The Travails of ♂♀ Relationships Amid Gender Roles and Expectations in Flux

26 Dec

Introduction

Before I wrote this commentary, I had been wanting to have a conversation with female friends concerning these thoughts about cis women, men and gender roles from observations I’ve made within experiences I’ve had. The primary experiences I draw from… are my romantic and non-romantic relationships with 2nd generation Latinas from humble beginnings that are now professionals with advanced degrees. Henceforth, when referring to women, I refer to this profile. As my observations extend to secondary experiences I draw from with other women of color and Latinos, my thoughts within may well similarly apply.

My lived observations are the specific instances from which the commentary infers broad trends. These observations are of a small sample of people with whom I have been friends and/or lovers. In heeding some advise, I acknowledge that my observations and inferences are made with my eyes and interpreted with my mind with all that has gone to shape its current state. Therefore, the ideas should be viewed with healthy skepticism as the sample is small and its selection biased.

This commentary also springs from the contributions of six female friends who generously agreed to be readers of an early version. These women’s reactions varied with some giving favorable reviews and others either dismissing it or suggesting I burn it. I learned a lot from their remarks and I sincerely hope my attempts to incorporate their critiques improves the commentary’s quality. For example, I learned how some of my reactions to relationships situations, however understandable, actually undermined and limited the scope of the message I sought to convey. Consequently, I am grateful for the time they took, their patience and insight.

I want to dedicate this commentary to its most important source, my mother Josephine Rodriguez Morales. My mother was also a 2nd generation Latina, only her parents arrived from Puerto Rico in the 1920’s. She also came from humble beginnings and became an educated professional after much hard work. She also became an avowed feminist in the wave of feminism of the early 1970’s.

As the wave shaped my mom’s personal evolution, so my mom shaped mine. Fortunately, I was able to read a version of this commentary to my mother before she passed last year. She gave me a guarded approval, for which I am grateful .

Thus, that wave has ushered in another period of societal change in gender roles as scholarly work has recently shown to have happened many times in the past1. It’s my hope that this commentary makes a minuscule, yet positive contribution to this change.

The commentary’s purpose is to point out relationship challenges that some cis humans have in this historical moment and suggest an approach to them. I identify these challenges as a cis male participant in varied relationships with women, my comrades and collaborators in change. I want to emphasize that while the observations I make apply to both women and men, they apply asymmetrically and to varying degrees. I suggest that these observations lean more towards women because history has given them a leading role in this era’s social change. As women strive to achieve the fullness of their humanity, shaping our social evolution, they pave the path that men follow.2 I suggest that men will trail as content equals because compassion is felt for our inevitably imperfect efforts as partners and mates.

Notwithstanding the application of these challenges to both cis genders, my attention is directed first to Latinas and then to myself as a man. These challenges are often missteps arising from common foibles. Accordingly, my comments seek to gently nudge readers to consider modest refinements in our respective parts of this endeavor. No one is to blame for the challenges, but we all bear responsibility to be thoughtful and have compassion as we haltingly forge a way forward. These comments take on more urgency now because just as a grand gender role change is underway, so too a reaction has been percolating.

Part one

To begin, people today, some more, some less… appear to be “ambivalent” (or having “simultaneous conflicting feelings”) about their changing gender roles. Ambivalence seems plainly true for women, given their position at the forefront of these changes. This idea’s nuances include ambivalence directed at a culture that encompasses gender roles. Thus, women may feel ambivalent about their cultures… should they adhere to, respect, accept or defy, disrespect, reject their culture’s traditional roles for women? For some, being Latina is actually synonymous with their culture and the question becomes should their culture be abandoned or just adjusted? Moreover, others point to more granular contributors to ambivalence such as an individual’s personality and past experiences. Importantly, this ambivalence has consequences for cis relationships.

However the idea is formulated, at a basic level, I surmise that ambivalence arises from a deeper drive… people want “connection” to others…in other words, intimacy, closeness and social bonds.

All the same, cis human relations are a numbingly complex “choreography” that “dancers” follow to mediate the forming and dissolving of social bonds. The “steps” in this choreography include gender roles each dancer learns to follow to enable those bonds across and within gender lines. Historically, “sticking to the steps” or conforming to gender roles, favors bonds, and yet, sometimes they don’t.

Unsurprisingly, a person will usually move towards enhancing bonds, but still, sometimes not. Thus, “sticking to the steps” likely fluctuates amongst men and women throughout history – sometimes less, sometimes more. Accordingly, the regard dancers have for their place in the dance is shaped by and shapes this undulation – some are more part of the dance, others less so.

These days, dancers’ regard for their “set sequence of movements” varies significantly… that is to say they may have ambivalence. Thus, people sometimes want freedom from constraining gender roles…but on the other hand, consciously or unconsciously, also want to stay within the bounds of traditional gender roles.

Actually, people, consciously and not, go back and forth between freedom from and conforming to gender roles as they deem necessary. I’ve observed that people are sometimes comfortable with traditional roles, even like them; they can “feel right”3… yet still, sometimes not. Other times, people are not even aware that they are conforming. Thus, people go back and forth consciously or not, at any one time or over time. Most interesting is when a person (for me, especially a woman) is aware they’re being traditional, but still want to conform to these roles anyway. It’s interesting because it would seem that those who initiated the gender role shift would stay true to what their sister’s started.

Fundamentally, I suggest that people conform to avoid alienation from themselves and from other people in their lives. In conforming, a person signals the steps they follow to those around them following their common dance. When those around them know what to “expect” from them, their steps correspondingly “mesh”, enabling connection. Despite the desire to be free from constraints driving changing gender roles, the human drive for connections or social bonds is strong, thus, ambivalence is understandable.

In the tricky realm of cis romantic relationships, these dynamics play out even more so. This realm displays another feature of this ambivalence…a person’s expectation of the person in their life to “mirror” their gender role behaviors at any given moment (the “mesh” mentioned above). Continuing the analogy, when dancing salsa… as a person moves forward, the other person moves back…the couple coordinates and someone “leads”. This coordination signals privately and publicly, at least for a time, a favoring of traditional social bonds.

Coming of age in the 80’s, I have been a “dance partner” with women whose expectations frequently aligned with critical views of patriarchy. These women ostensively did NOT want traditional male behaviors directed to them, but DID want to receive non-traditional behaviors (e.g., respect, admiration, cooperation, support). But this NOT wanting some behaviors and WANTING others was more complicated.

It got complicated and confusing because my “dance partners”, consciously or unconsciously, wanted to go back and forth, conforming or not conforming to traditional female gender roles. Similarly, they did and did not want X or Y male gender role behaviors at one time and not another. Thus, X or Y were both desirable and undesirable depending on the circumstances.

An illustration of these complications arises in sexuality. On more than one occasion, I’ve heard cis men scornfully say of their non-traditional partners comments like “…they just want their ass slapped”. It was disturbing to hear this because they were pointing to apparent contradictions in these women so as to undermine non-traditional thinking. I was troubled hearing how these men seemed to disrespect women in their lives. I was even more disconcerted when in the bedroom, my non-traditional women partners similarly adopted traditional sexuality with me! Actually, it’s even more complicated than this! Regardless, I had to take many steps back to see how this behavior could be part of a larger liquid-like “ambivalence”.

This fluid space is where the “missteps” we take as “dance partners” comes into play. The “missteps” were not ambivalence, but a more common foible…”dance partners’” tendency to not communicate expectations. Consequently, when either of us didn’t live up to unspoken expectations, mismatches between behavior and preferences arose, conflict could ensue and our dance was disturbed.

For my part, I found myself in a weird place. Because I took the women’s views seriously, I naively thought they wanted to be non-conformists all the time and did NOT want to follow traditional gender roles…like ever! It took time for me to realize that that wasn’t true. Further, my “dance partners” frequently didn’t want to have to say…”I’m going to conform now”… perhaps because it would aggravate their internal contradictions…they just wanted me to “get it”. These unspoken gender roles shifts, with their accompanying “dance partner” expectations, set the stage for seemingly inevitable conflict and misunderstanding. Still and all, as a sincere and loyal “dance-mate”, disapproval from unvoiced expectations was difficult.

The conflict made it easy, at first, to view the women’s public, non-traditional views as hypocrisy or even a contemptuous affectation. Still, I was wrong! Through empathy and careful consideration, I grasped that “ambivalence” could be a complex psychological process… it can appear one way on the surface, but on deeper levels it could be part of a larger, understandable state of being.

Thus, the disapproval was a likely outcome of this fluctuation between conflicting gender roles and behaviors. I was seeing conflicting expectations of me as a partner in their struggles with conflicting gender roles. I get it. While eventually comprehensible, if she recognized her own feelings and made them known, things could have gone differently. Never-the-less, these missteps led our dance to suffer.

Part two

Notably, the missteps don’t stop there. The dance shoe is on the other foot when “ambivalence” applies to me as a man. Although my mother was a feminist, she was raised in the 1930’s of traditional Puerto Rican immigrant parents during the Great Depression. Similarly, while my father was a “free thinker”, he was also raised in a traditional Puerto Rican family as the first-born man child of immigrants during the depression. Growing up with these parents within this household in the change filled 60’s -70’s Bronx suffused me with turbulent tendencies.

While my aversion to traditional “masculinity” grew in part from many paternal conflicts, a yearning for closeness with him persisted in me and fueled my care for him during his illness and passing. Similarly, an affinity towards my mother from her gentle acceptance grew to an enormous respect for her capability, independence and competence (an early nurse practitioner!). Thus, my inner tides formed me as a mirror image of the “dance partners” I eventually sought. Consequently, I too, as a man, have ambivalence regarding gender roles.

In my life, I consciously or unconsciously conform to the traditional male gender role in a variety of ways… the role feels mostly comfortable in guy friendships, inevitable in sexuality, correct in helping others, standard in movie preference, unsurprising in reaction to non-gender conforming people, expected in clothing preference, not unusual regarding vanity or product use, usual with hobbies, typical re. cleaning and common in color preferences.

However, sometimes I also, consciously or not, have not wanted to conform to male gender roles in different ways. Since I see male gender roles as impoverishing of a man’s humanity, I’ve wanted to claim my humanity more fully. For instance, I have wanted to embrace my inner emotional life, the related quality of my male and female relationships, my aesthetics, and my sexuality. I’ve also claimed other aspects of my life… including my cultural preferences, my consumer, movie, sports, and TV preferences, my hobbies, my self-care and care of others.

JUST like women, during MY struggles with changing roles, these preferences ALSO include my expectations of my “Dance partner”. Sometimes, when anticipating certain responses to MY traditional or non-traditional behaviors, mismatches and clashes arose.

On occasion, when conforming to traditional male gender roles, my expectations would be at odds with my partner’s preferences at the time. For example, in two instances with two women, during public festivities, my traditional expectation to dance with my partner was met with refusal and her dancing with others. That mismatch upset me just as it had with my “dance partner” in different circumstances.

Other times, it was my not conforming to traditional male gender roles that created conflict. For example, I was expecting my “dance partners” to be ok with my full spectrum of emotions. Never-the-less, contrary to expectations, that was not always true. I met disfavor when I was ignorant about cars or handiwork, had female friends, was disinterested in pro sports, or was even “too nice”. Their displeasure was sharpest however when I displayed my vulnerability… sometimes by showing emotions about my parents, my growing up, familial conflicts, wanting emotional closeness, or even when I would get physically hurt. If I said directly… “I want to be emotional now “… would it have helped? Perhaps. At least one woman had to struggle with herself saying … “he only wants to be a human being!”

In these instances, when my behavior didn’t match my “dance partners” expectations, or typical “guy behavior”, their comfort seemed to be affected. It was confounding that my feminist partners seemed to want traditional behavior from me at times. Perhaps, the women had this traditional preference because they were familiar …they “knew those steps”. Maybe they also had this preference because they wouldn’t be asked to be a mirror…by being vulnerable themselves. Clearly, relationships are risky, challenging and vulnerability is probably not easy whether in or out of tradition.

Finish

Thus, while changing gender roles don’t guarantee relationship success, they hopefully crack open a bit more space of possibilities. These possibilities start with a person shedding gender constraints and inching toward becoming all they wish to be. These changing roles, fortunately, or unfortunately, also open possibilities that complicate how we relate to each other.…with our roles and expectations both meshing and clashing. Thus, I’ve tried to call attention to how these complications pose challenges to our cis romantic relationships. Still, these challenges are also opportunities for us to improve our relationships. Hopefully, as we steer to become more fully ourselves, we can have more thoughtful compassion for each other as we navigate these complications and more responsible communication about our respective journeys to be with one another. Following this course, we may just find in each other everything from workable accommodations to blissful fulfillment. Whatever the case, it’s important to acknowledge, for good or ill, that we’re all together during this great societal change in human gender roles and we all have a big stake in making it work.

Afterword – The Stakes of Shifting Gender Roles

The stakes of the intricate dance of our cis romantic relationships are not confined to personal fulfillment; our relationships are microcosms closely linked to the broader cultural and political landscape and larger societal shifts. Today, as gender roles evolve, we are simultaneously witnessing a surge in reactionary movements steeped in traditionalist and often authoritarian ideologies. These movements not only challenge the progress toward gender equality, but also threaten the very fabric of our democratic values. For instance, the reversal of Roe v. Wade, followed by state abortion restrictions and challenges to contraception are stark reminders of how deeply personal freedoms are tied to societal politics (see references below).

Significantly, these traditionalist movements gain traction by exploiting the clashes, uncertainties and fears associated with changing gender norms. The rise of the “Manosphere” and its various offshoots, including more extreme elements advocating for overt male supremacy, is a clear manifestation of this backlash. Similarly, Christian Nationalism and other authoritarian tendencies mirror this sentiment, positioning an aggrandized masculinity as a counterforce to the perceived threats of feminism and gender equality. This “hypermasculinity” aligns to fascism’s history that always glorifies aggression, dominance, and militarism. Their rhetoric often idealizes a past where gender roles were rigidly defined and adhered to, appealing to those who find the current flux in identities and relationships disorienting or threatening (see references below).

This cultural pushback has bled into mainstream politics and social policies manifesting in rolling back abortion rights, LGBTQ+ rights, domestic violence services and others. The dynamic is clear, as individuals bitterly grapple with changing gender roles, public opinions skews towards conservatism, driving regressive policies and ideologies (see references below).

Nevertheless, a profound opportunity exists. One based on a conviction that humans beings value unity, liberty and equality. Our power is to mirror a society that values free identities and equitable partnerships. We build a broader culture of acceptance by fostering relationships that embrace flexibility over rigidity. By successfully navigating relationship complexities—with compassion, understanding, and open communication—we help reenforce a more empathetic society that values reciprocity, freedom and cooperation.

Each successful relationship serves as a microcosm of what we can achieve on a larger scale: a society that embraces change and diversity without resorting to backlash or repression. Together, as we dance on, let us lead with empathy, recognizing our tangled fates, ensuring our steps towards progress are compassionate and bold.

Links:

Footnotes:

1“The Dawn of Everything: A New History of Humanity”, David Graeber and David Wengrow, 2021, Farrar, Straus and Giroux

2 “…the great humanistic and historical task of the oppressed: to liberate themselves and their oppressors…”

3 This feeling is like a pre-conscious “click” when parts built to fit join. This slippery notion may be the kind of mental moment that results from conditioning that’s early and on-going.

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A Crash Caused Christmas

21 Dec

Long, long, long ago, in time’s deepest night, there lived a mighty grandmother star. Her heart burned bright with all the elements of creation – the iron in our red blood, the gold of our gleaming treasures, the calcium of our bones, and more. When, as with all things, her time grew near, she performed a final, magnificent mambo – a blazing burst that scattered her essence across the cosmos like seeds in a celestial garden.

From these precious star-seeds, a new light was born – our mother star, Sol. As Sol grew strong and bright, she gathered around her swirling clouds of detritus and stardust, the remnants of her own mother’s gift… the solar afterbirth, if you will. This twirling cosmic dance slowly gave birth to Sol’s children – the planets – each one unique and precious.

Baby Earth was one of these children, already wrapped in a delicate veil of gases and beginning its never-ending journey around mother Sol. In those early days, when Earth was but a few breaths old (though a single breath would last millions of years), another astral child wandered into Baby Earth’s path ’round Sol… its celestial cradle. This was little Theia, namesake of an ancient goddess of heavenly light.

Excitedly scampering about their mother, Theia and Earth drew closer and closer until, in a TITANIC CRASH, they collided! While that titanic impact was utterly destructive, flinging pieces of Sol’s children far and wide, part of our solar sibling Theia became forever part of Earth. One great piece – which we now call “Moon” – was cast up and up until it found its own stately path around its new mother Earth.

The great collision changed Earth forever. Not only did baby Earth lose a lump, but like a child learning to pirouette, Earth now twirled at a tilt, forever leaning 23° in its oval dance around mother Sol. Deep within Earth’s heart, wise stone-readers have found pieces of Theia still nestled there, like memories of that ancient cosmic embrace.

This divine tilt made all the difference to Earth’s story. Now, as Earth dances its great oval around Sol, it leans closer to its mother’s warmth for part of its journey and further away in others. So while one part of Earth basks in warmth, its opposite cools, and then they trade places as the dance continues.

Later, after baby Earth settled down, life arose and fit itself to this endless cycle of change. Eventually, some life that walked upon Earth’s skin came to know these times of warm and cold as seasons, adapting their own small dances to this greater cosmic waltz.

Among all the points in Earth’s yearly dance, there is one special moment when Earth’s top tilts furthest from Sol’s embrace. The wise ones call this the winter solstice – the longest night – when darkness wraps the world in its longest embrace before light begins to grow again. For those creatures that would gaze upward and wonder, Sol’s place in the sky became a beacon of deep meaning.

Throughout time, the human children of our now much older Earth have marked this special moment with festivals and ceremonies celebrating the eternal dance of darkness and light, the symbolic death and rebirth of their mother star Sol.

Even today, when the winter solstice nears, many still celebrate this celestial ballet, though they may call it by different names. All are celebrating that same eternal story – the story of our cosmic lineage, as it has been since long, long before the time of our grandmother star. The newest celebration of light born from darkness, of death leading to rebirth, is now known as Christmas.

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A Crash Caused Christmas!!

26 Dec

Long, long, long ago… when the Earth was an infant planet, the inner solar system was full of the detritus from planet formation… the solar afterbirth if you will…

The baby Earth had already started its “never-ending” journey around its mother star Sol when another solar child wandered in the path of baby Earth. They got closer and closer until, in a TITANIC CRASH, they collided!!! That impact hit our earth so hard, that our solar sibling was utterly destroyed and a sizable chunk of baby Earth, later known as “Moon”, flew off and started its own orbit around its new mother planet … Earth!

Not only did baby Earth loose a lump of itself, but it could never travel straight again! It was forever tilted at the propitious angle of 23.45º off its axis and THAT made all the difference!! Now during one part of its great oval orbit around the sun, the baby Earth’s tilt made the portion tilting towards mama Sol hotter and the portion tilting away cooler. During the exact opposite part of the eternal oval, the hotter and cooler portions reversed! In all the parts in between, temperatures shifted accordingly.

Later, after baby Earth settled down, life arose and fit itself to this cycle of change with adaptations to the periods of hot, cold and in-between. Later, some life developed language and called these variously warm & cold periods “seasons”.

Just as the heat from Mama Sol changed along the great oval, so did the position of sol in the sky for those creatures that would gaze upward and wonder. Of the various solar positions in the sky, winter solstice is an important one for those attentive creatures.

The winter solstice is the time when the earth’s pole is tilted furthest away from our sun, with sol’s light falling on earth for the shortest time… thusly, on that day the night is the longest. The human creatures of the earth always attached significance to this day as the symbolic death and rebirth of the their mother star Sol. Many festivals and ceremonies were attached to this special point in the celestial motions of our now much older earth. The latest of which is another death and rebirth ritual … this time calling this day near the solstice …

Christmas.

Gender Role Commentary coming up

16 Dec

I’ve been working on a commentary about gender roles. I’ve been working on it since the summer little bit at a time. I’ve gotten several people to give me feedback on an early draft. I hope it’ll be thought provoking.

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Covid’s 2020 Lesson for Me

16 Dec

For years, there’ve been issues concerning to me (eg. Climate change) as I paid attention to the world.  However, observing other’s reactions broadly and narrowly to the same issues left me frustrated.  

For example, in the media, climate change was not taken seriously for years by the majority of US society.  I naively  thought that if I tell friends and family about it, I would get similar concern from them and some discussion.  Didn’t happen. Amazingly to me, the facts didn’t seem to carry weight.

Warming Air Was Trigger for Antarctic Ice Shelf Collapse | Climate Central
This is the Larsen B ice shelf breaking off that I had a discussion about over family dinner in 2002. Dad could not accept that this was something to worry about.

Then Covid happened and the reactions were different. True, in the early days, media reactions about the threat were muted. However, after telling friends about covid before lockdown, I was surprisingly taken seriously, and eventually, covid became a “global” fact of life.  However, in time, the range of reactions grew  to include various forms of denialism.   Apparently, a spectrum of reactions to concerning situations is inevitable. That’s a big lesson of covid.

When observing the US nowadays, many see disturbing political trends. Trends like … women’s choice being eliminated, the growth of inequality (e.g. space billionaires), spreading anti-Trans laws., increasing climate catastrophes, fascism bubbling up within and around the Republican party, American history revisionism, banning books, Jan 6 thuggery and lies, the dismantling of our democracy through voter suppression, gerrymandering, voting rigging, intimidation etc. and a host of events reported everyday including a stubborn Covid denialism.

More Lost Cause mythology
Truly shocking subway flooding
I was blown away
Hurricane Maria’s Devastation
Seems “crazy”

I keep on expecting that as the worrying events pile up in our society in the news everyday, clear minded people, especially in my circles, will express concern. Unfortunately, I have to acknowledge that denialism is a really powerful and dismaying part of the human reaction spectrum.

I recently realized that, much like there are some people who don’t acknowledge the reality of covid or climate change no matter the facts, there are many people who will not acknowledge the distressing political events in society. Denialism appears to underly people’s unwillingness to even just talk about what’s going on. 

denial-cartoon | Breaking The Code

To be fair, as one of a sword’s edges, denial is probably a short term coping mechanism, to get through tough times. Unfortunately, the other edge is not acknowledging distressing information is harmful past the short term.

Politically, I think this is very much aligned with what Timothy Snyder observes is the major factor determining likelihood of a country having a fascist takeover. That factor is denial or people not believing that it can happen.  

Timothy Snyder

“In the end, though, freedom depends upon citizens who are able to make a distinction between what is true and what they want to hear. Authoritarianism arrives not because people say that they want it, but because they lose the ability to distinguish between between facts and desires.“

I realized that I’ve been waiting for things to get bad enough so that somebody contacts ME saying…”I’m scared, I think it’s time to start talking about what’s going on.” I thought the same about climate change. I realized now, that will probably not happen very often.

What’s dismaying is that I realized that it doesn’t matter how bad things get… the facts don’t matter for some people.  People WILL NOT grapple with scary things period! No matter what!   I realized that this is just like pretending covid is not dangerous and claiming climate change isn’t real.  People don’t want to talk about reality…. educated or not.  Moreover, they may even say things are fine.

Everything is not fine – Allyphant on Parade

I’ve taken to saying that Covid has taught me that the power of “crazy” is not to be underestimated.  Still, “crazy” is not right.  I realized I don’t really have a good word for ignoring dangerous, scary things that are biting your ass . … “crazy” has been my go-to during these covid days. 

BUT, these people are not paranoid schizophrenics hearing voices and seeing hallucinations… that’s “crazy”.  This is something else. Denial was suggested to me, but even denial seems inadequate.

I don’t know what the right word is, but it’s not what you’d call cold, clear-eyed rationality.  It’s something else. Denying reality is irrational BUT I’ve realized that crazy and irrational are not the same.  I hope I come across some writing that lays out a good framework for this.

As a coping mechanism, I suspect that we all do denial to some extent, some times, about some topics.   But, that doesn’t make it rational.  This behavior is irrational or non-rational and I would guess that it’s usually not helpful and probably pretty harmful to self and/or others.  Denial is not to be favored, admired or emulated.  

That said, it’s hard to be rational sometimes.  Like its hard to be fearless or ethical or self-less at times on certain topics.  Doesn’t mean that being fearful, unethical or self-centered is noble or good.  Just probably easier is all the small ways they are. People just need support to be their best selves….to be reality facing.  

Sadly, being our best selves will include knowing there will be those that die of covid, drown in flood waters, burn in fires proclaiming covid and climate change are hoaxes. Help is likely not possible for some. This is particularly scary when thinking about the political situation and how brutal people can be.

Damn!
This was unreal and real simultaneously
Blew me away! Like a movie!
What’s the Latino guy’s problem? Yo, look in the mirror lately?
Crazy is global
Island nations rising sea levels

The problem is, these problems (Covid, climate change, fascism) are not individual, they are eminently social, they can’t be solved by a few. The fewer who think rationally on these issues and act accordingly (e.g. COVID), the more  thousands to millions people will die and or suffer.  In these cases, collective thinking and action are necessary for collective survival. 


Like few other things, 2020 taught this lesson to me .

Coming Up!

24 Sep

Thanks for the Vote of Confidence!

24 Sep

Skewed Covid Booster Discussion Framing

17 Sep

The FDA advisory panel will release their recommendations on Booster shots later today. One thing that I have noted in reading press reports is the absence of discussion of whether vaccines should be sent abroad to places where people aren’t getting vaccinations. American’s are not getting the information that sending vaccines abroad will protect American’s.

I can’t help but think that skewed framing arises from fears of the right-wing in this country. Commentators may be fearing that they will be charged with putting the lives of THOSE PEOPLE ahead of American lives. I worry that the increasingly extreme belligerency of the right is silencing the discussion of the how vaccinating the world is the best protection for all people including Americans.

At least in the US, folks know that for the right wing, our lives matter more than their lives. What would be really crazy making is if the right thinks this is the terms of the discussion. They may completely misunderstand what will keep Americans safe. Who knows! Maybe they do understand and just don’t care. I have to say, I won’t be surprised at anything coming from the US right wing nowadays and for the foreseeable future.

Bottom line, we need to send vaccines abroad and the press has to explain why.

Covid booster: Data shows third shots ‘not appropriate’ at this time, scientists say

13 Sep

An expert review of data concludes Covid vaccine boosters are not needed at this time for the general public, a group of U.S. and international scientists said.
— Read on www.cnbc.com/2021/09/13/covid-booster-shots-data-shows-third-shots-not-appropriate-at-this-time-scientists-conclude.html

Good!!!!

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Covid Vaccine Inequality: Boosters or Abroad? An Answer from Cholera’s history

8 Sep

WHAT IS THE PROBLEM?

Wealth inequality is a critical problem in the US and is especially acute in the global context. Unsurprisingly, during the Covid pandemic, the global wealth inequality has borne “vaccine inequality” or the uneven distribution of Covid vaccines. Most recently, the USA and developed countries have seen the emergence of a “vaccine inequality” flashpoint. Should fully vaccinated US people be given a 3rd shot or “Booster” – OR – should a larger portion of humanity residing in the Developing world be given their 1st shot? In short, Boosters or abroad? 

Responding to the idea of boosters, many concerned for the Developing world express consternation. For example… “Instead of solving the problem by vaccinating the world and cutting off new variants, rich countries seem prepared to fork over more money for boosters, and live in a state of endless fear…” US citizens and policy makers must grapple with this consequential decision.

The accompanying articles from major news and science outlets journals explore this issue.

Covid vaccine booster shots for Americans show the rich getting richer again
“Covid boosters for wealthy nations sparks outrage
Making vaccines available to other countries before offering Domestic Booster Vaccinations

HISTORY POINTS TO THE SOLUTION

The purpose of this post is to answer this question. I contend that disease history provides tools to guide our steps forward. I propose that, as we approach the 200 anniversary of the UK’s first cholera case in 1831, that cholera’s history may serve as a lens to sharpen our focus on this issue. 

In this historical analogy, mid 18th Century London stands in for today’s entire world. As London had its wealthy and poor denizens, so the world has its developed and developing countries. As conditions of life in London at that time are relevant, so are the world’s conditions of life today. As Londoners suffered epidemics of cholera, so does humanity suffer from the Covid pandemic. 

Remarkably, the similarities continue. When cholera spread from the Indian subcontinent to Europe, efforts were made to prevent the arrival of the disease with a quarantine of incoming ships. Today, the USA and European countries sought to stop Covid’s spread by limiting air travel to their countries. 

European physicians were entirely unfamiliar with cholera’s symptoms, prognosis, transmission, treatments or cure. Analogously, Covid was unknown to science resulting in ignorance of Covid’s disease characteristics, as well as treatments or vaccines. Cholera’s terrifying symptoms and course prodded the English public’s imagination seeing it as a foreign epidemic (‘Asiatic cholera’) ‘invading’ the nation. Today, US politicians saw Covid as a foreign epidemic dubbing it the “Kung Flu” or the “China virus”. 

A bitter irony is that while the scourge of cholera is in London’s past, many curable diseases, LIKE cholera, devastate developing countries today. Cholera remains a threat because the WHO estimates that 78% of people in the Developing world lack clean water supplies, and 85% are without adequate sewage infrastructure.

Unclean water supply in Yemen

POVERTY AND DISEASE

For the Developed world to learn from its own history, we turn to London some 200 hundred years ago. In the midst of a rapid industrialization and urbanization, it was clear that a major facet of life was the growing gulf between rich and poor. The daily life of London’s poor was in the squalor of overcrowded slums. Human waste was heaped in courtyards, and filth from the flooding of basement cesspits swamped into the gutters and waterways in that sewer-less era. 

Unfortunately, today, much of the world’s people contend with similar issues of poverty, housing and sanitation. Today’s world has hundreds of millions living in extreme poverty, 1.6 billion people live in inadequate shelter and 55% of the global population do not use a safely managed sanitation service. Today, around 2.2 billion people are without access to safe drinking water and 1 in 9 people world-wide is hungry or undernourished. 

CONDITIONS PROVOKE DISEASE

Clearly, cholera was connected to the conditions of life of the city’s poor. From every cholera epidemic for which statistics are available, the malady found an excessive number of its victims from London’s poverty-stricken corners. Cholera appeared confined to the shacks and hovels of the new industrial districts, with the disease’s hardest blow’s falling upon those described as “… the destitute, the intemperate, and the degraded.”

The Londoners confronting cholera soon understood that those conditions ushered in four outbreaks of cholera and thousands of deaths.  Indeed, observers noted that “It is in a nation’s dens of poverty … that the cholera is engendered…” 

Edwin Chadwick

Various figures played important roles in meeting these challenges. Among them was Edwin Chadwick, a public health campaigner who was tasked with tackling public sanitation. He bucked the dominant view at the time that disease and urban poverty resulted from bad habits and flawed character. Instead, in “The Sanitary Conditions of the Laboring Population (1842)”, Chadwick proposed a direct link between poor living conditions, disease and life expectancy. He urged that rapid population growth, overcrowded housing and sanitation problems needed to be addressed to curb cholera’s spread. New York City, suffering similar epidemics at that same time, prompted an observer to observe that cholera was “a scourge of our vicious social state.” 

Unsurprisingly, just as conditions of life in London slums made cholera possible, so does the Developing world’s current conditions also set the stage for the Covid pandemic. The developing nations confront Covid with meager health systems incapable of basic services, fragile economic systems and severely restricted financial resources. Further, they meet the pandemic with scant skilled services and a poorly educated populace.  For instance, there is only 1 doctor for over 2000 inhabitants in Sub-Saharan African and South East Asian countries. Necessarily, Covid’s impact on the Developing world will be much more severe with devastating social and economic consequences.

EVERYONE IS AFFECTED 

London’s detestable living conditions and cholera spread were not confined to the slums of the poor.  For example, Parliament was prompted to close for a time because of the raw sewage stench of the River Thames and the accompanying fear of smell’s ability to provoke disease . Many observers at the time registered cholera’s indifference to wealth or status as the comments clearly show.

“The pestilence was literally sweeping everything before it, neither age, nor sex, nor station escaping.”

“During this outbreak …There was apparently no discrimination between the houses of the rich and those of the poor.

“Not the poor and the vicious classes alone will fall victims to the coming pestilence… will infect and kill many persons among the more favored class.”

John Snow

When those of higher station recognized cholera’s disdain for boundaries of wealth in the fourth outbreak, ingenuity was fully brought to bear on the crisis. In 1854, Soho, a suburb of London, felt the ravages of a terrible cholera outbreak. Soho was, at the time, the most densely populated district in greater London. Soho was an economically diverse neighborhood with a wide array of businesses, residences and industry. The people were a mix of destitute, poor, working poor and merchants, nestled amidst the more opulent quarters of the favored classes. The physician John Snow, now known as the pioneer of public health research in a field known as epidemiology, lived near Soho. This proximity likely influenced Snow’s considerable efforts to evaluate his theory that contaminated water was the cause of the outbreak.

Today, Covid mirrors cholera’s disregard of affluence spreading to all countries and classes. Indeed, when spread seemed imminent upon crossing international borders, Covid grabbed the full attention of the Developed world. For example, a month after the WHO declared Covid a global emergency, did US citizens became infected and the government put forward pandemic response plans. Additional measures were invoked when (D, B, G) variants from the Developing world displayed even greater enthusiasm for homo sapiens of every class and station.

CITY STRUCTURAL CHANGES

London’s upper classes, after the illness and death of thousands of its poor, ultimately grasped that only with London-wide, large-scale action would cholera finally yield. Thus, the decision makers undertook city-wide structural changes that affected all of London’s peoples. 

Original map made by John Snow in 1854. Cholera cases are highlighted in black.

Starting from the foundation of understanding the problem, doctors and reformers like as Edwin Chadwick, William Farr, and John-Simon had helped communicate the dangers of poor drainage, foul water, and crowded tenements. They advanced the notion that disease had to be prevented through cleanliness and sanitation. Later, the Reverend Henry Whitehead and physician John Snow, used rigorous empiricism, statistics and disease maps to prove the theory that the cholera outbreak cause was contaminated water. 

The understanding that the widespread and sudden outbreak was closely associated with housing conditions and filth led public health reformers to advocate that active measures, such as cleaning, drainage and ventilation, would improve London’s working people health. Thus, structural changes were enacted with a series of laws, such as the Cholera Morbus Prevention Act, the Nuisances Removal and Diseases Prevention Act and The Sewerage and Drainage of Liverpool Act etc. New governmental bodies were set up such as the Metropolitan Commission of Sewers and the Metropolitan Board of Works after the Metropolis Management Act was passed. 

Importantly, parliament authorized a new sewer network for London, in what became one of the century’s great engineering projects. Even the river Thames was refitted to better handle London’s sewage. Thus, by accepting scientific findings and acting accordingly with city-wide structural change could cholera be prevented “from becoming a common nuisance in the social organization.”

QUESTION: GLOBAL STRUCTURAL CHANGES?

The open question is whether analogs of the structural changes to London that stemmed cholera’s tide will happen with Covid. Will today’s London elite…the Developed world… take actions that benefit the entire of today’s London … the world?

If we focus on providing vaccines to the unvaccinated, it’s evident what doing nothing will result in. Global health researchers caution that this strategy will promote conditions that prolong the pandemic. The continued spread of Covid among the majority of humanity remaining unvaccinated are precisely the conditions needed for the rise of dangerous variants that will eventually escape vaccine or infection related immune responses. This could set up conditions where both the Developed and Developing world will always be at risk from new variants. More infectious and virulent Covid variants could likely disrupt the revival of the global economy with estimates of US $4.5 trillion being eliminated from the global gross domestic product by 2025.

ANSWER: PROTECT YOURSELF BY PROTECTING EVERYONE

We can learn from our Victorian predecessors and reason as they did. Just as London’s wealthy registered that their protection depended on the protection of all their city’s people, so Developed world must learn that they can only protect their health if they protect the health of all the world’s people. 

A first step of paramount importance is vaccinating everyone who have received no doses. That means that booster shots should wait till sufficient numbers of people are vaccinated world-wide to inhibit the rise of more dangerous variants. In fact, the benefits of boosters to people already vaccinated is minimal compared to the benefits from inoculating the unvaccinated. This way, we can get way more vaccination bang for the buck!

The vaccination rate in the Developing world needs to increase 19-fold to immunize 40% of the unvaccinated by 2022. The alternative, according to the West coast NGO KFF, is maintain the current vaccination rates thereby providing significant Covid protection by early 2023.

Thus, the first step in analogous structural changes in the world’s public health systems is Universal Covid Vaccination. Booster vaccinations can be a sensible longer-term measure for global health, but only when Covid vaccine shortages end or the current vaccines are no longer effective against new variants. A more significant structural change would be to reform global Intellectual Property Rights to allow those countries in the Developing world to manufacture their own vaccines.

Further structural changes could include the prevention and treatment of the many other infectious diseases afflicting millions in the Developing world. While Covid caused 2 million deaths in 2020, malaria kills 3 million people per year for decades. 

Just as the experience of London and other European cities had with cholera demonstrated the benefits of public health reform, so can those experiences inform our current global public health crisis. The Victorian lesson for Covid is that our health depends on the world’s health.

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