On Galileo’s Middle Finger by Alice Dreger

Galileo’s Middle Finger by Alice Dreger is about bioethics and medical research with the main focus on sexual organs in young people. The chapters break out to issues on intersex children and nonconsensual surgeries related to a misunderstanding of the relationship between sexual organs, sexual orientation, and gender identity; activist-academic “cancel culture”; and the treatment of fetuses during the prenatal period and pregnant women in the effort to prevent sexual ambiguity. The book uses a lot of opinion statements and colloquial language. In many ways, it’s more of a commentary than a scientific or objective exploration of these issues. However, that’s sort of Dreger’s point, that objectivity and pursuit of truth without a pursuit of justice is useless, “that truth and justice cannot exist without the other,” (p262). So, the book is opinionated in a way that tracks with her world views. 

At large, I really liked the topics addressed in this book and would have appreciated more objectivity and information about why intersex birth happens, side effects including psychological, and then moving into the unethical surgeries taking place on young people without consent. Because I didn’t have the background, it took me a little longer to fully appreciate the magnitude of this issue. An interesting facet of this book is that Dreger is self-identifying as a highly liberal feminist who also maintains that a key principle of democracy is a free academic society. This is a valid and important point which demonstrates the nuance of today’s politics, once she must go on defensive against “identity politics” (p22). Effectively, it’s a demonstration of the infighting she was a victim of and potentially perpetrated (though that wasn’t in this book) amongst people who, at baseline, agree with each other. To her credit, there is a webpage dedicated to attacking her as a right-wing extremist by a person named in the book, Andrea James. 

Additionally, I was not sure why Dreger owns the stance of others, including somewhat controversial situations, in her book. I suppose this was in the pursuit of academic freedom but I found it confusing. Throughout the book, the author emphasized the ongoing and ever-worsening struggle to communicate nuanced topics effectively in the Age of [Dis]information. I don’t know what the answer is and it would have been nice for Dreger to suggest one. The difficulty in communicating scientific topics that are also political is a very real problem, but this book doesn’t address that head on, only alludes to it.

Overall, I would have liked more information on the biological and anatomical pieces of intersex, autogynephilia, and the like. However, the last section provided excellent background on congenital adrenal hyperplasia (CAH). I would have appreciated all the chapters following that model. 

Dreger’s ending is an inspirational invocation of our Founding Fathers and our precious governmental system ending the book like this: “Evidence really is an ethical issue, the most important ethical issue in a modern democracy. If you want justice, you must work for truth. And if you want to work for truth, you must do a little more than wish for justice.” (p263). 

Nevertheless, it is not a specific call to action or solution.

Miscellaneous quotes: 

“CAH-affected women are more likely to be bisexual or lesbian, and less likely to be interested in becoming mothers,” (p194). 

In response to a disappointing reaction from the federal government, “How often in the history of major medical ethical travesties has the government, when called upon to act, done the right thing the first time around?” (p230) 

Relating to the ongoing push for expedient research for funding and shifting priorities in academia, “who needs fact-checking when accuracy is not rewarded and sloppiness is rarely punished?” (p259) 

Thank you to my husband, Josh, for the suggestion!