>> doctor rubinstein in conversation doctor horowitz is a cardiologist on the faculty of harvard medical school. on evolutionary biology and there is the author of ubiquity in the international society for evolution medicine in public health and has recently launched a research initiative across the tree of life with the interdependent health of women and the planet that we share and then the right who is an intellectual

and codirector of undergraduate store these for evolutionary biology at harvard university earning her phd at harvard studying testosterone. and has s received numerous teaching awards so we trust you are excited to to frame today's conversation for our audience. is a 37 euros feminist institution to stay in hard and complex conversation to assume best intent about clear information making firm choices of our bodies and mmcommunities and think about who possesses the power to shape the policies and procedures that shape our destiny we live in the era

when science is actively recruited especially children and teens as well as parents and teachers who are trying to help them. the other times and thus could argue it still is that them when they are created to justify and those who deviate on mental curve. we can talk about science about power and human desire so the book is useful tool for all of us to better understand ourselves in the role. i'm personally invested in this conversation as a diabetic and that means i rely not on one but two hormones tell me with a happy and

healthy and well-balanced life. and those by doctors and scientists biological aberrations and problems to be solved but rather as part of the biological universe that what i appreciated about the doctors book that biology's consequences that we have a responsibility to understand those aspects of our roles and behavior. and doctor rubin's book it is important for all of us to respond to data and actually how that data may be interpreted by groups or individuals. it is hard but the doctor acknowledges herself but it's important to understand so if

we are going to make changes with the true diversity of human life and experience i invited doctor ruben to speak tonight and it's important for all people for just public policy with a safer happier healthier world. please welcome our gas. >> that was a really moving introduction. i appreciate it souc much because that is really what i was trying to do in my book, testosterone. i will tell the audience. i tear up a lot. itie is normal. i found that very moving and it made me emotional and i started to tear up. if i do that again, don't be alarmed it is just a feature. may be a bug i am not sure. thank you so much for having me. i am delighted to be here. it is an honor. >> and so happy to be here

with my friend and colleague. >> i found that introduction to be inspiring and the last time so thank you for that and having us here tonight. you want to start by congratulating you with a scientifically impeccable book. there is the first major review from yesterday's wall street journal but as a gorgeous combination of professional and personal so

why you wrote this book and where we need to clarify the role. >> so little background professional and personal so it's important for people to understand how people got to the positions they are in. we are into on —- interested in it because sometimes the students are very nervous how they will get where they want to go. so what i always say is i was at the bottom of my high school class. i'm not ashamed of that. that may be uim. i'm starting to tear up. i had a lot of struggles as a young person in part of the struggles were i did not have a lot of parental oversight and i had some difficulties and sexual assaults.

i had a hard time and a lot of different ways. and i think that experience helped me to understand men. that planted the seed because i had an emotional need and sometimes that drives our intellectual curiosity. i found that with fellow academics in the psychology department. it came from a place i was not set up to be where i am now. it took me a long time to get to where im. and a bunch of different twists and turns and a career that was ten years after college and then to apply from the harvard graduate program. and then i described that going to live in uganda to research wild chimpanzees in a

did that and basically lived in the jungle. there is a confluence of circumstances in the late nineties and there was some pretty serious political upheaval in the region and there was a lot of violence all around me very severe and disturbing violence. and i was also following the chimps around. but i was struck by the uncanny parallels of the behavior of the chimps and the ihumans with the sex differences. i was pretty naïve at that time evolutionary biology. but what i observed was that on average the males were

status of test and relatively aggressive in the futurear was very clear of course the males could also be peaceful and nurturing and the females could be aggressive but on average just like in humans when there is overlap there was a novel a lot of overlap these were his mistake a boy could not be explained by culture. so that solidified my interest to understand the origins of human sex differences in came out that from observing while jimson interested in the role of testosterone is one of the biggest differences between male and females. that testosterone evolution into shapes who we are and how those biological forces interact with our human

environment and our culture and how we explain who we are in our culture and expression of sex differences with the expression of thect human nature so that's an explanation how i got to harvard focusing on a phd so that is my trajectory here. >> oneo the things you can do so well is that scientific content so then i want to

describe the observations about the role of testosterone and other hormones to shape behavior than push back or even the relationship. and look at that landscape looks like and then to offer some understanding why there is concern about connecting biology to behavior. >> it is an important question and i can pick up where i left off starting this research and finding results how

testosterone shapes sex differences in cognition. we don't totally understand why. culture has something to do with that but biology also has something to do with it. i was naïve and i first started out. i didn't understand how heated and controversial in my particular perspective i was literally coming out of the jungle where i was consumed with a biological perspective. when i started out i didn't have an appreciation with that importance in the intensity of the interaction between biology and culture and it took some time for me to appreciate and understand and that is the ongoing process to learn more and more about how forces interact for human

behavior or the behavior of any animal is the interaction between genes and culture. when i started to feel push back to the research i was doing with my own data which is those that are important and the sexer differences of the levels of testosterone and the evolutionary pressures that act differently of male and female to have different problems we have to solve to reproduce where they have in turn all gestation it is expensive and we will be smaller animals on average in males do not have internal gestation and they moved to

these opportunities any more muscle and less fat so this helps to facilitate those adaptations more fat and more nurturing behavior and less physical aggression for females of other species and for males, larger bodies size and more muscle mass and physical aggression in the session with status on average for. all meals are like that. that is not the case there is a lot of overlap talking about patterns. so this is such a satisfying impersonal way and then to do a lot of traveling mostly with myself and then to become

assessed with explaining the differences of human behavior but the commonalities and how they connected to i had seen in the chimps of the nonhuman animals. but i was meeting resistance but i didn't understand where this is coming from. why so many people seem to have this innate preference for cultural explanations and a hostility because i felt so empowered so much about me to understand myself and the men inys my life but the trauma and what i observed in the jungle. that was an education for me. >> and you are talking those explanations that are singularly cultural. >> so there is a continuum of resistance. there are people who are very

smart who completely reject biological ask the nations for sex differences in behavior even those but there are those people who really just want to assert sex differences are purely the result of cultural influences. but i then the movement that gets more attention more seriously is the effort to consistently downplay biological explanations in favor of cultural ones there's a bunch of reasons but there isnd that effort so my point of view is that we should be concerned with is the truth and how to discover the truth. but like it was so beautifully articulated, power is always a

part of science. so there is a value to being critical of the methods that we use and how it really comes into play how it can be used to support those agendas and then how we produce the science and it should be strict from social agendas to understand how the world works but then caution of the implications and those implications how we say clearly in logical ways and

with that cognitive ability to have a relationship to some degree in biology that if males are more aggressive on average because of testosterone it doesn't mean that it is writer can't change is no evidence to support that. we know like diabetes, that is genetic, type one diabetes and type two diabetes so some are much more prone to diabetes. but we know the environment plays a huge role. / just an analogy. the same way with behavior. men have a higher predisposition than women for certain types of behavior. it is the environment i can more that expression that we want to be concerned with and the consequences of that behavior and focus judgment on the behavior and the

consequences. not on the causes to understanding behavior and using that information to address problematic behavior to do what we can to improve it with their social circumstances and equality for everybody. >> you are describing the misapplication so there is no question. twentieth century biologist of how that was take and use in many areas. so it is an evidence-based approach to understanding the role of hormones and biological features and who we are. so the role of testosterone

from conception and then on the same page. >> i should say that i alluded to this before but the sex hormones are steroids first of all. that is important and some hormones like insulin our proteins and some are steroids. the clear thing about steroids means they can cross through the cell membranes in the blood brain barrier. they just all get into our brains so we produce them mostly in our ovaries and testes. and for women the adrenal gland is important piece of the androgen production but those hormones get into our brain and shape behavior that

is clear and human and nonhuman animals with the important effect on the body and on behavior that is there. not because they help us survive to regulate blood sugar but as an example quickly because that is the hormone that acts of the body to regulate energy and blood sugar but it coordinates behavior with the energetic needs of the body so a single one —- signals to the brain with those active transports and then it tells the brain essentially what the energy needs of the t body are and then to get up and go find food or not because you have enough blood sugar in your body. so there is a coordination

between energetic needs of the body and the behaviors the body has to engage and to stay alive and maintain energy levels. so these hormones do something very similar but for reproduction. not to maintainot energy but to produce excess sperm and to coordinate the availability with the motivation and ability to make and care for in mammals especially for the females the offspring. and for males the motivation is more likely to compete so the availability of the physical trait that we need to engage of nurturing and competition asking the brain to motivate t individuals to use thoseua traits. it's no good to have lactation

if you have motivation to use those muscles are the brass to feed your offspring. so they do all of these different things to affect the way energy is spent on muscle or fat, et cetera and that all starts with the males in utero. onfemales don't actually need their ovaries to produce estrogen to develop their reproductive anatomy. or to do anything special to their brain. that males typically in humans and other animals have their testes in utero produce very high levels ofy testosterone that masculine those structures that grow the penis and the associated internal plumbing in utero.

during that same period testosterone also acts in the brain to masculinized certain structures so that for instance young male animals including boys have higher rates of rough-and-tumble play that with rats and chimpanzees in so many other animals that they play more roughly and then how does testosterone levels in utero can shape the brain to promote that typical behavior in utero. it starts in utero when testosterone shapes the body and the brain for mail reproduction. then after birth it goes up again. t were not sure why for three months. then it stays low until prior

to puberty and then it picks up again. then you know a lot about that because that is what your most recent book was about. so a lot of changes happen in the body andnd in the brain during puberty that can convert a little boy into reproductively viable adult. the same thing for young women for adolescents to help them become mature. >> what about female brains? and there are the studies but with a whole other species in those that have more and then

in the environment and those temperaments. >> so that is totally correct about the spotted hyenas i don't know about the ground squirrels about the males disperse atgh puberty? >> that in experimental conditions but the point is the female brain can be impacted a. >> so generally it is extremely low androgen with that same testosterone. and those other derivatives that might be active.

where humans and mostt other mammals for those females in utero are very low and that is extremely sensitive to elevation in androgens and that congenital adrenal hyperplasia where the adrenal gland is missing a particular enzyme to produce cortisol. it doesn't have the enzyme and cannot produce cortisol it is overstimulated and produces androgen on —- androgen that acts on the female brain in utero in ways that result in higher levels of typical male behavior. that is true in humans and nonhumans. so we know those in utero is an extremely important period to differentiate behavior in humans and nonhuman animals

but for typical female behavior and they say there are typical behaviors and a lot of that is the research on nonhuman animals something like sexual behavior and seaggressive behavior is differentiated much more strongly than humans. so the research is not the same. we have so much overlap with that aggressive behavior. but we do know from these conditions from the exposure in females deviates from what is typical that we have that masculinization that persistence into adulthood even though itnd is corrected at birth and that testosterone levels are normal at birth. and i should just mentioned that they can also be

masculinized so they girls can be born with the large s that can resemble a penis so there is the argument it is the genitalia and the knowledge of the eggs since that is responsible for the masculinization of behavior that is the counterargument so that is one of all the other evidence that we see the nonhuman animals and don't have a good explanation for why especially when girls have surgery to change their clearest into something that is more typical there is no value judgment or a big controversy whether you should surgically alter genitalia that is atypical. but even with the girls who

have had surgery there has been so much attention paid to the genitalia the behavior becomes masculinized. so the simplest way to understanday the evidence is we have all thehu other evidence that shows very clearly that increased antigens in utero increases behavior so if you don't have androgens in utero they will express typical female behavior when exposed to estrogen and adolescence. and then to show typical male behavior they need to have that exposure and to have the exposure to high levels of testosterone to have typical male behavior. >> to what extent of engaging in rough-and-tumble behavior, to what extent does

that create aha hormonal response? >> so there is probably no effect because the testosterone levels are so low at that point but then the questionha is really important relationship that we see during and after adolescence. we really only see this in males. not that testosterone is molding behavior but the social environment in particular the generally in the moment of competition which can be considered in some sense there is some robust evidence that when men

compete, the reaction to that competition can predict whether testosterone goes up oror down. and those changes seem to protect those for the individual of the environment and the social system. >> so talking developmentally succumbing into a conversation more and more young people are identifying as trends or binary and that is a complicated area and becomes controversial. >> sure. so the book really dove into the scientific literature on

puberty blockers and the effects of altering testosterone levels as part of a gender transition. so i know what the scientific literature says that also i interviewed a male to female transgender person and a young binary person who just started to take puberty blockers and someone who has the transitioned female to male and back to female so using their words to describe their experience. and interestingly it was very consistent with what the scientific literature had to say. it is so controversial right now from my perspective is we need more research so if you

exclude the transition are with the non- binary person were very happy with their transitions. the male to female transgender this is a good example because she went through the mail puberty and because she went through a typical mail puberty of high testosterone so perhaps she wasn't quite so tall but it's hard to be 6-foot four woman with a deep voice so that is something that is difficult for her and is doing voice therapy and would prefer not to have that masculine sounding voice with that identity. so the issue with puberty

blockers it ismp completely understandable that someone who has gender dysphoria and wishes to transition that is the worst thing that could happen is to develop the physical or evensi psychological traits that is not what you feel yourself to be so we don't have enough really goodll science on what the long-term outcomes are. physically and emotionally. and it is a controversial area because people want to be validated. but some of those people are young kids and it is true that gender can be fluid at that age.

and puberty is a time who they are sexually and they change their identities in various ways so you're watching that opportunity so i do know the evidence but that is an opportunity for people sometimes to come to terms with the fact that they might be gay and that's why they felt so intensely uncomfortable in their bodies because they have not felt very different from the other kids of the same sex. but then again it is completely valid and understandable for people to want to block that space i don't know who those people are in figure that out but i wish we had more evidence with the long-term outcomes and a

12 -year-old kid is a am fine with losing my fertility. that is my biggest worry is the long-term irreversible consequences. if youly don't allow your own reproductive system to sexually mature then you lose the ability to have kids in the future that's a huge responsibility for someone to make and that is paint also have the answershr they are. but there should be a lot more attention paid to the long-term outcomes. >> w i appreciate what you wrote about this including going back to the data to layout a basic understanding of the very complicated area from the scientific perspective and the

perils that can be used with that t agenda and that we should be very frightened. >> myy goal is to give people all of the evidence available so that they have all the evidence that is available to help them make these really difficult decisions. that is what i think is important. to not shield people from the truth of the science but what they need forha that autonomy. >> .

>> and then from one controversial topic to another. >> and so to give that way with that topic with those conversations that are rooted in science. >> thank you. this and difficult to talk aboutt because people like laurel who isca a trans woman was competing in the olympics. because people call her a cheater. she is not a cheater it is not cheating that the evidence suggest that yes she does have a physical advantage because she went to a typical mail puberty with highbe testosterone

but but i know she herself has the advantage but trans women who went through mail puberty will tend to be bigger and stronger even if they suppress their testosterone even dropped to eight years they cannot lose the size and strength of the benefits and types of that muscle mass goes down but doesn't go down anywhere near the typical female so there are other physical advantages. however. but first of all i think there is an important human rights issue here that deserves to be heard that is extremely important. sorry.

i really do see the science that people argue about the science and they are not listening and so we have to understand where the trans women are coming from and what it is like to identify as a woman and love your sport and not be allowed to play in the woman's category and be called a cheater that is wrong. i do get annoyed when people try to twist the science to push the agenda that people like laurel hubbard should compete on the women's team because it causes people who might otherwise listen to your case and causes them to shut down and i know you're up to something and then to pull one over and that isn't a good

strategy to say that we can grant that the science points to there is an advantage. but but now let's focus our energy compassionately with respect to the case of women were trends who now have been given the right to compete for the female category. what do we do about that? and if there is a physical advantage on average is there a way to equalize that? we need to have a conversation and not stigmatized trans women who want to do with a love. that bothers meuc so much. it isl painful for a lot of people. and i'm not happy at how that conversation is going or not going as the case may be. >> and with those components

of individuals and with those ideas and a set of handicapping. it is complicated. >> no. there is a reason there are male and female categories but within that is a bunch of variations. >> thinking that going back to work as a teacher and we both teach students are 18 and 22 and then in all kinds of ways.

>> so i have a 12 -year-old son griffin. he is sick of hearing about testosterone. but i feel strongly that he should understand what it will be doing to his body and to his brain and the things he may be feeling or wanting and that was writing the information is tremendously useful because he may assume that the girls of the young women may want to feel the same things that he is. and they are probably not on average with different desires and needsre on average and it's important to understand how's that works is not because of

culture but be part of our nature s and then to be sensitive to that of what he is feeling and where it's coming from and have a great respectful person and then toep change him and ways to be prepared for. >> and so on the basis of those teaching. >> because they are awesome figuring out the world and figuring out themselves and are so curious and so if they disagree i love it and i want them to disagree on a look at the evidence together maybe they don't agree with my

interpretation of the evidence it is so satisfying and i learned so much that the big thing for me is critical thinking and telling them how the world is and how they choose the evidence andth what do you think and what are you bringing to me? and then doo using the tools of science and with those implications are. and what that means for our lives. and i have a journey with them and they are just so open-minded and curious and wonderful and i feel so incredibly lucky. >> you are so open about your

own journey. and it was toxic in a sense. it was disturbing about sexual coercion. >> in the professor and then go to the evidence go to the data and go to the science. and it may be frustrating that. >> can i tell about that? >> i just think it would be helpful because i know what it's like something to be true i know it's like for a certain

explanation to feel and validating i read about this in the book i think it was my second year in graduate school. i had major imposter syndrome. and others graduate student seminar we were reading a paper and discussing it on the evolution of race and scorpion fly. i cannot say this with asc straight face. and the implications stated explicitly by the author was that males evolved to be larger than females and humans so basically they cannot attain the resources they needed to attractive female just ten them down and rape them like the scorpion fly does. i had a history of a sexual assault doing what i am right now. and i was shaking and i was hurt and felt small and i was

angry. it was a male instructor and it was my turn to talk. i said this guy is an ass hole. of course it cannot be true he's and acyl for even writing atthe paper. the point is first of all, the professoroc just to me to focus on the argument and look at the data. i thought what you doing? this is crazy. but i realize we're supposed to do is a scientist and eventually i did and found that to analyze the hypothesis. he could be in acyl on —- and asked whole but if so i want to know about it. suddenly realized i've got to be able to put what i want to be a cage or what seems right

to goes over here and somewhere else i need to engage my science brain to understand the world because i need that information it is important and empowering and then not argue about the guy whether nine chevron the paper as he did later. but that iss a lesson that i share with my students every here. and i try to remember when i feel this person makes me feel that way i have to put that aside and evaluate the evidence. >> and the fact it is described to this point is not necessarily generalized or how broadly that can be applied. and that sexual coercion, that is not reproductive so it is

all made for that information so it is with that overgeneralization so really what you are describing again is an opportunity for us for that evolution in a responsible way and in a careful way but those past horrors and the misuse of the science. >> absolutely. and a thousand and conversations that they recognize those common abuses.

>> and those conversations we have had. >> . >> and so the sciences impeccable and that evidence to turn the lights on and it is a positive agenda. >> thank you. >> thank you so much. >> between human and animal aladolescents so that just means

it is popular so keep trying. that the bottom of the screen so then you can buy the book from us. so that i went to see if there is what you want to promote are other parts of you were talk about? >> any other questions? >> . >> . >> that my main question does

comeal back with that variation a sports and is designed for genetics for people who are at the very end of distribution so when it comes to trends and intersect - - trans and intersect people and as i was trying to get my head around. in the logic behind that has higher levels of testosterone. and that is a difference so

that is a big difference in nature. that is something i often struggle with. >> and part of the problem is the way they communicated via journalism is not responsible in my view. it is super biased and maybe they're not getting the correct information for one thing and there are so many different views and if they should be sex segregated in the first place so my own only real contribution is the changes that happen with male puberty so look at males and females it's no contest those

at the elite level in almost every sport not like golfing and archery so the elite femaleses even in the olympics i cannot remember the exact numbers can be been by the best high school boy. so just know is on a totally different level. / is thinking about sex differences there is just this fuzzy area about trans women and those advantages of the evidence suggest not a lot so he is gone through typical meal puberty you will retain a lot of those significant advantages and to a much larger extent than the

differences which are on the spectrum basically not the qualitative between males and females. so those differences is that the language becomes very important here i don't like to step into it because i like to define with the respect that they self identify but in most. of these cases but the people that are described is actually high testosterone typically have x why chromosomes they go through typical meal product puberty so that they describe this in a way that is confusing so it is tough

because you want to respect people's identities but then you make policy so many people is just like michael phelps so it's not that simple. to say if we have that conversation we should be informed should be done with sensitivity and compassion so people are really interested ready recommend people go? >> and he is very up-to-date.

>> so it is very well research and the narrative so yes that was my goal. how can we work with the facts it is possible. super passionate about the goals that you probably are which are reducing suffering especiallyly for people who are suffering the most. that is the ultimate goal and that is my goal and then it is never a good idea and it is

disrespectful to people inec my view. >> do you have any suggestions or rule of thumb for those across gender for men and women? >> i just wrote about this sexually for uk magazine and i talked about it in the boston globe. so this was terrified describe being married i am very emotional and it is embarrassing and i cannot control it my husband is a british philosopher and is very stable and doesn't know what's going on he doesn't

know what is going on and this is a problem what's wrong with you? is it because you are british what happened when you were little? why don't you know what's going on inside of you? what you thinking think about philosophy. think about nothing or what are you talking about? >> we had therapy. it didn't change. i changed after writing this w book because and then they changed the emotional expression and of you had the same experience and those thats have the same range of emotions and being a jerk i am

a totally key fossett person so that helped our marriage. with that viewpoint so he is a great person and i was not accepting who i thought he should be more like me. but he is more open with me now. >> and nine more open to science now because i experienced those changes when he went on testosterone a very clear my brain operates very differently than it did before and after than the transition. >> when i was estrogen dominant i can hold 20 threads of information. [laughter]

>> and then it seems to show more interest. but part of it and that's why some are very shortsighted because it is the capacity. >> it is more short-term goal oriented. >> i work for a feminist organization. i'm an emotional person and then the way that i think about what needs to happen next and then to take that information it has shifted.

>> . >> and also there is also. >> and we have been looking and looking to explain at one end of the continuum and there's just a lot of literature. >> and what she considers. >> i definitely recommend it.

>> and then i went to just make sure if you have any other advice or rules about cross sex communication? [laughter] >> and with those androgen blockers for example and then to hear mee in that context of those conversation that is fascinating and in the ways in which that conversation is used to suppress people. and then the hormones and then to become surgeons that

nonscientific aggressive piece of history those that have conversation. >> so again, please the bottom of the screen thank you so much. i wish you both well hope the rest of your tour is great. >> thank you to your audience. this is a fantastic book.

>> .an >> have a good night.

>> some people >> some say that will make the human race obsolete and people don't want to think about ai artificial intelligence as a subjectim but even if you don't want to think about it it is thinking about you. or is it?