A widely criticized peer-reviewed study that measured the attractiveness of women with endometriosis has been retracted from the medical journal Fertility and Sterility.
The study, “Attractiveness of women with rectovaginal endometriosis: a case-control study,” was first published in 2013 and has been defended by the authors and the journal in the intervening years despite heavy criticism from doctors, other researchers and people with endometriosis for its ethical concerns and dubious justifications, with one advocate calling the study “heartbreaking” and “disgusting.”
The study’s conclusion was: “Women with rectovaginal endometriosis were judged to be more attractive than those in the two control groups. Moreover, they had a leaner silhouette, larger breasts and an earlier coitarche.”
Coitarche is the age at first sexual intercourse.
Rectovaginal endometriosis is a severe form of the disease in which tissue similar to the lining of the uterus — called endometrium — grows outside the uterus, often attaching to other organs and causing pain, scarring and sometimes infertility. One in 10 women and other people with a uterus of reproductive age have the disease.
The women taking part in the study had not given their consent to be judged for their attractiveness and did not know this was happening as part of their medical consultations. The study received ethics approval and was publicly funded by the University of Milan school of medicine.
The authors asked the women about their sexual history and measured their body mass index, waist-to-hip ratio and breast-to-underbreast ratio. Only Caucasian women were selected for inclusion in the study.
Authors have defended the study, saying that knowing if certain phenotypes — or bodily characteristics — were more susceptible to severe endometriosis would be useful. The lead researcher, Paolo Vercellini, an obstetrician and gynecologist at University of Milan and past president of the World Endometriosis Society, said: “Several researchers believe that a general phenotype exists which is associated with the disease.”
But critics, including American gynecologist Jennifer Gunter, have said that while characteristics such as body mass index may be relevant to endometriosis severity, this is not what the study actually measured.
“I fail to understand how a small group of Italian doctors rating attractiveness of women with different stages of endometriosis contributes anything to medical science. Fertility and Sterility should be ashamed they accepted it for publication,” she wrote. She added: “Objectifying women has no place in medicine. It is even more horrifying that such a publication comes from a department on OB/GYN.”
The journal did not issue an apology but published a letter from the authors on Tuesday requesting the article be withdrawn.
“We conducted the study in good faith and according to correct methodology. We believe that our findings have been partly misinterpreted, but at the same time realize that the article may have caused distress to some people. Women’s respect is a priority for us, and we are extremely sorry for the discontent the publication originated,” the authors stated.
Rebecca Szabo, an Australian obstetrician and gynecologist and academic at the University of Melbourne, has been campaigning for an apology for this study for seven years. She said she was “shocked” it had been retracted after the journal had defended it for so long but worried that by retracting it, the lessons from it would be lost.
“This non-apology, this retraction, seven years after many people had written to [the authors and editors], with no comments from the editor, I think is cowardly.”
Szabo said she was disappointed the editorial board of Fertility and Sterility had not issued an apology or provided a justification of why they did not retract it earlier. She said there were systemic and cultural issues within healthcare and medicine that has led to studies like this one being conceived and published.
“The question is: how is it possible that [this study was] conceived?
It was 2012, not 1912.
“This is a really significant journal and it’s a journal that primarily goes towards women’s health.”
She added that the time taken to retract the study is the average time it takes to be diagnosed with endometriosis.
Kate Young, a public health researcher at Queensland University of Technology whose previous work has focused endometriosis, has been instrumental in bringing this study to the public’s attention. She said it was an example of studies that get published but do not actually help women and other people with the condition.
“That paper is a really good example of what happens when we do research about women but not for them. And that’s partly a reflection of the patriarchal society that we live in and also the way we’ve structured research and research funding.
“We really need better systems in place that come from the bottom up.
We need research to be influenced by the people who it is for.”
Sylvia Freedman, co-founder of the patient advocacy group EndoActive, said she was glad the study had finally been retracted.
“When I first read the study and saw it was by Vercellini, I thought I must be reading it wrong, since he is such a powerful and respected endometriosis specialist. But it would appear that time, money and energy has been put into a study trying to draw a connection between rectovaginal endometriosis and the way a woman looks, from the perspective of others.
“It’s disgusting, it makes me sick. We’re here begging for research funds. Endometriosis is so grossly underfunded globally compared with what it costs the economy, and to know precious money has been put to a study like this is heartbreaking.”
A study last year for EndoActive by ErnstYoung found that endometriosis costs the Australian economy US$7.4 billion annually. In 2018 and last year, US$15 million was announced by the Australian government for endometriosis research funding as part of the national action plan for endometriosis.
Lesley Freeman, fellow co-founder of EndoActive, said: ‘’When I read the title of this paper, I felt physically ill. And it’s taken eight years for this disgusting paper to be retracted?”
Last week, a study that was published in the Journal of Vascular Surgery that looked at the “prevalence of unprofessional social media content among young vascular surgeons” was retracted after criticism that it was sexist in its methodology and conclusions. The authors and journal issued an apology.
Taipei is almost flat. At least the parts in which most people live, work and play. Furthermore, many major thoroughfares have designated bicycle lanes separating them from motorized vehicles, while minor roads offer quiet, sometimes leafy alternatives. There are also over 200km of riverside bike paths connecting the downtown with places as distant as Tamsui, Keelung, Muzha, Xindian, Yingge and Bali. Less than five percent of all journeys in the capital are undertaken by bicycle, however. “And this proportion is falling,” says Chan Kai-sheng (詹凱盛), founder of the non-profit Taiwan Urban Bicycle Alliance (台灣城市單車聯盟; TUBA). Chan thinks this may be due
Warren Hsu (許華仁) sees chocolate making as creating art and performing magic. Zeng Zhi-yuan (曾志元) “talks” to his cacao beans and compares the fermenting process to devotedly caring for a child. Despite their different products and business models, the two helped put Taiwanese chocolate on the map in 2018 at the prestigious International Chocolate Awards’ (ICA) World Finals when Hsu’s Fu Wan Chocolate (福灣) claimed two golds, five silvers and two bronzes, while Zeng took home four golds. That year, Taiwanese chocolatiers burst through the gates with a total of 26 medals, an impressive feat given that many locals don’t
SEPT. 14 to SEPT. 20 When then-county commissioner Chen Ding-nan (陳定南) announced that movie theaters in Yilan County no longer needed to play the national anthem before each showing, the authorities were displeased. It was Sept. 13, 1988, over a year after the lifting of martial law, but the decades-old tradition where moviegoers had to stand and sing the anthem still endured. Of course, Chen sugarcoated his decision: “Considering the environment of the theater, the contents of the movies and the reactions of the audience, we believe that it’s actually disrespectful to play the anthem before each showing. We
Chen Zhiwu (陳志武) says that the COVID-19 crisis puts into sharp focus that we are in a new cold war, with China and the US being the two protagonists. “It’s almost literally in front of us,” says Chen, Director of Asia Global Institute and Chair Professor of Finance at the University of Hong Kong. Political observers were hesitant, Chen says, even up to the beginning of this year, to confirm a new cold war was underway. “But ... the coronavirus has made clear the clash in values and way of life between what China would like to pursue, and what