Also from the original post, the issue is that self-identified as homosexual is also left of center but doesn't have the same correlation with Long COVID.
I would guess that self identified homosexual is less lefty than self identified bisexual tbh.
I can never remember which way the Kinsey scale goes, but if 0 is so straight an engineer can reliably use your sexuality to design a bridge, and 10 is so gay that Oscar Wilde rises from his Parisian grave to greet thee...
...then I would guess lefties on average prolly identify as straight if they’re a 0 to maybe 2, bi if they’re maybe 3-8, and gay if they’re 9-10. OTOH I would guess conservatives might be more likely to publicly identify as straight if they’re anywhere in that whole 0-8 range, maybe identify as bisexual around 8, but still identify as gay around 9-10.
That would have the end result of making bisexuality way more left coded than being gay.
I’m not sure the thresholds for conservatives is exactly 8, but I think there is absolutely something here. Compare with “being on the down low” in the black community- whole lot of dudes fucking, and everyone self reports as straight. Ties in nicely with the line above about monosexuality as a culture bound disease
Just a simple question on psychosomatic conditions. Do all, or almost all conditions have some psychosomatic shadow? Short of losing a limb, is there a possibility of psychosomatic responses when diagnosed with any disease?
And is there any way to actually prevent "catching" psychosomatic conditions?
I think all or almost all *symptoms* have a psychosomatic shadow for sure. At the moment I legit can’t think of a single *symptom* that doesn’t.
On the other hand, the significant majority of illnesses (at least the illnesses I work with; I’m a hospitalist) have an empiric foundation that couldn’t possibly be psychosomatic.*
For instance, you can come to the ED with psychosomatic chest pain, but you will not have a psychosomatically elevated troponin, a psychosomatically abnormal nuclear stress test, or a psychosomatically occluded LAD on cardiac cath.
Same goes for just about any significant medical condition.
*Some of the empiric signs could be fabricated by someone with Munchausen’s, but that’s different.
Oh, and re: “catching,” I think it’s super normal to have psychosomatic symptoms, to the point that if someone tells me they never have, I don’t believe them.
Really (I want to ask such people)? You’ve NEVER had butterflies in the stomach before an important event, or started in with a headache/shoulder pain when under a lot of pressure?
That’s just the human condition. It becomes more of an issue when someone is convinced there must be an organic cause, and won’t take no for an answer.
Probably the best inoculation is trying to trust that the medical system, while very imperfect, is still pretty darn good at ruling out anything that’s going to kill you.
Agree with this! And also that you if you find yourself hyperfixating on a minor symptom and noticing it all the time, practice consciously letting go of those thoughts and actively focus your thoughts elsewhere. Focusing thoughts on pain sensations somewhere in the body just leads to hypersensitivity, which leads to more focus in that area, which leads to...
Isn't that broadening the term "psychosomatic" to the point of uselessness? Of course every experience is ultimately in the brain, but suggesting blood vessels in your intestines constricting due to emotional state to make you feel "butterflies in your stomach" is basically the same as delusional parasitosis is absurd.
That’s what the word “psychosomatic” means, though: that the emotional state is the driver of the symptom, rather than an organic issue. As a descriptor it’s not any more meaninglessly broad than “organic.”
And no, I am not conflating butterflies in the stomach with delusional parasitoses. The first is a symptom; the second is a syndrome or disease.
Psychosomatic *symptoms* are possible and even common; only relatively rarely does it rise to the level of syndrome or disease.
"You’ve NEVER had butterflies in the stomach before an important event, or started in with a headache/shoulder pain when under a lot of pressure?"
I actually haven't. I don't feel good when under stress, but it has never manifested as physical pain except for very indirect reasons (e.g. I'm stressed, so I don't pay as much attention, so I cut myself on paper).
If it's not too personal a question, are you neurotypical ? Have you ever had any unexplained symptoms ?
I ask because I used to report the same thing - never felt emotions affected me physically -, then spent months trying to understand why I had violent, I-think-I-might-die stomach pains where the hospital couldn't find anything or help me except by giving me morphine, and eventually realized these were probably panic attacks.
I found it fascinating how much of a disconnect there was (in my mind) between my physical and emtional state, despite there being a very strong connexion in my body.
I'm a high-functioning autistic male in my thirties, and most of my life emotions were a weird thing I didn't experience the way most people do. I wonder to what degree this is linked to that disconnect.
I'm fairly neurotypical, though I might be slightly autistic. I haven't been able to explain every illness (can anyone?), but I rarely have odd unexplained symptoms. For example, I've had diarrhea where I couldn't figure out what food I ate was bad, but that's not very mysterious. I've also had one episode of odd unexplained pains throughout my groin area, which I concluded is likely psychosomatic--but likely not due to stress, because I wasn't stressed at that time.
Why do you think your stomach pains were panic attacks? It's entirely possible to have pains with physical causes that modern medicine (or at least the tests your local hospital chose to perform) cannot yet explain.
Wouldn't that be better addressed by a whole new question? After all just like attraction to various genders asexuality comes in degrees and someone who is quite asexual might still have a view about which gender is less unappealing to them. So ideally you have a two dimensional response of both strength of sexual interest/disinterest and affinity towards various genders.
Ofc if you are very strongly asexual you might not be able to pick any point on the Kinsey scale so maybe there should be an option for that as well.
That implies there should be a Kinsey-scale equivalent for each of the 5 kinds of attraction, which is a concept that I think would generate some very neat data! The traditional Kinsey scale, however, is specifically focused on sexual attraction and not its commonly-confused cousins romantic or aesthetic attraction.
When I went looking this up (because I was sure I'd be unable to answer a Kinsey Scale question until I found out that Kinsey did include a response category for no sexual attraction) I did find that there's a long history of attempting to iterate on the Kinsey Scale and create 2- or even 3-dimensional charts for various elements of sexual attraction, so if this is something you feel strongly about, you might want to investigate the options and suggest something better to Scott!
> Ofc if you are very strongly asexual you might not be able to pick any point on the Kinsey scale so maybe there should be an option for that as well.
This is me; this is why I asked for the "X" option if Scott does include this on the next survey.
The Kinsey scale is absolute garbage. It does not correctly model sexual attraction/repulsion, not the least of which is its inability to distinguish between bisexual, asexual and antisexual that you mentioned.
I appreciate that it doesn't capture all the variation in human sexuality, but I think there is some value in forced response questions with limited options. I mean each of us is unique so if you don't collapse some distinctions when you ask questions you don't get any information.
So, rather than it being garbage, I'd simply argue it's incomplete. Yes, you are correct it doesn't make those distinctions you mention. Ok, so if you want to make those distinctions as well then ask additional questions. Sexuality is a high dimensional space so any single dimensional measure will collapse a lot of things but as far as single dimensional measures go it seems like a decent one.
We just need to keep in mind it's a projection of a multidimensional quantity onto a single basis.
I wrote up a response to last week’s ACX post on “Raise Your Threshold For Accusing People Of Faking Bisexuality”. I walked through Scott Alexander's statistical argument and wrote up a critique of it: "Is Bisexuality a Political Statement?" https://taboo.substack.com/p/is-bisexuality-a-political-statement
My main concern was that the post failed to take into account the fact that college campuses have a shortage of men comparable to the United Kingdom after the First World War. And liberal women on these campuses are now majority LGBT. This means that on a campus with an average number of male students, bisexual women have a nearly equal number of male/female suitors.
Isn't alot of this just definitional? It seems like you are both saying that these young women are genuinely sexually attracted to both men and women. So just because under other circumstances they might not date any women doesn't mean they aren't really bisexual.
I have no idea who they're actually attracted to. But my point is this: the function he used implies that the more women there are who identify as bi/lesbian then the more likely they are to partner with other women. But the opposite is happening. The ratio of women ostensibly in the dating pool is increasing. The number of them partnering with other women is decreasing.
You might argue that those women were in the closet before, and so even if the number publicly identifying, the actual number is not changing. But what is definitely changing is the number of men, so the gender ratio of their pool is definitely shifting to be more female. But once again, the number of bisexual women partnering with other women is decreasing.
So something else is going on that is not explained by the availability of female partners.
I think it depends on what you see the argument as proving. It seems to me the argument still proves it's plausible that most of the people claiming to be bisexual but who haven't dated men recently in some sense for so by chance.
I agree whatever numbers you use you need to include other factors, eg, some people will be in different places on the Kinsey scale so we shouldn't assume that all bisexuals choose randomly.
I mean I'd assume that the women identifying as bisexual back in 2008 were probably farther toward the lesbian end of the scale than those identifying as bisexual now because of the very availability issues you cite.
But it still shows that it's not true that the only plausible explanation for that 50% figure is faking it.
> It seems to me the argument still proves it's plausible that most of the people claiming to be bisexual but who haven't dated men recently in some sense for so by chance.
How so? The only way I see it happening by chance is if they're averaging one sex partner in total. I've seen studies showing that young people are having less sex than before, but not so much less that's it's only one partner by 24.
Aren’t these different age cohorts? College dating is much different than marriage- or child-bearing-age dating.
Bisexual women may have plenty of female partners to date in college, but afterward, when their environment doesn’t have the same ratio, and if they are interested in having children, they’re in a whole different population.
Technically, sure. But the median age at first marriage for American women is 28; for men it's 30. That suggests that most Americans who get married aren't marrying someone they dated in college, if most people finish undergrad around age 22-23. It's perhaps helpful to distinguish between "can legally marry and can biologically have children" and "seeking to get married and have children."
Anecdotally, when I was in college (graduated 2018, so fairly recently) I knew plenty of people who dated someone they would never consider marrying--both straight people and queer people.
It's really interesting how the college graduation rate is affecting the makeup of entire cities. Since the data was all based on women age 18 - 29, the average age would be around 24. Due to the recent surge, it might be a year or two younger than that. But: “In Manhattan, the pool of 24-and-under college grads has 38 percent more women than men. In Raleigh, North Carolina, the gap is 49 percent. In Miami and Washington, D.C., it’s 86 percent and 49 percent, respectively”. Note that this extra 38% female in Manhattan isn’t on a college campus, this is on the entire island of Manhattan. And it’s only graduates, not current students.
Of all the responses to the bisexuality post, I wish Scott had responded to this one instead. Plugging in the actual values of male students and other women being bi then the number of expected women not having sex with other women goes down to 1%.
Tangential questions about the bisexuality part. The stereotype is (and has been for awhile) that young bisexual women are likely to identify as, or at least act, exclusively straight later in life, whereas young bisexual men are likely to identify as/act exclusively gay.
Is this true?
If true, why?
Also, if true, is it something biological relating to actual levels of attraction, or a result of societal attitudes/different standards for when you call yourself bisexual?
I have some ideas but not strongly held, so want to see what others say...
It's pretty true and I think has a pretty easy answer. In studies about degree of attraction to various sexes most men cluster at the extremes compared to women who more often have a result that's in the middle.
Now think about how this works out with social pressure. If you're a young confused man it's quite likely you are saying you are bisexual because you are scared of being gay/pressured to like women (if you are bi you still get to bring a gf home to mom etc). But since you really are only into dudes you eventually settle into being gay.
OTOH if you are a woman there is much less pressure (maybe even negative pressure) not to try dating other women. However, if both men and women are attractive to you in the long run it's easier just to go marry a dude (both socially and because there are just more potential dates).
Most women have a relatively passive style of partner-seeking, so the average bisexual woman is likely approached by orders of magnitude more men than women. I'm not actually familiar with the other half of the stereotype and don't have a good explanation if true
The average bisexual man is much less limited by the relative number of partners that approach him, because he is much more likely to initiate the approach.
This is no surprise. COVID and bisexuality are both very closely tied to vasopressin and renin-angiotensin-aldosterone system.
COVID infects cells via their ACE2 receptor.
Sexuality is understood as driven by oxytocin+vasopressin beyond any other hormones.
Homosexual males have significantly more vasopressin ennervation in their suprachiasmatic nuclei and other key hypothalamic-hippocampal-arousal-adjacent areas.
"In 1990, we described the first brain difference related to sexual orientation in the suprachiasmatic nucleus (SCN)—the brain's “clock”—which in HoM [homosexual males] is twice the size that it is in HeM [heterosexual males] (6). We later induced a similar brain difference in rats by pharmacologically disturbing the interaction between testosterone and the developing brain, using the aromatase inhibitor ATD in the neonatal period (7). This experiment yielded bisexual adult rats that had a larger-than-normal number of vasopressin neurons and total cells in their SCNs."
I don't think 'believe in god' is is quite like being bisexual or thinking you have long COVID. We see belief as much more of a volontary action than these other categories, same with being vegetarian. Also, I think with both bisexuality and long COVID there is an element of anxiety involved (even if being bisexual isn't something you think is bad finding out you aren't what you always thought you are can be scary). OTOH things like ADHD diagnosis is often comforting rather than worrying.
But this would suggest a positive correlation here with some aspect of hypochondria and I vaguely think you said that was ruled out for some reason.
So I agree these points are evidence against my hypothesis and have reduced my probability in it. Just still don't have a better idea.
I found it interesting that ambidexterity and bisexuality both showed such high correlation, and combined with the comment about (grossly simplifying it here) the body getting confused in some ways, it also makes me wonder about how much the brain gets confused.
I didn’t take the survey, but I’m a bisexual woman, and I’ve often lamented to myself how confusing it can feel to not just be one or the other. It complicates a range of unexpected experiences and ideas, which itself causes some amount of anxiety, sometimes even clinical anxiety.
I’d be curious to hear ambidextrous people’s experiences and whether it causes any sense of confusion or anxiety on some level.
I don’t see believing in God as a choice like vegetarianism. And in some cases I think it could be similar to whether or not one feels one is bisexual in this respect.
I would say that “being a Christian” isn’t the sort of thing that leads to vague self-identification. If someone has been baptized and hasn’t specifically renounced their beliefs, they consider themselves Christian, even if they don’t really believe in God. Kind of like citizenship: I’m a US citizen regardless of my faith in the country until I actually renounce my citizenship. In practice that’s been my experience at least.
Republican/Democrat are more vague. I know plenty of people who identify as one of them without being an official member of a political party, and also people who are registered as one party to be able to vote in closed primaries without considering themselves a member.
I’ll admit this is anecdotal (based on a large number of interactions with Christians of varying faiths over many years), and I’m open to changing my mind based on actual data that might show otherwise.
"JDK writes 'Didn't a pretty well done Norwegian study show that there wasn't even link between "long Covid" and actually having contracted Covid among adolescents?'
I’m pretty skeptical of this. As mentioned above, I think it’s very unlikely Long COVID is 100% psychosomatic. But even 100% psychosomatic conditions obey their own supposed rules; people who had had COVID would be more likely to psych themselves into thinking they had Long COVID than people who didn’t. So the total lack of correlation is surprising on any theory."
I think two separate things are being a bit conflated here.
1) Many of the early, terrible methodology long COVID studies did little/nothing more than ask people who said they had had COVID whether they had X symptoms Y amount of time later. The problems with this are many:
- No control group i.e. what is the base rate of these conditions?
- No controls for confounders and/or self-selection into the sample
Methodology like this is the easiest way to generate claims of 20-30% rates of long COVID.
I guess some researchers eventually got tired of this bad methodology, and attempted to merely check if control groups of people who hadn't had COVID were different in their rate of attesting to symptoms. This is what the Norway study appears to be (from a 5 second glance).
There was a particularly famous UK study - I think in 2020 or 2021 that did just this, and found the same thing - no difference in rates of symptoms in no-Covid controls as Covid treated for children. (I think, but may be misremembering, that they used whether you had ever tested PCR positive). They also found much more muted differences for adults.
This doesn't mean long COVID is necessarily 100% psychosomatic. It implies true long COVID is fairly uncommon (we haven't even controlled for confounders at this point, merely added a control group), and many of these symptoms measures produce a tonne of false positives, because the control group has them too.
Aka: it the treated group has the same rate of the outcome as the control group, it doesn't mean the treated group are all/mostly taking their symptoms. It just means they probably aren't caused by treatment.
2) "But even 100% psychosomatic conditions obey their own supposed rules; people who had had COVID would be more likely to psych themselves into thinking they had Long COVID than people who didn’t."
Suppose the following data generating process:
- Long COVID is rare, say 5%, among those who've had COVID
- Hypochondriacs exist, and will self report having everything. Say they are 2% of the population. Suppose they'll all claim they've had Covid (irrespective of whether they've had positive or negative tests), and will also all claim to have Long COVID.
Then, if you do a study of long COVID at a point in time where seroprevalence is still modest (say most of 2020), e.g. 10%, then:
- ~12% of people will claim to have had COVID, of which ~20% which be people who actually never tested positive but swear they are sure they had it "back in February" etc. (Many such cases).
- ~20% of people who say they've had Covid will claim they have long COVID
- ~70% of those who attest to having long COVID have never tested positive
- There would be very little difference in Pr(Claims long COVID) between "never tested positive" (2%) and tested positive (2.45%). With sampling variation, probably dominated by noise.
For the claim you posit to matter ("more likely to psych themselves into thinking"), you want a situation where the hypochondria acts (at least partially) conditional on actually being infected, rather than on everyone. COVID was probably a perfect storm for this to be less true than usual - it's a disease where the symptoms are vague and common and difficult to discern from other common diseases we all get all the time, severity differs massively, and public attention was orders of magnitude higher than usual. All of this would surely encourage hypochondriacs to think they had been infected. I'd still tend to think there's some truth to your point, but all you need is something like "hypochondriacs take more precautions and are less likely to actually have had Covid" to make the correlation actually go negative.
I think this is probably pretty close to what is happening in a wide variety of cases, and that the percentage of hypochondriacs these days is much higher than 2%.
"There’s no rule saying you can’t detect an effect with a sample size of 254. It depends on the size of the effect you’re trying to detect. If you think groups look different, you do a significance test to see whether the difference you found is significant given the sample size. I did a chi squared test and it was 0.016 for the analysis Coyne is talking about."
I think this is a bit misleading. Statistical significance testing *doesn't* mean you don't have to worry about small sample sizes, for two reasons:
1) Small sample sizes usually have low power, so statistically significant results tend to be overestimates. Andrew Gelman calls this the "statistical significance filter".
2) To use a statistical significance test, you need to assume that the statistic you're testing comes from a certain distribution (i.e. normal, chi squared, etc. ) You can either do this by making unrealistic assumptions about the world ("alll my variables just happen to be normally distributed"), or you can rely on theorems that say things like "as N gets big this approaches a normal distribution", which is what people implicitly do in practice but relies on having a large enough sample size for the tests to give the right answer!
I haven't thought about it enough in this case (and probably won't) to know if having numbers like 1, 17, and 18 in some of the bins is too small for these tests to be reasonable, so I won't take a side on that. But I do think the "I did a hypothesis test so I don't have to worry about small sample size" assumption is common practice but not good statistical practice.
"as N gets big enough everything trends to being Normally distributed" starts kicking in well enough around N = 20 for binomial distributions like we're looking at here. Given that Scott is looking at groups with 17 and 18 reports of Long Covid, the assumption is a bit borderline but IMO fine for a qualitative analysis. A bin of 1 is useless and functionally indistinguishable from 0.
There is also an additional requirement on N * p for the central limit theorem to be reasonable (the parameter can't be near the boundary 0 or 1). That's why the low (and high cell counts) are an issue.
To the second point, there are definitely situations where you have to worry about this. But I think the situation here is not one of them.
The point is that Scott asked binary questions (YES/NO). This means that the distribution here is not mysterious in any way, it is a binomial distribution. A binomial distribution is pretty close to a Gaussian distribution. You can correct for that, and it will shift your significance levels slightly, but only slightly.
It's very different if your data is non-binary. If you want to estimate how many friends ACX readers have on average, then good luck, you will get out garbage if you assume normal distribution here. (And otherwise; this question is intrinsically hard due to the heavy-tailed distribution.)
There is one caveat, which is that we assume the answers to be independent. But this is less of an issue than it sounds. Or rather, it is an issue, but a universal issue that affects all data collections, so we are used to dealing with it.
I may have missed it in this or the previous article, but have any power calculations been done? Assuming an alpha of 0.05, given the group sizes and the observed effect size, what power does the study have?
The question is whether the difference between long COVID rates reported by straight and bisexual people is significant. Going with the female sample because it's a bigger effect, the group sizes are 232 bisexual women (ignoring the null responses), of whom 18 had long COVID. There were 458 straight women, of whom 17 had long COVID. That's a rate of 7.76% in bisexual women and 3.71% in straight women. The effect size is just over 2x.
I plugged those numbers into this power calculator: https://homepage.univie.ac.at/robin.ristl/samplesize.php?test=proptest - and it told me the power is 0.63, which is pretty low. That said, it didn't give me the option to say what effect size I was looking for, which is annoying.
Using this: http://biomath.info/power/chsq.htm - if I use the number of bisexual women and proportion with long COVID, the test tells me that group 2 (ie straight women) would have a detectable effect if the proportion is less than 2.2% or more than 15%. Switching the groups (so using the number of straight women and proportion with long COVID) results in the proportion in the bisexual group needing to be under 0.5% or over 10%. Both of those are with an alpha of 0.05 and a power of 0.8.
This was a quick calculation on the commute to work, but if I am understanding the calculators and the numbers right, then there are not enough people in the study to draw a conclusion.
I think you're correct that there's not enough responses to say one way or the other.
However, you redacted null responses. The only way you can do that and still continue is either by assuming the nulls (if they responded) would not change the result or b) the number of nulls is small enough to not change things. I haven't looked at the number of nulls, but either could be false.
I went through and had a look, just using the second calculator. If nulls are consistently no long COVID or if they are consistently long COVID in both groups, that doesn't make a difference to the power (ie there still aren't enough people). However, if one group's nulls are all in fact people who had long COVID, and the other group's nulls are people who didn't, that might make a small difference. I don't know if I understand the maths or the sample population enough to say anything more specific.
I'm a rheumatologist who sees a lot of fibro, EDS, and long Covid. Rheumatologists actually sometimes joke that if a bi or genderqueer woman with brightly dyed hair walks into your clinic with joint pain, there is a 99% chance she/they has hypermobile EDS and fibromyalgia. It's not to denigrate these people or not to take them seriously (their suffering is real regardless of being "psychosomatic" or not, and besides we gotta catch that 1% who has RA or lupus and would actually benefit from immune suppression), but there's something about that personality type/set of life experiences that just always produces this same cluster of symptoms.
As someone who's actually got boots on the grounds with long Covid and other conditions in that cluster, you got it exactly right with this statement: "But I think the strong version of this is that straights have some fatigue, ignore it, and it goes away, whereas bisexuals have some fatigue and focus on it in a way that makes it worse and turns it into a trapped prior. This is how I think of chronic pain and several other psychosomatic illnesses." That's why these patients NEVER get better with immune suppression, or blood thinners, or hormone adjustments, or whatever other biological interventions, but they sometimes/often do get better with SSRI/SNRI and pain psychology therapy.
Isn't hypermobile EDS something that would be very not psychosomatic? How can hypermobility be psychosomatic? Seems like an odd one out with fibro and LC
Scott, I think there's some sort of copy-and-paste error: Your quote of Toggle's comment seems to contain a copy of Mike's later comment. (I didn't check to figure out the correct original comments.)
> When I’ve looked into depression biomarkers, it’s been very hard to distinguish them from general bad health markers, and Long COVID would be especially hard since you would have to distinguish them from previously-had-severe-COVID markers.
[posting this to provide more information re biomarker studies and to point at a promising biomarker finding which seems remarkably feasible to independently replicate: about $1200 for Angiopoietin-1 + P-selectin ELISAs, and access to a laboratory with a plate reader. Not arguing anything re psychosomaticity here. Thanks for featuring my comment and thanks for clarifying what you meant re psychosomaticity]
Several of the long COVID biomarker studies do compare against "people who recovered fine from mild COVID" (most people these days!) and/or "people who were in the ICU for COVID" groups and nevertheless effectively classify. Re specificity, indeed, some of the biomarker findings are not very diagnostically useful on their own. This study https://www.medrxiv.org/content/10.1101/2022.08.09.22278592v1 finds cortisol levels (halved in long covid patients (without significant changes in ACTH) compared to controls, even a year after acute infection) the most predictive single factor, but cortisol is...involved in a lot of things, so it's not very specific.
Re the Angiopoietin-1 + P-selectin (proteins involved in vascular/endothelial/platelet function) finding; there is essentially *no* overlap between long covid patients and any of the controls (healthy controls, people with mild covid, people with severe covid). The variance for the control groups is an order of magnitude smaller than the difference between the long covid group and any of the controls. Purely from eyeballing the figures, the average levels in long covid seem to be an order of magnitude higher than those in any of the other groups: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549814/figure/Fig3/
This points to "somehow actively involved in the disease process" more than "biomarker for bad health".
Some chronic conditions do elevate Ang-1 and P-sel, but much less than was observed in this study. https://pubmed.ncbi.nlm.nih.gov/30047017/ finds *at most* a 30% elevation in P-selectin in people with T2DM with high vascular risk factors. Not an order of magnitude increase.
Between the remarkable reported specificity/sensitivity, samples collected by simple blood test, and affordable immunoassays available for the relevant biomolecules, this seems like the most promising biomarker finding for LC I've seen so far. If I had access to a laboratory, I would try to replicate these findings (assuming I could find some people with long COVID who'd be up to participate; I don't have it, I'm just interested in it).
Hi, thanks for interesting info! I don’t understand graphs B and D from figure 3 (the link in your comment ending with Fig3). The in-graph legend mentions a notes a green and a blue line, but on the charts themselves I only see blue lines. Not that I understand those, either. Could you maybe sketch an explanation for someone who doesn’t know what they’re looking at?
> ROC curve for Long-COVID versus healthy control (green) hidden by ROC curve [(blue)] for Long-COVID versus acutely ill COVID-19 patients.
it's bad wording but; my understanding is that the green ROC curve (LC vs healthy) was identical to the blue ROC curve (LC vs acutely ill C19) and so the green one is hidden since the blue one is rendered above it.
"a study showing that bisexuals had more cancer, asthma, and heart disease than straight (or gay) people"
Yes, but the interesting claim about long covid is that gays and straights are similar, while bisexuals are outliers. This study makes bisexuals look like gays. That's not a surprising result. Lots of the arguments in this post assume that bisexuals are like gays. Maybe those arguments explain these results, but they don't explain the long covid results, where gays are like straights.
In 5/6 comparisons (3 diseases x 2 sexes) bisexuals have more disease prevalence than gays and straights, but in only two cases does it match the long covid pattern of gays and straights being similar. In three cases gays are in the middle, twice halfway, once close to bisexuals. In the final case, bisexuals are like straights and gays are the outlier. The cases that match long covid in bisexuals being the outlier are heart disease in both sexes. The cases where gays are halfway in between are asthma in men and cancer in women. The case where bisexuals are in the middle but close to lesbians is asthma in women. The case where bisexuals are like straights is cancer in men.
"I find libertarians and Marxists, who I would expect to be less interested in the right-wing project of minimizing COVID than conservatives, sort of interesting."
Libertarians in America are for the most part aligned with the right, many with the extreme right. Even those who are not, in my anecdotal experience, were very anti-COVID restrictions (for the obvious reasons one would expect libertarians to be against extreme restrictions on individual liberty), and also COVID skeptics, as a way to justify the resistance to even mild COVID restrictions. For these reasons I'd by and large expect libertarians to be similar to conservatives on questions relating to COVID.
Marxists, on the other hand, are just weirdos. There is no one political camp in America where self-identified Marxists can find a home, and in my (also anecdotal) experience a lot of people who identify as Marxist don't really mean much specific by it. I've known folks with a wide range of political orientations (including a small number who would probably be called right wing, though this has been rare) who call themselves Marxists. So yeah, I'm not sure what this means.
There's definitely a libertarian divide over the covid vaccine. As I noticed when my friend described how she tricked a vaccine requirement to attend a concert in San Francisco. On one hand, I laughed with her because San Francisco did go overboard on pandemic restrictions. But on the other, dude, why don't you just get the vaccine?
Considering also that a genuine Marxist analysis of Trump’s ascent to presidency and its aftermath is obviously incompatible with most of the left’s anti-Trump talking points, it’s surprising that the two sides have not coalesced even more.
I am under the impression that at this stage their Marxism is mostly merely performative though. We don’t see much of a praxis-theoria-praxis feedback loop, do we?
Isn't that worse than if there was feedback from reality to theory? The fact that you don't bother to consider whether your ideas are any good doesn't mean you only hold those ideas performatively. It can also mean that you actively seek to realize horrifying goals.
I suspect that the goal is to legitimize the status quo, which you can argue is horrifying but it’s not too different from what their colleagues in economics departments are doing, just with a different toolset. Of course no amount of false consciousness among those holding cushy academic jobs while self identifying as Marxists can deny the soundness of Marxist analysis as a methodological tool.
To date, there is no compelling discriminant validity evidence for a distinct "Long COVID" syndrome. It is generalized post-viral symptomatology until empirical evidence clearly indicates otherwise. Nonetheless, the common cause herein is negative emotionality (NE) /affective dysregulation.
Is there data comparing the prevalence of individual long-covid symptoms? Some seem more 'psychosomatic' than others. 'Fatigue' is pretty vague and subjective, but a friend of my dad's has lost all sense of taste and smell since getting COVID in 2020. He's lost a significant amount of weight since he's no longer been able to taste food, it seems very likely that losing your sense of taste/smell is much less likely to be psychosomatic than fatigue or 'brain fog'.
"fatigue" might sound vague and subjective at low levels, but can mean "was an athlete, now struggles to walk to the mailbox", which which hard to precisely quantify is also clearly something and not just a different perspective on the usual.
> If this were true, the bisexuality effect would be stronger for milder cases of Long COVID
I don't think this is right. I'd expect a personality trait that pushes people to round off "maybe long COVID" to "long COVID" would also make them round "maybe severe case" to "severe case", so you'd get the same bias in severe/mild case as you do in long COVID.
Is «could and wanted to expend all the effort to get formally diagnosed» a significant factor in «diagnosed by MD»? Because all the healthcare access discussions seemed to imply there is some barrier.
Reporting thresholds and slack to compensate for mild damage are surely always relevant: I (male, straight) had some lingering effects after a definite viral cold likely to have been CoViD that might be too weak to even call symptoms and they are perceptible in very specific situations that can arise or not…
"Also, if sexual contact caused immune problems down the line, this would be a big deal and we would already know."
Do we not already have pretty good hints in this direction? This seems obvious enough that I wonder if I've misunderstood you somehow.
I mean, ignoring the low-hanging fruit of HIV/AIDs, most of the pathogens which maintain persistent infections do so by tamping down the immune system in one way or another. The herpatic viruses are notorious for this. They often interfere with iNOS or deplete arginine which has a similarly depressive effect on macrophages.
• Reactivations of EBV, CMV and HHV-6 are frequent in severe COVID-19.
• EBV reactivation is associated with longer ICU length-of-stay.
• EBV reactivation occurs early after ICU admission.
CMV reactivation occurs later after ICU admission and may require anti-CMV treatment.
" cytomegalovirus (CMV, HHV-5, a β-herpesvirus) imposes a surprisingly profound impact. The majority of the world’s population is CMV+, and the virus goes through 3 distinct infection phases en route to establishing lifelong détente with its host. Immune control of CMV in each phase recruits unique arms of host defense, and in turn the virus employs multiple immune modulatory strategies that help facilitate the establishment of lifelong persistence....This strategy of hijacking host IL-10 immunosuppression to promote viral persistence is similarly employed by MCMV "
To be clear, I'm not saying that this is relevant to the immediate discussion. I just wanted to address the point that STDs can impact immune responses.
Man, the entirety of section 5 should be its own essay emphasizing the perspective that basically anything can be psychosomatic. The heart attack and chest pain statistics are a significant update for me, and while I intuitively understood that some illnesses are heavily mixed - I knew this is very true for well-known-frequently-psychosomatic stuff like LC and back pain; incidentally, just the other day I had to wonder if a headache I was having was a recent stress or dehydration - I still didn't realize it was such a common pattern, and based on the previous discussions I'm guessing most people didn't.
I think part of the problem is that it is down to self-identification, so you will have real bisexuals and the social contagion bisexuals and the real Long Covid or post-viral syndrome sufferers and the 'maybe I have it! everyone else on Tiktok does!' lot.
The audience here will tend to skew towards "yes indeed real bisexual" along with a lot of other minority positions on things, but in the general population?
How do you define bisexual?
And again, I do incline to the view that people who are more on the left/liberal/progressive side of the fence will more easily identify as A, B, or C than people more on the right/conservative side, as well as older versus younger. If you're in a place and/or time where it's socially acceptable to be some variety of queer, then you're more likely to identify as that than if it's a place where you're in the closet unless you really, strongly, definitely are gay, lesbian or bi.
So how do you define bisexual? It's not "have you had sex with people of both sexes?" because according to this randomly selected site:
"People use a few common labels to identify their sexuality. Your sexuality isn’t defined by who you have sex with – it’s about how you feel and how you choose to identify yourself. The important thing is that you choose what label feels comfortable, or you choose no label at all. You might find, like many others have, that the label you choose changes over time."
So if you're young and you go "I think Barbie is cute", then you may go "Oh wow, am I bi/lesbian?" and the answer seems to be "If you think you are, yes! So long as you find that description comfortable, then you are, and when it's not, then you're not".
So, TMI time again. In my attempts to figure out what the heck was wrong with me over the years of my youth and adulthood, one of the considerations was "well, do you prefer girls then?" And considering it as a hypothetical, the idea of having sex with a woman didn't make me go "Ugh, no!!!" (Sex with a real person in reality being not at all the same notion because no thank you to anyone of any sex or gender).
I don't consider myself bisexual. *But* were I a young adult *now* and a good bit more left-leaning in social attitudes, I well might identify as such. "But you've never had sex with/dated a same-gender person!" Yeah, shut up bigot, not necessary for self-identification.
Same with long covid. I've had covid, and since then I do feel that I have a perceptible change in taste. I have bouts of fatigue, breathlessness, 'brain fog', many of the very vague and multiply-applicable symptoms.
But I can also put these down to getting older and existing health conditions.
So, do I have long covid? I say no. But again, a slight difference in inclination, and I could say "yes".
When answering the survey, I said no to both the bisexuaity and long covid parts. But rotate me 45 degrees, and I'd be answering yes. For the same physical entity with the same physiological symptoms.
Now you tell me: am I bi or not? long covid or not?
To be fair though, sexuality is kind of a spectrum (for women much more so than for men), and so is Long Covid. Outside of a few extreme cases, identifying as "bisexual" or "suffering from Long Covid" is kind of pointless, just like identifying as "tall" is pointless. Unless you're the tallest person in the world, there are always going to be some people who are taller or shorter than you. However, this does not in any way mean that height is a social contagion and if we just got off TikTok we'd realize that we're all the same size.
Yeah, but if you were a young woman who was 5' 4" in height, which is average American height for a woman if I believe Google, and you were being bombarded with images of tall, leggy girls on Instagram and TikTok being successful and happy, and other women were posting "studies show that short people are unfairly discriminated against" and the rest of it, it's possible you might come away with "Hey, I *am* being societally discriminated against by heightphobia!"if you've felt a bit uncomfortable all your teenage years about being shorter than your friends and how the girls who were popular and got dates and the rest of it were all taller than you, and all the advice about "yes, you're not as tall as that model or sports star but you're perfectly normal height" would be dismissed as "you're just perpetrating bigotry against short people".
People go out and get leg-lengthening surgery because they think they're too short. It happens. I do think it's possible that current teens and young women getting told about how WONDERFUL being some flavour of queer is, and that boring cis het is not alone dull and boring but repressive and to blame for all the persecution, and that victimhood is strength and gets you sympathy, validation, and support online - then it's easier to parlay "okay I like the idea of kissing girls" into "I am bi and not boring vanilla cis het". You're fourteen, you want desperately to fit in with those around you, and you're seeing social media messaging about "you might be bi or trans or something if you've ever...."
I've always been a misanthrope, and when I was a kid nobody could persuade me to join the Girl Guides (as they were then) - not my mother, my friend who was in the Guides, or even the nun in charge of them. So I've been protected by my thick shell of anti-social attitudes.
But if I were fourteen today? And a little more desperate for friendship and connection? And had my same awkward-angles personality? If someone sympathetic came along and murmured to me that there were supportive places for those like me where nobody would judge you, just come along and see, nobody is going to make you join, but have you considered that maybe?
Yeah, I might decide "Oh, *this* is why I don't fit in! This is why I'm not interested in talking about boys like the rest of the girls!" Best of all? I don't have to *do* anything, self-identification is enough. Now I have a shiny new identity that means my weirdness is not a bad thing, it's explained in a way that is supported and validated: I'm a victim of prejudice and outdated expectations!
Yeah, sure, you can have any kind of self-identified identity that you want; my only point is that it's not super informative to discuss what is and isn't "true" bisexuality, since in reality there's no such thing. The best you could possibly say is something like, "I prefer men to women at a rate of 1.32".
Is that the same as a "gay/straight alliance", only rebranded ? Back in my day, those places had the reputation of being clubs for closeted gay people, where they could gay out with each other.
Is there research on if life or death social situations cause psychosomatic symptoms?
Like consider rooms clapping for Stalin or the purge by Saddam Hussein; I dont know how you'd ethically test such a situation if say >50% of the room had migraines, but would it be the most unusual thing in the world?
If you social group is burning witches maybe its for the best for your nervous system if you join in to the hysterical dancing, illnesses and people do just have a shut down switch when they believe there is lethal danger and their tribe is angry with them.
"It's possible that both trans-ness and bisexuality are the result of a sort of anatomical and neuro-hormonal "chimerism" that isn't present in either fully straight or fully gay cis people. I don't mean they're the result of literal genetic chimerism (which is far rarer than bisexuality or gender dysphoria), but rather, that they're caused by some sort of mismatch involving the body's neurological and hormonal transmitters and receptors."
This doesn't seem right. Wouldn't this mismatch she speaks of be more prevalent in homosexuals than in bisexuals? We've all encountered effeminate gay men and butch lesbians, have we not? They would figure to have the highest degree of this mismatch, I would imagine, but that's not where the incidence of long Covid seems to be the highest, right?
"Christians and Republicans had no more Long COVID than people who said no religion or no political party, but polyamorous people and rationalists did."
During the pandemic, I noticed that the SF tech scene (i.e., polyamorous rationalists) went deeper into social distancing than any other demographic on the planet. People I knew who were actually immunodeficient did not isolate nearly as much as these guys. Social distance became a moral imperative and covid became The Worst Thing That Could Ever Happen To You.
"I think the worst-case scenario is that, since Long COVID is in the news, extremely sympathetic, and has maximally vague symptoms, its psychosomatic shadow could be much bigger than normal"
Especially if you were so traumatized by a positive covid test result, or maybe even just something that you suspect was covid but couldn't get a test for (remember that other infectious diseases are also still a thing), that your recovery was followed by a laser focus for anything that might be long covid. Because of course you must be injured! If you isolated like a champ only to discover that covid was a nothing burger for you, how foolish would that feel?
I didn't realize there was a correlation between polyamorism and rationalism (and whose locus is apparently the SF tech scene...). What is the explanation for that?
The correlation is mentioned in the article we're both commenting on. Its overlap with the SF tech scene is just my personal observation. I don't have an explanation, though I have heard the joke that SF adults below the age of "I bought my house twenty years ago" skew polyamorous because that's the only way to afford rent.
Coyne’s arguments convinced me that your survey effect probably isn’t real. There is huge difference between replicating an established result and establishing a new result. One of those is significantly harder than the other.
And if you (formally or informally) considered more than 3 hypotheses when looking at the data then a p-value of 0.016 is not significant after adjusting for multiple comparisons.
In case that second paragraph is too pithy, digging around in survey data to find interesting hypotheses, then doing a statistical test on the strongest effects is literally the classic xkcd: https://xkcd.com/882/
And this is true even if you didn’t formally do statistical tests on all of the potential hypotheses that didn’t seem like they would pan out.
That doesn’t mean exploratory data analysis is worthless. It’s great for hypothesis generation but not hypothesis confirmation. Unless the effect sizes are so strong as to remove any doubt (but these are obviously no where close).
Quick note: Coyne expects confidence intervals from Scott, but I don't think it's possible to construct those given the type of analysis he used. I say this because I attempted to replicate Scott's numbers and provide these confidence intervals.
I'm assuming Scott used a chi squared test for independence. This is well and good for seeing whether long covid in bisexuals or not follow the same distribution. In tests like these we get a p-value and then see how small or large it is. Then we can reject the null or not.
This is not the time to construct confidence intervals. My understanding is we do that when we're estimating the parameters of a distribution. (i.e. what's the average height of Uzbeks?). Scott is not estimating any quantities here, so whatever confidence intervals Coyne has in mind don't apply here.
I also don't think we can construct a confidence interval around the p-value. Mathematically, it's just a single observation from a chi squared distribution.
As a digression, you can also see Scott as already having computed a confidence interval of some sort when he conducted the chi squared test. All a statistical test is is using the null hypothesis to say your test statistic will follow a certain sort of distribution (in this case, a chi squared one). You then say if the null is true, there's a .95 chance my statistic will lie in this interval. That interval looks a lot like a confidence interval.
Note I don't think all of Long Covid is psychosomatic, I discuss biological contributors in the 1st post. In my own case I suspect either Epstein-Barr reactivation or persistent virus for several months.
I explained this debate to my bisexual friend and she found the causality obvious: “bisexuals reproducibly sit in weird contorted positions which constantly make us hyperaware of our lung capacity.”
… (sorry about that, too quick with the finger, as it were) — does it mean Western Educated Industrial, etc.? Or is it a common way to describe statistically unusual or anomalous data or outcomes? Or is it just impolite?
My read is that it's used in the simple denotative sense, although it's appropriate to hear the echoes of WEIRD (Western, Educated, Industrialized, Rich, Democratic).
My thoughts on this are not fully formed, but I think you're missing out on the fact that sexual attraction is IN ITSELF subject to suggestion. When someone expresses attraction to you, that emotional state can be contagious-- people are turned on just by being desired. So bisexuals can be genuinely attracted to both sexes, while at the same time being more prone to social contagion that would lead them to delusionally believe they have a disease.
"Hundreds of biomedical findings have been documented, with many patients experiencing dozens of symptoms across multiple organ systems7 (Fig. 1). Long COVID encompasses multiple adverse outcomes, with common new-onset conditions including cardiovascular, thrombotic and cerebrovascular disease8, type 2 diabetes9, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)10,11 and dysautonomia, especially postural orthostatic tachycardia syndrome (POTS)12 (Fig. 2). Symptoms can last for years13, and particularly in cases of new-onset ME/CFS and dysautonomia are expected to be lifelong14. With significant proportions of individuals with long COVID unable to return to work7, the scale of newly disabled individuals is contributing to labour shortages15. There are currently no validated effective treatments."
Self-identified by bisexuals are more likely to be left of center, and left of center after more likely to report long covid as long covid? 🤔
Ah, that's along the lines of the first thing you mention
Also from the original post, the issue is that self-identified as homosexual is also left of center but doesn't have the same correlation with Long COVID.
True hm
I would guess that self identified homosexual is less lefty than self identified bisexual tbh.
I can never remember which way the Kinsey scale goes, but if 0 is so straight an engineer can reliably use your sexuality to design a bridge, and 10 is so gay that Oscar Wilde rises from his Parisian grave to greet thee...
...then I would guess lefties on average prolly identify as straight if they’re a 0 to maybe 2, bi if they’re maybe 3-8, and gay if they’re 9-10. OTOH I would guess conservatives might be more likely to publicly identify as straight if they’re anywhere in that whole 0-8 range, maybe identify as bisexual around 8, but still identify as gay around 9-10.
That would have the end result of making bisexuality way more left coded than being gay.
I’m not sure the thresholds for conservatives is exactly 8, but I think there is absolutely something here. Compare with “being on the down low” in the black community- whole lot of dudes fucking, and everyone self reports as straight. Ties in nicely with the line above about monosexuality as a culture bound disease
Just a simple question on psychosomatic conditions. Do all, or almost all conditions have some psychosomatic shadow? Short of losing a limb, is there a possibility of psychosomatic responses when diagnosed with any disease?
And is there any way to actually prevent "catching" psychosomatic conditions?
"Psychosomatic inoculation" is an interesting idea!
I think all or almost all *symptoms* have a psychosomatic shadow for sure. At the moment I legit can’t think of a single *symptom* that doesn’t.
On the other hand, the significant majority of illnesses (at least the illnesses I work with; I’m a hospitalist) have an empiric foundation that couldn’t possibly be psychosomatic.*
For instance, you can come to the ED with psychosomatic chest pain, but you will not have a psychosomatically elevated troponin, a psychosomatically abnormal nuclear stress test, or a psychosomatically occluded LAD on cardiac cath.
Same goes for just about any significant medical condition.
*Some of the empiric signs could be fabricated by someone with Munchausen’s, but that’s different.
Oh, and re: “catching,” I think it’s super normal to have psychosomatic symptoms, to the point that if someone tells me they never have, I don’t believe them.
Really (I want to ask such people)? You’ve NEVER had butterflies in the stomach before an important event, or started in with a headache/shoulder pain when under a lot of pressure?
That’s just the human condition. It becomes more of an issue when someone is convinced there must be an organic cause, and won’t take no for an answer.
Probably the best inoculation is trying to trust that the medical system, while very imperfect, is still pretty darn good at ruling out anything that’s going to kill you.
Agree with this! And also that you if you find yourself hyperfixating on a minor symptom and noticing it all the time, practice consciously letting go of those thoughts and actively focus your thoughts elsewhere. Focusing thoughts on pain sensations somewhere in the body just leads to hypersensitivity, which leads to more focus in that area, which leads to...
Isn't that broadening the term "psychosomatic" to the point of uselessness? Of course every experience is ultimately in the brain, but suggesting blood vessels in your intestines constricting due to emotional state to make you feel "butterflies in your stomach" is basically the same as delusional parasitosis is absurd.
That’s what the word “psychosomatic” means, though: that the emotional state is the driver of the symptom, rather than an organic issue. As a descriptor it’s not any more meaninglessly broad than “organic.”
And no, I am not conflating butterflies in the stomach with delusional parasitoses. The first is a symptom; the second is a syndrome or disease.
Psychosomatic *symptoms* are possible and even common; only relatively rarely does it rise to the level of syndrome or disease.
"You’ve NEVER had butterflies in the stomach before an important event, or started in with a headache/shoulder pain when under a lot of pressure?"
I actually haven't. I don't feel good when under stress, but it has never manifested as physical pain except for very indirect reasons (e.g. I'm stressed, so I don't pay as much attention, so I cut myself on paper).
If it's not too personal a question, are you neurotypical ? Have you ever had any unexplained symptoms ?
I ask because I used to report the same thing - never felt emotions affected me physically -, then spent months trying to understand why I had violent, I-think-I-might-die stomach pains where the hospital couldn't find anything or help me except by giving me morphine, and eventually realized these were probably panic attacks.
I found it fascinating how much of a disconnect there was (in my mind) between my physical and emtional state, despite there being a very strong connexion in my body.
I'm a high-functioning autistic male in my thirties, and most of my life emotions were a weird thing I didn't experience the way most people do. I wonder to what degree this is linked to that disconnect.
I'm fairly neurotypical, though I might be slightly autistic. I haven't been able to explain every illness (can anyone?), but I rarely have odd unexplained symptoms. For example, I've had diarrhea where I couldn't figure out what food I ate was bad, but that's not very mysterious. I've also had one episode of odd unexplained pains throughout my groin area, which I concluded is likely psychosomatic--but likely not due to stress, because I wasn't stressed at that time.
Why do you think your stomach pains were panic attacks? It's entirely possible to have pains with physical causes that modern medicine (or at least the tests your local hospital chose to perform) cannot yet explain.
> And is there any way to actually prevent "catching" psychosomatic conditions?
avoiding contact with burning of witches, cults and modern news would probably be a reasonable place to start
If you're going to include the Kinsey Scale on the next ACX survey, please make sure to include the "X" (asexual/nonsexual) option!
Wouldn't that be better addressed by a whole new question? After all just like attraction to various genders asexuality comes in degrees and someone who is quite asexual might still have a view about which gender is less unappealing to them. So ideally you have a two dimensional response of both strength of sexual interest/disinterest and affinity towards various genders.
Ofc if you are very strongly asexual you might not be able to pick any point on the Kinsey scale so maybe there should be an option for that as well.
That implies there should be a Kinsey-scale equivalent for each of the 5 kinds of attraction, which is a concept that I think would generate some very neat data! The traditional Kinsey scale, however, is specifically focused on sexual attraction and not its commonly-confused cousins romantic or aesthetic attraction.
When I went looking this up (because I was sure I'd be unable to answer a Kinsey Scale question until I found out that Kinsey did include a response category for no sexual attraction) I did find that there's a long history of attempting to iterate on the Kinsey Scale and create 2- or even 3-dimensional charts for various elements of sexual attraction, so if this is something you feel strongly about, you might want to investigate the options and suggest something better to Scott!
> Ofc if you are very strongly asexual you might not be able to pick any point on the Kinsey scale so maybe there should be an option for that as well.
This is me; this is why I asked for the "X" option if Scott does include this on the next survey.
*climbs on hobbyhorse*
The Kinsey scale is absolute garbage. It does not correctly model sexual attraction/repulsion, not the least of which is its inability to distinguish between bisexual, asexual and antisexual that you mentioned.
*puts hobbyhorse back in the closet*
I appreciate that it doesn't capture all the variation in human sexuality, but I think there is some value in forced response questions with limited options. I mean each of us is unique so if you don't collapse some distinctions when you ask questions you don't get any information.
So, rather than it being garbage, I'd simply argue it's incomplete. Yes, you are correct it doesn't make those distinctions you mention. Ok, so if you want to make those distinctions as well then ask additional questions. Sexuality is a high dimensional space so any single dimensional measure will collapse a lot of things but as far as single dimensional measures go it seems like a decent one.
We just need to keep in mind it's a projection of a multidimensional quantity onto a single basis.
I wrote up a response to last week’s ACX post on “Raise Your Threshold For Accusing People Of Faking Bisexuality”. I walked through Scott Alexander's statistical argument and wrote up a critique of it: "Is Bisexuality a Political Statement?" https://taboo.substack.com/p/is-bisexuality-a-political-statement
My main concern was that the post failed to take into account the fact that college campuses have a shortage of men comparable to the United Kingdom after the First World War. And liberal women on these campuses are now majority LGBT. This means that on a campus with an average number of male students, bisexual women have a nearly equal number of male/female suitors.
Isn't alot of this just definitional? It seems like you are both saying that these young women are genuinely sexually attracted to both men and women. So just because under other circumstances they might not date any women doesn't mean they aren't really bisexual.
I have no idea who they're actually attracted to. But my point is this: the function he used implies that the more women there are who identify as bi/lesbian then the more likely they are to partner with other women. But the opposite is happening. The ratio of women ostensibly in the dating pool is increasing. The number of them partnering with other women is decreasing.
You might argue that those women were in the closet before, and so even if the number publicly identifying, the actual number is not changing. But what is definitely changing is the number of men, so the gender ratio of their pool is definitely shifting to be more female. But once again, the number of bisexual women partnering with other women is decreasing.
So something else is going on that is not explained by the availability of female partners.
I think it depends on what you see the argument as proving. It seems to me the argument still proves it's plausible that most of the people claiming to be bisexual but who haven't dated men recently in some sense for so by chance.
I agree whatever numbers you use you need to include other factors, eg, some people will be in different places on the Kinsey scale so we shouldn't assume that all bisexuals choose randomly.
I mean I'd assume that the women identifying as bisexual back in 2008 were probably farther toward the lesbian end of the scale than those identifying as bisexual now because of the very availability issues you cite.
But it still shows that it's not true that the only plausible explanation for that 50% figure is faking it.
> It seems to me the argument still proves it's plausible that most of the people claiming to be bisexual but who haven't dated men recently in some sense for so by chance.
How so? The only way I see it happening by chance is if they're averaging one sex partner in total. I've seen studies showing that young people are having less sex than before, but not so much less that's it's only one partner by 24.
Aren’t these different age cohorts? College dating is much different than marriage- or child-bearing-age dating.
Bisexual women may have plenty of female partners to date in college, but afterward, when their environment doesn’t have the same ratio, and if they are interested in having children, they’re in a whole different population.
> College dating is much different than marriage- or child-bearing-age dating.
I can't tell what you're saying here. College students are obviously of childbearing age. They are also of marriage age.
Technically, sure. But the median age at first marriage for American women is 28; for men it's 30. That suggests that most Americans who get married aren't marrying someone they dated in college, if most people finish undergrad around age 22-23. It's perhaps helpful to distinguish between "can legally marry and can biologically have children" and "seeking to get married and have children."
Anecdotally, when I was in college (graduated 2018, so fairly recently) I knew plenty of people who dated someone they would never consider marrying--both straight people and queer people.
It's really interesting how the college graduation rate is affecting the makeup of entire cities. Since the data was all based on women age 18 - 29, the average age would be around 24. Due to the recent surge, it might be a year or two younger than that. But: “In Manhattan, the pool of 24-and-under college grads has 38 percent more women than men. In Raleigh, North Carolina, the gap is 49 percent. In Miami and Washington, D.C., it’s 86 percent and 49 percent, respectively”. Note that this extra 38% female in Manhattan isn’t on a college campus, this is on the entire island of Manhattan. And it’s only graduates, not current students.
Of all the responses to the bisexuality post, I wish Scott had responded to this one instead. Plugging in the actual values of male students and other women being bi then the number of expected women not having sex with other women goes down to 1%.
Unfortunately, I didn't post this until just a couple hours before this.
Tangential questions about the bisexuality part. The stereotype is (and has been for awhile) that young bisexual women are likely to identify as, or at least act, exclusively straight later in life, whereas young bisexual men are likely to identify as/act exclusively gay.
Is this true?
If true, why?
Also, if true, is it something biological relating to actual levels of attraction, or a result of societal attitudes/different standards for when you call yourself bisexual?
I have some ideas but not strongly held, so want to see what others say...
It's pretty true and I think has a pretty easy answer. In studies about degree of attraction to various sexes most men cluster at the extremes compared to women who more often have a result that's in the middle.
Now think about how this works out with social pressure. If you're a young confused man it's quite likely you are saying you are bisexual because you are scared of being gay/pressured to like women (if you are bi you still get to bring a gf home to mom etc). But since you really are only into dudes you eventually settle into being gay.
OTOH if you are a woman there is much less pressure (maybe even negative pressure) not to try dating other women. However, if both men and women are attractive to you in the long run it's easier just to go marry a dude (both socially and because there are just more potential dates).
Most women have a relatively passive style of partner-seeking, so the average bisexual woman is likely approached by orders of magnitude more men than women. I'm not actually familiar with the other half of the stereotype and don't have a good explanation if true
The average bisexual man is also likely approached by orders of magnitude more men than women.
The average bisexual man is much less limited by the relative number of partners that approach him, because he is much more likely to initiate the approach.
Scott wrote this up last week in a separate post about bisexuality, especially in women.
This is no surprise. COVID and bisexuality are both very closely tied to vasopressin and renin-angiotensin-aldosterone system.
COVID infects cells via their ACE2 receptor.
Sexuality is understood as driven by oxytocin+vasopressin beyond any other hormones.
Homosexual males have significantly more vasopressin ennervation in their suprachiasmatic nuclei and other key hypothalamic-hippocampal-arousal-adjacent areas.
For example--
https://www.pnas.org/doi/10.1073/pnas.0805542105
"In 1990, we described the first brain difference related to sexual orientation in the suprachiasmatic nucleus (SCN)—the brain's “clock”—which in HoM [homosexual males] is twice the size that it is in HeM [heterosexual males] (6). We later induced a similar brain difference in rats by pharmacologically disturbing the interaction between testosterone and the developing brain, using the aromatase inhibitor ATD in the neonatal period (7). This experiment yielded bisexual adult rats that had a larger-than-normal number of vasopressin neurons and total cells in their SCNs."
Ohh that's a good theory. It may now replace mine about how you rate ambiguous stimuli as my most likely theory.
I don't think 'believe in god' is is quite like being bisexual or thinking you have long COVID. We see belief as much more of a volontary action than these other categories, same with being vegetarian. Also, I think with both bisexuality and long COVID there is an element of anxiety involved (even if being bisexual isn't something you think is bad finding out you aren't what you always thought you are can be scary). OTOH things like ADHD diagnosis is often comforting rather than worrying.
But this would suggest a positive correlation here with some aspect of hypochondria and I vaguely think you said that was ruled out for some reason.
So I agree these points are evidence against my hypothesis and have reduced my probability in it. Just still don't have a better idea.
I found it interesting that ambidexterity and bisexuality both showed such high correlation, and combined with the comment about (grossly simplifying it here) the body getting confused in some ways, it also makes me wonder about how much the brain gets confused.
I didn’t take the survey, but I’m a bisexual woman, and I’ve often lamented to myself how confusing it can feel to not just be one or the other. It complicates a range of unexpected experiences and ideas, which itself causes some amount of anxiety, sometimes even clinical anxiety.
I’d be curious to hear ambidextrous people’s experiences and whether it causes any sense of confusion or anxiety on some level.
I don’t see believing in God as a choice like vegetarianism. And in some cases I think it could be similar to whether or not one feels one is bisexual in this respect.
I would say that “being a Christian” isn’t the sort of thing that leads to vague self-identification. If someone has been baptized and hasn’t specifically renounced their beliefs, they consider themselves Christian, even if they don’t really believe in God. Kind of like citizenship: I’m a US citizen regardless of my faith in the country until I actually renounce my citizenship. In practice that’s been my experience at least.
Republican/Democrat are more vague. I know plenty of people who identify as one of them without being an official member of a political party, and also people who are registered as one party to be able to vote in closed primaries without considering themselves a member.
I’ll admit this is anecdotal (based on a large number of interactions with Christians of varying faiths over many years), and I’m open to changing my mind based on actual data that might show otherwise.
"JDK writes 'Didn't a pretty well done Norwegian study show that there wasn't even link between "long Covid" and actually having contracted Covid among adolescents?'
I’m pretty skeptical of this. As mentioned above, I think it’s very unlikely Long COVID is 100% psychosomatic. But even 100% psychosomatic conditions obey their own supposed rules; people who had had COVID would be more likely to psych themselves into thinking they had Long COVID than people who didn’t. So the total lack of correlation is surprising on any theory."
I think two separate things are being a bit conflated here.
1) Many of the early, terrible methodology long COVID studies did little/nothing more than ask people who said they had had COVID whether they had X symptoms Y amount of time later. The problems with this are many:
- No control group i.e. what is the base rate of these conditions?
- No controls for confounders and/or self-selection into the sample
Methodology like this is the easiest way to generate claims of 20-30% rates of long COVID.
I guess some researchers eventually got tired of this bad methodology, and attempted to merely check if control groups of people who hadn't had COVID were different in their rate of attesting to symptoms. This is what the Norway study appears to be (from a 5 second glance).
There was a particularly famous UK study - I think in 2020 or 2021 that did just this, and found the same thing - no difference in rates of symptoms in no-Covid controls as Covid treated for children. (I think, but may be misremembering, that they used whether you had ever tested PCR positive). They also found much more muted differences for adults.
This doesn't mean long COVID is necessarily 100% psychosomatic. It implies true long COVID is fairly uncommon (we haven't even controlled for confounders at this point, merely added a control group), and many of these symptoms measures produce a tonne of false positives, because the control group has them too.
Aka: it the treated group has the same rate of the outcome as the control group, it doesn't mean the treated group are all/mostly taking their symptoms. It just means they probably aren't caused by treatment.
2) "But even 100% psychosomatic conditions obey their own supposed rules; people who had had COVID would be more likely to psych themselves into thinking they had Long COVID than people who didn’t."
Suppose the following data generating process:
- Long COVID is rare, say 5%, among those who've had COVID
- Hypochondriacs exist, and will self report having everything. Say they are 2% of the population. Suppose they'll all claim they've had Covid (irrespective of whether they've had positive or negative tests), and will also all claim to have Long COVID.
Then, if you do a study of long COVID at a point in time where seroprevalence is still modest (say most of 2020), e.g. 10%, then:
- ~12% of people will claim to have had COVID, of which ~20% which be people who actually never tested positive but swear they are sure they had it "back in February" etc. (Many such cases).
- ~20% of people who say they've had Covid will claim they have long COVID
- ~70% of those who attest to having long COVID have never tested positive
- There would be very little difference in Pr(Claims long COVID) between "never tested positive" (2%) and tested positive (2.45%). With sampling variation, probably dominated by noise.
For the claim you posit to matter ("more likely to psych themselves into thinking"), you want a situation where the hypochondria acts (at least partially) conditional on actually being infected, rather than on everyone. COVID was probably a perfect storm for this to be less true than usual - it's a disease where the symptoms are vague and common and difficult to discern from other common diseases we all get all the time, severity differs massively, and public attention was orders of magnitude higher than usual. All of this would surely encourage hypochondriacs to think they had been infected. I'd still tend to think there's some truth to your point, but all you need is something like "hypochondriacs take more precautions and are less likely to actually have had Covid" to make the correlation actually go negative.
I think this is probably pretty close to what is happening in a wide variety of cases, and that the percentage of hypochondriacs these days is much higher than 2%.
"There’s no rule saying you can’t detect an effect with a sample size of 254. It depends on the size of the effect you’re trying to detect. If you think groups look different, you do a significance test to see whether the difference you found is significant given the sample size. I did a chi squared test and it was 0.016 for the analysis Coyne is talking about."
I think this is a bit misleading. Statistical significance testing *doesn't* mean you don't have to worry about small sample sizes, for two reasons:
1) Small sample sizes usually have low power, so statistically significant results tend to be overestimates. Andrew Gelman calls this the "statistical significance filter".
2) To use a statistical significance test, you need to assume that the statistic you're testing comes from a certain distribution (i.e. normal, chi squared, etc. ) You can either do this by making unrealistic assumptions about the world ("alll my variables just happen to be normally distributed"), or you can rely on theorems that say things like "as N gets big this approaches a normal distribution", which is what people implicitly do in practice but relies on having a large enough sample size for the tests to give the right answer!
I haven't thought about it enough in this case (and probably won't) to know if having numbers like 1, 17, and 18 in some of the bins is too small for these tests to be reasonable, so I won't take a side on that. But I do think the "I did a hypothesis test so I don't have to worry about small sample size" assumption is common practice but not good statistical practice.
"as N gets big enough everything trends to being Normally distributed" starts kicking in well enough around N = 20 for binomial distributions like we're looking at here. Given that Scott is looking at groups with 17 and 18 reports of Long Covid, the assumption is a bit borderline but IMO fine for a qualitative analysis. A bin of 1 is useless and functionally indistinguishable from 0.
There is also an additional requirement on N * p for the central limit theorem to be reasonable (the parameter can't be near the boundary 0 or 1). That's why the low (and high cell counts) are an issue.
To the second point, there are definitely situations where you have to worry about this. But I think the situation here is not one of them.
The point is that Scott asked binary questions (YES/NO). This means that the distribution here is not mysterious in any way, it is a binomial distribution. A binomial distribution is pretty close to a Gaussian distribution. You can correct for that, and it will shift your significance levels slightly, but only slightly.
It's very different if your data is non-binary. If you want to estimate how many friends ACX readers have on average, then good luck, you will get out garbage if you assume normal distribution here. (And otherwise; this question is intrinsically hard due to the heavy-tailed distribution.)
There is one caveat, which is that we assume the answers to be independent. But this is less of an issue than it sounds. Or rather, it is an issue, but a universal issue that affects all data collections, so we are used to dealing with it.
I may have missed it in this or the previous article, but have any power calculations been done? Assuming an alpha of 0.05, given the group sizes and the observed effect size, what power does the study have?
The question is whether the difference between long COVID rates reported by straight and bisexual people is significant. Going with the female sample because it's a bigger effect, the group sizes are 232 bisexual women (ignoring the null responses), of whom 18 had long COVID. There were 458 straight women, of whom 17 had long COVID. That's a rate of 7.76% in bisexual women and 3.71% in straight women. The effect size is just over 2x.
I plugged those numbers into this power calculator: https://homepage.univie.ac.at/robin.ristl/samplesize.php?test=proptest - and it told me the power is 0.63, which is pretty low. That said, it didn't give me the option to say what effect size I was looking for, which is annoying.
Using this: http://biomath.info/power/chsq.htm - if I use the number of bisexual women and proportion with long COVID, the test tells me that group 2 (ie straight women) would have a detectable effect if the proportion is less than 2.2% or more than 15%. Switching the groups (so using the number of straight women and proportion with long COVID) results in the proportion in the bisexual group needing to be under 0.5% or over 10%. Both of those are with an alpha of 0.05 and a power of 0.8.
This was a quick calculation on the commute to work, but if I am understanding the calculators and the numbers right, then there are not enough people in the study to draw a conclusion.
I think you're correct that there's not enough responses to say one way or the other.
However, you redacted null responses. The only way you can do that and still continue is either by assuming the nulls (if they responded) would not change the result or b) the number of nulls is small enough to not change things. I haven't looked at the number of nulls, but either could be false.
I went through and had a look, just using the second calculator. If nulls are consistently no long COVID or if they are consistently long COVID in both groups, that doesn't make a difference to the power (ie there still aren't enough people). However, if one group's nulls are all in fact people who had long COVID, and the other group's nulls are people who didn't, that might make a small difference. I don't know if I understand the maths or the sample population enough to say anything more specific.
I'm a rheumatologist who sees a lot of fibro, EDS, and long Covid. Rheumatologists actually sometimes joke that if a bi or genderqueer woman with brightly dyed hair walks into your clinic with joint pain, there is a 99% chance she/they has hypermobile EDS and fibromyalgia. It's not to denigrate these people or not to take them seriously (their suffering is real regardless of being "psychosomatic" or not, and besides we gotta catch that 1% who has RA or lupus and would actually benefit from immune suppression), but there's something about that personality type/set of life experiences that just always produces this same cluster of symptoms.
As someone who's actually got boots on the grounds with long Covid and other conditions in that cluster, you got it exactly right with this statement: "But I think the strong version of this is that straights have some fatigue, ignore it, and it goes away, whereas bisexuals have some fatigue and focus on it in a way that makes it worse and turns it into a trapped prior. This is how I think of chronic pain and several other psychosomatic illnesses." That's why these patients NEVER get better with immune suppression, or blood thinners, or hormone adjustments, or whatever other biological interventions, but they sometimes/often do get better with SSRI/SNRI and pain psychology therapy.
This feels intuitively right.
It's also what everyone assumes is the explanation when they first hear there's a correlation between bisexuality and Long covid.
That's actually really interesting, thanks.
Isn't hypermobile EDS something that would be very not psychosomatic? How can hypermobility be psychosomatic? Seems like an odd one out with fibro and LC
Scott, I think there's some sort of copy-and-paste error: Your quote of Toggle's comment seems to contain a copy of Mike's later comment. (I didn't check to figure out the correct original comments.)
Looks like a Toggle original to me!
Yes, I see that Scott has since corrected the error I pointed out.
> When I’ve looked into depression biomarkers, it’s been very hard to distinguish them from general bad health markers, and Long COVID would be especially hard since you would have to distinguish them from previously-had-severe-COVID markers.
[posting this to provide more information re biomarker studies and to point at a promising biomarker finding which seems remarkably feasible to independently replicate: about $1200 for Angiopoietin-1 + P-selectin ELISAs, and access to a laboratory with a plate reader. Not arguing anything re psychosomaticity here. Thanks for featuring my comment and thanks for clarifying what you meant re psychosomaticity]
Several of the long COVID biomarker studies do compare against "people who recovered fine from mild COVID" (most people these days!) and/or "people who were in the ICU for COVID" groups and nevertheless effectively classify. Re specificity, indeed, some of the biomarker findings are not very diagnostically useful on their own. This study https://www.medrxiv.org/content/10.1101/2022.08.09.22278592v1 finds cortisol levels (halved in long covid patients (without significant changes in ACTH) compared to controls, even a year after acute infection) the most predictive single factor, but cortisol is...involved in a lot of things, so it's not very specific.
However other long COVID biomarker findings are unambiguously COVID-related: persistent circulating SARS-CoV-2 Spike in blood months after acute illness, persistent SARS-CoV-2 nucleocapsid + RNA in gut months after acute illness: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9057012/ https://academic.oup.com/cid/article/76/3/e487/6686531
Re the Angiopoietin-1 + P-selectin (proteins involved in vascular/endothelial/platelet function) finding; there is essentially *no* overlap between long covid patients and any of the controls (healthy controls, people with mild covid, people with severe covid). The variance for the control groups is an order of magnitude smaller than the difference between the long covid group and any of the controls. Purely from eyeballing the figures, the average levels in long covid seem to be an order of magnitude higher than those in any of the other groups: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549814/figure/Fig3/
This points to "somehow actively involved in the disease process" more than "biomarker for bad health".
Some chronic conditions do elevate Ang-1 and P-sel, but much less than was observed in this study. https://pubmed.ncbi.nlm.nih.gov/30047017/ finds *at most* a 30% elevation in P-selectin in people with T2DM with high vascular risk factors. Not an order of magnitude increase.
To put it another way, the *chronic* P-selectin elevations found in long COVID patients seem (if I've done my math right) to be commensurate with *acute* P-selectin elevations in conditions like acute myocardial infarction (https://pubmed.ncbi.nlm.nih.gov/9672405/) or acute ischemic stroke (https://www.ahajournals.org/doi/10.1161/01.STR.28.11.2214).
Between the remarkable reported specificity/sensitivity, samples collected by simple blood test, and affordable immunoassays available for the relevant biomolecules, this seems like the most promising biomarker finding for LC I've seen so far. If I had access to a laboratory, I would try to replicate these findings (assuming I could find some people with long COVID who'd be up to participate; I don't have it, I'm just interested in it).
The authors use a "Endothelial Injury Marker 12-Plex Human ProcartaPlex™ Panel, EPX120-15849-901" (which costs $2600 and requires a Luminex xMAP fluorescent magnetic bead system) which let them assay 12 endothelial-related proteins per sample at once. There are much less expensive commercially-available immunoassay kits for Angiopoietin-1 and P-selectin, which only require a plate reader: $1200 gets you 96 ELISA tests for Angiopoietin-1 (https://www.thermofisher.com/elisa/product/Angiopoietin-1-Human-ELISA-Kit/EHANGPT1) along with 96 ELISA tests for P-selectin (https://www.thermofisher.com/elisa/product/P-Selectin-Soluble-CD62-Human-ELISA-Kit/BMS219-4).
This study (https://molmed.biomedcentral.com/articles/10.1186/s10020-023-00610-z) by the same group finds even *more* proteins in the blood with excellent specificity/sensitivity for long COVID, and again, the levels in long covid patients are completely disjoint with the "5th percentile to 95th percentile protein expression range of healthy control subjects": https://molmed.biomedcentral.com/articles/10.1186/s10020-023-00610-z/figures/2
Hi, thanks for interesting info! I don’t understand graphs B and D from figure 3 (the link in your comment ending with Fig3). The in-graph legend mentions a notes a green and a blue line, but on the charts themselves I only see blue lines. Not that I understand those, either. Could you maybe sketch an explanation for someone who doesn’t know what they’re looking at?
can you paste the URL you're asking about?
Here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549814/figure/Fig3/
> ROC curve for Long-COVID versus healthy control (green) hidden by ROC curve [(blue)] for Long-COVID versus acutely ill COVID-19 patients.
it's bad wording but; my understanding is that the green ROC curve (LC vs healthy) was identical to the blue ROC curve (LC vs acutely ill C19) and so the green one is hidden since the blue one is rendered above it.
🤦 duh. Yes, that makes perfect sense, thank you, Shasha!
"a study showing that bisexuals had more cancer, asthma, and heart disease than straight (or gay) people"
Yes, but the interesting claim about long covid is that gays and straights are similar, while bisexuals are outliers. This study makes bisexuals look like gays. That's not a surprising result. Lots of the arguments in this post assume that bisexuals are like gays. Maybe those arguments explain these results, but they don't explain the long covid results, where gays are like straights.
In 5/6 comparisons (3 diseases x 2 sexes) bisexuals have more disease prevalence than gays and straights, but in only two cases does it match the long covid pattern of gays and straights being similar. In three cases gays are in the middle, twice halfway, once close to bisexuals. In the final case, bisexuals are like straights and gays are the outlier. The cases that match long covid in bisexuals being the outlier are heart disease in both sexes. The cases where gays are halfway in between are asthma in men and cancer in women. The case where bisexuals are in the middle but close to lesbians is asthma in women. The case where bisexuals are like straights is cancer in men.
"I find libertarians and Marxists, who I would expect to be less interested in the right-wing project of minimizing COVID than conservatives, sort of interesting."
Libertarians in America are for the most part aligned with the right, many with the extreme right. Even those who are not, in my anecdotal experience, were very anti-COVID restrictions (for the obvious reasons one would expect libertarians to be against extreme restrictions on individual liberty), and also COVID skeptics, as a way to justify the resistance to even mild COVID restrictions. For these reasons I'd by and large expect libertarians to be similar to conservatives on questions relating to COVID.
Marxists, on the other hand, are just weirdos. There is no one political camp in America where self-identified Marxists can find a home, and in my (also anecdotal) experience a lot of people who identify as Marxist don't really mean much specific by it. I've known folks with a wide range of political orientations (including a small number who would probably be called right wing, though this has been rare) who call themselves Marxists. So yeah, I'm not sure what this means.
There's definitely a libertarian divide over the covid vaccine. As I noticed when my friend described how she tricked a vaccine requirement to attend a concert in San Francisco. On one hand, I laughed with her because San Francisco did go overboard on pandemic restrictions. But on the other, dude, why don't you just get the vaccine?
Considering also that a genuine Marxist analysis of Trump’s ascent to presidency and its aftermath is obviously incompatible with most of the left’s anti-Trump talking points, it’s surprising that the two sides have not coalesced even more.
> There is no one political camp in America where self-identified Marxists can find a home
Most academic humanities departments.
I am under the impression that at this stage their Marxism is mostly merely performative though. We don’t see much of a praxis-theoria-praxis feedback loop, do we?
Isn't that worse than if there was feedback from reality to theory? The fact that you don't bother to consider whether your ideas are any good doesn't mean you only hold those ideas performatively. It can also mean that you actively seek to realize horrifying goals.
I suspect that the goal is to legitimize the status quo, which you can argue is horrifying but it’s not too different from what their colleagues in economics departments are doing, just with a different toolset. Of course no amount of false consciousness among those holding cushy academic jobs while self identifying as Marxists can deny the soundness of Marxist analysis as a methodological tool.
*Bernie Sanders waves hi from his USSR honeymoon*
To date, there is no compelling discriminant validity evidence for a distinct "Long COVID" syndrome. It is generalized post-viral symptomatology until empirical evidence clearly indicates otherwise. Nonetheless, the common cause herein is negative emotionality (NE) /affective dysregulation.
Is there data comparing the prevalence of individual long-covid symptoms? Some seem more 'psychosomatic' than others. 'Fatigue' is pretty vague and subjective, but a friend of my dad's has lost all sense of taste and smell since getting COVID in 2020. He's lost a significant amount of weight since he's no longer been able to taste food, it seems very likely that losing your sense of taste/smell is much less likely to be psychosomatic than fatigue or 'brain fog'.
"fatigue" might sound vague and subjective at low levels, but can mean "was an athlete, now struggles to walk to the mailbox", which which hard to precisely quantify is also clearly something and not just a different perspective on the usual.
> If this were true, the bisexuality effect would be stronger for milder cases of Long COVID
I don't think this is right. I'd expect a personality trait that pushes people to round off "maybe long COVID" to "long COVID" would also make them round "maybe severe case" to "severe case", so you'd get the same bias in severe/mild case as you do in long COVID.
Is «could and wanted to expend all the effort to get formally diagnosed» a significant factor in «diagnosed by MD»? Because all the healthcare access discussions seemed to imply there is some barrier.
Reporting thresholds and slack to compensate for mild damage are surely always relevant: I (male, straight) had some lingering effects after a definite viral cold likely to have been CoViD that might be too weak to even call symptoms and they are perceptible in very specific situations that can arise or not…
"Also, if sexual contact caused immune problems down the line, this would be a big deal and we would already know."
Do we not already have pretty good hints in this direction? This seems obvious enough that I wonder if I've misunderstood you somehow.
I mean, ignoring the low-hanging fruit of HIV/AIDs, most of the pathogens which maintain persistent infections do so by tamping down the immune system in one way or another. The herpatic viruses are notorious for this. They often interfere with iNOS or deplete arginine which has a similarly depressive effect on macrophages.
• Reactivations of EBV, CMV and HHV-6 are frequent in severe COVID-19.
• EBV reactivation is associated with longer ICU length-of-stay.
• EBV reactivation occurs early after ICU admission.
CMV reactivation occurs later after ICU admission and may require anti-CMV treatment.
https://www.sciencedirect.com/science/article/pii/S2666991921000051
discussion of CMV and autoimmune disorders
https://www.sciencedirect.com/science/article/abs/pii/S0882401018304789
Subclinical CMV viremia is associated with increased nosocomial infections and prolonged hospitalization in patients with systemic autoimmune diseases
https://www.sciencedirect.com/science/article/abs/pii/S1386653221001165
" cytomegalovirus (CMV, HHV-5, a β-herpesvirus) imposes a surprisingly profound impact. The majority of the world’s population is CMV+, and the virus goes through 3 distinct infection phases en route to establishing lifelong détente with its host. Immune control of CMV in each phase recruits unique arms of host defense, and in turn the virus employs multiple immune modulatory strategies that help facilitate the establishment of lifelong persistence....This strategy of hijacking host IL-10 immunosuppression to promote viral persistence is similarly employed by MCMV "
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992493/
To be clear, I'm not saying that this is relevant to the immediate discussion. I just wanted to address the point that STDs can impact immune responses.
Man, the entirety of section 5 should be its own essay emphasizing the perspective that basically anything can be psychosomatic. The heart attack and chest pain statistics are a significant update for me, and while I intuitively understood that some illnesses are heavily mixed - I knew this is very true for well-known-frequently-psychosomatic stuff like LC and back pain; incidentally, just the other day I had to wonder if a headache I was having was a recent stress or dehydration - I still didn't realize it was such a common pattern, and based on the previous discussions I'm guessing most people didn't.
I think part of the problem is that it is down to self-identification, so you will have real bisexuals and the social contagion bisexuals and the real Long Covid or post-viral syndrome sufferers and the 'maybe I have it! everyone else on Tiktok does!' lot.
The audience here will tend to skew towards "yes indeed real bisexual" along with a lot of other minority positions on things, but in the general population?
How do you define bisexual?
And again, I do incline to the view that people who are more on the left/liberal/progressive side of the fence will more easily identify as A, B, or C than people more on the right/conservative side, as well as older versus younger. If you're in a place and/or time where it's socially acceptable to be some variety of queer, then you're more likely to identify as that than if it's a place where you're in the closet unless you really, strongly, definitely are gay, lesbian or bi.
So how do you define bisexual? It's not "have you had sex with people of both sexes?" because according to this randomly selected site:
"People use a few common labels to identify their sexuality. Your sexuality isn’t defined by who you have sex with – it’s about how you feel and how you choose to identify yourself. The important thing is that you choose what label feels comfortable, or you choose no label at all. You might find, like many others have, that the label you choose changes over time."
So if you're young and you go "I think Barbie is cute", then you may go "Oh wow, am I bi/lesbian?" and the answer seems to be "If you think you are, yes! So long as you find that description comfortable, then you are, and when it's not, then you're not".
So, TMI time again. In my attempts to figure out what the heck was wrong with me over the years of my youth and adulthood, one of the considerations was "well, do you prefer girls then?" And considering it as a hypothetical, the idea of having sex with a woman didn't make me go "Ugh, no!!!" (Sex with a real person in reality being not at all the same notion because no thank you to anyone of any sex or gender).
I don't consider myself bisexual. *But* were I a young adult *now* and a good bit more left-leaning in social attitudes, I well might identify as such. "But you've never had sex with/dated a same-gender person!" Yeah, shut up bigot, not necessary for self-identification.
Same with long covid. I've had covid, and since then I do feel that I have a perceptible change in taste. I have bouts of fatigue, breathlessness, 'brain fog', many of the very vague and multiply-applicable symptoms.
But I can also put these down to getting older and existing health conditions.
So, do I have long covid? I say no. But again, a slight difference in inclination, and I could say "yes".
When answering the survey, I said no to both the bisexuaity and long covid parts. But rotate me 45 degrees, and I'd be answering yes. For the same physical entity with the same physiological symptoms.
Now you tell me: am I bi or not? long covid or not?
To be fair though, sexuality is kind of a spectrum (for women much more so than for men), and so is Long Covid. Outside of a few extreme cases, identifying as "bisexual" or "suffering from Long Covid" is kind of pointless, just like identifying as "tall" is pointless. Unless you're the tallest person in the world, there are always going to be some people who are taller or shorter than you. However, this does not in any way mean that height is a social contagion and if we just got off TikTok we'd realize that we're all the same size.
Yeah, but if you were a young woman who was 5' 4" in height, which is average American height for a woman if I believe Google, and you were being bombarded with images of tall, leggy girls on Instagram and TikTok being successful and happy, and other women were posting "studies show that short people are unfairly discriminated against" and the rest of it, it's possible you might come away with "Hey, I *am* being societally discriminated against by heightphobia!"if you've felt a bit uncomfortable all your teenage years about being shorter than your friends and how the girls who were popular and got dates and the rest of it were all taller than you, and all the advice about "yes, you're not as tall as that model or sports star but you're perfectly normal height" would be dismissed as "you're just perpetrating bigotry against short people".
People go out and get leg-lengthening surgery because they think they're too short. It happens. I do think it's possible that current teens and young women getting told about how WONDERFUL being some flavour of queer is, and that boring cis het is not alone dull and boring but repressive and to blame for all the persecution, and that victimhood is strength and gets you sympathy, validation, and support online - then it's easier to parlay "okay I like the idea of kissing girls" into "I am bi and not boring vanilla cis het". You're fourteen, you want desperately to fit in with those around you, and you're seeing social media messaging about "you might be bi or trans or something if you've ever...."
I've always been a misanthrope, and when I was a kid nobody could persuade me to join the Girl Guides (as they were then) - not my mother, my friend who was in the Guides, or even the nun in charge of them. So I've been protected by my thick shell of anti-social attitudes.
But if I were fourteen today? And a little more desperate for friendship and connection? And had my same awkward-angles personality? If someone sympathetic came along and murmured to me that there were supportive places for those like me where nobody would judge you, just come along and see, nobody is going to make you join, but have you considered that maybe?
https://gsanetwork.org/what-is-a-gsa/
Yeah, I might decide "Oh, *this* is why I don't fit in! This is why I'm not interested in talking about boys like the rest of the girls!" Best of all? I don't have to *do* anything, self-identification is enough. Now I have a shiny new identity that means my weirdness is not a bad thing, it's explained in a way that is supported and validated: I'm a victim of prejudice and outdated expectations!
Yeah, sure, you can have any kind of self-identified identity that you want; my only point is that it's not super informative to discuss what is and isn't "true" bisexuality, since in reality there's no such thing. The best you could possibly say is something like, "I prefer men to women at a rate of 1.32".
> https://gsanetwork.org/what-is-a-gsa/
Is that the same as a "gay/straight alliance", only rebranded ? Back in my day, those places had the reputation of being clubs for closeted gay people, where they could gay out with each other.
Is there research on if life or death social situations cause psychosomatic symptoms?
Like consider rooms clapping for Stalin or the purge by Saddam Hussein; I dont know how you'd ethically test such a situation if say >50% of the room had migraines, but would it be the most unusual thing in the world?
If you social group is burning witches maybe its for the best for your nervous system if you join in to the hysterical dancing, illnesses and people do just have a shut down switch when they believe there is lethal danger and their tribe is angry with them.
"It's possible that both trans-ness and bisexuality are the result of a sort of anatomical and neuro-hormonal "chimerism" that isn't present in either fully straight or fully gay cis people. I don't mean they're the result of literal genetic chimerism (which is far rarer than bisexuality or gender dysphoria), but rather, that they're caused by some sort of mismatch involving the body's neurological and hormonal transmitters and receptors."
This doesn't seem right. Wouldn't this mismatch she speaks of be more prevalent in homosexuals than in bisexuals? We've all encountered effeminate gay men and butch lesbians, have we not? They would figure to have the highest degree of this mismatch, I would imagine, but that's not where the incidence of long Covid seems to be the highest, right?
The link under "psychosomatic blindness" goes to http://file///C:/Users/Scott%20Alexander/Desktop/admin,+9729-34293-1-CE.pdf, which non-you people cannot access.
@Scott:
FYI, the first link in this sentence:
> Psychosomatic blindness has fallen out of style these days, but used to be quite popular - the British commander in the Revolutionary War had it.
Apparently links to a pdf file on your desktop, rather than to an actual web link.
Whenever you talk about psychosomatic illness, people read a whole lot of things into it that you didn't say.
To call something psychosomatic does NOT mean:
—that it isn't real
—that it can't cause real pain, distress, and disability
—that the person suffering is lying
—that the person shouldn't get treatment
—that the person doesn't deserve sympathy
It's saying: these symptoms do not have a physical cause.
"Christians and Republicans had no more Long COVID than people who said no religion or no political party, but polyamorous people and rationalists did."
During the pandemic, I noticed that the SF tech scene (i.e., polyamorous rationalists) went deeper into social distancing than any other demographic on the planet. People I knew who were actually immunodeficient did not isolate nearly as much as these guys. Social distance became a moral imperative and covid became The Worst Thing That Could Ever Happen To You.
"I think the worst-case scenario is that, since Long COVID is in the news, extremely sympathetic, and has maximally vague symptoms, its psychosomatic shadow could be much bigger than normal"
Especially if you were so traumatized by a positive covid test result, or maybe even just something that you suspect was covid but couldn't get a test for (remember that other infectious diseases are also still a thing), that your recovery was followed by a laser focus for anything that might be long covid. Because of course you must be injured! If you isolated like a champ only to discover that covid was a nothing burger for you, how foolish would that feel?
Long covid as biological sunk cost fallacy.
I didn't realize there was a correlation between polyamorism and rationalism (and whose locus is apparently the SF tech scene...). What is the explanation for that?
The correlation is mentioned in the article we're both commenting on. Its overlap with the SF tech scene is just my personal observation. I don't have an explanation, though I have heard the joke that SF adults below the age of "I bought my house twenty years ago" skew polyamorous because that's the only way to afford rent.
Coyne’s arguments convinced me that your survey effect probably isn’t real. There is huge difference between replicating an established result and establishing a new result. One of those is significantly harder than the other.
And if you (formally or informally) considered more than 3 hypotheses when looking at the data then a p-value of 0.016 is not significant after adjusting for multiple comparisons.
In case that second paragraph is too pithy, digging around in survey data to find interesting hypotheses, then doing a statistical test on the strongest effects is literally the classic xkcd: https://xkcd.com/882/
And this is true even if you didn’t formally do statistical tests on all of the potential hypotheses that didn’t seem like they would pan out.
That doesn’t mean exploratory data analysis is worthless. It’s great for hypothesis generation but not hypothesis confirmation. Unless the effect sizes are so strong as to remove any doubt (but these are obviously no where close).
Quick note: Coyne expects confidence intervals from Scott, but I don't think it's possible to construct those given the type of analysis he used. I say this because I attempted to replicate Scott's numbers and provide these confidence intervals.
I'm assuming Scott used a chi squared test for independence. This is well and good for seeing whether long covid in bisexuals or not follow the same distribution. In tests like these we get a p-value and then see how small or large it is. Then we can reject the null or not.
This is not the time to construct confidence intervals. My understanding is we do that when we're estimating the parameters of a distribution. (i.e. what's the average height of Uzbeks?). Scott is not estimating any quantities here, so whatever confidence intervals Coyne has in mind don't apply here.
I also don't think we can construct a confidence interval around the p-value. Mathematically, it's just a single observation from a chi squared distribution.
As a digression, you can also see Scott as already having computed a confidence interval of some sort when he conducted the chi squared test. All a statistical test is is using the null hypothesis to say your test statistic will follow a certain sort of distribution (in this case, a chi squared one). You then say if the null is true, there's a .95 chance my statistic will lie in this interval. That interval looks a lot like a confidence interval.
Is "PHQ-1" a typo for "PHQ-9", or is it a tongue-in-cheek way of saying "just directly asking if someone is depressed"?
I'm late to the party, but see my three posts on Long Covid psychosomatic effects:
"Psychosomatic contributors to Long Covid suffering"
https://moreisdifferent.substack.com/p/psychosomatic-contributors-to-long
"The "false fatigue alarm" theory for Long Covid fatigue"
https://moreisdifferent.substack.com/p/the-false-fatigue-alarm-theory-for
"How to treat Long Covid as a brain-based (psychosomatic) illness"
https://moreisdifferent.substack.com/p/how-to-treat-long-covid-as-a-brain
Note I don't think all of Long Covid is psychosomatic, I discuss biological contributors in the 1st post. In my own case I suspect either Epstein-Barr reactivation or persistent virus for several months.
I explained this debate to my bisexual friend and she found the causality obvious: “bisexuals reproducibly sit in weird contorted positions which constantly make us hyperaware of our lung capacity.”
Sorry if this is a hopelessly stupid question. Is Scott’s use of the term “weird” in this piece
… (sorry about that, too quick with the finger, as it were) — does it mean Western Educated Industrial, etc.? Or is it a common way to describe statistically unusual or anomalous data or outcomes? Or is it just impolite?
My read is that it's used in the simple denotative sense, although it's appropriate to hear the echoes of WEIRD (Western, Educated, Industrialized, Rich, Democratic).
Oh, the STRANGE bias subsection following WEIRD is interesting, and speaks to many other points brought up in these discussions, https://en.wikipedia.org/wiki/Psychology#STRANGE_bias
My thoughts on this are not fully formed, but I think you're missing out on the fact that sexual attraction is IN ITSELF subject to suggestion. When someone expresses attraction to you, that emotional state can be contagious-- people are turned on just by being desired. So bisexuals can be genuinely attracted to both sexes, while at the same time being more prone to social contagion that would lead them to delusionally believe they have a disease.
Is there a reason you're ignoring the absolute mountain of evidence of pathophysiology in long covid? This Nature review has the goods.
https://www.nature.com/articles/s41579-022-00846-2
"Hundreds of biomedical findings have been documented, with many patients experiencing dozens of symptoms across multiple organ systems7 (Fig. 1). Long COVID encompasses multiple adverse outcomes, with common new-onset conditions including cardiovascular, thrombotic and cerebrovascular disease8, type 2 diabetes9, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)10,11 and dysautonomia, especially postural orthostatic tachycardia syndrome (POTS)12 (Fig. 2). Symptoms can last for years13, and particularly in cases of new-onset ME/CFS and dysautonomia are expected to be lifelong14. With significant proportions of individuals with long COVID unable to return to work7, the scale of newly disabled individuals is contributing to labour shortages15. There are currently no validated effective treatments."