Last week my wife and I saw the biopic Kinsey in which Liam Neeson plays the entomologist turned pioneering sex researcher, Dr. Alfred Charles Kinsey. It's a pretty good movie. Rent the DVD. Kinsey spent the early part of his career as a zoologist studying gall wasps, on which he became the world's foremost expert. He collected over one million different specimens and published two books on the subject. Then, at some point in the early 30s, while pondering the variety of sexual behavior in the wasps he was studying, he started wondering about the range and variety of sexual behavior in humans. When he looked into it, he was dismayed by the prevalent scientific ignorance about even very basic physiological sexual function in humans, much less complex sexual behaviors. Remember, this was a time when even college-age men and women often had very little information about sex.
But in this vacuum of knowledge where the angels of science feared to tread, as usual, the ever-confident fools of myth and dogma had rushed in with loud proclamations such as: masturbation causes blindness; oral sex leads to infertility; the loss of one ounce of precious, life-giving semen is equivalent to the (rather more obviously enervating) loss of 40 ounces of blood; and so on and on. We've all heard these sorts of things. In addition there was very little information about more real dangers and risks of sexual behavior, such as venereal disease transmission. When Kinsey taught a "marriage" class at the University of Indiana at Bloomington, a type of early sex-ed, his students often asked him questions that he could not answer because the answers simply were not known.
Embarrassment at this state of affairs prompted Kinsey to action. As an accomplished ethologist (one who studies animal behavior in the natural environment) he realized that in addition to studying the physiological sexual equipment of humans and the mechanics of sexual response, it was important to compile data on human sexual behavior "in the wild", and he undertook the prodigious task of conducting detailed surveys of men and women across the 48 states of America to compile statistics about their sexual behavior. He didn't reach his goal of interviewing more than a hundred thousand people, but he did make it to the tens of thousands. I cannot go into the details of his methodology here but it has been fairly well defended. In 1948, Kinsey published the first of two books based on his exhaustive sex research that would eventually alter the course of this country in significant ways: Sexual Behavior in the Human Male. Five years later he published Sexual Behavior in the Human Female.
What Kinsey found is well-known now but was absolutely scandalous at the time: the prevalence of homosexuality and bisexuality; the ubiquity of masturbation, especially in males; the common practice (at least much more than anyone had previously thought) of oral sex, anal sex, premarital sex, infidelity, and other forms of "deviant" behavior. While Kinsey simply reported the raw data, never advocating social policy or drawing moral conclusions, the effects of an open airing of these previously taboo subjects had far-reaching effects, not only contributing significantly to the sexual revolution of the 60s, but, importantly, resulting in the eventual massive decriminalization of various sexual practices such as (but not limited to) sodomy and oral sex across the states. There were other results as well: it took until 1973 for the American Psychiatric Association to remove homosexuality from its list of mental illnesses, but it happened at least partly because of Kinsey's work. Most significant of all, however, Kinsey's reports went a long way toward lifting the clouds of ignorance and fear that had long whelmed sex.
Now it occurred to me after I saw the movie, that there is an area of human practice (and, yes, it is more-or-less universal) which is today covered in the same clouds of ignorance and fear; which has distorted the well-intentioned aims of the criminal justice system and is filling up our jails; and which is dominated by myth and dogma in much the same way sex was before Kinsey had the courage to defy the taboos surrounding it and clear that fog with his bright beam of information: it is drug use.
What is drug use? I shall define it here for my purposes as a consumption (whether by ingestion, inhalation, injection, absorption or any other means) of a substance with little or no nutritional benefits, simply out of a desire for its effect on the nervous system. This then includes substances ranging from caffeine and nicotine, to alcohol, marijuana, LSD, PCP, ecstasy, cocaine, crystal meth, heroin, and the thousands of other substances that people use to enhance, or at least alter, their subjective experience of the world. And I won't even get into prescription drug (ab)use from Valium to Viagra. Extremely large portions of all the cultures that I know of use at least some of these and other substances. Of course, most people enjoying a friendly chat over tea are not explicitly aware that they are taking a drug, but they are, and it makes them feel better, more energetic, and more awake. Just as some sexual practices are relatively harmless, while others pose real dangers to those who practice them, certain drugs and related practices are more dangerous than others.
Here's the problem: there is very little useful information available about drugs. The reason is that there is a reluctance bordering on taboo on the part of government and non-government agencies alike to actually spell out the risks of taking drugs. In the case of illegal or other "bad" drugs, there is an absolute refusal to accept the fact that a large part of the population uses and finds pleasure in these substances, and an attempt to marginalize all drug users as criminals, addicts, and degenerates; just as in Kinsey's time, absolute abstinence is at present the only acceptable message for the public. "Just say no!" That's it. Where there should be informed messages of the exact risks of various substances, there is fear-mongering instead: the "this is your brain on drugs" ad on TV showing a frying egg, for instance. The implication is, just as an egg cannot be unfried, once you have used drugs (which drugs? how much? for how long? --these questions are not to be asked, and cannot be answered), your brain is permanently fried, whatever that means. After all, a fried brain is just a metaphor, it does not say anything scientific about exactly what sort of damage may be done to one's brain by how much of what drug over what period of time. "Cocaine Kills!" is a common billboard ad. Have you noticed that Kate Moss hasn't died? Why? I happen to know a bunch of Wall Street types who have been snorting lines off little mirrors in the bathrooms of fancy downtown clubs pretty much every weekend for at least a decade, and so, probably, do you. None of the ones I know have died so far. I also know a man who tried cocaine for the first time and ended up in an emergency room. So what is the real risk?
The problem with just telling people "Cocaine Kills!" and nothing more is that because they may see many people doing cocaine who are not dropping like flies, they completely dismiss the message as a crying of wolf. Or, they may think, "Yeah, sure cocaine kills, but so does skiing. Think Sonny Bono. Think Michael Kennedy. Just say no to skiing? I don't think so. The pleasures outweigh the risks for me." Why not tell them something useful about what the real statistical risks are? What percentage of the people who do it die from cocaine? What are the chances of dying for every ten times, or a hundred, or a thousand that you take cocaine? In the almost religious zeal to curb smoking, even there the situation about the actual risks is endlessly confusing. I have repeatedly read that 9 out of ten people who have lung cancer were smokers, but this tells me nothing about what risk I am taking of getting lung cancer by smoking. It could be that only a small percentage of the population gets lung cancer, and of those, the smokers are at disproportionately higher risk. There are hugely inflated figures of the number of deaths caused by smoking which are routinely thrown around. I have even seen a poster claiming that 3 million people are killed every year in the U.S. by smoking. That's more than the total number of deaths every year in the U.S.! What I would really like to know is, on average, how much I am shortening my life with every pack-year of cigarettes I smoke? I just looked at various websites such as those of the American Heart Association, the Centers for Disease Control, the World Health Organization, and countless others, and I cannot find this simple information. Why? Just as Kinsey could not answer many of his students' questions about sex, if a young person today asks just how risky it is to use ecstasy at a rave, for example, we have nothing to say.
Another problem with this "just say no" approach is that just as the total abstinence approach masks the differences in danger to one's health of different sexual practices (having frequent unprotected sex with prostitutes is obviously not the same risk as having protected sex with a regular partner) because they are equally discouraged, this approach also masks the differences between the various practices of using drugs. Smoking a joint is not the same as mainlining heroin, but there is no room for even such crude distinctions in this simplified message. There is only the stark line drawn between legal and illegal drugs. Go ahead and have your fourth martini, but, hey, that hash brownie will kill you!
The same unrealistic refusal to acknowledge that drug use is very common (yes, there are always a few polls of high school sophomores and college freshmen, but nothing serious and comprehensive) across all strata of society results in a distorted blanket approach to all drug use, and the same ignorant fear-mongering that used to exist about sex. The first thing to do is to compile, like Kinsey, detailed information on all drug use (or at least the top twenty most used drugs) by employing the best polling techniques and statistical methods we have. Let's find out who is using what drugs, legal or illegal. Break it down by age, gender, race, income, geographical location, education, and every demographic category you can think of. Ask how often the drug is taken, how much, in what situations. Ask why the drug is taken. What are the pleasures? Poll emergency rooms. Research the physiological effects of drugs on the human body. Write a very fat book called Drug Taking Behavior in the American Human. I am not advocating any policy at all. I am just advocating replacing ignorance and confusion with irrefutable facts. New directions will suggest themselves once this is done. Maybe just as people who engage in oral sex are no longer seen as perverts and degenerates, maybe one day Bill Clintons won't have to say "But I didn't inhale," and George W. Bushes won't have to lie about their cocaine use. On the other hand, maybe we will decide as a society that Muslims were right all along, and ban alcohol. Go ahead, be the new Kinsey.
Have a good week!
My other recent Monday Musings:
General Relativity, Very Plainly
Regarding Regret
Three Dreams, Three Athletes
Rocket Man
Francis Crick's Beautiful Mistake
The Man With Qualities
Special Relativity Turns 100
Vladimir Nabokov, Lepidopterist
Stevinus, Galileo, and Thought Experiments
Cake Theory and Sri Lanka's President
Go ahead! Be the new Kinsey.
Thats my message to you after reading this thought provoking Monday Musing. And I mean it.
Posted by: Javed | Monday, October 10, 2005 at 04:53 AM
Go ahead! Be the new Kinsey.
This is my message to you after reading this thought provoking Monday Musing. And I mean it.
Posted by: Javed | Monday, October 10, 2005 at 04:55 AM
Kinesy was culturally valuable of course, but his data was pretty dubious. His effect was, as you point out, to make clear that these "deviant" practices were pretty common. But we already know that much about drug use: lots of different kinds is pretty common among many kinds of people. But don't hold Kinsey up as a model of data gathering to be emulated in drug studies--just cause he published a fat dry-titled text doesn't mean his data was especially good.. In fact I bet we have more accurate data about teen drug use than Kinsey had about sex practices, and we *still* can't make common sense win the day.
Posted by: Kenny Kinsay | Monday, October 10, 2005 at 11:28 PM
Kenny,
There is some controversy over Kinsey's methods, and I am guilty of glossing over this because I believe that basically his results were valid for the most part, and many of the attacks on his findings were and continue to be made for various ideological reasons.
I disagree that we have a lot of data. Where is it? There are some studies of teenagers, etc., but even these need to be collected in one place, just as Kinsey did for sex data. Just in PR terms, one needs a bit fat book with a provocative title and lots of good data (collected with greater care and better methods than Kinsey, to be sure), just to get the nation's attention, I think. This is not a minor problem, but one of the major "wars" our government (and our society)is currently fighting and losing. Isn't it time to shine some light on it and look at it hard?
Posted by: Abbas Raza | Tuesday, October 11, 2005 at 12:20 AM
Allow me to third Javed's first two encouragements. We all find our paths, don't we.
Following up on the comments above, Kinsey's impact on our culture was enormous, and its vehicle wasn't the data, regardless of its merits, but the popular response to his first book. The Kinsey effect grew out of popular titillation and a willingness to buy and talk about the book. In other words, our culture prompted the shift, and maybe it would've found another stimulus if Kinsey had stuck with gall wasps. It seems likely to me that the absence of knowledge about drugs and their effects stands for willful ignorance. I suspect Doc Raza will be ignored if he publishes his opus anytime in the near future.
Posted by: Jed | Wednesday, October 12, 2005 at 09:27 PM
Jed,
IMHO, you are right and you are wrong. You are right that it wasn't so much the data, but the fact that someone was willing to bring a scientist's objective perspective to the study of sex that made such a huge impact. You are wrong that "our culture prompted the shift." In fact it is Kinsey who prompted the shift in our culture, and I am not as pessimistic as you about whether it could be done again, this time in the case of drug use.
I, however, am no "doc" and must leave it to a qualified 3QD reader to take up this challenge. There IS someone at 3QD with a prodigious knowledge of statistical methods, though: Dr. Varghese, you up for this?
Posted by: Abbas Raza | Wednesday, October 12, 2005 at 10:02 PM
You're being silly, of course. It takes more than just training in stats to do this, any more than knowing how to hammer nails for pictures enables you to make sculptures by chiseling stone.
I suspect that these studies have been done and do exist. They're probably just hard to come by, given that people may not want to publicize anything other than averages.
Call the CDC.
Posted by: Robin | Thursday, October 13, 2005 at 03:46 PM
As happens here often, you 3QD science and philosophy dorks are missing the forest for the shrubbery you're trodding on. It's not about the data, the statistical methods or, for that matter, the objectivity of Kinsey, and the evidence is in his own work. The first book, about the sexuality of the male, was a revolutionary cultural event and a great publishing success. The second book, data for which were compiled in the same way and at the same time, was a great failure, and marked the effective end of Kinsey's professional life. And in fact we--by which I mean the culture--know--by which I mean the culture knows as a broad generality--a lot about and feel comfortable with (to a cliched extent) men's sexual nature. What about women's? How does the culture feel and think about a woman's sexuality? Is it as integrated as a man's in the culture? Are we (again, broadly) as soaked in the woman's counterpart to the man's "6-inch is normal/we all jerk off 6 times I mean once a day/erectile dysfunction" culture? No. We know far less about girls than we do about boys, and we like it that way. What we can tell from this is that the shift Kinsey inspired or coalesced with or discovered in advance is not about data or any particular individual, but about inscrutable cultural forces.
Posted by: Jed | Thursday, October 13, 2005 at 09:07 PM
Another thought provoking essay from you and quite sensible. I agree with much of what you said. I just want to point out that John Hunter who was the father of modern surgery (took the fielld of surgery from barbers to medical profession in the 18th century England) and was way ahead of his times, repeatedly said that masturbation was not the evil it was proclaimed to be, but the myth continued to this century. As for drugs there is a lot of data available like studies that show that one marijuana cigarette has the same damaging effect on the lungs as a full pack of regular cigarettes. Or the risk of emphysema or lung cancer from smoking. When they talk about deaths from cigarettes they include it's effect and contribution to lung cancer, heart disease, strokes, emphysema and peripheral vascular diseases besides pneumonia, bronchitis, bronhiectasis and many other ailments. So the total number of deaths to which cigarettes contribute is closer to a million, although not quite three million which as you pointed out is more than the total number of deaths in this country. If some one is serious about the kind of study you suggest one can start by an extensive review of the available literature on smoking and drug use and analyse and categorise it....will take several years and a lot of work, and then see if further questions need be answered or asked. Adding tea and coffee would make the effort prohibitive since there use is so widely accepted. So should we volunteer someone?
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