Author’s personal communication, Scott Kerlin, September 12, 2001.

the goal of the DCCS is to determine whether the health risk of cancer Centers for Disease Control, http://www.cdc.gov/DES.

not only increased incidence of hypospadias but also “lower ratings” I. D. Yalom, R. Green, and N. Fish, “Prenatal Exposure to Female Hormones,” Archives ofGeneral Psychiatry 28 (April 1973): 554—61.

A study published in 1992 by researchers at the Kinsey Institute J. M. Reinisch and S. A. Sanders, “Effects of Prenatal Exposure to Diethylstilbestrol (DES) on Hemispheric Laterality and Spatial Ability in Human Males,” Hormones and Behavior 26, no. 1 (1992): 52—75.

this subject, as I don’t need to tell you Personal communication, Pat Cody to Scott Kerlin, June 8, 2001.

Since we cannot create fresh studies of DES in humans Author’s personal communication, Scott Kerlin, September 10, 2002.

In 2001, the researcher Niels Skakkebaek and colleagues N. E. Skakkebaek, E. Rajpert-De Meyts, and K. M. Main, “Testicular Dysgenesis Syndrome: An Increasingly Common Developmental Disorder with Environmental Aspects,” Human Reproduction 5 (July 2001): 972—78.

the biological plausibility of possible damage to certain human functions (particularly reproductive and developing systems) World Health Organization, “Global Assessment of the State of the Science of Endocrine Disrupters,” retrieved from http://www.who.int/pcs/emerg_site/edc/global_edc _TOC.htm, July 31, 2002.

It is somewhat ironic that two synthetic chemicals John McLachlan, “Environmental Signaling and Endocrine Disruption,” Endocrine Reviews 22, no. 3 (2001): 323.

Reviewers considered the work metaphysical Sheldon Krimsky, Hormonal Chaos: The Social and Scientific Origins of the Environmental Endocrine Hypothesis (Baltimore and London: Johns Hopkins University Press, 2000), 13.