Congressional Obsfucation

Today I came across an interesting article that suggests that members of the United States Congress are aware of the obvious relationship between endocrine disrupting chemicals and changes in gender and sexuality, but that they refuse to actually study the problem appropriately.

According to the Belmont Citizen-Herald, Edward J. Markey, the Massachusetts Democratic Chairman of the House Energy and Commerce Energy and Environment Subcommittee, made several comments at a hearing last Thursday, entitled “Endocrine Disrupting Chemicals in Drinking Water: Risks to Human Health and the Environment:”

In his statement, he said: “Just last week a local newspaper warned that the Potomac River and other mid-Atlantic rivers are laced with toxins that may be responsible for bizarre deformities in fish, frogs and other wildlife that come in contact with the contaminated water. This includes male fish that have begun growing female sexual organs, and female fish that can no longer reproduce."

The Congressman then went on to say “There are serious concerns that the same chemicals that are responsible for these deformities in wildlife may also have similar effects in humans and may be the culprit for the widespread increase in human disorders such as infertility, obesity, diabetes and cardiovascular disease. These contaminants, which fall under a class of chemicals called Endocrine Disruptors, are pervasively showing up in our nation’s waterways, including in water that millions of people rely on for drinking.” [emphasis mine]

So here we have a United States Congressman acknowledging that the effects observed in wild animals, including “male fish that have begun growing female sexual organs,” are possibly also happening to humans.

The Congressman also stated:

“W.C. Fields once said, ‘I never drink water because of the disgusting things fish do in it.’"
 
“Today, people wonder whether they should be drinking the water that comes out of their taps because of the disgusting things it is doing to the fish, and possibly to them."

Isn’t this an interesting pair of statements? I think the Representative from Massachusetts made an incredibly poor word choice in using the term “disgusting.” Personally, I don’t find male animals growing female sexual organs to qualify as “disgusting.” It just happens. What I do find disgusting is the lack of chemical regulation and enforcement of the existing regulations by Congress and the EPA.

Notwithstanding Mr. Markey’s value-laden judgment about “disgusting” outcomes such as male fish growing female sex organs, there is in fact already a term for humans that do not sexually differentiate along “normal” lines. Known as intersexuals, these are typically people whose genitalia do not develop in concordance with their genotype. To the best of my knowledge, there have been no government studies examining the prevalence or incidence of intersexualism in the U.S. population.

One academic study from 2000, by Blackless, et. al., did try to quantify the prevalence, and determined that approximately 0.1-0.2% of live births received “corrective” genital surgery, based entirely on reports in the academic literature. They estimated that up to 2% of the population could be characterized as intersexual, based upon a lack of concordance between genes, hormones, or physical characteristics such as the size and configuration of the genitalia. Given that most of the source material for these estimates was quite old, was from around the world rather than just from the U.S., and that made a number of assumptions, this number probably represents a gross underestimate of the actual numbers.

The Intersex Society of North America, (ISNA) an education, outreach, and advocacy organization oriented around issues of importance to intersex people reports a similar incidence, however, in a posted discussion among ISNA staff members, they note the same lack of evidentiary information in determining any hard numbers, and in fact, they rely on two sources, the previously mentioned Blackless paper, and a book by one of the authors of that same paper, which utilized most of the same source material referenced in the Blackless paper. So in summary, as of this date, there is really only a single study has actually made an attempt to count the number of intersex people in the world, and the methodological limitations indicate that this is most likely an underestimate.

Further, one of the unarticulated assumptions in this paper is that the rate of intersexualism in the world is a constant. Yet if one looks at the environmental health literature, and specifically at effects observed in animals, the evidence is unequivocal that the frequency of effects relating to sexual development is increasing. So if there is a connection between effects seen in animals to those expected in humans, then it suggests that the number of intersex people is similarly increasing. Consequently, the intersex prevalence figure is probably a gross underestimate, as any estimate is trying to pin down a moving target.

Another area where this same pattern exists is in studies examining the incidence and prevalence of transsexualism. The pattern is two-fold: consistent under-reporting, coupled with the assumption that the prevalence rate is a constant. For example, the World Professional Association for Transgender Health (WPATH) publishes what is known as the Standards of Care for Gender Identity Disorders, now in its sixth edition. In the earlier editions, the prevalence was reported as 1 in 37,000 for male to female transsexuals, and 1 in 107,000 for female to male transsexuals. More recent versions have utilized epidemiological evidence from the Netherlands, reporting the figures 1 in 11,900 for male to females and 1 in 30,400 for female to males. This increase in prevalence is typically attributed to: 1) better reporting and data collecting, 2) increased benevolence of society, permitting more people to “come out” as transsexuals, and 3) improved diagnosis and availability of treatment.

However, in 2007, Femke Olyslager and Lynn Conway published a paper at the WPATH 20th International Symposium in Chicago that took a different approach. They simply surveyed surgeons to count the number of actual sex reassignment surgeries and made an estimate of the prevalence based on these figures. They estimated that the prevalence for male to female transsexualism at between 1 in 1,000 and 1 in 2,000 based on these data.

But as with all estimates of the prevalence of people who are intersexual or transsexual, the authors implicitly assume that the rate is actually a constant, regardless of whether the authorities are under-reporting the “true” prevalence.

Yet if Mr. Markey’s concerns are legitimate, and there is in fact a relationship between effects observed in animals and those expected in humans, then it should be clear that the prevalence is not a constant, but is instead steadily increasing.

While I applaud the Representative from Massachusetts for proposing legislation to improve water quality, it is far past time to take action. Way back in 1993, a number of prominent researchers in the field of endocrine disruption, including Theo Colborn, Louis Gillette, Jr., and Frederick Vom Saal, testified in front of Congress, describing the observed effects of endocrine disruptors in animals and the likely consequences for human health. As a result of this hearing, Congress mandated the Environmental Protection Agency (EPA) to study these chemicals and their effects, and the EPA subsequently created the Endocrine Disruptor Screening and Testing Advisory Committee (EDSTAC). According to the EPAs website,

“EPA charged EDSTAC to advise the Agency regarding:
1. Methods for chemical selection and priorities for screening,
2. A set of available, validated screening assays for early application,
3. Ways to identify new and existing screening assays and mechanisms for their validation,
4. Processes and criteria for deciding when additional tests beyond screening would be needed and how to validate such tests, and
5. Processes for communicating to the public about EDSTAC's agreements, recommendations, and information developed during priority setting, screening, and testing.”

In 1998, EDSTAC submitted a final report to Congress, which outlined the approach they recommended to the EPA. Yet after twelve years, practically nothing has been done. Just last year, on October 21, 2009, the EPA published a list of chemicals proposed for Tier 1 screening – the first step in the screening process - that included just 67 chemicals. Given that there are approximately 80,000 chemicals in commerce today and that approximately 4000 are imported/used in the United States in quantities exceeding 1 million pounds per year, the EPAs endocrine disruptor program is completely lacking in credibility. The program is a bad joke.

If EDSTAC and the EPAs nonexistent effort over the last twelve years is the best the government can do, then we can surely expect that there will be a vast increase in the number of “disgusting” outcomes. It boils down to the simple fact that if one does not look, one will not find. If Mr. Markey is really concerned about these chemicals and their “disgusting” effects, might I suggest that he propose simply looking for the same outcomes in humans that are observed in animals?