Re Steven Stark's "Gap Politics," (July Atlantic): I know of no conclusive historical evidence that "this country long defined its politics by sex far more than did other industrialized nations." But this is a catchy way to open a paragraph. Most of the other "firsts" or sweeping generalizations Stark provides are equally questionable as interpretation or fact. The "first recorded gender gap" in this country probably showed up during early sessions of the Continental Congress, when Abigail Adams's much quoted 1776 appeal to John Adams to "Remember the Ladies" (referring to the lack of rights of married women) and Hanna Lee Corbin's 1777 request to her brother Richard Henry Lee to support voting rights for tax-paying widows were both ignored by those two founders -- and no doubt by all others at the time.
Most important, the Equal Rights Amendment was lost in part owing to the tactical and logistic ineptness of the National Organization for Women but primarily owing to the conservative backlash that set in after the 1973 Paris peace accords. Like previous reform movements in postwar periods, the women's and civil-rights movements could not counter this general backlash. Failure to pass the ERA had little to do with the "anti-majoritarian" aspects of the national legislation that Congress passed under the influence of an eastern-corridor group of female reformers. Likewise, "upper-middle-class activists" were not exclusively focused on abortion before or after Roe v. Wade, for the simple reason that they were the very women who had been able to obtain safe illegal abortions before 1973. Wages and child care were not slighted because of an overemphasis on abortion by liberal women (granted, conservative women overemphasized it), as can be seen in the impressive pieces of economic, civil-rights, and child-care legislation passed by Congress beginning in 1963 and continuing through the 1970s, to say nothing of Supreme Court decisions before and after Roe favoring women's economic equality -- cases often argued and won by feminist attorneys. The first and most numerous cases brought by the Equal Employment Opportunity Commission involving women since the early 1970s have concerned wage discrimination, and both political parties supported quality day care in the 1972 election (even Richard Nixon's unsuccessful welfare-reform bills included federally funded child-care facilities).
Women continue to be disadvantaged in the United States, while men, despite their misplaced anger at affirmative action, continue to be privileged -- in all race and class categories. Disadvantaged people always hold views that differ from those of the privileged, however complicitous their behavior may appear. Although the men's movement in the United States is mentioned only in the last paragraph, the entire article is based on thinly disguised masculine cultural theory.
Steven Stark's article about gender politics is thought-provoking, though readers should keep a few things in mind.
1) In the 1994 congressional elections, in which Stark suggests the gap was pronounced, 57 percent of men voted Republican, as compared with 46 percent of women. This does sound like a large disparity, and it is larger than what has occurred before. Nonetheless, let's look at the numbers from the other side: 46 percent of the female population voted Republican, along with the majority of men.
2) Over the years voting preferences have followed economic status much more than gender, and I would argue that it is that trend we now see displayed in the growing gap between men's and women's voting preferences. The more women become (or perceive they have become) members of the underclass, the poverty class, or simply the lower-income working class, the more likely they are to vote Democratic.
3) The reported "white male revolt" is more white than it is male. The black-white gap in voting behavior is huge. Republican candidates never even get into two-figure percentages with black voters. Appreciation for the role of government and adherence to the Democratic Party are nearly monolithic in the black political community. If and when the black-white voting gap closes to the current 22 percent gender gap that Stark points to with dismay, there will be jubilation in the streets! Pundits will crow about how far we've come and how close we finally are in the reconciliation of the races.
In short, the gender wars are not here, though the media and political consultants dearly wish it so. Most women vote like most men on most issues.
Joan Adams makes a good point: More men and women vote alike than vote differently, and the economic-status and racial gaps are far larger than the ones between the sexes. What makes the recent gender gap different and interesting is that its rise was unforeseen, and it seems to be far more important to our current political debate and the two parties' agendas than the numbers themselves might indicate. This may have the odd effect, as I pointed out in the piece, of widening the gap in coming years and ironically benefiting the "male party" -- the Republicans.
I am sorry that The Atlantic published David Plotkin's article "Good News and Bad News About Breast Cancer" (June Atlantic). Disseminating this type of biased polemic in a lay periodical has the potential to misinform thousands of women whose health and in some cases lives will be jeopardized.
The vast majority of the increase in breast-cancer incidence relates to an aging population and mammographic technology. The number of menstrual periods that women experienced prior to the Industrial Revolution is unknown. What is clear, however, is that a contemporary woman will live longer than a medieval one did, on a statistical basis, by approximately forty years, and this clearly has more to do with her risk, menstruating or not.
The proportion of highly aggressive as opposed to slow-growing, less aggressive breast cancers being detected has not changed because of menstrual activity. Most important, the aggressive carcinomas have not disproportionately diminished in number, so this does not explain the relatively better current cancer survival rate. However, the size of breast cancers has changed, most dramatically on the basis of mammography. When I started practice, in San Francisco in 1972, the average size of an invasive breast cancer was 30 mm (1.2 inches). By 1994 the average size of an invasive breast cancer was 14 mm, and of one detected mammographically 11 mm (about two fifths of an inch).
In 1972, 40 percent of women with invasive breast cancer suffered a recurrence or died of their disease within five years, whereas of the patients with mammographically detected 11 mm invasive breast cancers, only 10 percent will have suffered a recurrence within five years. Most of those who die of breast cancer remain older women, who are reluctant to have breast examination or mammography, and who present with much larger cancers at higher stages. In my present practice, with a population with an average age of sixty-nine, the average size of invasive breast cancer is 28 mm -- not significantly different from what it was a quarter century ago in the same city.
Dr. Plotkin's comments suggest that pathologic grading of invasive carcinomas is imprecise and subject to a great deal of inter-observer variability. This is not the case. A standardized system of grading of invasive breast carcinomas has been available since 1970. This system is simple to use and highly reproducible. The grade established by this system more accurately reflects disease-free survival than does the receptor status (the measure of estrogen- and pro-
gesterone-receptor protein in the carcinoma). One of the senior investigators in a clinical trial in which Plotkin participated (B. Fisher) noted little difference between estrogen-receptor-positive and -negative status and outcome (Fisher et al., 1986). Not a few high-grade (aggressive, poorly differentiated) invasive carcinomas are estrogen-receptor-positive and still grow quite rapidly.