Are boys and girls really that different? Twenty years ago, doctors and researchers didn't think so. Back then, most experts believed that differences in how girls and boys behave are mainly due to differences in how they were treated by their parents, teachers, and friends. It's hard to cling to that belief today. An avalanche of research over the past twenty years has shown that sex differences are more significant and profound than anybody guessed. Sex differences are real, biologically programmed, and important to how children are raised, disciplined, and educated. InWhy Gender Matters, psychologist and family physician Dr. Leonard Sax leads parents through the mystifying world of gender differences by explaining the biologically different ways in which children think, feel, and act. He addresses a host of issues, including discipline, learning, risk taking, aggression, sex, and drugs, and shows how boys and girls react in predictable ways to different situations. For example, girls are born with more sensitive hearing than boys, and those differences increase as kids grow up. So when a grown man speaks to a girl in what he thinks is a normal voice, she may hear it as yelling. Conversely, boys who appear to be inattentive in class may just be sitting too far away to hear the teacherespecially if the teacher is female. Likewise, negative emotions are seated in an ancient structure of the brain called the amygdala. Girls develop an early connection between this area and the cerebral cortex, enabling them to talk about their feelings. In boys these links develop later. So if you ask a troubled adolescent boy to tell you what his feelings are, he often literally cannot say. Dr. Sax offers fresh approaches to disciplining children, as well as gender-specific ways to help girls and boys avoid drugs and early sexual activity. He wants parents to understand and work with hardwired differences in children, but he also encourages them to push beyond gender-based stereotypes. A leading proponent of single-sex education, Dr. Sax points out specific instances where keeping boys and girls separate in the classroom has yielded striking educational, social, and interpersonal benefits. Despite the view of many educators and experts on child-rearing that sex differences should be ignored or overcome, parents and teachers would do better to recognize, understand, and make use of the biological differences that make a girl a girl, and a boy a boy.

<p><b>LEONARD SAX, M.D</b>., is a pediatrician and a psychologist and the founder of the National Association for Single-Sex Public Education. An independent Washington-area pediatrician with a very large practice, he has won a number of local awards.</p>

One: Differences

1

(10)

Two: Female Brains, Male Brains

11

(28)

Three: Risk

39

(16)

Four: Aggression

55

(22)

Five: School

77

(38)

Six: Sex

115

(25)

Seven: Drugs

140

(24)

Eight: Discipline

164

(39)

Nine: Lesbian, Gay, Bisexual, Transgender, Sissy, and Tomboy

203

(31)

Ten: Beyond Pink and Blue

234

(18)

Extra Material

A Semantic Note on "Sex" and "Gender"

252

(2)

How Feminine Are You?

254

(4)

How Masculine Are You?

258

(4)

Acknowledgments

262

(3)

Source Notes

265

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1

DIFFERENCES

We're entering a new period in science, in which the rewards will come less from the breakthrough investigations of individual scientists than from fitting together the pieces of research to see what it all means . . . Social and biological insights are leaping together, part of a large and complex jigsaw puzzle to which the contributions of many sciences are essential.

--Shelley Taylor, professor of psychology, UCLA, 20021

Matthew turned five years old the summer before kindergarten started. He was looking forward to it. From what he had heard, kindergarten sounded like just one long play date with friends. He could hardly wait. So his mother, Cindy, was surprised when, in October, Matthew started refusing to go to school, refusing even to get dressed in the morning. More than once, Cindy had to dress him, carry him writhing and thrashing into the car, and then drag him from the car into the school. She decided to investigate. She sat in on his kindergarten class. She spoke with the teacher. Everything seemed fine. The teacher—gentle, soft-spoken, and well-educated—reassured Mom that there was no cause for alarm. But Cindy remained concerned, and rightly so, because major problems were just around the corner.

Caitlyn was a shy child and just the slightest bit overweight all through elementary school. In middle school, she underwent a metamorphosis from chubby wallflower to outgoing socialite. She lost weight so quickly that her mother, Jill, worried she might be anorexic. For the next four years, though, everything seemed great—in a frantic and crazy sort of way. Caitlyn was juggling a heavy academic load, had lots of friends, and maintained a full schedule of after-school activities, staying up until midnight or later doing homework. But she seemed happy enough: often frenzied and frazzled, sure, but still happy. Or at least that's what everybody thought until the phone rang at 3 a.m. that awful, unforgettable November night. A nurse told Jill that Caitlyn was in the emergency room, unconscious, having tried to commit suicide with an overdose of Vicodin and Xanax.

These true stories(2) share a grim common element: each kid started out okay, then took a turn in the wrong direction. There is another element in common as well. In both cases the problem arose because the parents did not understand some basic differences between girls and boys. In each case, trouble might have been averted if the parents had known enough about gender differences to recognize what was really happening in their child's life. In each case, the parents could have taken specific action that might have prevented or solved the problem.

We will come back to both of these kids later in this book. Right now it may not be obvious to you how each of these stories illustrates a failure to understand sex differences in child development. That's okay. Later on, we'll hear more about Matthew and Caitlyn. Armed with some basic knowledge about hardwired gender differences, you'll be able to recognize where the parents made the wrong decision or failed to act, and you'll see how the story might have ended differently.

The Dubious Virtue of Gender-Neutral Child-Rearing

I enrolled in the Ph.D. program in psychology at the University of Pennsylvania in September 1980. Governor Ronald Reagan was challenging President Jimmy Carter for the Presidency. The original Apple computer had recently come on the market. "My typewriter is working fine," was the answer the department secretary gave me when I asked her whether she would be getting a word processor anytime soon. Nobody I knew had ever heard of Bill Gates, e-mail, or the Internet. The invention of the World Wide Web still lay ten years in the future.

Among the courses I took that fall was a graduate seminar in developmental psychology. "Why do girls and boys behave differently?" my professor, Justin Aronfreed, asked rhetorically. "Because we expect them to. Imagine a world in which we raised girls to play with tanks and trucks, in which we encouraged boys to play with dolls. Imagine a world in which we played rough-and-tumble games with girls while we cuddled and hugged the boys. In such a world, many of the differences we see in how girls and boys behave—maybe even all the differences—would vanish."

In another seminar my fellow graduate students and I learned about the extraordinary work of Professor John Money at Johns Hopkins. Professor Money had been consulted by the parents of an unfortunate little boy whose penis had literally been sizzled off during a botched circumcision. At Dr. Money's recommendation, the boy had been raised as a girl, with excellent results (according to Dr. Money). The child loved to play dress-up, enjoyed helping Mom in the kitchen, and disdained "boy toys" such as guns or trucks. "Dr. Money's work provides further evidence that most of the differences we observe between girls and boys are socially constructed," professor Henry Gleitman told us. "We reward children who follow the sex roles we create for them while we penalize or at least fail to reward children who don't conform. Parents create and reinforce the differences we observe between girls and boys."

We nodded sagely. In clinical rotations we often encountered parents who still clung to the quaint notion that girls and boys were different from birth. But we knew better.

Or so we thought.

When I left Philadelphia to begin my residency in family practice, I threw out most of the papers I had accumulated during my six years at the University of Pennsylvania. Stacks of photocopied scientific papers had to go out in the trash. But there was one manila folder I didn't throw out, a folder containing a series of studies done by Professor John Corso at Penn State during the 1950s and 1960s, demonstrating that females hear better than males.(3)

Four years later, after I finished my residency, my wife and I established a family practice in Montgomery County, Maryland, just outside of Washington, D.C. Years passed. I wasn't thinking much about gender differences. Then in the mid-1990s, I began to notice a parade of second- and third-grade boys marching into my office, their parents clutching a note from the school. The notes read: "We're concerned that Justin [or Juan or Michael or Tyrone] may have attention deficit disorder. Please evaluate."

In some of these cases I found that what these boys needed wasn't drugs for ADD, but rather a teacher who understood the hardwired differences in how girls and boys learn. Upon further inquiry, I found that nobody at the school was aware of gender differences in the ability to hear. I reread Professor Corso's papers, which documented that boys don't hear as well as girls. In the next chapter we'll look more closely at evidence for gender differences in hearing.

Think about the typical second-grade classroom. Imagine Justin, six years old, sitting at the back of the class. The teacher, a woman, is speaking in a tone of voice that seems about right to her. Justin barely hears her. Instead, he's staring out the window, or watching a fly crawl across the ceiling. The teacher notices that Justin isn't paying attention. Justin is demonstrating a deficit of attention. The teacher may reasonably wonder whether Justin perhaps has attention deficit disorder.

The teacher is absolutely right about Justin showing a deficit of attention. But his attention deficit isn't due to "attention deficit disorder," it's due to the fact that Justin can barely hear the soft-spoken teacher. The teacher is talking in a tone of voice that is comfortable to her and to the girls in the class, but some of the boys are practically falling asleep. In some cases we might be able to fix the problem simply by putting the boy in the front row.

Once, after I had done such an evaluation and made my recommendations, the parents told me that the school had advised them to seek a second opinion. "It's not that we don't trust you, Dr. Sax," Mom said. "It's just that the school really thinks we should get an opinion from an expert."

I soon learned that the only doctors that this particular school considered to be "experts" were doctors who always prescribed medication. Curious to know whether my experience was unique, I obtained funding from the American Academy of Family Physicians to survey all the doctors in the Washington area. Our survey basically asked one simple question: Who first suggests the diagnosis of ADD? The results: in the majority of cases the diagnosis of ADD is made by the teacher. Not by the parents, nor the neighbors, nor the doctor.(4)

There would be nothing wrong with teachers diagnosing their students as long as they had the training—and the resources, and adequate time—to distinguish the boy with ADD from the boy who just doesn't hear as well as most girls do. But after talking to dozens of teachers in our county, I didn't find one who was aware of the studies showing that girls hear better than boys.

"You should write a book, Dr. Sax," one of these parents told me. "Write a book so that teachers know about the differences in how girls and boys hear."

I allowed myself a patronizing smile. "I'm sure that there must already be dozens of such books for teachers, and for parents," I said.

"There aren't," she said.

"I'll find some for you," I said.

That conversation took place about seven years ago. Since then I've read lots of popular books about differences between girls and boys. And guess what. That mom was right.

Not only do most of the books currently in print about girls and boys fail to state the basic facts about innate differences between the sexes, many of them promote a bizarre form of political correctness, suggesting that it is somehow chauvinistic even to hint that any innate differences exist between female and male. A tenured professor at Brown University recently published a book in which she claims that the division of the human race into two sexes, female and male, is an artificial invention of our culture. "Nature really offers us more than two sexes," she claims, adding, "Our current notions of masculinity and femininity are cultural conceits." The decision to "label" a child as a girl or a boy is "a social decision," according to this expert. We should not label any child as being either a girl or a boy, this professor proclaimed. "There is no either/or. Rather, there are shades of difference."(5) This book received courteous mention in the New York Times and the Washington Post. America's most prestigious medical journal, the New England Journal of Medicine, praised the author for her "careful and insightful" approach to gender.(6)

I soon assembled a small library of best-selling books that counsel parents that the best child-rearing is gender-neutral child-rearing. These books tell parents that true virtue is to be found in training your child to play with toys traditionally associated with the opposite sex. You should buy dolls for your son, to teach him how to nurture.(7) You should buy an Erector set for your daughter. The underlying assumptions—that giving dolls to boys will cause boys to become more nurturing, or that giving girls Erector sets will improve girls' spatial relations skills—are never questioned. In fact, no scientific evidence exists to support the claim that gender-neutral child-rearing has any measurable benefit, regardless of which parameter you measure.(8)

On the same bookshelf you can find books that do affirm the existence of innate differences in how girls and boys learn. But what books! Books with titles like The Wonder of Boys and Girls Will Be Girls promote antiquated and inaccurate gender stereotypes. "Girls are more emotional than boys." "Boys have a brain-based advantage when it comes to learning math." As we'll see, those familiar notions turn out to be false.

On one hand, you have books claiming that there are no innate differences between girls and boys, and that anybody who thinks otherwise is a reactionary stuck in the 1950s. On the other, you have books affirming innate differences between girls and boys—but these authors interpret these differences in a manner which reinforces gender stereotypes.
These books have only one thing in common. They are based less on fact, and more on their authors' personal beliefs or political agenda—either to deny innate sex differences, or to use sex differences in child development as a justification for maintaining traditional sex roles.

After waiting a few years for somebody else to write a book about girls and boys based on actual scientific research, I finally decided to write one myself. But I made myself a promise. Every time I make any statement about how girls and boys are different, I will also state the evidence on which my statement is based. Every statement I make about sex differences will be supported by good science published in peer-reviewed journals.

There is more at stake here than the old question of nature versus nurture. The failure to recognize and respect sex differences in child development has done substantial harm over the past thirty years—such will be my claim throughout this book. Children today face challenges that are substantially different from those you faced as a child or teenager, fifteen or twenty or thirty or forty years ago. Look at the statistics on drugs and alcohol, for starters. Teenage girls today are four times more likely to drink than their mothers were. They're fifteen times more likely to use drugs than their mothers were.(9) Traditionally, alcohol abuse has been more of a problem for teenage boys than for teenage girls. Not anymore. In a report published in 2004, the National Research Council reported that young teenage girls are now more likely than boys to be drinking alcohol regularly—not because boys are drinking less, but because girls are drinking more.(10)

If girls have closed the gender gap with regard to alcohol abuse, boys are still more likely to be getting into trouble with drugs. According to FBI statistics, the number of boys under eighteen arrested for drug abuse offenses has increased by more than 50 percent in the past ten years; boys under eighteen are still five times more likely to be arrested for drug abuse violations than are girls under eighteen.(11) In chapter 7, I'll explore how the cultural and professional neglect of sex differences has compounded the drug problem.

But school, not drugs, is the "new" problem for boys. While today's girl is more likely to have problems with drugs and alcohol than her mother was, today's boy is much more likely to be struggling in school than his father was. Boys today are increasingly alienated from school. Recent investigations have shown a dramatic drop over the past twenty years in boys' academic performance in American schools.(12) According to the United States Department of Education, the average eleventh-grade American boy now writes at the same level as the average eighth-grade girl.(13) Similar gender gaps have been documented in the United Kingdom, Australia, New Zealand, and Canada.(14) And the percentage of boys going on to college, and graduating from college, is falling. The U.S. Department of Education now projects that in the year 2011, there will be 140 women graduating from college for every 100 men—very nearly a 60/40 female-to-male ratio.(15)

The future may already have arrived. Several major U.S. colleges and universities, such as New York University and the University of North Carolina, already report that their student body is more than 60 percent female.(16) I'm all in favor of women's colleges, but you have to ask the question: Why are nominally coed schools looking more and more like all-women's colleges? The proportion of boys going on to college is dropping steadily, as is the proportion of young men who are sticking around long enough to graduate. The high school dropout rate in the United States is now close to 30 percent, and the great majority of dropouts are boys.(17) More and more boys, discouraged by years of failure in elementary school, middle school, and high school, are asking: "Why should I stick around for any more of this?" Later in the book we'll hear from teachers who know how to use gender differences to kindle real enthusiasm for learning in both girls and boys.

Still, many educators and policymakers stubbornly cling to the dogma of "social constructionism," the belief that differences between girls and boys derive exclusively from social expectations with no input from biology. Stuck in a mentality that refuses to recognize innate, biologically programmed differences between girls and boys, many administrators and teachers don't fully appreciate that girls and boys enter the classroom with different needs, different abilities, and different goals.

Excerpted from Why Gender Matters: What Parents and Teachers Need to Know about the Emerging Science of Sex Differences by Leonard Sax
All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.