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Coronavirus and sex hormones — baldness may be a risk factor and anti-androgens a treatment
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Jenny Graves, La Trobe University
Two small studies published recently suggested most men hospitalised with COVID-19 are bald, generating headlines around the world.
While this may sound strange, science does offer a plausible explanation.
Male pattern baldness is associated with high levels of male sex hormones called androgens. And androgens seem to play an important role in the entry of SARS-CoV-2, the coronavirus that causes COVID-19, into cells.
So it’s possible high levels of androgens might increase the risk of severe infection and death from COVID-19.
This hypothesis is important to identify people at risk and raises the possibility of new treatment strategies for COVID-19.
Men suffer more than women from COVID-19
It’s been obvious from early in the pandemic. Men are at greater risk of severe infection and death from COVID-19 than women.
There are several possible factors at play here. For one, men are more likely to suffer from chronic conditions known to pose a higher risk of serious illness from COVID-19. These include heart disease and diabetes.
Another is that men’s immune systems are not as good as women’s at warding off the severe effects of viral infections.
These factors are indirectly influenced by sex hormones. Now it seems sex hormones might also have a direct effect on SARS-CoV-2’s ability to enter our cells and establish infection.
Baldness and COVID-19
In one study of 122 male COVID-19 patients admitted to hospitals in Madrid, 79% were bald — about double the population frequency.
Another small study in Spain observed a similar overrepresentaton of baldness among men hospitalised with COVID-19.
Read more:
Starting to thin out? Hair loss doesn’t have to lead to baldness
Male pattern baldness is strongly associated with a higher level of dihydrotestosterone (DHT), a more active derivative of testosterone, and one of the androgen family of male sex hormones.
Confirming this correlation between baldness and susceptibility to COVID-19 with larger samples, controlling for age and other conditions, would be significant. It would suggest a higher DHT level could be a risk factor for severe COVID-19.
How does this link make biological sense?
SARS-CoV-2 enters human lung cells when a protein on the virus’ surface (the spike protein) latches onto protein receptors (ACE2 receptors) embedded in the cells’ surfaces.
How does this work? Recently scientists discovered that an enzyme called TMPRSS2 cleaves the SARS-CoV-2’s spike protein, enabling it to bind to the ACE2 receptor. This allows the virus to enter the cell.
The gene that encodes TMPRSS2 is activated when male hormones, particularly DHT, bind to the androgen receptor (a protein on the surface of cells, including hair cells and lung cells).
So the more male hormone, the more androgen receptor binding, the more TMPRSS2 is present, and the easier it is for virus to get in.
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A preliminary, non-peer-reviewed study which correlated the androgen levels of hundreds of people in the UK with COVID-19 severity supports this theory. Higher androgen level was associated with susceptibility to and severity of COVID-19 in men (but not women, who have much lower androgen levels in their blood).
The same researchers showed that inhibiting androgen receptors reduced the ability of SARS-CoV-2’s spike protein to bind to ACE2 receptors on stem cells in culture.
Androgen disruptions are linked to different diseases
Over- or underproduction of androgens in the body causes a variety of conditions in both men and women.
For instance, men with benign prostate enlargement overproduce androgen, as do women with polycystic ovary syndrome.
Many such conditions are treated with androgen deprivation therapy (ADT), which inhibits the production or effect of androgens. For instance, prostate cancer, in which cancer cell growth is fuelled by androgens, is routinely treated with ADT.
Conversely, some people have low androgen production, or mutations that affect the binding and action of androgens — such as women with androgen insensitivity syndrome caused by mutations of the androgen receptor.
It will be important to find out whether, as the androgen hypothesis predicts, patients with over- or under-production of male hormones are at greater — or lesser — risk of COVID-19.
Read more:
How can I treat myself if I’ve got – or think I’ve got – coronavirus?
A potential treatment option?
If the androgen link holds up, this would encourage exploration of anti-androgens as a way to prevent and treat COVID-19.
Many anti-androgens are already approved for the treatment of other conditions. Some, like baldness treatments, have been used safely for years or decades. Some, like cancer treatments, can be tolerated for months.
A study which looked at men hospitalised with COVID-19 in Italy showed the rate of infection was four times lower in prostate cancer patients on ADT than in untreated cancer patients.
Perhaps a single dose given to someone who tests positive to SARS-CoV-2, or has just been exposed, would suffice to lower the chance of the virus taking hold.
But we need research to confirm this. Several androgen-suppressing drugs are now undergoing clinical trials to determine whether they reduce complications among men with COVID-19.
It will be important to verify that anti-androgen treatment works in the lungs as well as the prostate, and is effective in cancer-free patients. We’d also need to find out what dose is effective, and when it should be administered.
Anti-androgen treatments have several side effects in men, including breast enlargement and sexual dysfunction, so medical oversight is a must.
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A promising new direction in COVID-19 research
The androgen link could go a long way to explaining why men are more susceptible to COVID-19 than women. It also may explain why children younger than ten seem very resistant to COVID-19 because, until puberty, boys as well as girls make little androgen.
The more we know about who is at heightened risk from COVID-19, the better we can target information.
The androgen link also opens up an avenue for the discovery of drugs which might mitigate some of the impact of COVID-19 as it continues to sweep the globe.
Jenny Graves, Distinguished Professor of Genetics and Vice Chancellor’s Fellow, La Trobe University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
‘Soft’ voters scathing about Turnbull’s handling of sex in politics: focus group research
Michelle Grattan, University of Canberra
Prime Minister Malcolm Turnbull handled the Barnaby Joyce affair badly and his ban on ministers having sex with members of their staff is risible, according to “soft voters” in focus groups held last week.
The research, done ahead of the South Australian election but canvassing views about the federal leaders as well as state issues, also found people critical of Bill Shorten, especially disdainful of what they saw as his “opportunistic” position on the Adani coal mine in Queensland.
Four focus groups each of nine or ten “soft” voters – those who had not decided who to vote for in next Saturday’s election – were conducted on March 7 and 8: two each in Adelaide and the regional city of Murray Bridge. The work was done by Landscape Research on behalf of the University of Canberra’s Institute for Governance and Policy Analysis.
These soft voters, meeting on the heels of Turnbull’s Newspoll slump in the wake of the Joyce affair, believed Turnbull misjudged the public mood on the issue, didn’t handle it well, and let it drag on to become much more of a distraction than it should have been.
“I didn’t think it was even any of his business to be quite frank,” a 61-year-old male real estate agent said. “He wasn’t even in the same party.”
Many soft voters wonder why Turnbull didn’t simply get Joyce to keep his mouth shut.
Read more:
Politics podcast: the ‘X factor’ in the South Australian election
A retired man in Murray Bridge said that “publicly dissing Barnaby … was bad”, while a customer services manager from the town thought “he should have got rid of him quicker”.
As for the sex ban: “That rule about no bonking in parliament was an absolute joke,” an Adelaide male security office declared, while a social worker in Murray Bridge thought it “probably inflamed the situation”.
A young woman from retail was sceptical about implementation. “It’s going to happen. They can’t stop it.”
A retired female cook summed up the cynicism: “I mean, for goodness sake!”, while another woman said: “At the end of the day does it really matter? Just focus on what you need to focus on and stop focusing on people’s sex lives.”
When it comes to representing Australia on the world stage, these voters prefer Turnbull over Shorten. But more generally, many see Turnbull hamstrung by his party, weak and wishy-washy because he can’t free himself and be true to his own beliefs.
There is a strong sense that Turnbull’s perceived lack of leadership has let down many voters who expected big things from him.
“There’s no passion anymore,” said an Adelaide pensioner. A retired male teacher thought he was “not a conviction politician. You don’t feel he’s got a set of beliefs.”
An older Murray Bridge participant struggled with the gap between Turnbull’s words and actions, as shown by recent events.
“He comes across as a very decent sort of man. He made a statement at the beginning of the year about his aspiration for things to be better in parliament. And then we have Michaelia Cash getting out of her tree and he virtually starts making excuses for her, and then we’ve got Peter Dutton and a couple of other ministers being very, very personal about the marital affairs of others, and he lets all that happen in spite of what he’s already said.”
Given Turnbull is seen as still preferable to his opponent, soft voters would like him to improve and “act like a leader”, and especially to gag the voices behind him, who they regard as undermining him.
But there is doubt that he can break through. A young male factory worker thought “he’s had too many scandals in his party and it’s starting to take effect on how people see him. Like, he has no control over his party. And people are thinking, maybe he’s not cut out for the job.”
Shorten is seen as having sat back and gloated at the government’s troubles. But there was a surprisingly high unprompted awareness of his “opportunistic”, “two-faced” position on Adani. Shorten’s union association also lingers in people’s minds.
A young Adelaide bank worker observed: “Recently he went up to Queensland and said he was in favour of the Adani coal mine and then he was in Melbourne and said he was against the coal mine. Flip-flops.”
Another Adelaide voter parodied Shorten’s statements on the project: “Yeah but, yeah but … we won’t tear the contract up but …”
For both leaders, these soft voters have become an unforgiving lot – which in part explains the attraction of casting a protest vote.
Michelle Grattan, Professorial Fellow, University of Canberra
This article was originally published on The Conversation. Read the original article.
Turnbull’s ‘sex ban’ speech reveals that politics is still not an equal place for women – but it is changing
AAP/Lukas Coch
Carol Johnson, University of Adelaide
The appropriateness of Malcolm Turnbull’s trenchant criticisms of Barnaby Joyce’s “shocking error of judgement” and his announcement of a ban on ministers having sex with staffers has already been widely debated.
However, when he made those statements, Turnbull also raised much broader issues about the position of women in parliament that are worth discussing in more depth.
Turnbull acknowledged that there were “some very serious issues about the culture of this place, of this parliament” that involved gender.
He stated: “Many women … who work in this building understand very powerfully what I am saying”. Consequently, the old Ministerial Code of Conduct needed to be revised because it didn’t adequately reflect the values “of workplaces where women are respected”.
Turnbull went on to say:
I recognise that respect in workplaces is not entirely a gender issue, of course. But the truth is, as we know, most of the ministers, most of the bosses in this building if you like, are men and there is a gender, a real gender perspective here.
Turnbull is crafting an image of “protective masculinity”, of a fatherly protectiveness toward potentially vulnerable women, which he hopes will appeal both to social conservatives and feminists.
Leading Liberal Party social conservatives such as Scott Morrison have supported his ban. As has been pointed out, Turnbull’s position also references the challenging of conventional gender power relations in the workplace by movements such as #MeToo. (Though it should be noted that both some social conservatives and feminists may have reservations about the specific measures Turnbull advocates.)
It was an acknowledgement of gendered power relations in parliament that more socially conservative predecessors such as John Howard or Tony Abbott would have been unlikely to make. Indeed, Turnbull’s broader statements also raise feminist issues that may cause some tensions with social conservatives in the longer term.
For example, why, as Turnbull acknowledges, are most of the ministers in parliament male?
Turnbull was pulled up when he mistakenly claimed to have the most female cabinet ministers of any Australian government so far. It was pointed out that, at best, his record equalled Kevin Rudd’s, and that number has actually dropped since the resignation of Sussan Ley.
Indeed, Rudd had a higher percentage of female cabinet members – 30% compared with Turnbull’s initial 27% that dropped to 24% after Ley’s resignation, and to 22% when Turnbull expanded his cabinet from 21 to 23. Furthermore, there is only one female minister out of the seven in the Turnbull government’s outer ministry.
AAP/Lukas Coch
Turnbull should be praised for having both a female foreign minister and defence minister, since these are senior portfolios not traditionally held by women.
Nonetheless, Peter Van Onselen has written tellingly regarding the apparent gender bias in Liberal cabinet selections, and the serious female talent that has been overlooked as a result, in both the Abbott and Turnbull cabinets.
Despite this, the situation has obviously improved markedly under Turnbull.
Julie Bishop has talked about her experience of being the only woman in Abbott’s first cabinet, and of how she’d put forward excellent ideas that were ignored, only to have a male colleague repeat the same idea and be lauded for it.
It was, she said, a form of unconscious bias that resulted in “almost a deafness”. Clearly cultural change and more respect for women in the workplace were needed there.
Furthermore, it isn’t just a case of the majority of ministers being male – so are the majority of politicians.
Women are seriously underrepresented among Liberal MPs. As of November 2017, only 22% of Liberal politicians were women (with Labor’s proportion then being 45%).
Consequently, it isn’t just the culture in ministers’ offices that needs changing. Some female Liberal politicians, such as senator Linda Reynolds, have drawn attention to the need for broader cultural change in the Liberal Party to ensure more female politicians are recruited and women’s abilities are recognised.
Some have even suggested that, given merit is clearly not being recognised in candidate pre-selection, the Liberal Party should consider introducing quotas like Labor has done.
Read more:
How the Liberals can fix their gender problem
Parliamentary culture in general remains highly gendered, with women often bearing the brunt of sexist attitudes. The culture is also one that has often rewarded particularly macho conceptions of masculinity that can disadvantage some men as well as women.
No wonder women can become the target or collateral damage, often aided and abetted by highly gendered media coverage. The problems are not just confined to the Coalition, pervading most if not all parties, although some are doing better than others.
Indeed, while it has substantially increased its number of female politicians, Labor sometimes falls back on some of its old habits in regard to gender. These include appointing exceptionally capable female candidates to try to improve Labor’s image after male politicians have made a mess of things — a scenario that former premiers Carmen Lawrence and Joan Kirner knew well.
Think of Kristina Keneally replacing Sam Dastyari in the Senate – although at least she is guaranteed her spot, unlike Ged Kearney, who is faced with the difficult task of trying to retain Batman for Labor against the Greens following David Feeney’s departure.
However, clearly things are changing, and the gendered nature of parliamentary politics is under challenge. Turnbull’s acknowledgement of gendered power imbalances in parliament reveals that, even if he avoided discussing his own party’s contribution to them.
All states in Australia, other than South Australia, have now had a female premier, with some having had more than one. While Australia’s first female prime minister, Julia Gillard, regularly had her gender used against her, Australians will be watching the progress of New Zealand’s third female prime minister, Jacinda Ardern, with great interest. Perhaps, one day, we will even stop discussing her baby and her shoes.
Carol Johnson, Professor of Politics, University of Adelaide
This article was originally published on The Conversation. Read the original article.
Banning workplace romances won’t solve the problem of sexual misconduct in the office
AAP/Lukas Coch
Paula McDonald, Queensland University of Technology
The recent revelation of a sexual relationship between Deputy Prime Minister Barnaby Joyce and a young woman working in his office has created considerable embarrassment for the government and those involved. Prime Minister Malcolm Turnbull responded by announcing that sexual relations between ministers and their staff will be prohibited under a change to the ministerial code of conduct.
Read more:
Turnbull announces sex ban – and signals Joyce should consider his position
Turnbull gave several justifications for the ban. These included that although ministers were entitled to privacy in personal matters, they must lead by example because they occupy positions of responsibility and trust.
Recently in the US, sexual relationships between Capitol Hill lawmakers and their staffers were prohibited in response to multiple scandals and in the wake of the #MeToo movement.
Inappropriate and unlawful sexual behaviour at work
To judge whether workplace relationship bans are an effective or appropriate response to alleged or actual sexual misconduct, we must first understand the difference between “inappropriate” sexual relationships and unlawful sexual behaviour.
Unlawful sexual conduct includes sexual abuse, sexual assault and sexual harassment. Sexual harassment is any unwanted or unwelcome sexual behaviour that makes someone feel offended, humiliated or intimidated. It is not interaction, flirtation or friendship that is mutual or consensual.
In contrast, inappropriate relationships – while not explicitly unlawful – are usually associated with unequal power relationships.
Read more:
What’s the difference between sexual abuse, sexual assault, sexual harassment and rape?
Organisational codes of conduct often set out guidelines around the behaviour of supervisors and managers over their subordinates. A power imbalance between two employees may arise due to age, seniority or other factors, such as the capacity to influence outcomes.
The development of a sexual relationship in particular – even if it is apparently consensual – creates the potential for abuse of position, for damage to the less-empowered and potentially vulnerable individual, and for conflicts of interests to arise.
A common requirement in codes of employee conduct is for the person with the greater power to notify their supervisor of the relationship and immediately cease any decision-making role in respect of the subordinate. Such guidelines raise awareness of the potential for workplace relationships that may lead to later problems for those involved, and raise risks for organisational reputation and functioning.
By providing a clear course of action, such codes of conduct also acknowledge that workplace relationships do occur.
In contrast, outright bans on consensual sexual relationships at work are likely to be seen by many employees as over-reaching into their private lives. They may also perceive that it undermines their autonomy and dignity.
Retail fashion chain American Apparel recently introduced a policy barring managers from engaging in romantic relationships with employees over whom they had a perceived or actual influence. The policy also mandated the disclosure of such relationships – not to the person’s supervisor, but the human resources department.
Romantic relationships were defined broadly, and included both casual dating as well as committed relationships.
Public/private boundaries
In recent years, a considerable blurring of public/private boundaries in organisational life has occurred. Examples include the installation and monitoring of CCTV in workplaces, the enforcement of wearable surveillance devices that measure employees’ productivity in real time, and the “profiling” of job applicants through searches for private online information.
These employer actions have reshaped the boundaries between the relatively public sphere of work and the private lives of employees.
Workplace relationship bans may also be impractical and have unintended consequences. Many people meet their future partners at work or engage in short- or long-term consensual relationships that run their course.
The prospects of an employer effectively standing between two adults who are attracted to each other, or who fall in love, and preventing a relationship developing between them, seems slim.
Worse, bans may drive relationships underground. Employees who fear punitive consequences from ignoring a codified directive will likely conduct the relationship in secret. This may obfuscate loyalties and threaten the development of trust among co-workers. Engaging in a secretive relationship when those involved would prefer it was open may also prove stressful.
At its most extreme, regulating workplace relationships may damage women’s careers rather than contribute to them through a raising of professional standards.
Some male executives and senior politicians such as US Vice-President Mike Pence have been said to avoid working with women altogether to avoid being accused of inappropriate behaviour. This constrains opportunities for sensitive and strategic workplace discussions, and holds women back from key advancement opportunities.
Balancing competing interests
Joyce’s case raises several important issues insofar as preventing fall-out when colleagues engage in romantic and/or sexual relationships.
Banning relationships is likely to be ineffective and may result in disengagement, secrecy and resentment by employees of the encroachment of employment policies into genuinely private matters.
Outright bans also imply a connection between sexual misconduct and romantic relationships that is dubious at best. For example, although some sexual harassment cases arise following the breakdown of a former consensual relationship, most do not.
Preventing and redressing sexual harassment and achieving gender equality requires far more nuanced and multi-faceted approaches.
However, relationships of unequal power clearly need to be carefully managed to avoid the harmful consequences that may result for those involved. This can be achieved through carefully crafted and implemented policies and practices that raise awareness among employees of expectations about professional behaviour and where the greatest risks lie.
However, power comes in many forms. And it can only be judged on the basis of the particular circumstances and people involved.
Policies must also be sensitive to balancing the competing interests of employees and employers. This includes employees’ interests in privacy and autonomy, and employer interests in promoting workplace harmony and avoiding reputational damage.
Responses need to also acknowledge the reality that relationships between consenting adults are an inevitable and almost certainly enduring feature of many contemporary workplaces. Attempting to ban them is unlikely to be a panacea.
Paula McDonald, Professor of Work and Organisation, Queensland University of Technology
This article was originally published on The Conversation. Read the original article.
Turnbull announces sex ban – and signals Joyce should consider his position
Michelle Grattan, University of Canberra
Malcolm Turnbull has announced that, from now, sexual relations between ministers and their staff will be prohibited under a change he has made to the ministerial code of conduct.
Addressing a news conference late on Thursday, Turnbull also strongly hinted he would like to see Barnaby Joyce step down.
Joyce had made “a shocking error of judgement in having an affair with a young woman working in his office”. In doing so he had set off a “world of woe” for his wife, daughters and indeed his new partner, and had “appalled all of us”.
When asked why he wouldn’t urge Joyce to resign, Turnbull pointed out that he was leader of the minor party in the Coalition.
But his preference was clear. “Barnaby has acknowledged his fault, his error, his grief about his conduct. He has to consider his own position obviously. These are matters for Barnaby Joyce to reflect on.”
Earlier Turnbull told parliament that when he visits the US next week, Senate leader Mathias Cormann – not Joyce – would be acting prime minister.
Turnbull said the ban on sexual relationships would apply even if the minister was single.
The ban parallels a prohibition last week passed by the US House of Representatives – although that was included in legislation while this is only in the ministerial code, and is only enforceable politically not legally.
It also follows a call by crossbencher Cathy McGowan last week for a “conversation” about conduct between MPs and their staff. Her call was dismissed at the time.
Turnbull said then: “Members of parliament, ministers all have to be accountable for their actions. As grown-ups, we are all accountable for our actions. Relations between consenting adults is not something that normally, you would be justified in, if you like, seeking to regulate.”
But government sources said Turnbull had been working on the sex ban all week.
Turnbull told his news conference the Joyce affair had raised “some very serious issues about the culture of this place, of this parliament”.
He said the present ministerial code was “truly deficient”.
“It does not speak strongly enough for the values that we should all live, values of respect, respectful workplaces – of workplaces where women are respected.”
He said this respect in workplaces was not entirely a gender issue. But “most of the ministers, most of the bosses in this building” were men and “there is a real gender perspective here”.
He said that whatever people might have turned a blind eye to in years past, in 2018 it was not acceptable for a minister to have a sexual relationship with someone who worked for them.
“It’s a very bad workplace practice. And everybody knows that no good comes of it.
“Of course you know what attitudes in the corporate world and elsewhere are to this kind of thing. So, it is about time that this change was made. Probably should have been made a long time ago.”
Michelle Grattan, Professorial Fellow, University of Canberra
This article was originally published on The Conversation. Read the original article.
India: Another Sexual Crime Exposed (How Many Are Not?)
I remember a year or so back when an Indian student or two had been bashed here in Australia that there was a great outcry from India about racism and the like in Australia. The odd bashing doesn’t make the whole country guilty of the crimes that had taken place at the time. Perhaps India could get serious about dealing with what is very obviously a major problem in that country – sex crimes against women. Deny it they may, but hide it they can’t – there is clearly a major problem there. I would suggest this isn’t the only major issue facing India, as this Blog clearly demonstrates time and time again.
The link below is to an article reporting on yet another example of major sex crimes against women in India.
For more visit:
http://www.theguardian.com/world/2015/jan/03/indian-brothers-held-alleged-kidnap-rape-japanese-student
Badaun shows how the police are part of Uttar Pradesh’s unending rape crisis
Morocco: Child Sex Tourism
Random Thoughts 
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