Q. What is your reaction to a recent report that male hormones can change females into males? Does this hold any implications for treatment of homosexuals?
A: The report you refer to is more complicated than your question suggests. I urge you to read it in full (May 31, 1979, issue of the New England Journal of Medicine) and also the editorial on page 1269 of that issue.
The report concerns a complicated form of sexual development in rare individuals. There is some evidence that male hormone levels influenced the outcome of gender choice -- whether a child will be male or female -- in 18 patients born with so-called male pseudo-hermaphrodism.
As indicated in the article and editorial, it is still difficult to determine -- even in these distinct cases -- whether hormone levels or environmental factors, such as rearing practices and peer pressure, play the dominant role in deciding an individual's gender.
I think it's clear, though, that both are involved. The exact role of either is often difficult to sort out.
The question of whether male hormones might be useful in treatment of homosexuality is also complicated. There is some evidence that suggests male hormone levels may be a factor in homosexual versus heterosexual development. But there's no solid evidence to back the idea that male hormones can or should be used in treatment of homosexuality.
Q: Are the recent outbreaks of polio among the Amish likely to threaten the whole country?
A: Most health authorities think the possibility is unlikely unless the polio virus involved has somehow changed drastically enough to become almost a new disease organism.
Our main protection is that routine vaccinations are now at a reasonably high level.
Unfortunately, the Amish usually don't seek vaccination against the childhood diseases. Consequently, they run a high rish of such diseases.
Q: What do doctors mean when they speak of a "high risk" of getting lung cancer? I've been a two-pack-a-day smokers for 20 years, and I'm still going strong. What IS the risk?
A: There are many ways to answer your question. But perhaps the grimmest, most dramatic way is to say that one out of every 10 heavy smokers eventually develops lung cancer.
So, visualize 10 heavy smokers you know -- including yourself -- all standing in a straight line. Watch, then, as the dark hand of death moves over you and selects one from that line-up.
That, I think, should put the risk into perspective. Those are rather scary odds.