Jason Schnittker
Associate Professor of Sociology
University of Pennsylvania
“Learning to do Well or Learning to do Good?
Using Twins to Estimate the Effects of Schooling on Social and Personal Outcomes”
Abstract
Although some point to the large effects of schooling on social capital (usually measured in terms of volunteering and participation in civic organizations) and social cohesion (usually measured in terms of social networks and relationship quality), the effects of schooling on social outcomes have not been estimated with the same rigor as the effects of schooling on labor-market outcomes, such as earnings.
Using samples of unrelated persons, ordinary siblings, and identical twins, this study explores the effects of schooling on non-market outcomes, including assorted measures of civic engagement and social relationships, and market outcomes, including income and labor-force participation. The sibling models control for assorted endowments, including average family genetic endowments, and reveal a more complex picture than the standard individual estimates. Results reveal a robust positive association between schooling and earnings: well-schooled persons work more and earn more. On the other hand, the results reveal more tenuous and occasionally negative associations between schooling and social outcomes. These results are interpreted in light of the tension schooling creates between market and non-market commitments, as well as between independence and interpersonal reliability. Schooling may, indeed, change certain values in a pro-social direction, but schooling also allows the individual the choice of whether to pursue more personal interests as well, and these interests can occasionally contravene social pursuits.
Thursday, November 19th
3:30 – 5:00 pm
2125 Rolfe Hall
Refreshments will be served
Reception to follow
Reconstructing Indian Population History
A roundtable discussion of the recently published paper: Reconstructing Indian Population History (Reich et al. 2009).
Wednesday, November 18, 2009
3:30 PM - 5:00 PM
2125 Rolfe Hall
Los Angeles, CA 90095
India has been underrepresented in genome-wide surveys of human variation. We analyze 25 diverse groups in India to provide strong evidence for two ancient populations, genetically divergent, that are ancestral to most Indians today. (Reich et al. 2009) For full article, please click here.
With special guests:
John Novembre and Krishna Veeramah
Human Evolutionary Geneticists
Sanjay Subrahmanyam and Nile Green Historians and Center for India and South Asia faculty
The Department of Ecology and Evolutionary Biology and the Center for Society and Genetics at UCLA present:
The Darwin Evolving Lecture Series
2009 is a banner year for the theory of evolution. 150 years before, On the Origin of Species was published and 200 years before, the man who wrote it was born. But evolution today is much more than Darwin envisaged. Extending Theodosius Dobzhansky, “Nothing makes sense in biological and social life, except in the light of evolution” (1973). Darwin’s theory of evolution by natural selection provides the framework both for understanding pattern and process in the natural world at all levels, from the gene to the ecosystem, and for evolutionary thinking about language, culture, and economics. Yet many continue to seek a better understanding of the key concepts of variation and natural selection, of recent developments in the theory, and of its significance for such aspects of everyday life as nutrition, disease, and emotion.
In recognition of the significance of evolution for biology and society, we are proud to present a distinguished lecture series for the winter and spring quarters of 2009. The talks will be open to the public and given in the evenings by notable scientists, most of whom have authored books on evolution for the popular press.
7-8pm, The Harry and Yvonne Lenart Auditorium, UCLA Fowler Museum
Additional UCLA Sponsors: Cotsen Institute of Archaeology , The Institute of the Environment and The Divsion of Life Sciences
The DNA and History Seminar Series
Sponsored by the UCLA Mellon Foundation Transforming the Humanities Initiative and the UCLA Center for Society and Genetics
"DNA and History" is a faculty seminar held at the Center for Human Genetics at UCLA. There are a number of talks with clear archaeological foci, both winter and spring quarters. Please visit their web page for the schedule, readings, podcasts and more details.
Corruption of Blood: Reviving a Medieval Standard of Guilt Through Modern Forensic Science
Mitchell Morrissey
Familial Search Investigations (not available)
Wayne Grody; Jay Koehler; Edward McCabe; Mitch Morrissey; Tania Simoncelli
Panel Discussion
CONGRATULATIONS to HANNAH LANDECKER!
Hannah Landecker, Associate Professor of Society and Genetics and Associate Professor of Sociology, was Awarded the Levinson Prize for her book, "Culturing Life: How Cells became Technologies" (Cambridge, MA: Harvard U. Pr., 2007), at the 2008 History of Science Society Meeting. The Suzanne J. Levinson Prize is given "for the best book on the history of the life sciences and natural history."
CONGRATULATIONS to RENE ALMELING!
Rene Almeling is a Graduate Student Fellow Aumna of the Center for Society and Genetics and PhD Candidate in Sociology. In fall 2008, Rene Almeling began a postdoctoral fellowship with the Robert Wood Johnson Foundation's Scholars in Health Policy Research Program at the University of California, Berkeley. The Scholars in Health Policy Research Program offers a highly competitive fellowship to outstanding new PhDs in economics, political science, and sociology to advance their involvement in health policy research. In January 2010, she will join the faculty at top-ranked Yale University as an Assistant Professor of Sociology.
Christopher Kelty is involved in anthropological and historical research on science and technology, free and open source software, intellectual property and open access, the politics of electronic voting, the history of software, and the ethics and politics of nanotechnology. His recent book is Two Bits: The Cultural Significance of Free Software (twobits.net). He also teaches classes about issues related to these technologies. From 2001 to 2008 he was Assistant Professor of Anthropology at Rice University, in Houston, TX. He is currently an associate professor with joint appointments in the faculty of Information Studies and the Center for Society and Genetics at the University of California, Los Angeles. You can find more information about his work at http://kelty.org
RICHARDDELERINS Faculty Fellow
Richard C. Delerins is a Visiting Scholar from the Ecole des Hautes Etudes en Sciences Sociales (EHESS), Paris. His current research focuses on “Cuisine, Nutrition and Genetics in France and the United States”. Richard Delerins is also a fellow of the Cordon Bleu Culinary Arts School (Paris) and he is laureate of the 2008 NIVEA-CNRS Prize in Social Sciences.
ERICVILAIN Faculty Fellow
Eric Vilain, M.D., Ph.D. is currently an Associate Professor of Human Genetics, Pediatrics and Urology at UCLA. He is also Chief of Medical Genetics, the Director of Research on Sexual Medicine in the Department of Urology, the Graduate Advisor in the Department of Human Genetics, and an attending physician in the Department of Pediatrics. Dr. Vilain received his Ph.D. at the Pasteur Institute in 1994. In 1995, he received his M.D. at the Faculté de Médecine Necker – Enfants Malades. In addition to his clinical responsibilities, Dr. Vilain is the Principal Investigator in a laboratory working at discovering the genetic bases of sex determination and sexual orientation. He has received numerous awards, notably from the NIH and the March of Dimes. Dr. Vilain is an expert in the field of genetics of sexual development. He deciphered a large number of molecular mechanisms responsible for intersexuality in humans, such as mutations in the sex-determining genes SRY and SOX9. His laboratory continues to work on the mechanisms of early gonadal development and brain sexual differentiation.
DEBRAGREENFIELD Postdoctoral Fellow
Debra Greenfield received her J.D. from Pepperdine University School of Law in 2001, and a MA in Bioethics and Health Policy from Loyola University, Chicago in 2006. Following a long and successful career in the film and television industries, Ms. Greenfield became an attorney, and has worked on seminal cases involving genetics and biotechnology. Her Master’s thesis, published in the Annals of Health Law, explores the issue of “unjust enrichment” as applied in the context of patents on human genetic material illustrated by the case of Greenberg v. Miami Children’s Hospital. She has also published in both the Hastings Center Report and its Bioethics Forum. Additionally, Ms. Greenfield serves on the ABA subcommittee on Reproductive and Genetic Technologies; the Los Angeles Bar Association Bioethics Committee; and the Center for Health Care Ethics of Cedars-Sinai Hospital. In the coming year she will continue to work on the issue of the legality of patents on human genetic material, as well as the legal status of human tissue and genetic material provided for medical research; asserting that an “individual rights” paradigm, including the 1st Amendment, should be considered where trends in the common law of property, contract and the constitutional limits of intellectual property law are failing to protect the rights of research subjects to their own biological material.
ELANI STREJA Graduate Student Fellow
Elani Streja is a second year doctoral student in the Department of Epidemiology, School of Public Health. Elani completed her Bachelor of Science in Biochemistry with a minor in Philosophy at UC Davis. Following graduation, she moved to Glasgow, Scotland to conduct research on the association of genetic markers in clotting cascade and the development of Pre-eclampsia. Her current research is on the genetics of inflammatory markers and the development of cerebral palsy in a Denmark cohort. She is also researching the racial paradoxes in survival of chronic kidney disease for Dr. Kalantar-Zadeh at UCLA-Harbor in Torrance, California.
"Estimating size,scope, and membership of the speech/sign communities of undocumented indigenous/village sign languages: The Ban Khor case study"
in Language and Communication
an article by
byAngela Nonaka Alumna, Center for Society and Genetics
Assistant Professor of Anthropology, University of Texas at Austin
Professor Russell Korobkin and Dr. Rahul Rajkumar's Article in the New England Journal of Medicine
Professor Korobkin is a Center for Society and Genetics Faculty Fellow, UCLA Professor of Law, and author of "Stem Cell Century: Law and Policy for a Breakthrough Technology."
July 24, 2008
"The Genetic Nondiscrimination Information Act: A Half-Step toward Risk Sharing"
Consider three Americans — one with an increased genetic risk for colon cancer, one with a family history of colon cancer, and one with a colonoscopic finding of several large adenomatous polyps. Under the Genetic Information Nondiscrimination Act (GINA), which was recently signed into law by President George W. Bush, health insurance companies may not refuse to cover and may not raise premiums for the first two people, whose genetic information or family history puts them at higher risk for colon cancer (Pub. L. No. 110-233, 122 Stat. 881 (2008)). Insurers could, however, refuse to sell the third person an individual policy or could quadruple his or her premiums. If the third person is enrolled in an employer-sponsored group health plan, insurers could raise the rates for everyone in the group.
In making such distinctions, GINA is emblematic of this country's piecemeal and inconsistent approach to health care policy, which makes little sense and leaves many Americans without access to care or in danger of financial ruin if they seek care. Our recent history is replete with examples of similar half-measures in health policy. The Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986 ensures that neither the poor nor the sick can be denied emergency medical treatment, but it leaves those without insurance completely on their own when it comes to follow-up care. So when a patient presents at the emergency room with a myocardial infarction with ST-segment elevation, she will receive a lifesaving coronary-artery stent, but she may not be able to afford Plavix (clopidogrel) — which she must take to avert in-stent restenosis — and may not have access to follow-up care, which might enable her to modify her risk factors for heart disease. Medicare might help if the patient is 1 day past her 65th birthday, but not if she is 1 day shy of it. Medicaid might help if her income is lower than the qualifying threshold in her state, but not if she earns $1 more.
GINA, heir to this tradition, is yet another expression of this inconsistent approach to policy. It indulges our egalitarian instinct by protecting people who have an elevated risk of illness as a consequence of their genes or their family history. The law requires that the cost of insuring them against the diseases for which they have heightened genetic risk be spread over a larger insurance pool, ultimately raising costs for those whose risks are low or unknown. The sharing of this risk is appropriate, since these people bear no personal responsibility for their genes. Their bad luck could have befallen any of us.
But GINA does not protect people with other immutable characteristics — such as a finding on a colonoscopy — that predispose them to illness, though they, too, are more expensive to insure than the average person. An insurance company can discriminate against these people in coverage and pricing because of the increased risk they represent, yet they bear no more responsibility for their increased risk than people whose genes predispose them to illness. If we are willing to spread the costs associated with genetic risk across the population, why shouldn't we do the same for all health risks?
We could content ourselves with observing that politics is the art of the possible and that incremental change is better than no change at all, if it were not for the fact that this sort of half-measure may be hazardous to our collective health.
First, GINA not only fails to protect the person with colonic polyps; it actually leaves him worse off than he would otherwise be. Because insurance companies may no longer make use of clearly relevant information such as family history in their risk assessment, they will rely even more heavily on current health status when setting rates, even when it has only slight value in predicting future illness. In a post-GINA world, not only will the very sick have even more trouble obtaining affordable insurance, but so will the mostly well.
Second, while those who get bad news from genetic tests will rely on GINA to obtain health insurance at a subsidized rate, those whose genes put them at lower risk can opt out entirely or, more likely, purchase insurance with higher deductibles, greater cost sharing, and more exclusions. If the lower-risk portion of the population segregates itself into what is essentially a separate insurance pool, the goal of spreading the cost of genetic risk cannot be satisfied.
These problems illustrate a reality that we should have understood long ago: in the long run, haphazard health care reform sometimes creates new problems even while solving old ones. It may also leave our system unstable and unsustainable — and, more important, leave patients worse off.
One response would be to retreat from the egalitarian impulse of GINA and leave health insurance to market forces, as we do with consumer goods. Health insurance risk would be priced as accurately as technology permitted, and patients would pay their own expected medical costs in premiums. Everyone would have an incentive to stay as healthy as possible, and no one would have an incentive to avoid the risk pool. The costs of modern medicine, however, make this version of social Darwinism undesirable for all but the wealthiest among us. Most of the population would be one illness away from bankruptcy (Himmelstein DU, Warren E, Thorne D, Woolhandler S. Illness and injury as contributors to bankruptcy. Health Aff (Millwood) 2005;Suppl Web Exclusives:W5-64–W5-73).
The better solution is to fully embrace the basic ethic of GINA and admit that the law's distinction between genetic information and other immutable characteristics is arbitrary. The irony of GINA is that its application in today's world is limited by our current knowledge of the genetic basis of disease. A person with colonic polyps may have a genetic predisposition to them that is not yet understood. Indeed, one can imagine a future in which most, if not all, diseases are known to have genetic causes or at least are made more likely by genetic susceptibilities. In such a world, the distinction between genetic information and other health information would collapse entirely.
The arbitrary nature of the categories GINA creates suggests that we should fully commit ourselves to the step that the legislation approaches but is too hesitant to take: the prohibition of medical underwriting — the rating and pricing of health insurance on the basis of any health information, not just genetic information. Health insurance premiums should be assessed on the basis of a "community rate" and should be set the same for all people within a given age group — possibly with exceptions somehow made for risk factors that are deemed to be within each person's reasonable control.
Moreover, to ensure that the costs of bad health are shared equitably, all Americans would have to be in the same risk pool. This would mean enacting a health insurance mandate either for employers or, if health insurance could be made affordable, for individuals — and specifying a minimum set of benefits that everyone would be required to have. Given the growing disparity between the cost of modern medicine and the incomes of many Americans, enforcing such a mandate would be difficult. Even with income-based subsidies, an individual mandate could place an undue financial burden on many families. Nonetheless, bringing everyone into the same risk pool is an important long-term goal.
With such reforms, GINA could become the first step toward a just and sustainable health insurance system. This approach would recognize that, because many of the most important determinants of health are beyond people's reasonable control, no one should have to bear the costs of health care alone.
No potential conflict of interest relevant to this article was reported.
Center Co-Director Dr. Edward McCabe Interviewed for
Wired.com Article on DNA Storage
May 21, 2008 - Newborn-Blood Storage Law Stirs Fears of DNA Warehouse
An obscure bill that sailed through Congress and was signed into law last month is stoking fears of a nationwide DNA warehouse potentially open to abuse by law enforcement agencies or health insurance companies.
But proponents say the law is a much-needed rationalization of the way the government stores and tests blood from newborns.
The Newborn Screening Saves Lives Act of 2007 (S.1858/H.R. 3825), signed into law on April 24, empowers a committee to provide guidelines to all states on how -- and for how long -- they should store blood. At present, all states store blood from all newborns, and some, like California, store it indefinitely. Eight of the committee's nine members are medical researchers, who almost universally favor longer storage times, so critics fear that the national guidelines will lead to more storage of samples, which contain recoverable DNA.
"What we are doing is taking an individual genetic code and saying it's the government's," said Twila Brase, of the Minnesota activist group Citizens' Council on Health Care. "And once we do that, it's available for whatever a legislature wants to do in 20 years. The fact of the matter is that we don't know what they could or would do."
States have been storing blood samples from newborns since blood screening for genetic defects and diseases began in the 1960s. The samples can help detect and treat a wide range of diseases, but in the age of the genome, the issue of storing samples has taken on unprecedented importance. Blood samples contain DNA that can be unambiguously linked to individuals, which may in the future present tempting data to governments, businesses and health providers.
Currently, each state has its own policy about storing newborn blood samples. California has screened and stored more than 12 million newborn babies' blood spots since 1980, while Texas disposes of them within months.
Brase's group wants to see all so-called biobanks destroyed.
"You're building an entire DNA warehouse for the public without the public's consent," Brase said. "Who will own the DNA of the citizens and what is that going to mean? And what we're doing is pushing an entire genetic research program on the population without the consent of the population."
Proponents, however, say the scientific and medical value of the blood samples far outweigh the privacy risks of storing biological material from every newborn.
"They are extremely valuable when they are anonymized for research when looking at new technologies," said Edward Howell, chairman of the committee referred to in the bill, the Advisory Committee on Heritable Disorders and Genetic Diseases in Newborns and Children to the Health Resources and Services Administration. "Those conspiracy theories are very popular on the blogs, but … the states have been very careful in dealing with [blood spots]."
Howell says law enforcement agencies have asked states for blood samples and been turned down.
"The bottom line is that many states have kept these for a very long time and I am unaware of anything that has been done with them that would concern even a very conservative person," Howell said.
Edward McCabe, co-director of the UCLA Center for Society and Genetics and co-author of DNA: Promise and Peril, agreed that so far, states have been trustworthy guardians of their biobanks.
McCabe said that even in the case of the identification of a missing child, California's health regulators still turned down a law enforcement request to use a blood spot.
He applauded that decision and others like it that establish a clear policy for dealing with the samples and limiting their use.
"We actually think there ought to be a firewall between forensic and medical uses," McCabe said.
And he argued that -- from a health care perspective -- the samples are extremely and uniquely useful.
"It's one of the most unbiased cross sections of the newborn population of a state," McCabe said.
Donna Levin, who as general counsel for the Massachusetts Department of Public Health works in the trenches with the issue, said she believed her state's policy had the right ethical safeguards in place.
"Parents are told prior to screening that the residual specimen is kept for at least 10 years," she wrote in an e-mail.
She also noted that all research conducted on residual specimens has to be approved by an Institutional Review Board, which set ethical guidelines for human experiments. The state also requires that research on identified specimens only be conducted with the informed consent of the subject of the specimen, or a parent/guardian.
Professor Russell Korobkin's Op-Ed Piece
in the Los Angeles Times
Professor Korobkin is a Center for Society and Genetics Faculty Fellow, UCLA Professor of Law, and author of "Stem Cell Century: Law and Policy for a Breakthrough Technology."
April 26, 2008, page A27
"Insuring Amy, Beth and Cindy"
(Copyright (c) 2008 Los Angeles Times)
Amy carries the BRCA1 gene, which is associated with an elevated risk of breast cancer. Beth has an aunt and a sister who had breast cancer. Five years ago, Cindy had breast cancer, which is now in remission. What these three women have in common is a much higher risk than the average woman of one day developing breast cancer. Should a health insurer be allowed to charge them higher premiums, or deny them coverage altogether, as a result?
Thursday, the Senate passed the Genetic Information Nondiscrimination Act (GINA), which prohibits insurers and employers from discriminating against individuals on the basis of their genetic makeup. Sponsors expect the House to follow suit and President Bush to sign the bill quickly. GINA offers protection for Amy and Beth but not for Cindy. As such, it takes two steps in the right direction, but it is still inadequate.
There is no getting around the fact that, from an actuarial point of view, Amy is more expensive to insure than the average woman. If the premium she is charged is not commensurate with this risk, the cost must be shared by others: her fellow workers, if Amy is fortunate enough to have employer-based insurance, or the rest of us, in the form of higher insurance premiums or taxes. In a just society, we would all share the risks of ill health that are beyond any individual's reasonable control, such as one's genetic makeup. Because GINA promotes this result, it deserves applause.
Beth is also more expensive to insure, and GINA deserves credit for requiring that her costs be spread across the entire insurance pool. The new law characterizes family history as "genetic information," even if it is unknown whether the increased health risk associated with Beth's family history is attributable to genetic inheritance, shared environmental exposures or a combination of the two. Insurers no longer will be allowed to seek such information or use it in coverage or pricing decisions should they have it.
But if Amy and Beth should not be charged insurance premiums that reflect their true risks of illness, why is Cindy less entitled to protection? She's not any more at fault for the possibility that she will suffer a relapse than Amy and Beth are responsible for their risk profiles.
Even worse, by prohibiting insurance companies from charging higher prices or refusing coverage altogether to Amy and Beth but not to Cindy, GINA increases insurers' incentives to discriminate against individuals who have modest health problems that are only weakly related to possible future illnesses. For example, what if Debbie, who has no family history of cancer, has a colonoscopy that finds a benign polyp, which is weakly associated with a heightened risk of colon cancer? She might find herself subject to increased discrimination because insurers will be prevented from seeking information that would be more relevant to evaluating her actual risk.
The only way to solve the problem is to extend federal law to ban what is known as medical underwriting -- basing coverage and pricing decision on any indicators of health status -- and instead require what is called community rating of all people within the same age category. Exceptions should be permitted to allow insurers to surcharge customers who engage in risky activities within their individual control, such as smoking.
How would this expansion of the law affect premiums? For those with individual policies, it would reduce premiums for people who have a medical condition, like Cindy; it would raise them for people who have no medical conditions, like Emily. If they have group insurance through their workplace, extending the law would reduce premiums for everyone in Cindy's employment group but increase them for everyone in Emily's. Is this fair? Well, yes. The purpose of insurance is to share the risk. Cindy's arbitrary bad luck shouldn't subject her to higher prices. And there is certainly no reason that a co-worker should pay more for his insurance because, by happenstance, Cindy sits in the next cubicle rather than Emily.
One valid fear is that without medical underwriting, more healthy people (and small businesses with healthy employees) would choose to go without coverage rather than pay the added costs to subsidize the less healthy. But the data indicate the choice to go without insurance has far more to do with income than health status, suggesting that relatively few people are likely to game the system in this way. Most who are tempted to go without coverage are adults in their 20s, and their premiums are unlikely to increase much under an age-based community-rating system because the vast majority of them are very healthy. In any event, it would be better to have a few more healthy people choosing to go without insurance than many people with serious or even very modest health issues unable to afford it or find it at any price.
The genetic revolution has provided incredibly valuable information about our DNA, information that can be used to benefit and inform--but also to judge, discriminate, and abuse. An essential reference for living in today's world, this book gives the background information critical to understanding how genetics is now affecting our everyday lives. Written in clear, lively language, it gives a comprehensive view of exciting recent discoveries and explores the ethical, legal, and social issues that have arisen with each new development.
Newborn screening (NBS) represents the largest volume of genetic testing. The 45-year history of NBS has demonstrated its benefits, as well as the importance of an evidence base. The recent addition of tandem mass spectrometry (MS/MS) resulted in a fivefold increase in the number of tests. Experience with MS/MS also showed that laboratory tests are just one part of the NBS system. The lessons learned from NBS will provide important insights as we move into the predictive, preventive, and personalized era of genomic medicine.
The explosion of interest in stem cell research raises a raft of controversial policy questions. When should human embryos be used to create stem cells? Should cloning be outlawed? Should egg and tissue donors be paid? Should we allow scientists to patent stem cells? Is the government entitled to a portion of the revenue from stem cell technology created with public funds? How should the regulators and courts balance the competing goals of access to revolutionary treatments and protection of the public from unknown risks?
Russell Korobkin, with contributions from Stephen R. Munzer, provides the first thorough discussion and analysis of these and other unsettled questions of law, policy, and ethics that surround stem cell science. His clear and concise description of complex problems coupled with logical and well-balanced conclusions makes this volume essential reading for all Americans, general readers and experts alike, interested in the promise of stem cell research and the future of regenerative medicine.
Building Genetic Medicine Breast Cancer, Technology and the Comparative Politics of Health Care
a book by
Professor Shobita Parthasarathy Former Postdoctoral Fellow of the UCLA Center for Society and Genetics
Currently, Assistant Professor and Codirector of the Science, Technology, and Public Policy Program at the Gerald R. Ford School of Public Policy, University of Michigan
In Building Genetic Medicine, Shobita Parthasarathy shows how, even in an era of globalization, national context is playing an important role in the development and use of genetic technologies. Focusing on the development and deployment of genetic testing for breast and ovarian cancer (known as BRCA testing) in the United States and Britain, Parthasarathy develops a comparative analysis framework in order to investigate how national "toolkits" shape both regulations and the architectures of technologies and uses this framework to assess the implications of new genetic technologies.
BRCA testing was one of the most highly anticipated and publicized technologies of contemporary medicine. Parthasarathy argues that differences in the American and British approaches to health care and commercialization of research led to the establishment of different BRCA services in the two countries. In Britain, the technology was available through the National Health Service as an integrated program of counseling and laboratory analysis, and was viewed as a potentially cost-effective form of preventive care. In the United States, although BRCA testing was initially offered by a number of providers, one company eventually became the sole provider of a test available to consumers on demand.
Parthasarathy also reports on an unsuccessful attempt by the American provider of BRCA testing to market its services in Britain. British scientists, health-care providers, and patients rejected the American technology, she argues, because it was part of a social, economic, and political system to which they were not accustomed. Parthasarathy draws lessons for the future of genetic medicine from these cross-national differences, and discusses the ways in which comparative case studies can inform policy-making efforts in science and technology.
From American Sociological Review's Press Release:
New sociological study finds sperm donors valued less than egg donors in reproductive marketplace
When Rene Almeling decided to look into the operations of U.S. sperm banks and egg agencies, the UCLA PhD candidate in sociology thought she knew what she would find.
She figured that any discrepancies in compensation rates for the building blocks of assisted reproduction could be explained by either market forces or the biological differences between female egg donors, who must undergo hormone therapy and outpatient surgery, and their male counterparts, who, as one recruitment ad put it, “get paid to do what you already do.”
Instead, Almeling, whose findings appear in the June issue of the American Sociological Review, uncovered a topsy-turvy market that often defies not just conventional wisdom but also the basic law of supply and demand.
“Men donors are paid less for a much longer time commitment and a great deal of personal inconvenience,” she said. “They also are much less prepared for the emotional consequences of serving as a donor of reproductive material. Women, meanwhile, are not only paid more for a much shorter time commitment, they are repeatedly thanked for ‘giving the gift of life.’
“From compensation rates to the smallest details of donor relations, sperm donors are less valued than egg donors,” Almeling said. “Egg donors are treated like gold, while sperm donors are perceived as a dime a dozen.”
The inequities persist despite the fact that profiles of hundreds of potential egg donors languish on agency Web sites, far outstripping recipient demand, while suitable sperm donors are quite rare, Almeling found. In fact, only a tiny fraction of the male population possesses a sperm count consistently high enough to be considered donation-worthy, and more than 90 percent of sperm bank applicants are rejected for this and other reasons. As a result, sperm banks routinely resort to finder’s fees to meet the need.
“A pronounced double-standard exists in the way that men and women donors are valued by the fertility industry, and it can’t be explained medically or by market forces,” Almeling said. “Based on the availability of donors alone, you would expect the abundance of potential egg donors to drive down compensation fees and the scarcity of potential sperm donors to drive up their fees. But I found just the opposite.
Almeling’s findings are part of a growing body of research on the sociology of markets in life-saving and life-giving material, including blood and organ donations and life insurance payouts. But Almeling’s study, which is based on interviews with 25 staff members at two sperm banks and two egg agencies, is believed to be the first detailed comparison of gender-based differences in U.S. compensation rates for reproductive material. Almeling has been gathering data on the medical market in genetic material for the past five years.
Almeling found that it is not unusual for egg donors in large cities to make upwards of $5,000 per donation — no matter the outcome. Agencies also encourage recipient couples to provide female donors with thank-you notes, small tokens of appreciation and even cash bonuses.
In contrast, sperm banks do not pay as well or encourage such displays of gratitude. Male donors make between $50 and $75 per donation, and they are paid only when their samples meet the high fertility standards required for freezing. Over the length of their contracts — generally, an entire year — sperm donors may make as much as their female counterparts do over the course of a single six-week cycle, but only if they donate more than the required one sample per week. Invariably, however, earnings of sperm donors fell short, either because donors missed weekly sessions or their samples failed to meet fertility standards. Women also may donate as many as three times in a year, and their fees increase with each completed cycle.
So an egg donor actually stands to make far more during the same period of time than even the most diligent and fertile sperm donor.
Moreover, men work much longer for their pay than women, and their activities are much more restricted as a result. In addition to requiring weekly donations for a year, sperm banks instruct men to refrain from sex for two days prior to donation or risk the possibility that their samples will fail to meet fertility standards. Being sick or stressed also has a negative effect on sperm count.
“Even the doctors who were working with infertile couples were surprised when they learned just how demanding the process is for men,” Almeling said. “Sperm donors basically have to schedule their sex lives for a year.”
Meanwhile, their female counterparts also have to refrain from sex, but their activities are restricted only for six weeks. However, the women have to commit to a degree of bodily invasiveness not experienced by men: a six-week regime of hormone therapy, which leads to serious complications in 1 to 2 percent of cases, and a single egg-extraction procedure that causes some discomfort and leads to serious complications in less than 1 out of 1,000 cases, according to the American Society for Reproductive Medicine.
Men and women weren’t just compensated dramatically differently. They also experienced dramatically different “working” conditions. Almeling found that women were repeatedly reminded of their generosity, whereas men tended to be reminded that sperm donation was to be viewed like any other job.
“Staff at egg agencies constantly thank women and encourage them to think about what a wonderful difference they’re making in the lives of recipients,” Almeling said. “The sperm bank staff is appreciative, but men aren’t told how amazing they are and what a great gift they’re giving. They’re treated more like reproductive service workers. They come in. They clock in and out. Their sample is checked for quality. And they’re only paid when they produce an acceptable sample.”
The medical community has justified compensation rates for egg donors by pointing out that egg extraction is more difficult and risky than extracting sperm and that the female body has a limited supply of eggs, while the male body replenishes sperm. But Almeling does not believe these biological differences fully explain this market. While an individual woman has fewer eggs than an individual man has sperm, women never run the risk of “running out” of eggs due to donating. Moreover, the huge oversupply of women willing to be donors means that eggs are not actually scarce for couples seeing to acquire them.
Cultural norms of parenthood, which are perpetuated though marketing efforts, interact with these biological understandings to produce the differences in market prices, Almeling believes.
“Both eggs and egg donors are more highly valued than sperm and sperm donors, where it is not just reproductive material but visions of middle-class, American femininity and masculinity and motherhood and fatherhood that are marketed and purchased,” she said.
Donor recruitment at the egg agencies and sperm banks appeared to reinforce these stereotypes, Almeling found. Egg agency advertisements tend to appeal to women’s altruism, while men are informed of a job opportunity. The application process for donors also favors what Almeling called “gendered stereotypes of selfless motherhood and distant fatherhood.” Although egg donors stood to be handsomely compensated, women who indicated there was a financial motive behind their participation were routinely rejected in favor of applicants who expressed more altruistic motives, such as the desire to “help” infertile couples. Sperm banks, meanwhile, were much less explicit about the need to appear altruistic.
“While most egg donors will never meet their genetic children, women are expected to reproduce well-worn patters of ‘naturally’ caring, helpful femininity, guiltily hiding any interest that they might have in the promise of thousands of dollars,” Almeling said. “This ruse is not demanded of sperm donors. Men, who are more likely to be contacted through the banks’ identity release programs, often do not even consider that children will result from regular deposits at the sperm bank.”
In fact, one sperm donor was dumbstruck when he was informed that one of his contributions had resulted in conception.
“I hadn’t really thought about the fact there were going to be pregnancies,” he said.
