第 4 章
Down the Rabbit Hole: The Transgender Controversy
Shortly after shifting her career toward activism, Dreger began investigating a controversy that would unexpectedly transform her perspective. In 2006, she researched how transgender activists had attacked Northwestern sex researcher J. Michael Bailey for his book suggesting transgender identity in male-to-female transitions related to sexual orientation, not just inborn gender identity. Bailey's book contained genuinely affectionate support for transgender women but also featured several problematic passages that read as if written from heterosexual white male privilege-stereotyping feminine men, commenting on trans women's appearances, and suggesting some were suited for sex work.
Dreger's investigation revealed that a small group of powerful transgender women had fabricated serious accusations against Bailey, nearly destroying his reputation using activist tactics similar to those she'd employed in intersex advocacy. When she published her meticulously documented findings, she became their next target, receiving disturbing emails calling her son a "precious womb turd" and facing veiled threats that prompted her to contact university police.
Most fascinating was discovering that Bailey's chief critics had previously acknowledged what they now vehemently denied. Lynn Conway maintained a university website featuring herself in bikinis with measurements listed-seemingly embodying the very erotic femininity she denied motivated her transition. Deirdre McCloskey, another prominent critic, had written in her 1999 memoir about being "sexually aroused" by stories of "complete transformation" to womanhood. Even Andrea James, who had posted Bailey's children's photos online with sexually explicit captions, had written a 1998 email "readily admitting to my own autogynephilia" while praising Blanchard's work distinguishing early and late-transitioning transsexual patterns.
After nearly a year of research, Dreger concluded the entire campaign against Bailey was a sham-a calculated effort using clever rhetorical tricks to make it appear that every trans woman in Bailey's book felt abused by him. Anne Lawrence described it as "narcissistic injury followed by narcissistic rage"-an attempt to silence a messenger bringing unwelcome information and ensure no one else would dare to do the same.
第 5 章
When Scholars Face the Mob
The backlash against Dreger was swift and severe. Her online reputation was hijacked with false claims that she was anti-LGBT and anti-intersex. Critics falsely claimed "the Bailey group" had funded her work, when she'd paid for everything herself. She received ethics complaints, hostile emails, and lecture hosts worried about security. She remembers crying quietly in her kitchen one morning, trying not to let her son see.
Amid this storm, she received a Guggenheim Fellowship to study conflicts between scientists and activists over human identity issues. Soon she discovered she wasn't alone-academics everywhere were being attacked for research that offended various identity groups. She began contemplating intellectual freedom's boundaries, wondering if there should be limits to what we study. She felt a newfound reverence for academia, seeing the pursuit of truth as fundamentally connected to justice and democracy. The genius of science-peer review-paralleled the genius of democracy with its checks and balances. Both emerged from Enlightenment principles.
Yet she questioned whether these ideals could be maintained against moneyed interests, identity politics, external funding pressures, and manipulative legislators. Despite seeing colleagues' experiences lowering their view of humanity, Dreger found hope in remembering administrators who had defended academic freedom when researchers were most vulnerable.
As she prepared to fly home on Halloween 2008, she spotted Obama's campaign plane. Taking a photo with permission from a Secret Service agent, she thought about how in four days "the people will peer-review" and elect this intelligent man who spoke of restoring science to its rightful place. She felt inspired by the possibility of academics reclaiming their role as truth-seekers, teaching people to distinguish between self-serving narratives and rigorously reviewed empirical studies.
第 6 章
The Margaret Mead Controversy: Deception in Anthropology
Dreger's investigation into academic controversies led her to examine Derek Freeman's attack on Margaret Mead's famous work in Samoa. Freeman had claimed Mead was hoaxed by Samoan informants who told her what she wanted to hear about sexual freedom. But Dreger discovered Freeman himself was the real hoaxer.
Curiously, Freeman left behind in archives the very documentation that would expose his deception. Among these materials, anthropologist Paul Shankman discovered evidence showing Freeman had set up interviews specifically to turn informants against Mead. Even more damning, there was no information about sex from the two supposed "joshing informants" in Mead's field notes-Freeman had completely fabricated their role.
Freeman's motivations appear complex: he wanted to promote a biology-heavy view of human nature (using Mead as a naive foil) and developed an unhealthy obsession with Mead, viewing her as a threat to anthropology, Samoans, and even himself. He genuinely believed it was his duty to take her down, threatening those who opposed him. Most disturbing were signs of deep delusion-during a 1961 trip to Sarawak, Freeman became convinced sexually graphic tribal statues were exerting mind control over him and being used by Soviet agents to subvert the local government. After destroying one statue, authorities banned him from further research there. As one colleague confided, "We all know he's crazy, but we can't say it!"
Freeman ultimately succeeded in hoaxing the world by following what Dreger learned is the cardinal rule of deception: make claims so unbelievable that people feel compelled to believe them.
第 7 章
The Yanomamo Controversy: When Activism Trumps Evidence
Dreger's most extensive investigation concerned anthropologist Napoleon Chagnon, who had been accused of causing a measles epidemic among the Yanomamo people of Venezuela and conducting unethical research. These accusations came from journalist Patrick Tierney in his book "Darkness in El Dorado," which appeared scholarly with impressive-looking footnotes that convinced many readers, including those who nominated it for a National Book Award.
But many of these citations simply didn't check out. When Tierney claimed Chagnon had vaccinated Yanomamo during the 1968 epidemic (implying he'd caused a child's death), Dreger examined the cited 1970 article and found it named no vaccinators whatsoever. This pattern of misrepresentation appeared throughout her year-long investigation involving forty interviews.
Even Tierney's former allies admitted his dishonesty. Brian Ferguson, an anthropologist critical of Chagnon, told Dreger that Tierney misrepresented his views about missions being less disruptive than Chagnon's presence. When Ferguson objected, Tierney angrily accused him of "backing down" and making "a political move," claiming to have tape recordings that didn't exist.
More damning evidence came from Leda Martins, whom Tierney credited in his acknowledgments for providing "an important resource"-a dossier on Chagnon. This dossier had been used to deny Chagnon research permits, effectively ending his fieldwork. When Dreger obtained a copy from Martins, she confessed Tierney himself had written it, and she had merely translated it to Portuguese and circulated it in Brazil, trusting him without checking his references.
This revelation confirmed Chagnon's long-held suspicions. In a 1995 email to colleague Raymond Hames-five years before "Darkness" was published-Chagnon had identified Tierney as the likely author of the dossier, noting Tierney had visited his office and denied knowledge of it. "I think he is a liar," Chagnon wrote.
Despite these revelations, the American Anthropological Association took action against Chagnon and geneticist James Neel based largely on Tierney's claims-contrary to every other scholarly organization's position. Most readers wouldn't know about the hidden relationships between Tierney and his sources, or that his citations were far less reliable than they appeared.
第 8 章
The Prenatal Dexamethasone Scandal: Medicine Without Ethics
Just as Dreger reached clarity about what activism should look like, her old intersex-rights allies asked for her help with a new issue: a clinician-researcher was promoting a high-risk drug regimen (dexamethasone) to pregnant women carrying children at risk for a particular intersex condition.
Dr. Maria New, a prominent pediatric endocrinologist, was offering this potent synthetic steroid to pregnant women whose fetuses might develop ambiguous genitalia due to congenital adrenal hyperplasia (CAH), claiming it was "effective and safe" despite lacking FDA approval for this purpose. The intervention raised serious ethical concerns, as seven out of eight (or more accurately, nine out of ten) embryos exposed to dexamethasone could never benefit from the treatment, since only female fetuses with CAH potentially developing ambiguous genitalia were the intended beneficiaries. Yet all exposed fetuses faced unknown risks from early developmental exposure to high levels of glucocorticoids.
Despite numerous medical societies calling for the highest scientific and ethical precautions, including the American Academy of Pediatrics which had admonished New in 2001 to confine such treatment to "controlled prospective, long-term studies," the intervention continued without proper oversight. When Dreger contacted New about informed consent procedures, she didn't respond. At a conference in Miami, New became defensive when questioned about consent forms, refused to answer, and rushed through slides showing poor-quality data with more than half the exposed children unaccounted for.
Dreger's investigation revealed that Maria New had been studying prenatal dexamethasone for CAH since the mid-1980s under a continuously funded NIH grant. She began offering the treatment through her Cornell clinic in 1986, obtaining IRB approval to study the effects but not for the high-risk prenatal administration itself-a critical ethical distinction. These trials lacked scientific rigor-no placebo controls or blinded assessments-despite exposing seven out of eight fetuses to risks with no potential benefit.
New's IRB applications contained serious red flags that went unnoticed for sixteen years. She failed to check boxes indicating her research involved pregnant women and fetuses-which would have triggered special reviews. The consent forms minimized risks in shocking ways, describing potential harms as "transient and reversible" and later claiming the treatment "has been shown to be safe for the fetus" even while supposedly studying its long-term safety.
By 1996, the NIH was specifically funding New to study whether prenatal dexamethasone could "succeed" in making CAH-affected females more likely to be heterosexual and interested in motherhood, with no apparent ethical questions raised about this goal. New's research revealed troubling attitudes about gender, characterizing CAH-affected women as having "abnormal" behaviors including "lower interest in getting married and performing the traditional child-care/housewife role" and less interest in having sex with men.
第 9 章
When Watchdogs Fail: The Collapse of Research Protections
When Dreger and colleagues contacted federal agencies responsible for protecting human research subjects, they expected impartial, well-informed investigations. Instead, they encountered a system that had essentially stopped functioning. The Office for Human Research Protections (OHRP) and FDA responded with brief memos indicating they had found nothing worth pursuing. The OHRP accepted New's defense that she had enrolled some women in IRB-approved trials years back and wasn't personally writing prescriptions at Mount Sinai. The FDA investigator claimed New had received an "investigative new drug" exemption in 1996, suggesting the FDA didn't consider the fetal experiment special enough to warrant extensive review.
Most troublingly, the FDA assigned the investigation to Robert "Skip" Nelson, who served on the editorial board of the American Journal of Bioethics (AJOB) with Larry McCullough (who was defending New) and was actively negotiating to become editor-in-chief of a new AJOB journal-creating a serious conflict of interest. Nelson falsely claimed that New had obtained an FDA investigational new drug exemption in 1996 specifically for using prenatal dexamethasone to prevent virilization in female fetuses. When Dreger obtained the actual exemption letter, it appeared to be for treating pregnant women who themselves had CAH, not for preventing intersex traits in fetuses.
The letter Nelson cited was vague, and when Dreger contacted the physician who signed the 1996 letter, he had no recollection of the matter. Nelson knew there was no documentation to support his public misrepresentation, telling OHRP staff that related documents had been shredded during an FDA move. Instead of providing the letter's actual wording, he made it appear the FDA had already reviewed and approved the intervention.
Sweden remains the only place where prenatal dexamethasone for CAH has been properly studied with full ethics oversight and informed consent. Two months after U.S. agencies dismissed Dreger's concerns, Swedish researchers were so alarmed by their results that they shut down their clinical trial. Their study of forty-three prenatally exposed children revealed that boys "accidentally" exposed may be genitally and behaviorally feminized. It confirmed earlier findings of impaired verbal working memory in exposed children without CAH. Most alarmingly, they documented eight "severe adverse events" among forty-three children, including growth disorders, a mood disorder requiring hospitalization, and three cases of mental retardation-about ten times the normal rate.
第 10 章
Truth, Justice, and the American Way: A Call to Action
In the late 1980s, Dreger's family visited Poland as it emerged from Soviet oppression. In a tiny farming village, they discovered a solitary German soldier's grave from WWII, meticulously maintained despite being outside a proper cemetery. Her mother explained that during the war, this soldier had refused his Nazi officer's order to massacre a village harboring Jews. For his refusal, the officer shot him dead on the spot. The survivors had honored him with this burial and continued tending it decades later.
This story embodies the worldview Dreger's mother shared with her: dogma isn't particularly useful, but in most situations, if you think clearly beyond yourself and your loyalties, you can discern right from wrong. Being good meant being good to others, including strangers. Human reasoning is imperfect and biased, but the quest for truth must ultimately guide how you enact good.
Today, evidence-based activism has become common, with data-oriented scholars engaging in advocacy work across many fields. But both scholarship and activism face serious threats. Social activism suffers from internet-induced distraction and false senses of accomplishment, while the collapse of investigative journalism means no one follows through to separate reality from illusion. Universities have shifted to a corporate model where faculty are judged by grant money rather than knowledge generation, pushing work toward political safety or industrial expedience.
Most troubling is the tendency in some humanities to dismiss the quest for objective understanding as naive or even dangerous. This betrays the very idea of an academy of learners. Those who claim there is no objective reality typically haven't witnessed the real-world consequences of such thinking-whether it's the effects of clitoroplasty or prenatal dexamethasone advertised as "safe" without scientific support.
The Founding Fathers understood the critical connection between freedom of thought and freedom of person. Justice depends upon truth, and the quest for truth cannot occur in an unjust system. When the Declaration of Independence was first read publicly in Philadelphia, it happened on a platform erected seven years earlier by the American Philosophical Society for astronomical observations-a perfect symbol of how scientific inquiry set the stage for political freedom.
To activists: if you want justice, support the search for truth. To scholars: we must protect each other and the public from misinformation. The best activists and scholars long for the same world-a free one. Evidence is the most important ethical issue in a modern democracy. If you want justice, you must work for truth. And if you want to work for truth, you must do a little more than wish for justice.
第 11 章
Progress and Setbacks: Where We Stand Today
Despite setbacks, progress on intersex rights is accelerating rapidly. In 2012, following pressure from Swiss intersex activists, the Swiss National Advisory Commission on Biomedical Ethics acknowledged the suffering experienced by people with differences of sex development due to past medical practices that violated fundamental human rights. In 2013, the United Nations special rapporteur on torture recommended legal actions to stop "forced genital-normalizing surgery" on children too young to consent.
A landmark case is moving through American courts involving a boy born with ambiguous genitalia who was surgically feminized at sixteen months while in foster care. After adoption, his parents supported his male self-identification. The family's lawyers argue his Fourteenth Amendment rights were violated, making intersex clinicians nervous about potential legal protections for intersex children.
Meanwhile, many transgender people still struggle to access gender-affirming care that intersex babies receive without consent. Though more American children's hospitals now provide supportive transgender care, some clinicians may be too quick to medicalize gender-nonconforming children. A growing movement of American parents is rejecting medical intervention for gender-nonconforming children, letting them develop naturally and decide for themselves about bodily changes later.
Despite efforts to suppress Blanchard's research on autogynephilia, more people now openly identify with this orientation. Anne Lawrence's groundbreaking 2013 book analyzing hundreds of autobiographical narratives emphasizes that for autogynephilic natal males who transition, female identity becomes necessary for survival, not a game or fetish. Research consistently shows transition improves transgender people's psychological and social well-being.
The problem remains fundamental: people don't understand that good intentions can't prevent harm. Most people believe the goodness of their souls will keep them from committing bad acts. They see history as simple moral dramas of good versus evil rather than as tragic human errors. Despite Santayana's warning that those who cannot remember the past are condemned to repeat it, people rarely listen to historians' warnings until it's too late. We can bear witness afterward, but witnessing alone is never enough.
