Category Archives: Human Reproduction

The coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has precipitated a global health crisis of unprecedented proportions. Because of its severe impact, multiple COVID-19 vaccines are being rapidly developed, approved and manufactured. Among them, mRNA vaccines are considered as ideal candidates with special advantages to meet this challenge. However, some serious adverse events have been reported after their application, significantly increasing concerns about the safety and efficacy of the vaccines and doubts about the necessity of vaccination. Although several fertility societies have announced that COVID-19 mRNA vaccines are unlikely to affect fertility, there is no denying that the current evidence is very limited, which is one of the reasons for vaccine hesitancy in the population, especially in pregnant women. Herein, we provide an in-depth discussion on the involvement of the male and female reproductive systems during SARS-CoV-2 infection or after vaccination. On one hand, despite the low risk of infection in the male reproductive system or fetus, COVID-19 could pose an enormous threat to human reproductive health. On the other hand, our review indicates that both men and women, especially pregnant women, have no fertility problems or increased adverse pregnancy outcomes after vaccination, and, in particular, the benefits of maternal antibodies transferred through the placenta outweigh any known or potential risks. Thus, in the case of the rapid spread of COVID-19, although further research is still required, especially a larger population-based longitudinal study, it is obviously a wise option to be vaccinated instead of suffering from serious adverse symptoms of virus infection.

Keywords: ACE2; COVID-19; SARS-CoV-2; angiotensin-converting enzyme 2; coronavirus disease 2019; fertility; mRNA vaccine; pregnant women; reproductive system; severe acute respiratory syndrome coronavirus 2.

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Effects of COVID-19 and mRNA vaccines on human fertility

Abstract

BACKGROUND: Vaginal anatomy has been poorly studied. This study aimed to measure baseline dimensions of the undistended vagina of women of reproductive age. METHODS: We combined baseline information collected from five clinical trials using magnetic resonance imaging (MRI) to quantify distribution of a vaginal gel. Seventy-seven MRI scans were performed on 28 women before gel application to establish baseline vaginal measurements. Average dimensions were calculated for each woman and for the population. The influence of potential covariates (age, height, weight and parity) on these dimensions was assessed. RESULTS: MRI measurements are reproducible. The SD surrounding the mean at each anatomical site, and with summary measurements, was significantly smaller with each subject compared with the population. Mean vaginal length from cervix to introitus was 62.7 mm. Vaginal width was largest in the proximal vagina (32.5 mm), decreased as it passed through the pelvic diaphragm (27.8 mm) and smallest at the introitus (26.2 mm). Significant positive associations were parity with vaginal fornix length, age with pelvic flexure width and the height with width at the pelvic flexure. CONCLUSION: No one description characterized the shape of the human vagina. Although there is variation among women, variables such as parity, age and height are positively associated with differences in baseline dimensions.

In comparison with other female pelvic organs, the anatomy of the vagina has been relatively poorly studied. Our knowledge of female pelvic anatomy is based on old descriptions derived from the dissection of a small number of female cadavers. These studies depict the vagina as a straight hollow tube extending vertically upwards towards the sacral promontory (Grant, 1943; Eycleshymer and Schoemaker, 1983; Sultan et al., 1993). In the late 19th century, Hadra in Lesions of the vagina and pelvic floor, discussed the possibility of differences in anatomy for a living patient, also noting that the vaginal axis is different in the upper and lower vagina (defined as the sections of the vagina above and below the pelvic diaphragm) (Hadra, 1888).

New research on pelvic imaging has focused on paediatric, premenopausal and post-menopausal groups; or disease entities like utero-vaginal anomalies, prolapse, fistula or pelvic malignancies. As the focus of past research has been mainly curative, limited study has been conducted on the normal anatomical variations of the vagina of young, healthy and sexually active women (Hafez and Evans, 1978).

The literature, to date, describes the relaxed vagina as a fibro-muscular tube that exists as a collapsed potential space. The shape of the tube is not symmetrical or similar to any known geometric shape. Rather, the vaginal lumen is a potential space with walls that are easily distensible. The overall shape and stretching of the vaginal canal are constrained by the elasticity of the vaginal wall and its relationship to other pelvic organs. The cross section of the relaxed vagina at the level of the cervical os has been classically characterized as an H shape. More recent data suggest that the shape may instead resemble a W (Barnhart et al., 2004a).

Studies have utilized casts to visualize the vagina in three dimensions and to compare vaginal shape, dimensions and surface contact in various ethnic populations. The casts consisted of wax, rapidly solidifying dental impression paste, polyvinyl siloxane, etc. (Morgan, 1961; Richter, 1967; Pendergrass et al., 1996). These studies were limited by the abnormal distension of the vagina; however, they suggested differences among vaginal shapes and dimensions in African-American, Caucasian and Hispanic women (Richter, 1967; Pendergrass et al., 2000). These studies have also suggested a uniform size of all the different shapes of the vagina, and hence have supported the development of the one size fits all vaginal product, formulation or microbicide (Pendergrass et al., 2003).

The goal of this project was to define baseline, nondistended dimensions of the vagina of women of reproductive age using noninvasive imaging. Magnetic resonance imaging (MRI) is the optimal imaging modality for female pelvic organs because the images have excellent spatial resolution and inherently high soft tissue contrast (McCarthy and Vaqueno, 1986; Aronson et al., 1990; Barnhart et al., 2001, 2004b). A secondary goal was to explore the importance of the potential covariates to the dimensions of the human vagina including the impact of age, height, weight, gravity and parity. This information may help researchers optimize vaginal products and drug delivery.

This study was reviewed and approved by the Institutional Review Board of the University of Pennsylvania (Protocol CSA-03-333). This study is an analysis of the baseline MRI at entry in five clinical trials evaluating the distribution of a vaginal product. Data from the following five experimental protocols were utilized for this study:

spread of 3 ml of KY jelly and Replens with and without ambulation (unpublished data);

comparison of two volumes of cellulose sulphate (2.5 ml versus 3.5 ml) with and without ambulation (Barnhart et al., 2005a);

effect of volume (3.0 ml versus 5.0 ml) and ambulation on gel spread, and a substudy on the effect of simulated intercourse on the spread of gel in the vagina (Barnhart et al., 2004b);

study of spread of Savvy gel in the vagina (Barnhart et al., 2005b) and

vaginal distribution of miconazole nitrate suspension from administration of a single vaginal insert (Barnhart et al., 2004c).

As part of these trials, an MRI was performed prior to use of any study product to serve as a baseline for comparison after gel insertion. The trials then quantified the spread of the gel depending on time from application, ambulation of the volunteer, sexual activity of the subject, gel volume and formulation. Other data that quantified the spread of the gel were not included. The analysis for this study is confined to the MRI examinations of these volunteers before using the experimental product to assess the baseline vaginal dimensions of women of reproductive age.

All subjects were aged 1845 years, not at risk for pregnancy (using reliable contraception or abstinence), menstruated regularly and had a normal Papanicolaou smear.

MRI examinations were performed on a dedicated research GE 1.5 Tesla Signa scanner with the assistance of a phased array surface coil centred on the pelvis, to allow small fields of view and to increase signal to noise ratio. We used Sun Ultra workstation, GE Advantage Windows 3.1 software, electronic callipers and digitally stored images to make measurements. The specific details of MR techniques have been published previously (Barnhart et al., 2001, 2004b, 2005a; Pretorius et al., 2002).

The linear length of the vagina was the measurement in the sagittal plane from the external cervical os to the introitus (approximately at the level of the hymeneal ring) (Figure 1). Measurements were also taken at the following anatomic structures in millimetres: (i) two measurements of the posterior vaginal fornixwidth and length in the anterior posterior (AP) and sagittal planes; (ii) transverse measurement of upper vagina (1 cm below the cervix); (iii) pelvic flexure widthtransverse measurement of the flexure of the vagina as it passes through the pelvic diaphragm; (iv) transverse measurement of the lower vagina (3 cm above the introitus); (v) at the level of the introitus (transverse measurement of the vagina 1 cm above the introitus). An example of a measurement in the transverse plane is demonstrated in Figure 2. Measurements at all five demarcated areas were assessed as demonstrated in Figure 2. Surface contact is a summary measurement of the dimensions of the vagina and is calculated by the summation of length of the fornix (AP plane) and the transverse measurement at the four other demarcated sites (Pretorius et al., 2002).

Figure 1.

This figure represents a sagittal image of the human vagina. For illustration purposes this is an image that contains gel mixed with gadolinium contrast (white) to demarcate the vaginal canal. The outline of the vagina can be seen from the cervix and linearly to the introitus. The length of the curved line in the vertical plane is the linear length of the vagina. In this case, the measurement was 63 mm.

Figure 2.

Panel A represents a sagittal image of the human vagina. For illustration purposes these images contain gel mixed with gadolinium contrast (white) to demarcate the vaginal canal. The outline of the vagina can be seen from the cervix (above the dotted line) and linearly in the vertical plane to the introitus. The lateral dimensions of the vagina are measured in the transverse plane as depicted by the dotted line in Panel A. The image is 90 from the vertical plane. Panel B represents complete cross section of the vagina in the transverse plane (1 cm below the cervical os), as the vagina can be seen contiguously from left to right. In this instance, the measurement was 22.5 mm. Surface contact is the sum of the transverse measurements at five demarcated sites in the vagina.

The data were manually checked for any discrepancies resulting from illegal values, extreme outliers and suspicious combinations. We explored various analytical techniques, statistical methods and experimental designs to determine the optimal use of MRI to study the baseline vaginal dimensions. Comparisons using Wilcoxon signed rank tests were made at each distinct measurement within the vagina. SAS (Cary, NC, USA) software was used for statistical analysis.

Multivariate statistical methods were used to summarize the measurements derived from images in the most efficient manner. Repeated analysis of variance and related methods such as mixed effects models were used. Standard data reduction techniques such as principal components and factor analyses were used to form a reduced set of variables. For dichotomous and discrete variables we used appropriate methods such as logistic regression or generalized estimating equation (GEE). All P-values were produced using Fischers exact tests methods. The association of baseline vaginal dimensions with age, race, gravity, parity, height and weight were determined.

Data from 28 volunteers were included in the analysis. The average age of the participants was 29.2 5.8 years with a range of 1839 years. The average height was 1.66 0.05 m with a range of 1.51.7 m. The average weight was 70.13 12.6 kg with a range of 49.995.3 kg. The ethnic distribution of the participants was as follows: 17 were Caucasians, eight African-Americans, two Hispanic and one Asian/Pacific Islander. Of the participants, 14 women were nulliparous and 14 were parous.

Most women (23) participated in one trial; one woman participated in all five. Seventy-seven MRI measurements were performed at baseline (minimum one and maximum twelve per subject). Thirteen of the 28 women had more than one baseline MRI either in the same study or in a second study.

The mean dimensions of the resting human vagina are presented in Table I. These represent the average of the mean values of each of the 28 women. In other words, the average dimensions (and SD) for each woman was calculated if she had more than one MRI. Average dimensions and SD were then calculated for all 28 women. Also presented in Table I are data about the SD of the mean for each woman (within subjects) and the SD of the mean for the population of 28 women (between subjects). The SD within subjects was noted to be significantly less than the SD of the mean for the population of 28 for all individual and summary measurements.

Dimensions of the human vagina with comparison of inter- and intra-person standard deviation

Dimensions of the human vagina with comparison of inter- and intra-person standard deviation

The average linear length of the vagina was 62.7 mm with a relatively large range (40.895 mm). It was noted that the width of the vagina varies throughout its length. The transverse diameter of the vagina is the highest at the level of the vaginal fornices (41.87 mm). The transverse diameter then progressively decreases from the cervical os (32.52 mm) to the pelvic flexure (27.97 mm), mid-lower vagina (27.21 mm), to the narrowest part of the vagina at the level of the vaginal introitus (26.15 mm).

Table II gives results of evaluation of the relationship between baseline vaginal dimensions and covariates of age, weight, height and parity. Surprisingly, there were very few statistically significant associations noted with multivariable analysis. Race was not associated with any differences in measurements of vaginal dimensions. Parity was more predictive than gravidity; hence it was used (and gravidity was eliminated) in the final models. Associations noted were between (i) parity and length of vaginal fornix, (ii) age and vaginal width at the pelvic flexure and (iii) height and vaginal width at the pelvic flexure. A nonstatistically significant trend was noted between the overall length of the vagina and weight (P-value = 0.07).

Factors that affect the baseline dimensions of the human vagina

Factors that affect the baseline dimensions of the human vagina

Neither a single shape nor one summary measurement can characterize the dimensions of the resting vagina in women of reproductive age. Using a noninvasive imaging modality we were able to gain some insight into the anatomy. We confirmed that the axis and dimensions of the upper and lower vagina are different (data not shown). The axis of the lower vagina (from the introitus to the pelvic diaphragm), in relation to a standing woman, is vertical and posterior. The upper vagina changes its axis at the level of the pelvic diaphragm (from the pelvic diaphragm to the cervix), and it becomes more horizontal. We have previously noted that the transverse shape of the upper vagina at the level of the cervix is not always an H and instead is often a W (Barnhart et al., 2004). We also note that measurements of the transverse diameter of the vagina vary along its length. The width of the vagina is narrowest at the level of the introitus with minimal change in width noted at the level of the pelvic diaphragm. Above the pelvic diaphragm, the transverse width of the vagina is greater, around and behind the cervix (the transverse width of the fornix).

The differences in dimensions of the vagina along its length most likely result from the constriction by the surrounding pelvic tissues and the intrinsic compliance of the vaginal walls, resulting in the greater width and compliance of the upper vagina. The differences in the axis and the width of the vagina may not be readily appreciated by the clinician as an inserted speculum straightens the axis of the vagina. Once the speculum is opened, it is sometimes difficult to appreciate the differences in width along the length of the vaginal canal.

There are differences in vaginal dimensions among women. The length of the vagina (from external cervical os to introitus) ranged from approximately 4.19.5 cm, a greater than 100% difference from the shortest to the longest length. There was also a large range in the width of the vagina at all demarcated sites measured. The width and the range of the width tended to increase from the introitus to the fornix. The largest range in the width of the vagina was noted in the width of the posterior fornix, which in the undistended vagina is the portion of the vagina behind (posterior) to the barrel of the cervix. The cervix extends from the upper wall of the vagina into the canal with the external os pointing in the general direction of the introitus. The area of the vagina cephalad to the external os, thus posterior to the barrel of the cervix, is the fornix. Using MRI we were able to measure the posterior fornix in both the transverse plane (right to left) and in the longitudinal plane (in the sagittal plane). Thus, the true length of the vagina is the length from the external os to the introitus plus the longitudinal length of the posterior fornix. These two aspects in length, however, are not in the same linear plane, and the connection between these two lengths will also often include some change in linear direction.

Interestingly, while there were differences in vaginal dimensions among women, there were only small differences in the dimensions when the same woman was imaged multiple times. Over the course of these trials, some women had repeated measurements as much as six months apart, and there was very little variation in these measurements, suggesting that the anatomy does not change substantially over short periods, and measurements using MRI have low intra-person variability.

Notably, few statistically significant associations could be drawn between the potentially influencing factors and baseline dimensions of the vagina. Although it has been suggested that there are racial differences in vaginal dimensions, our data did not demonstrate any such clear-cut differences. We noted that age of a woman is associated with an increase in the transverse diameter at the pelvic flexure. This is consistent with the clinical finding of increasing laxity of the vaginal walls in women of advanced age. Interestingly, by contrast, height of the subject was negatively associated with width of the vagina at the level of the flexion. Weight of a woman tended to be positively associated with overall length of the vagina and presented as a nonstatistically significant trend (P-value 0.050.10). Given the number of statistical comparisons performed in this study, it is possible that some of these findings may be due to chance.

Surprisingly, parity had little association with the overall surface contact and length of the vagina. Parity is associated with a significant increase in the length of the vaginal fornix. The potential effect of parity may be via stretching and elongation of the birth canal at the time of vaginal childbirth. This effect is especially significant in the upper part of the vagina where the dilation, thinning (effacement) and taking up of the cervix is an active process, as opposed to the lower vagina where passive stretching takes place during parturition.

Our summary measurement of surface contact is not a true measure of surface area. It was devised to objectively compare the spread of a vagina gel under experimental protocol to assess the effect of a variable such as time since insertion or gel volume. It is notable that our summary measurements of 137.58 18.37 mm with a range of 103.9165 mm appear to be larger than estimates of surface area reported in other studies. Prior studies that used casts to measure vaginal dimensions reported a surface area of 87.46 mm2, SD 7.8 mm2 and range 65.73107.07 mm2. A direct comparison of these measurements cannot be performed due to differences in methodology and because the casts showed either extrusion of cast material by a small vagina or improper filling in a roomy vagina, leading to understated measurements (Pendergrass et al., 2003). Our measurements of the width of the vagina are similar to those reported, which range from 23.9 to 64.5 mm (Pendergrass et al., 1996, 2003). However, we are unable to characterize the shape of the vagina as a heart, slug, pumpkin seed or parallel sides as suggested by other studies (Pendergrass et al., 1996, 2000, 2003).

The dimensions and shape of the vagina are of great importance in medicine and surgery; however, there appears to be no single way to characterize the size and shape of the human vagina. Although differences exist between women, there are few covariates associated with these differences. There does not appear to be large variation in the dimensions of the vagina within the same woman. Given the large range in the dimensions noted, it is most likely that one size for a vaginal device will not fit all women (Mauck et al., 2004). Prior research has shown that using a single size for fitting two cervical caps leads to the correct fit in only 33% of women. Moreover, it is possible that one volume of a gel intended to cover the vaginal epithelium may not be appropriate for all women. This information can be used to better design various devices used in the vagina. We have previously proved that deployment of a potential microbicide gel in the upper and lower vagina is affected by factors such as ambulation, time since insertion, volume and product (Barnhart et al., 2005). Baseline vaginal dimension may also be an important factor.

Support for this subproject [CSA-03-333] was provided by the Global Microbicide Project [GMP], a program of CONRAD, Eastern Virginia Medical School. The views expressed by the authors do not necessarily reflect the views of CONRAD or GMP.

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Baseline dimensions of the human vagina | Human Reproduction | Oxford ...

In Europe, this war climaxed with the enclosures, a process of privatisation that kicked peasants off the land and forced them to take on what work they could find in towns and cities. In Africa, Asia and the Americas, the class war took the form of genocide, enslavement and indentured labour.

Capitalism could have never happened without this theft: it provided the capital needed to drive the industrial revolution. Federicis contribution was to show that the theft of womens bodies and labour was just as indispensable to kick-starting capitalism.

All that genocide and land grabbing had inconvenient side effects. According to Federici, the population of South America dropped by 75 million while in Europe the enclosures helped generate the first modern inflation crisis, by allowing landlords to raise rents and merchants to hoard grain and hike prices. Real wages fell by two-thirds.

The starving poor had little resistance to plague or smallpox and populations began to decline. In Germany one third of the population was lost by the early 1600s.

From a commercial viewpoint, this decimation of the population was bad news. In the 1620s and 30s, markets shrank, trade stopped and unemployment became widespread, in the first international economic crisis, otherwise known as the General Crisis. The fledgling capitalist economy was on the verge of collapse.

What could be more logical, then, for the new ruling alliance than to seize control of womens bodies and their reproductive powers?

Women werent hunted at random. Witches were usually poor and were frequently accused either of crimes against property or of reproductive crimes. They were tried for procuring abortions, murdering children, sucking their blood, and making potions of their flesh.

Many witches were midwives or wise women, traditionally the holders of womens reproductive knowledge. In the Middle Ages, women had some access to contraception in the form of herbs turned into potions and pessaries, but now this was proof of the devils work.

When my friend Tim said that the government should protect unborn babies from the people gestating them, he was probably unaware that its only in the last few hundred years that the uterus has become the business of the state.

Federici described a process whereby male doctors took over birthing chambers. Strict laws were set around reproduction, on punishment of beheading. Womens sexuality ceased to be something for women to enjoy and was put to the service of the economy and of men.

Accompanying this assault on womens bodies was a devaluing of their work, and a redefinition of womanhood itself. The heterosexual, patriarchal family became the engine of the new economy. Strict gender roles were assigned. The womans place was now seen as being in the home, and all the work they did there was designated as non-work.

Non-work included all reproductive labour: both in the sense of literally having babies, and all the care and domestic work needed for humans to sustain and reproduce themselves. Not only were women expected to do all this reproductive work for free, they were supposed to do it with a smile on their faces, born out of that handy thing called maternal instinct.

This is not to say that under feudalism there was no gender inequality. But capitalism didnt exactly spell progress. The devaluing of womens work also affected their earning power when they did try to earn a wage. According to Federici, in 14th-century western Europe, women received half the pay of men for the same task. By the mid-16th century they were getting a third of the male wage.

For Federici, just as capitalism was grounded on genocide, slavery and land theft, it was grounded on womens free and cheap labour, taken from them by fire.

It wasnt by chance that Federici chose to write her history of capitalism during the 1990s and early 2000s. She was witnessing a new phase of capitalism, a new class war and a new war on women.

This was the era of globalisation and structural adjustment. The previous, social democratic phase of capitalism that had been built after the Second World War had ended in a deep stagflation and oil crisis. From the 1980s, neoliberalism was the response of business leaders and governments around the world.

Central banks hiked interest rates, inducing a deep recession. Governments and employers launched an onslaught on trade unions and wages. The IMF and World Bank forced newly independent countries to sell off land and resources to foreign corporations, cut public spending and worsen labour conditions in response to a debt crisis triggered by the interest rate hikes.

Governments and mass media criminalised migrants, cheapening their labour. And police forces and judiciaries incarcerated working class Black and brown people on a mass scale.

At the same time, Federici was seeing a feminisation of poverty (a widening gap between men and women living in poverty) and a surge in violence against women. In South Africa, Brazil and other places, this included actual witch hunting, often targeting those who fought back against corporate land grabs.

Neoliberal politicians like Ronald Reagan, Margaret Thatcher and Augusto Pinochet, though they had mixed records on abortion, espoused family values: the cis-gendered, heterosexual, patriarchal family model that had been forged centuries previously by Federicis witch hunters.

The parallels with today are too glaring to ignore. What with the climate apocalypse, the 2008 financial crash and its eternal aftermath, the COVID pandemic and now the new stagflation crisis, capitalism has utterly shat the bed. In response, capitalists and states have sought new money-making opportunities, requiring fresh onslaughts in the class war.

Central banks are again hiking interest rates. Corporations are grabbing land in response to the food and climate crises. Governments and firms have launched new attacks on trade unions, new privatisation and austerity drives, and new attacks on migrants. Debt has rocketed and wages are falling at record rates while profits are soaring.

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Capitalism and the crisis of reproduction - Open Democracy

Author Dr. Carole Hooven.

Evolutionary biologist Carole Hooven says that sex is real its biological. Its in your body. Its not in your head. Hooven has served as the co-director of undergraduate studies in Harvard Universitys Department of Human Evolutionary Biology, and she is aware that such statements might be seen as shocking in certain environments. Your bodys plan for gamete production has a lot of implications, but it doesnt dictate anyones value or rights, and it shouldnt in some places, sex is important. Like maybe in sports. Maybe in prison cells. Maybe in the data that we collect about sexual violence, she says.

Hooven believes that it is important to be able to talk about sexual differences in order to make the best decisions, and that it is necessary to include data from scientific research in such discussions. With that in mind, Hooven wrote the book T: The Story of Testosterone, the Hormone that Dominates and Divides Us. In it, she draws on her experience as a professor of human evolutionary biology to analyze studies about the role the hormone plays in sexual differences in both humans and animals; she combines that data with personal stories to support her thesis.

In a video call, the professor says she understands, in part, misgivings about certain claims made in the name of science. There is obviously a history of science being misused as a justification. You know, if I say that I think women have a nurturing instinct that is stronger than in men, maybe some politicians will come out and say, well, then women need to be the ones to stay home with the kids. No, thats not how it works. So, thats the connection I want to break: the link between what is natural and what society should be, she argues. I understand the resistance to just getting the facts out, but the answer to that problem is not to lie to people about reality.

Question. Do you believe that gender roles arise from biological preconditions, that they are not entirely created by culture?

Answer. So, nothing that is as cultural and complex as gender roles is totally social or totally biological. Every culture has something like sex roles. Gender is a complicated term, so for now Im just going to say sex roles. So, standards and norms of behavior for males and females, every culture has them. And there are some very strong and consistent norms across cultures that also are consistent with what we know about biological differences in humans and non-human animals. All cultures have norms about sexual behavior and regulating sexual behavior to some extent, and most incorporate greater latitude for male sexuality than for female sexuality. So, thats something that is fairly consistent across cultures that I think has a strong biological influence.

But culture is extremely important in terms of shaping how sex differences that may have biological roots manifest themselves within a society. There are patterns that are very basic, like those differences in sexual behavior that are never reversed in any culture. Like, theres no culture that I know of where female promiscuity is celebrated and encouraged, and male promiscuity is sometimes punished severely. That just doesnt really exist. And although theres variation in standards for female promiscuity and variation in standards for male promiscuity, you never see that basic pattern reversed.

That was just an example for sexual behavior. But when it comes to aggression and norms for the expression of male and female aggression, there are patterns there that arent reversed either. For example, patterns where female physical aggression is celebrated and rewarded and male physical aggression would be punished. So, I think those very basic patterns are strongly rooted in biology, but the way that theyre expressed and the specific norms in any society are a product of culture. Culture is influenced strongly by biology, and biology is also influenced by culture.

Q. When addressing these issues, some people are afraid that looking for or recognizing differences between the sexes is a way of justifying inequalities.

A. Well, if we find that there is a strong genetic influence on male promiscuity, if thats true, and I think it is true, then does that mean that its okay for men to cheat on their wives? Does that mean that they can never change that behavior? Well, no. But it does mean that theres a reality there that we have to understand and work with so that we can accommodate the reality of male sexuality instead of denying it, as many, many people do. Many feminists in particular seem to be under that misapprehension, or theyre intentionally misconstruing the evidence in order to try to achieve sex equality.

There are a lot of social problems caused by the differences in sexual appetite between the sexes and what that means for relationships, what that means for society, what that means for happiness and thriving. So, the solution, first of all, is to stop denying the facts, because I think this just causes suffering and makes it harder for us to maximize human thriving. So, first of all, one of the facts that we should be teaching and spreading through journalism and education in the classroom is that just because something exists in nature does not mean that its right or good. You know, illness is not good and thats natural. I dont think we should have to show that something is natural in order for it to be good. Just because something is innate does not mean that it is destiny or that individuals dont have any control over their behavior.

Suppose that male aggression, higher rates of physical aggression in males, is due to having a Y chromosome, which ultimately leads to high testosterone, which leads to a higher predisposition for physical aggression. Well, we already know that the environment makes a huge difference. Cultural norms make a huge difference in the extent to which individuals express physical aggression and might get into bar fights or commit murder or rape. We can see that just by looking at different cultural norms in different societies. In some places in the world theres no strong norms against rape and its even encouraged in some places and situations. In others, it is severely punished. So, biology is not destiny.

And if we can recognize those facts about the naturalistic fallacy and the myth of biological destiny, then it makes it easier for us to talk about reality and the changes that we can make socially in terms of policies and laws.

Q. In the book you talk about a fundamental difference between men and women, and between males and females in other mammals. The former continuously produces many small and, to some extent, cheap reproductive cells (sperm), and the latter produces large cells (eggs), which are much scarcer. This means that throughout history the two sexes have had different incentives with respect to their behavior and that has caused tension between the coexistence of the two.

A. If youre not an evolutionary biologist, its difficult to historically appreciate the depth of over a billion years of sexual reproduction, and this has become elaborated and elaborated and elaborated on as behavior. So, when were looking at mammals who bear the time and energetic costs of internal fertilization, you know, its not like fish or frogs or something. Its that we not only have internal fertilization, internal gestation, and once we actually expel the offspring to the outside world its almost like its still in us because were still growing it with our bodies, you know, breastfeeding. This is a tremendously impactful imbalance in reproductive investment.

So, the way we live now is weird, just bizarre from an evolutionary point of view. Were kind of freed from that energetic burden but our psychology hasnt been completely released from that lifestyle, those needs. Women typically want to have fewer sexual partners for a reason, because each potential conception is a large energetic burden, whereas it isnt for men. So we still retain these differences in reproductive psychology, and sex hormones and the differences in sex hormones really do condition and promote a lot of these differences.

I dont know of any culture in which female promiscuity is celebrated and encouraged and male promiscuity is severely punished

These differences are not just limited to sex and aggression. As it turns out, there are differences in professional interests. Women are more likely to go into helping, nurturing professions, and men are more likely to go into professions that involve more risk and risk-taking. Physical risk-taking is one of these sex differences because it could shorten a mans life relative to not taking those risks. If taking risks has strong reproductive payoffs, that can outweigh the costs or the risks of dying, basically. So, for men, physical risks have reproductive payoffs, but thats not necessarily true for females who need to live a long, healthy life to maximize their reproduction.

So yeah, there are these differences. The evidence for hormonal contributions to these differences is not as strong as the evidence of hormonal contributions to sexual behavior and physically aggressive behavior. I think culture does play a strong role there, but its hard to know because we have these sex roles where those kinds of differences are reinforced culturally. So we cant really know how much is biological, how much is cultural. We know that there is a strong interaction there. But my personal view is that striving for equality of outcome meaning we have equal levels of men and women across different professions seems totally misguided to me, because I do think there are differences in preferences. And I think what we should strive for is equality of opportunity and equality of pay. It would be great if teaching and caregiving, say, nursing, paid more than they do because these are more female-typical professions. But males are involved in professions that are pretty brutal in terms of their physical demands, and they deserve to be compensated for that too.

Q. But changes in an ecosystem change the biology of the animals that live in it. In an environment where theres less need for aggression to get ahead or to mate, would testosterone levels also drop?

A. Its hard to gather really good data [on testosterone, aggression and cultural differences]. Say we compare people in Europe with people in Japan. We know that there are testosterone differences that vary with ethnicity. And that has to do with something called a polymorphism that exists in the gene codes for the testosterone receptor. So there are differences genetically in the testosterone receptor that make it more or less responsive to testosterone. So you can take two guys who have the same level of testosterone. They can be of different ethnicities or not. But if you just look at the length of this CAG repeat in the gene, people who have longer CAG repeats have less active androgen receptors, and people who have shorter repeats have more active androgen receptors. So, for the same amount of testosterone, you could have very different effects individually.

There are studies showing that men in East Africa who live as hunter gatherers, the cultural norm is for [those] men to be very involved with their kids, to have lots of physical interaction in terms of carrying and feeding them, playing with them; fatherhood is really valued. And in those men, testosterone levels are lower, and they go down when the babies come. So, this is something that characterizes fathers everywhere in humans and in only less than 5% of mammals do we see male paternal investment where the fathers actually stick around and help to take care of their offspring. So, this is the case in humans, but it depends, of course, on the environment. And in environments where males do provide for their offspring, the offspring are more likely to survive, and the mens testosterone tends to decline. That is a product of the culture. Thats because the cultural norm is for men to invest in their offspring. Theres another African group where men do not invest in their offspring, its kind of a warrior culture. Those men have babies and are in the same ecological environment, but their behavior is different. Theyre not investing in their offspring in terms of actual interaction with them. So, in those men, we do not see a decline in testosterone.

Cultural norms can shift. Testosterone can reduce testosterone. And we do see this consistently in men all over the world who are highly involved with their kids, especially when theyre little. But I cannot really say that we have evidence that any cultural norm has changed a level of aggression. You know, we can attribute a change in testosterone to a reduction in aggression. Im not sure I could say that it is lower testosterone in any culture that is then also causally related to low aggression and relatively low aggression in that culture. But it could be. I think that could definitely be.

In environments where men take care of their children, the offspring are more likely to survive and mens testosterone levels tend to drop

Q. In the book you talk about differences between gay and lesbian behavior. Could this have to do with the way men and women are brought up, regardless of whether they are gay or straight, or can it be explained by biological differences to some extent?

A. Homosexual men have way more sex and way more sex partners than lesbians. Its a fact. Its a pattern. Everybody knows this is true, its totally fine. Theres no, like, moral judgment here. This is an observation. But the reason that gay men are having more sex is because they can. And because of testosterone. We know from studies on people who transition from one sex to another, or from one sex role to another, females who take male levels of testosterone as part of a gender transition report, pretty much across the board, with some variation obviously, but on average, the sense that a female gets when she takes male levels of testosterone is, whoa, this is the way that males go through the world. They start really obsessing about body parts, for one thing. This is somewhat consistent with the literature. So if you look at the scientific literature, its clear that sex drive is one of the strongest psychological responses from taking testosterone, that it really cranks up when you go from living as a woman to living as a man and take male-typical levels of testosterone. And Ive had many conversations now with trans men and trans women, as I did in the book. Its sort of mind-blowing for a female to start living as a male with high testosterone and to feel how strong the sexual urges are.

Not only does the libido really shoot up, but the nature of sexual attraction changes. And again, this isnt true for everyone, but many females who transition into living as males also feel this reduction in the requirement for emotional intimacy before sex. And there is that increased attention to the body and an increased attraction to the body as a sexual object, as opposed to the sense that sex and sexual attraction are about a whole human being. So this is something that actually happens: sexual objectification sort of rises with testosterone.

And we see the same thing happen in the other direction when males transition and start living as females: we see a reduction in their sex drive, which many trans women say is a relief. And its not that theyre not horny. Its not that they dont get pleasure from sex. Its just that its not the same intense drive that it was when their testosterone was high.

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Carole Hooven: Its obvious that men are much more driven by sex than women - EL PAS USA

The Human Rights Council this afternoon held its annual discussion on the integration of a gender perspective, focusing on overcoming gender-based barriers to freedom of opinion and expression. It also continued its general debate under agenda item four on human rights situations that require the Councils attention.

Introducing the annual discussion, Peggy Hicks, Director of the Thematic Engagement, Special Procedures and Right to Development Division of the Office of the High Commissioner for Human Rights, said freedom of opinion and expression was essential for the protection of every human right; the realisation of achieving this right was essential for achieving gender equality. There were new and growing threats to women and girls who spoke out in defence of their rights. Gender equality needed to be achieved. Measures to achieve this should include eliminating repressive legislation, adopting special measures for social protection, and including womens rights in school education.

Irene Khan, Special Rapporteur on freedom of opinion and expression, said the Internet had become the new battleground in the struggle for women's rights, amplifying the opportunities for women to access information and express themselves, but also creating new risks of repression and inequality. There was a clear link between the root causes of gender inequality, and the persistence of gendered censorship. Governments must abolish laws, policies, and practices of gendered censorship, and be more proactive in dismantling the structural and systemic roots of gender discrimination.

Mariana Duarte, Programme Officer, Gender Partnership Programme, Inter-Parliamentary Union, said that the main gender-based barrier observed by the Inter-Parliamentary Union on freedom of opinion and expression for women in politics was gendered violence. This violence was directed at women as a group, and aimed to eject them from the political arena. Eliminating gender-based violence in politics was essential for women to exercise their right to freedom of opinion and expression. It was also a guarantee for the effectiveness of parliament, for genuine democracy and for gender equality in society.

Julie Posetti, International Centre for Journalists, said gender-based online violence against journalists was one of the most serious contemporary threats to press freedom and the safety of women journalists internationally. It aided and abetted impunity for crimes against journalists, including physical assault and murder. It was designed to silence, humiliate, and discredit. The Human Rights Council could contribute to raising awareness of violence against women journalists by, among other points, ensuring that mechanisms and protocols to defend the safety of journalists and end impunity explicitly addressed violence against women journalists.

Mitzi Jonelle Tan, Convenor and International Spokesperson, Youth Advocates for Climate Action Philippines, said across the world the dangers against environmental defenders and activists were rising. Young girls, especially those most economically marginalised, who were ghting for human rights and climate justice were often belittled, pushed aside, and tokenised. Sexual violence was also used to silence women defenders, much of which was underreported. There should be more stringent rules on protecting human rights abuses against women.

In the ensuing discussion, speakers said overcoming gender-based barriers to freedom of opinion and expression could be extremely challenging, as these barriers were often rooted in social attitudes, cultural norms and patriarchal values, besides being imposed or integrated in discriminatory laws, policies and practices. Moreover, some harmful, implicit social norms often constituted root causes for gender-based discrimination and for undermining womens and girls rights, including freedom of opinion and expression, both online and offline. The international community needed to invest more to ensure that girls and young women could openly form their opinions in all spheres of public domain, including within this Council and other United Nations fora.

Speaking in the annual discussion were the European Union on behalf of a group of countries, Lithuania on behalf of a group of countries, Chile on behalf of a group of countries, Slovenia on behalf of a group of countries, Bahamas on behalf of a group of countries, Netherlands on behalf of a group of countries, Belgium on behalf of a group of countries, Australia on behalf of a group of countries, Israel, Egypt, International Development Law Organization, Timor-Leste on behalf of the Portuguese language countries, Ecuador, Luxembourg, Republic of Korea, Ireland, France, United Nations Childrens Fund, Colombia, United Nations Women, Afghanistan, Cyprus, and United States.

Also speaking were the Federation for Women and Family Planning, CHOICE for Youth and Sexuality, Centro de Estudios Legales y Sociales Asociacin Civil, Indonesia, Plan International Inc, Stitching Global Human Rights Defense, and Asia-Pacific Resource and Research Centre for Women.

In the general debate on agenda item four, some speakers said accountability must be ensured for all violations of the rights of indigenous and minority peoples. Violence against human rights defenders must also come to an end. The High Commissioner had a mandate to report on violations of human rights and to oversee progress made. Upholding the rights to freedom of assembly and of peaceful expression was crucial for the protection of human rights. Human rights were indivisible and all inherent to the dignity of the human person, whether economic, social and cultural rights or civil and political rights, and required the equal treatment and observation of the Council. There was a wide repression of womens rights, with an erosion of their rights to be seen in many areas of the world, with a rise in gender apartheid, which required collective action against institutionalised discrimination. The Council should ensure utmost transparency when dealing with human rights matters and that the principles of the United Nations Charter were fully respected.

Speaking in the general debate were Iceland, Israel, Bahrain, Ireland, Russia Federation, Australia, Afghanistan, Austria, Cyprus, Norway, Lichtenstein, Estonia, South Sudan, Denmark, Azerbaijan, Canada, Uruguay, Belgium, Kenya, Sweden, Georgia, Democratic Peoples Republic of Korea, Burundi, Kyrgyzstan, Barbados, Spain, Syria, Switzerland, Trinidad and Tobago, Iran, Nicaragua, Cambodia, Belarus, Algeria, Sri Lanka, Viet Nam and Egypt.

The webcast of the Human Rights Council meetings can be found here. All meeting summaries can be found here. Documents and reports related to the Human Rights Councils fifty-first regular session can be found here.

The next meeting of the Council will be at 10 a.m. on Tuesday, 27 September when it will hold a panel discussion on the right to work in connection with climate change actions, followed by the continuation of the general debate under agenda item four.

General Debate on Human Rights Situations that Require the Councils Attention

The general debate on agenda item four on human rights situations that require the Councils attention started in the previous meeting and a summary can be found here.

Discussion

Some speakers said accountability must be ensured for all violations of the rights of indigenous and minority peoples. Violence against human rights defenders must also come to an end. The shrinking of civic space in many parts of the world was of grave concern. The High Commissioner had a mandate to report on violations of human rights and to oversee progress made. Upholding the rights to freedom of assembly and of peaceful expression was crucial for the protection of human rights. Human rights were indivisible and all inherent to the dignity of the human person, whether economic, social and cultural rights or civil and political rights, and required the equal treatment and observation of the Council.

There was a wide repression of womens rights, with an erosion of their rights seen in many areas of the world, with a rise in gender apartheid, which required collective action against institutionalised discrimination. The response of the Human Rights Council and the Special Procedures could be further strengthened, commensurate to the situation on the ground, some speakers said. It was important to hold the perpetrators of gender-based violence to account. Countries that respected womens rights were generally more peaceful, with a more stable economy, and should therefore work to respect womens independence and protect their rights to a greater extent. Denying girls access to education impeded their social and economic development.

Human rights were a prerequisite for sustainable development, and human rights issues ought to be dealt with on the global stage through technical cooperation and assistance on the request of the country concerned, so that human rights projects could be supported, in full respect of the sovereignty of all countries, bearing in mind the cultural and historical specificities of each State, a speaker said. There should be greater international cooperation. The world was witnessing human rights violations and violations of fundamental freedoms, and a greater dialogue, including civil society, should be built throughout the world, ensuring States priorities were respected. One speaker said the inconsistent application of human rights standards was harmful to the agenda of the Council, which should engage in dialogue on contentious issues, in a balanced manner, as it sought to promote and protect human rights around the world.

One speaker said item four on human rights situations that required the Councils attention was one of the most divisive items on the agenda, as it was not always carried out in line with the principles and values that should lead the Council. The principles of impartiality and non-selectivity should be maintained. The Council was founded on the conviction that the promotion and protection of human rights throughout the world should be carried out through dialogue and with the participation of the country concerned, and this would serve the interests of the international community. The Council should ensure utmost transparency when dealing with human rights matters and that the principles of the United Nations Charter were fully respected. The independence and sovereign integrity of States were the fundamental norms governing international cooperation. One speaker expressed concern that the Council could be used to investigate matters that had not been confirmed or even authenticated.

A speaker said that while it was the weighty responsibility and sacred duty of the international community to intervene in situations of egregious violations of human rights, which had been corroborated by appropriate bodies following the requisite investigations, the untrammelled ability of individual States to conduct their internal affairs independently must not be proscribed, as it was counterproductive to the promotion and protection of human rights, and only increased polarisation among the Member States of the Council. Environments conducive to the fullest enjoyment of the rights of citizens of a country would be engendered with the cooperation of the international community through non-interference in the internal administration of the affairs of that country, and no State should impose its norms and standards upon others.

The global food security crisis and its concomitant impact on human rights was of concern to many speakers. Governments should ensure accountability and maintain stable peace. Violations of human rights and fundamental freedoms occurred in too many countries, and too many Governments used disinformation to hide their actions from the world at large: media freedom and reporting were essential to combat disinformation.

Annual Discussion on the Integration of a Gender Perspective Throughout the Work of the Human Rights Council, Focusing on Overcoming Gender-Based Barriers to Freedom of Opinion and Expression

Opening Statement

PEGGY HICKS, Director of the Thematic Engagement, Special Procedures and Right to Development Division of the Office of the High Commissioner for Human Rights , said freedom of opinion and expression was essential for the protection of every human right; the realisation of achieving this right was essential for achieving gender equality. Movements such as Me Too had swept the globe, with women taking a public stance against the sexual violence against women and girls both online and offline. Women played a crucial role in fighting systemic racial discrimination. Today, as the struggle for gender equality continued, there were new and growing threats to women and girls who spoke out in defence of their rights. Gender stereotypes and the patriarchal structure continued to keep women into lesser and submissive roles. There were many ways in which women were silenced and excluded from the public and private spaces, including repressive and discriminatory legislation, policies and practices, and religious and cultural norms which fuelled the violations of rights. Too often attacks against women were amplified and encouraged by public figures, with those engaging the attacks rarely being held accountable.

Ms. Hicks said that the digital world still offered immense possibilities of engagement and ability to drive social change, however, it was increasingly better known for the offline world where women were subject to misogynistic attacks. There had been a five per cent increase in the number of women human rights defenders and journalists who had been killed in 2021. These attacks were exacerbated for women subjected to intersecting discrimination. Barriers contributed to the progressive exclusion of women and girls from the public sphere; this urgently needed to change. Gender equality needed to be achieved. Measures to achieve this should include eliminating repressive legislation, adopting special measures for social protection, and including womens rights in school education. It was crucial to create an enabling environment for civil society to ensure advances in achieving womens human rights were upheld. The Human Rights Council had drawn attention to the violations and risks and had made recommendations to address these. The Council had an essential role to play in addressing gender-based barriers and ensuring all could contribute to society regardless of their gender.

Statements by the Panellists

IRENE KHAN, Special Rapporteur on freedom of opinion and expression , said her first thematic report had found that while there had been achievements on gender equality, expression was not free for many women and girls. The Internet had become the new battleground in the struggle for women's rights, amplifying the opportunities for women to access information and express themselves, but also creating new risks of repression and inequality. Gendered censorship was pervasive, and the monitoring, censoring, and criminalisation of women's social behaviour by States was concerning. Under the guise of protecting public morals, as seen recently in the case of Mahsa Amini, a young Kurdish woman in Iran, it could lead to serious violations of human rights, with tragic consequences. Women also played a disproportionate price for speaking out, with sexual and gender-based violence used as a weapon to silence women. While all women faced such threats, female politicians, journalists, human rights defenders, and feminist activists were particularly targeted. Unequal access to information and the Internet were major impediments to women's empowerment. Only about half of all women worldwide had access to the Internet, and that figure fell dramatically in the poorer and more remote locations of the world. Information of particular interest to women, such as data on workplace inequalities or on sexual and reproductive health, were often unavailable, outdated, or blocked.

Ms. Khan said there was a clear link between the root causes of gender inequality, and the persistence of gendered censorship. Governments must abolish laws, policies, and practices of gendered censorship, and be more proactive in dismantling the structural and systemic roots of gender discrimination. Social media platforms played a vital role in women's empowerment by enabling them to communicate, advocate, organise and access information. States must not use efforts to eradicate online violence, gendered hate speech and disinformation as a pretext to restrict freedom of expression. There could be no trade-off between women's right to be free from violence and the right to freedom of opinion and expression. The report recommended a threefold approach to avoid a trade-off, including a gender-sensitive interpretation of the right to freedom; an internationally accepted standard on what constituted online gender-based violence, hate speech and disinformation; and a calibrated approach to ensure that responses by States and companies were aligned with the level of harm. Ms. Khan encouraged the Office of the High Commissioner to explore these issues through multi-stakeholder consultations.

MARIANA DUARTE, Programme Officer, Gender Partnership Programme, Inter-Parliamentary Union , said that the main gender-based barrier observed by the Inter-Parliamentary Union on freedom of opinion and expression for women in politics was gendered violence. This violence was directed at women as a group, and aimed to eject them from the political arena. Three studies had been conducted, which highlighted percentages of psychological violence against women parliamentarians (over 80 per cent). The most common manifestation of psychological violence was sexist attitudes and remarks aiming to ignore or degrade women in politics, or to judge their physical appearance. Other emblematic examples of psychological violence included threats of death, rape, beating or abduction. The levels of such threats ranged from 42 per cent in Africa to 47 per cent in Europe. Online sexist attacks were also highly prevalent according to the three studies, especially in Europe, where 58 per cent of respondents had experienced such attacks. The studies also brought to light how multiple and intersecting forms of discrimination such as age, disability, minority group status, and marital status could lead to an exponential increase in gender-based violence against certain women parliamentarians.

Violence against women in politics required greater accountability and an urgent coordinated response from key actors at international and national levels.

Ms. Durante highlighted the importance of using existing international human rights mechanisms for addressing violence against women in politics. United Nations

mechanisms such as Special Procedures and treaty bodies could serve as important avenues for addressing individual cases. Women needed to be encouraged to use such mechanisms, and more must be done to open human rights mechanisms to cases of violence against women in politics. National reports under the fourth Universal Periodic Review cycle starting in November 2022 were due to focus more strongly on the role of parliaments in the promotion and protection of human rights.

This offered a unique opportunity for reporting States to provide information on the obstacles women faced to take part in politics without fear of reprisals, and what was being done, to address those challenges. Ms. Durante said that eliminating gender-based violence in politics was essential for women to exercise their right to freedom of opinion and expression. It was also a guarantee for the effectiveness of parliament, for genuine democracy and for gender equality in society.

JULIE POSETTI, International Centre for Journalists , said gender-based online violence against journalists was one of the most serious contemporary threats to press freedom and the safety of women journalists internationally. It aided and abetted impunity for crimes against journalists, including physical assault and murder. It was designed to silence, humiliate, and discredit. Additionally, there was a dangerous trend that correlated online violence with offline attacks, harassment and abuse. Targeted online attacks on women journalists were also increasingly networked, sophisticated, and at times State-linked.

While States were the main duty-bearers regarding the protection of journalists, with a responsibility to legislate accordingly and ensure law enforcement agencies responded appropriately, a number of governments stood accused of not only failing to fulfil their responsibility to protect women journalists, but of being actively part of the crisis endangering them. In many countries, individual political actors and parties had been identified as perpetrators, instigators and amplifiers of online violence targeting women journalists.

The Human Rights Council and its mechanisms could contribute to raising awareness of violence against women journalists by, among other points, ensuring that mechanisms and protocols to defend the safety of journalists and end impunity explicitly addressed violence against women journalists (online and offline), including the United Nations Plan of Action on the Safety of Journalists currently under review. The Council and its mechanisms could also consider a United Nations-level conduit to channel complaints against State actors engaged in targeted online violence campaigns, and social media companies which facilitated attacks on women journalists with impunity.

MITZI JONELLE TAN, Convenor and International Spokesperson, Youth Advocates for Climate Action Philippines , said across the world the dangers affecting environmental defenders and activists were rising. Existing socio-economic crises at hand led to young girls being more afraid to speak up. The lack of access to quality education added to the fear caused by societal prejudice and discrimination. Everyone should have proper access to education if there were to be solutions to the climate crisis that were led by the most marginalised and those most impacted. Young girls, especially those most economically marginalised, who were ghting for human rights and climate justice were often belittled, pushed aside, and tokenised at best, becoming a photo opportunity for world leaders and policymakers instead of actually listening to their demands for equity, and at worst being physically harassed and silenced. Sexual violence was also used to silence women defenders, much of which was underreported.

Across the world, States and human rights councils needed to actively consult women, and not just women from a certain class but those from the most marginalised classes. Marginalised women needed to be empowered with education and information, and given space in order to be active members of society, so girls education must be a priority. There should be more stringent rules on protecting human rights abuses against women, especially because in times of distress which the climate crisis would exacerbate, women and children were more prone to harassment and violence. The ght for climate justice included gender justice; it included the ght for womens liberation.

Discussion

In the ensuing discussion, a number of speakers said overcoming gender-based barriers to freedom of opinion and expression could be extremely challenging, as these barriers were often rooted in social attitudes, cultural norms and patriarchal values, besides being imposed or integrated in discriminatory laws, policies and practices. Moreover, some harmful, implicit social norms often constituted root causes for gender-based discrimination and for undermining womens and girls rights, including freedom of opinion and expression, both online and offline. It was therefore crucial to break the cycle of reproduction of gender stereotypes which ultimately impacted entire societies. Restrictions to freedom of opinion and expression could have wider impacts on human rights, and where women and girls were hindered in their expression, all were deprived of their valuable opinions. Sexual and gender-based violence, including abuse and harassment through digital technologies, was often used as a deliberate tactic to silence women and girls.

Despite the impressive and inspirational gains made by women and girls, as well as people with diverse gender identities, expression and opinion were still not equally free and protected for all persons. Currently many women and girls from diverse backgrounds faced endemic discrimination, and it was essential to establish good practice norms in the Council that aimed at the full eradication of gender-based discrimination. The Council had a mandate to ensure that this was a principle for all, ensuring the respect and guarantee of human rights for all. It was also vital to take an inclusive approach and engage men and boys when taking measures to address the safety of all journalists and other media workers. This was particularly important to effectively tackle gender-based violence, discrimination, abuse and harassment, including sexual harassment, threats and intimidation, as well as inequality, negative social norms and gender-stereotypes.

Cultural norms, gender stereotypes and ensuing discrimination online and offline continued to suppress, censor and mute the voices of women and girls. Unfortunately, women activists, politicians, human rights defenders, journalists and media workers were disproportionately targeted by State and non-State actors, including hate speech, bullying and acts of violence. Womens and girls leadership was essential to advancing gender equality. Respect, protection and promotion of the right to freedom of opinion and expression was a powerful tool to confront any form of gender-based discrimination, and lay at the heart of the international legal framework on political and civil rights. The effective exercise of the right of freedom of opinion and expression was essential for the enjoyment of other human rights and constituted a fundamental pillar for democracy. The international community needed to invest more to ensure that girls and young women could openly form their opinions in all spheres of public domain, including within this Council and other United Nations fora.

Concluding Remarks

MARIANA DUARTE, Programme Officer, Gender Partnership Programme, Inter-Parliamentary Union , said that violence against women politicians did not happen in a vacuum. By assuming a position of power, women were defying patriarchal norms and were particularly at risk. Many of the root causes were related to gender-based violence against women. A sound legal framework free from discrimination against women was required, as well as specific provisions in the law against violence against women in politics. It was important to educate men and boys from an early age. It was vital to understand and acknowledge the problem to address the issue. Perpetrators committing violence against female parliamentarians came from everywhere; their families, their party, or members of their staff. The more women there were in parliament, the more it would be accepted that they belonged where they were. If women in parliament were no longer a minority, they would be stronger. It was also important to have an institutional commitment to protect women in parliament.

JULIE POSETTI, Global Director of Research at the International Centre for Journalists , said impunity for crimes against journalists was a concerning issue; women journalists were targeted online, and were being threatened with cases of journalists who had been murdered with impunity within their own countries. Gender disinformation and gendered hate speech were key issues. These could be combatted by addressing the root causes, including structural inequality; however, these circumstances were often used to justify inaction. A book would be published in November with a 25-step plan to aid States in their responses to gender-based violence. The United Nations could not stay silent, when despots were targeting women in such ways, there needed to be a reckoning to allow women to be defended.

MITZI JONELLE TAN, Convenor and International Spokesperson, Youth Advocates for Climate Action Philippines , said gender injustices were still rising. It was not enough to have women lead - States had to go to the most marginalised lesbian, gay, bisexual, transgender and queer persons and women. States must play a role in the empowerment of lesbian, gay, bisexual, transgender and queer persons and women. Gender injustice could not be discussed in a vacuum - it had to be looked at in the context of all those who were discriminated against. Young people needed to be educated at a young age in gender injustice. Everything heard today was appreciated, but work needed to be done.

Lesbian, gay, bisexual, transgender and queer persons and young women were becoming ever more vulnerable to climate injustice. In every aspect of work, gender injustice needed to be discussed - it had to penetrate every aspect. It could not be seen just as being perpetrated by outside forces. In some countries the threats to women were not just threats to expression or opinion, but also to their rights to exist. Human rights defenders were often at the forefront of this, threatened sexually, and their families being turned away from them. These panels could not be the end - the system that was being created should not just empower women, but all people across all forms of life. Women needed to not just feel protected, but actually be safe, and to do this, there had to be a holistic approach, from communities, and in all aspects of work.

Link: https://www.ungeneva.org/en/news-media/meeting-summary/2022/09/afternoon-human-rights-council-holds-annual-discussion

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Human Rights Council Holds Annual Discussion on the Integration of the Gender Perspective, Focusing on Overcoming Gender-Based Barriers to Freedom of...

Two recently published papers have described experiments in which mouse embryo models were developed from pluripotent stem cells. Mina Popovic and Susana Chuva de Sousa Lopes from ESHREs SIG Stem Cells report.

Two research groups have recently achieved the unthinkable, demonstrating that mouse embryo models derived from stem cells have the potential to develop from pre-gastrulation until early organogenesis in vitro. (1,). The mouse embryo-like structures in these experiments were grown until the equivalent of embryonic day (E)8.5 (a third of a mouse pregnancy). Although many showed clear morphological abnormalities, some structures contained a beating heart, a brain rudiment with fore- and midbrain, patterned neural and gut tubes, migrating primordial germ cell-like cells and progenitors of other organs. Remarkably, they also developed extra-embryonic structures, such as an umbilical cord, amnion and yolk sac that formed blood islands all without the need for maternal tissues.

Over the past years, a flurry of studies have demonstrated the remarkable ability of (mouse and human) pluripotent stem cells to self-assemble into organised embryo-like structures in vitro.(3,4) While traditional developmental biology has been limited by the availability of natural (fertilised) embryos for research, this enhanced stem cell toolkit has enabled several aspects of mammalian peri-implantation development to be captured in vitro. Accordingly, blastoids have recapitulated the blastocyst, gastruloids model features of axis development and gastrulation, while various other embryoids mimic aspects of epiblast, trophoblast and (pro)amniotic cavity formation. Yet, up until now, none of these models have been able to demonstrate the full developmental potential of natural embryos.

Now, these two independent studies, published in Cell and Nature, have applied similar technologies to generate and culture stem cell-based embryo-like structures, demonstrating their self-organising capacity and unprecedented developmental potential. To generate these structures, the group of Magdalena Zernicka Goetz combined mouse embryonic stem cells (mESCs) with trophoblast stem cells, and extraembryonic endoderm-like cells, using methods previously pioneered by their own group.(5,6) The second group, led by Jacob Hanna, started solely from mESCs, yet some were made to transiently overexpress master regulatory transcription factors to induce both the trophoblast and extra-embryonic endoderm lineage. The aggregated stem cells first assembled into egg-cylinders and then further progressed into complete mouse embryo-like structures.

To maintain the embryo-like structures in culture, both groups used a platform for extended ex-utero culture of natural embryos from E5 to E11, previously optimised by Hannas team.(7) In this system, mouse embryos are cultured in glass vials rotating on a drum in the presence of rat (or human) blood serum, with an electronic ventilation system regulating gas and pressure.(8) Following extended culture on the rolling platform, the mouse embryo-like structures showed notable similarities to their natural E8.5 counterparts grown either in utero or ex-utero. Remarkably, they increased in complexity over time towards the formation of differentiated organ primordia. However, unlike natural embryos that can be cultured up to E11 using this system, the embryo-like structures could only reach the morphology of an E8.5 embryo. It remains unknown whether these differences are a result of the stem cell aggregation protocols or varying culture requirements.

Certainly, further optimisation of the technology will be necessary. A large proportion of the embryo-like structures developed abnormally, exhibiting a variety of abnormalities during ex-utero culture, including the complete lack of body segments. Of the normal egg-cylinder-shaped embryo-like structures at E5, only around 2% developed to E8.5, yielding an effective 0.1%0.5% efficiency from the total initial aggregates generated. These results were similar across both studies.

Heterogeneity during the formation of embryo-like structures also remains a challenge. Efficiency varied substantially between mESC lines, with some lines not able to generate embryo-like structures beyond E6.

Although further work is necessary to improve efficiency and reproducibility, mouse embryo-like models do hold some advantages over natural embryos. Primarily, they are more amenable to genetic modifications and may provide a powerful in vitro system for elucidating the diverse roles of genes during early organogenesis. This may ultimately reduce the need for experimental animals and natural embryos for research. Evaluating developmental pathways in greater detail than ever before could also enhance the efficiency and control of stem cell differentiation protocols for regenerative medicine.

To demonstrate the functionality of their model, the team of Zernicka-Goetz knocked-out Pax6 (a key gene involved in neural tube patterning, brain and eye development) in the embryo-like structures. Markedly, neural tube development was compromised in the structures lacking Pax6, which is consistent with natural embryos missing this gene.

Accordingly, the future development of similar embryo-like models in human may provide insights into longevity, (in)fertility and developmental diseases. Beyond basic research, Jacob Hanna is hopeful that this method may provide a source of new organs and tissues for human transplantation biotechnology. Yet, their use for reproductive purposes is not and should not be considered, especially since the embryo-like structures are in fact genetic clones of the donor stem cells used for their formation.

Nevertheless, translating this system from mouse to human will not be straightforward. Reaching these same stages of organogenesis in the human would correspond to a first-trimester fetus, a path undoubtedly fraught with technical as well as ethical concerns. In practice, capturing the length of human gestation, sheer size of human organ primordia and complexity of these developmental milestones, will certainly be an immense challenge. At present, the possibility of culturing human embryo-like structures beyond gastrulation, particularly in the absence of key maternal cellular constituents and proper implantation assays, remains unknown.

Concurrent to scientific innovation, continued ethical reflection and societal debate remain imperative. Given their benefits for research, it is reasonable to assume that the quality and developmental potential of human embryo-like structures will gradually improve. Moving forward, considering the extent to which the use of these models raises moral concerns characteristic of human embryo research will be essential. At present, it is unclear whether human embryo-like structures which mimic the intact human embryo show developmental potency beyond gastrulation because of a lack of adequate culture platforms and the 14 day rule, which prohibits in vitro culture of human embryos beyond 14 days. Last year, the International Society for Stem Cell Research recommended relaxing this standard.(9) However, any proposal for the culture of natural embryos or stem cell-based embryo models that mimic the intact human embryo beyond the current 14 day limit must gain broad public support and would require changes in national legislation.

Nonetheless, with the field of developmental biology brimming with continued efforts to refine embryo models, the stem cell toolbox is becoming increasingly valuable. We do anticipate that stem cell-based embryo-like structures will enhance the roadmap for studying early development, offering novel opportunities for exploring the early days of development in real-time and in unprecedented detail.

1. Tarazi S, Aguilera-Castrejon A, Joubran C, et al. Post-gastrulation synthetic embryos generated ex utero from mouse naive ESCs. Cell 2022; 185: 3290-3306.e25. doi.org/10.1016/j.cell.2022.07.0282. Amadei G, Handford CE, Qiu C, et al. Synthetic embryos complete gastrulation to neurulation and organogenesis. Nature 2022: doi.org/10.1038/s41586-022-05246-33. Rossant J, Tam PPL. Opportunities and challenges with stem cell-based embryo models. Stem cell reports 2021. doi.org/10.1016/j.stemcr.2021.02.0024. Veenvliet JV, Lenne PF, Turner DA, et al. Sculpting with stem cells: how models of embryo development take shape. Development 2021; 148: dev192914. doi.org/10.1242/dev.1929145. Sozen B, Amadei G, Cox A, et al. Self-assembly of embryonic and two extra-embryonic stem cell types into gastrulating embryo-like structures. Nature Cell Biology 2018; 20: 979-989. doi.org/10.1038/s41556-018-0147-76. Amadei G, Lau KYC, De Jonghe J, et al. Inducible stem-cell-derived embryos capture mouse morphogenetic events in vitro. Dev Cell 2021; 56: 366-382.e9. doi.org/10.1016/j.devcel.2020.12.0047. Aguilera-Castrejon A, Oldak B, Shani T, et al. Ex utero mouse embryogenesis from pre-gastrulation to late organogenesis. Nature. 2021;593(7857):119-124. doi.org/10.1038/s41586-021-03416-38. Tam PP, Snow MH. The in vitro culture of primitive-streak-stage mouse embryos. J Embryol Exp Morphol. 1980;59:131-143.9. See https://www.focusonreproduction.eu/article/News-in-Reproduction-Embryo-research

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No eggs, no sperm, no uterus: extending the boundaries of mammalian development in vitro - ESHRE