Yes, Even the President

A salient feature of the “debate” about the sexes is the stark difference in how we treat males and females when it comes to physical danger. Put simply, we emphasize protection for women while mostly ignoring men’s physical well-being. That’s a holdover from our long evolution that, due mostly to the basics of human reproduction, placed a higher value on female life.

The “strategy for survival” of Homo sapiens is a dubious one at best. Females usually gestate a single offspring at a time which is born extremely immature and takes 10+ years to reach sexual maturity. Until very recently, females were quite likely to die during pregnancy, childbirth or complications thereof and few offspring lived to see the age of five. Couple that with our slow speed and muscle weakness due to so much of our blood being devoted to our big brains plus our absence of claws or fangs and you have a recipe for extinction. Unsurprisingly, of the several (there’s much dispute about how many) species of the genus Homo, all are extinct except us.

All that plus the fact that one male can impregnate many females has always militated in favor of the devaluation of male life. So men have always been the ones to defend territory, serve the state in war and do the dangerous physical jobs. Female death always constituted a threat to the survival of the species that male death didn’t.

But now the situation is different; today, a lack of humans is scarcely what threatens our extinction; perhaps just the opposite. And that sea change has allowed us to consider abandoning those ages-old sex categories that originated to keep the species alive. A woman’s death today is no greater a threat to human survival than a man’s. So, along with increased rights and privileges for women, we should be giving protection to males commensurate with that afforded women.

But we don’t. Women have acquired the privileges of men and kept the ones they always had, but men are still the disposable sex.

That’s why there aren’t any women in the trenches in Ukraine and why the U.S. still requires males, but not females, to register with the Selective Service System. It’s why 90% of workplace fatalities are male and two-thirds of the victims of violent crime are male. It’s why male criminals are treated far more harshly throughout the criminal justice system than are female criminals. And on and on.

And, just as importantly, it’s why no one notices. If we considered male life to be as important as female life, we’d notice those inequalities and try to correct them. But again, we don’t.

That brings me to the latest Joe Biden scandal. The man’s got metastatic prostate cancer and he’s had it for years, but this is the first we’re hearing of it, raising the question “what’s been going on?” Conservative commentators are claiming that this is just another case of Biden Administration mendacity and, given the track record, it’s hard to deny the possibility. The years 2020-2024 provide far too many examples of outright lying and distorting reality for us to simply assume we’re getting the truth. Maybe we’ll see.

But here’s another possibility: no one knew about Biden’s cancer until very recently and they didn’t know because Biden’s physicians were following medical protocol. That protocol held that we shouldn’t provide Prostate Specific Antigen (PSA) screening to men over 70.

Indeed, in 2012, the U.S. Preventive Services Task Force recommended against PSA testing for all men. Period. That’s true despite the fact that PSA testing is easy, cheap and highly predictive for prostate cancer and its absence. In 2018, the Task Force recommended against PSA testing for men over 70. Why?

Well, we’re told it’s because of the chance of false positive results and unnecessary treatment based on same. But frankly, that’s just transparent nonsense. First, there’s not a medical test in the world that can’t give false positive results, but we continue to conduct medical testing. It’s just a given that sometimes testing gets it wrong and medical professionals need to be on the lookout. In the case of PSA testing, if a patient’s doctor isn’t sure of the result, it’s a simple and inexpensive matter to retest.

And no one treats for prostate cancer based solely on a PSA result. If that result is elevated, generally an MRI is done and if that suggests cancer, then a biopsy is performed to be sure. Then and only then is a plan of treatment put in place.

So having regular PSA testing done is just good sense. That’s even more obvious because, after the Task Force’s recommendations were put in place, the number of advanced prostate cancers soared.

A 2020 study in the Journal of the National Cancer Institute found that advanced cancers rose 5.2% a year between 2010 and 2016 among men 75 and older…

So it looks very much like Biden’s physicians were simply following protocol. According to a Biden spokesperson, he got a test done in 2014 when he was 71 and not thereafter. If that’s true, his doctors were doing what they were supposed to do.

The problem being of course that “what they were supposed to do” was unquestionably wrong if we care about male life and suffering as the current Biden case demonstrates so sadly and so well. After all, another $25 PSA test conducted in, say, 2018 would have caught the disease in its early and easily-treatable stages and the current trauma (including the treatment that is now much more complicated and expensive) would have been avoided. An old and infirm man would have had a much easier end of life.

But no, the protocol for testing for a disease that is unique to men reflected not sensible medical practice, but our relative indifference to male suffering and death. And, although it’s the former President of the United States that’s suffering the consequences and his situation headlines the news, no one notices. Of course they don’t.