This one's from 2011, and covers 34, 653 Canadians, but we have gay men with more mood and anxiety and substance use and cluster B disorders, whereas there are more bi men with cluster A personality disorders; both are more common relative to the general public. (Cluster C is about the same, though higher than the general public; same for suicide attempts.) Schizophrenia is more common among gay, though not bi men.
For women, it basically goes bi > gay> straight for all of the disorders except schizophrenia, which is lower among lesbians.
This study had 1239 people. Bi men were a little higher for anxiety and depression (it has scores on a scale but no breakdown) than gay men, no such effect for bi vs lesbian. Gay men were a little more likely to have used drugs.
This survey had 25,880 middle-aged and older people. Again bi > gay > straight for mental illness for both men and women, though again it doesn't break down, say, bipolar vs ADHD. Drug use for bi and gay men is about the same, though higher than straight men; for women it's again bi > gay > straight. Interestingly for chronic *medical* illnesses it goes gay > bi and straight for men (it's all the same for women); maybe it pays to have a woman nagging you to be healthy?
Ooohhhh! LOL. I did not get the joke (or even that there was a joke) until this thread.
It's not a terrible joke, it's just very (too?) subtle. I showed it to my wife, and she giggled nervously (she knew I thought it was funny because I had just laughed, but she didn't get it). I explained the joke to her, and she thought it was clever, too.
Sibling thread about wide Covid lying on its side because tired is also gold.
I like the idea, but I think the intent would've gotten across better with some form of repetition of the middle section rather than scaling the whole thing. 🙂
"Everyone knows a woman who claimed to be bisexual in their 20s yet goes back to getting together with men or never stopped in the first place."
This comment suggests you don't know what bisexuality is. Bisexuality means someone who would be happy dating someone of either sex. Compare to eg me saying I would be happy dating either blondes or brunettes. If I then date a brunette, and then later date a blonde, this doesn't prove I was lying when I said I was okay with either.
Again, I think this is misunderstanding bisexuality.
I wouldn't adopt the "bisexual" label for social reasons because I find the idea of dating a man to be repulsive. Some men do adopt that label, then go on to date both men and women, which apparently suggests they're built differently from me. Even if they eventually get married to a woman, or continue to date some women while also dating men (which is completely consistent with their claim that they're okay with either), that doesn't change my belief that there's something there different from me going on.
If there is an element of trendiness in choosing to self-describe as bisexual, then those who do so for trendy reasons are showing they are susceptible to social influence, and I expect that might be generalised into a tendency to be more influenced by other items in the social milieu, including self-diagnosing with the disease du jour. I don't care whether they are "real' bisexuals or not, whatever that might mean, only that we are very likely to see suggestible people in greater than expected numbers among those who claim to have internet-famous conditions.
There is a difference between something being *possible*, and something being so *frequent* that it explains statistical outcomes.
It is possible that a Chinese cardiologist is a murderer? Yes, certainly.
If we look at the statistics of how many Chinese cardiologists have Long COVID, and someone says: "well, the obvious hypothesis most people ignore is that they are murderers, and perhaps being a murderer changes your probability of reporting Long COVID because..." that is a much stronger statement.
*
Also, if we are using speculation as a research method, it works both ways. You know, there are also environments where people are under social pressure to publicly identify as "heterosexual", no matter how they actually feel (or sometimes who they secretly have sex with). By coincidence, these are often the environments where people publicly doubt whether COVID actually exists, or is actually dangerous. This would explain why people identifying as "heterosexual" are more likely to deny having symptoms of Long COVID.
I'm not denying that some people might claim to be bisexual because it's trendy, I'm denying that "she was bisexual, but also dated men" or "she was bisexual but eventually settled down with a man" provides evidence at all that a bisexual is doing that.
> Bisexual adults are overwhelmingly likely to be married to, or living with, someone of a different sex (32%) rather than someone of the same sex (5%).
I think that's some evidence that a lot of use of this label is of the trendy nature.
I think when you say it's either no difference or only opposite sex (or only same sex) you're oversimplifying things. Probably a lot of people have both strong sex urges and preferences that can't always be satisfied. IIRC Kinsey used a 9 level scale in this area. (That's second hand, and I never checked, so don't trust it.)
I've known multiple out-and-proud confirmed lesbians, across decades (so not evidence of a recent phenomenon), who later in life partnered with and even married men. I have never inquired about this choice, but I believe it has something to do with social acceptance (and maybe something about the male temperament) making for an easier, more relaxed partnership.
I've also known nominally gay women who didn't have a problem with dick, just with what was attached to it; they would have long-term relationships with women, and casual encounters with men. That might fall under "genderqueer" these days.
I don't think any of these people were lying to themselves, or anyone else; I think our categories are insufficiently descriptive of the human experience.
It's hard to take this seriously when your disrespect for this example person is coming through so clearly. Anyway I bet in many cases this isn't done for the social value of being edgy, or whatever, so much as it is based on a newly-acquired understanding that rigid sexuality is largely made up and actual sexuality can be much more fluid than believed in adolescence (gradually discovering that you can love or be attracted to all kinds of people). It can easily be a phase of positive growth rather than an attention-seeking reaction.
I've known people who did what seemed on the surface like what you described -- a bisexual 'phase' -- but if anything the big indicator is that they are, like, *turned on* by both sexes, which is to say, it's _real_ as far as anyone who's keeping score is concerned. But what you are turned on by and what you can imagine a stable relationship of don't have to overlap.
Gore Vidal (very famously openly gay) took the position that a word like "homosexual" shouldn't be used to describe a person at all. It describes an act.
Seen this way, all of this becomes kinda ridiculous because in our interactions in the world, it's only in very specific situations where we need to be able to predict someone's sexual behavior without other context (i.e..need an identifier).
Another complexity is that bisexuality is a plus in some social circles and a minus in others, including some homosexual social circles. I have no idea how the two balance out.
The point is that how you label your sexuality and your behavior are two different things.
A lot of bisexual-identified people have a revealed preference for heterosexual relationships. Some straight-identified people enjoy gay sex. This suggest that the difference between straight- and bisexual-identified people isn't just that of sexual preference.
To put it more rudely for the sake of clarity: Bisexual identity, like long covid, is transmitted socially. And people more susceptible to such transmission (notably women) are more likely to have both.
Bisexuality doesn't necessarily mean 'ambivalent gender of attraction'--lots of bi people have a preference for one or the other.
Your average male Kinsey 2, and even your average male Kinsey 4, is much more likely to identify as straight, because there's a huge amount of stigma attached to male bisexuality (and fear of STDs), whereas a female Kinsey 2 or 4 is much more likely to ID as bi. Identifying as a bi man will hurt you with straight women (who are much more numerous than gay men), whereas identifying as a bi woman will...not hurt you with straight men.
Well said about the blue-red tribe distinction (the bi women I knew weren't that bad drama-wise, though I'm sure you definitely experienced what you experienced!) and I should have taken that into account when writing that.
I still think you have a response-bias issue between men and women because the blue tribe is so big. But it's likely half as large as I anticipated initially, or smaller.
Given that most women exhibit a bisexual arousal pattern in formal studies, why can't we say that heterosexual female identity is transmitted socially?
A woman who identifies as bisexual is more likely to be accurately describing her physiological responses. Do we need to explain away accuracy as some kind of mental weakness?
To the contrary, increased awareness of one’s own physiology could apply across the board, all the way to spotting pathological alterations of it. So our hypothetical woman would be more likely to spot signs of long covid, even when they are subtle.
I think the blonde/brunette example is actually instructive. I think most people accept that "attractiveness" is at least somewhat culturally determined. Some cultures favor thicc butts (or whatever) and so *more* people in such a society then favor thicc butts. It's hard to differentiate between the people who would've liked thicc butts regardless of cultural impact and those who were swayed at the margin.
If attraction to same or other-sex people is similarly culturally mediated (which is Try Catholicism's suggestion), you'd still have a group of people who are intrinsically bisexual, but there would also be some number of people who would develop that attraction (or not) due to social factors. Those people would label themselves as "bisexual" while in the culture favors bisexuality, but then actually feel less/not bisexual if moved to a culture (let's call it "not college") that doesn't favor bisexuality. And those people may also be the people who are probably more likely to internalize other things (let's say, Long Covid) that are culturally favored or accepted in some way.
Not lying - I'm suggesting actual sexual preferences are affected by cultural factors, which I think is fairly well accepted when we're talking about physical attributes within sexes.
And I was referring to "thicc" butts. I'm not sure what the research says on big butts.
I think the real test would be be to observe, if a female were to enter the room with a large hip to waist ratio and curvaceous gluteus directly in your near-field view, would you become “sprung”?
We might be able to rule this out with an experimental manipulation. Have a confederate with a slim waistline but a large amount of gluteal adipose tissue enter the room, and observe whether these claimed big-butt lovers do, in fact, get sprung.
Of course, you'd need a control condition involving someone who does not got buns.
I know people who have the same level of interest in homosexual encounters as I do in heterosexual encounters. They occassionally find people of the same sex attractive, and are curious enough to act on it once or twice in a lifetime, but they clearly are more interested in opposite sex encounters. This is based on conversations and self-description, NOT observing who they date.
Yet these people would say on a survey "I'm bisexual," whereas I would say on a survey "I'm homosexual" because I'd rather simplify my self-presentation and they are motivated to complexify their presentation. They emphasize the ambiguity, I hide the ambiguity.
I have honestly considered the possibility that I have long covid. I entertain the possibility with comparable frequency to how often I entertain opposite-sex attraction: maybe every few months, when I'm in a certain frame of mind. But I said "no long covid" on the survey, because I'm not interested in broadcasting my random uncertainty.
Yeah, this was my off-the-cuff theory. Maybe rounding up is correlated with rounding up, and vice versa. There's all sorts of reasons why someone might round up or down, but maybe there's signal in the noise.
It's anecdotal but it does seem to be true that more young than old women identify as bisexual. Without wanting to gatekeep their sexuality, it does strike me at least a little as an affectation (And I can freely admit that if being a bisexual man were socially encouraged, I would have experimented with it more)
If we go by prejudices many homosexual men have an outgoing personality; yet they have even less long COVID than heterosexual men. You are just trying to shove your own prejudices and believes into the discussion ... (especially considering your Boomer numbers are outright wrong and used to validate your claims, even as far back as 1948 those numbers were much higher: https://en.wikipedia.org/wiki/Kinsey_Reports#Findingshttps://kinseyinstitute.org/research/publications/kinsey-scale.php )
Your whole argument hinges on 'Gen Z are more likely to identify as LGBTQ because it's 'trendy'' while not considering the inverse 'Boomers are less likely to identify as LGBTQ because of stigmatization'.
These are surveys about how people identify and they will be affected by the generation one was brought up in. If a Gen Z person has had even the slightest romantic attraction towards someone of the same sex, they will be more likely to identify as bi than an Boomer with those same feelings who will explain them away.
The proof is in the pudding. You have confirmed that you are standing on your beliefs and interpreting the data the way you do. Your bias is not an "obvious conclusion" or basis for a rational conversation. Thoughtful conversation requires a mind that is willing to be changed. Is your perspective on this something that could change and if so, what might be convincing to you?
You aren't comparing like with like there. Kinsey had a scale, whereas you are trying to compare his nuanced results with an absolute number you googled somewhere. Kinsey had a scale for a reason, and research has since become even more nuanced.
Additionally Kinsey did his research at a time where talking about such things was much more of a taboo back then. If anything, it's Kinsey's numbers which are skewed.
Also: holding random numbers from various sources side by side without context makes no sense at all. The actual ratios depend heavily on the methodology used. There is way more nuance to human sexuality than the heavy labels you are trying to slap onto it. Which is why your approach is prone to fail.
And yes: there is a cultural aspect the human sexuality as well. If society doesn't scold you for exploring your true self the results will of course be very different to those of a society which freaks out at anyone who even dares talking about sex. So yes: those numbers might have changed to a degree.
I don't take issue with Gallup. I take issue with your own personal interpretation of the results of their work ...
Your claims aren't their claims. All they claim is that to a certain question to a certain panel they got a certain ratio of responses. Everything else is your (faulty) interpretation ...
Trans and homosexuality are mostly sociocultural/environmental phenomena anyway (ie. not congenital/biological). This certainly does not mean they are a choice of course, but very little evidence that anyone is born trans or homosexual (and certainly not 30% of the population). So if they are mostly sociocultural/environmental phenomena, it should be normal that with greater acceptance their incidence will increase and vice-versa.
Considering that literally each and every sexually reproducing species of animals has been observed to perform homosexual practices I don't buy the "mostly sociocultural/environmental phenomena anyway" part. It's very obviously part of the natural variance of behaviors which come with sexual reproduction, even in animals which don't really form any kind of societies. Environmental factors could play a role, but those shouldn't vary in line with social acceptance.
Considering that homosexuality isn't an ON-OFF-switch, I fully agree with your "it should be normal that with greater acceptance their incidence will increase and vice-versa"; if by "incidence" we agree to mean that people act on this preference, instead of suppressing it trying to adhere to opposing social norms, if they feel allowed to do so.
Yes, homosexuality in nature occurs opportunistically but there is no evidence of a sustained sexual preference for the opposite sex in wild animals under natural circumstances. This has only been observed in human beings and in one breed of domestic sheep. In other words, given an equal choice in natural conditions, the sexual preference in nature is for the opposite sex (which is hard to argue against from a Darwinian perspective). In overcrowded conditions, homosexuality increases (which seems pretty self-explanatory), hence environmental factors are clearly at play. And very hard to argue that in the highly socialized existence that we humans have, that the socialcultural aspect is not extremely influential as well (perhaps the most important factor).
Animals don't engage in 'homosexual practices', as they--with very few exceptions--don't engage in social nor recreational sex. Homosexual activities in animals is a deviation of aim, not a deviation of objective.
Bulling behavior in cows, isn't one cow horny for another, its a cow overcome by hormones that in the natural world would have brought a large number of bulls to engage in sex with her.
FYI, Kinsey data expands to the following numbers, rounded for convenience:
40% of men engaged in same-sex activity at some point in their lives.
30% of men engaged in same-sex activity to orgasm, at some point in their lives.
10% of men had exclusively same-sex sexual contact for a period of at least five years.
4% of men had exclusively same-sex sexual contact for their entire lifespan.
Which of these you classify as 'gay', 'bisexual', etc. is kind of dodgy, especially in the 50s. If you take this data as gospel, I don't think it's at all out of the question that a fairly large plurality of the population would adopt bisexual identity in a 'neutral' setting, though it's honestly anyone's guess what the 'zero tension' number actually is given some hypothetical perfectly-tolerant society.
That's beyond the point. Whether those numbers were good or bad doesn't change the fact that they are MUCH closer to the numbers we find today than "Try Catholicism" claimed! So the change isn't as massive as he implied ...
Since there aren't any better numbers the same MUST be said for the initial claim I was contesting. Those are the numbers which exist; may they be bad or not. The other numbers were simply made-up.
Throughout this thread I repeatedly stated already that comparing those numbers without regard for methodology is stupid anyways. We agree on that account. I was merely stating that even by doing this stupid thing the outcome wouldn't be the one "Try Catholizism" claimed ...
Everyone is bisexual. Like, basically everyone. There may be exceptions, but you could never prove it. In a Kinsey scale sense, the *actual* 0s and 6s, if you could read minds instead of relying on surveys or observations, is a negligible percentage of the population.
So why doesn't everyone identify as bisexual?
Well, some of it is legitimately being a Kinsy 3 vs a Kinsey 1 or 5. But on the margins, some people are dedicated to expressing the complexity of their inner personality, and in the social cache of being "queer," while others are more interested in hiding their inner complexity and avoiding the social stigma of being "queer."
Heterosexual-identifiers have two potential motivations, but homosexual-identifiers have only one potential motivation (since they're queer anyways). Hence, anyone claiming to be homosexual in a survey must be statistically less interested in flaunting their inner complexity in surveys (compared to the population as a whole)
My personal crazy theory, of many years' standing, is that I think there's (at least) two axes here - attraction and (for lack of a better word) phobia. So I think some of what gets counted as 1s and 5s are people who have no attraction but simply aren't repulsed by that type of sex. Cats being grey at night, and all that.
Having the axes be completely independent would imply the existence of heterosexual people who are phobic of heterosexual sex or the opposite sex, and the homosexual equivalent. And frankly, I think that would explain a fair bit of pathological behavior.
I’d guess a similar correlation with queer or trans identities would warrant further speculation in this direction, but the sheer number of bisexual responses to the survey suggests you might be overly dismissive here.
I don’t think most people who casually use the word demisexual consider that an identity. I think it’s more a qualifier, used especially on dating apps to signal disinterest in hookups.
I've known three people who might be said to have had Long Covid. One was an fit fell runner who suffered extreme fatigue and poor concentration for over six months. This was in 2020. She is now ok but it was very scary, and very unpleasant. Another has had what might be called LC since falling mildly ill with Covid in 2021. Symptoms include aches and pains, physical weakening, and fatigue. Not life changing but not nice and still there.
On bisexuality, I am a bi male. Few people know that: for example, my children and most of my friends don't know. I haven't had any same sex action this century and I don't expect to do so in future: nonetheless I have in the past enjoyed it and felt attraction to men. That's a report on experience which may or may not be widely shared but which in fact I suspect to be quite common. If one has settled with a life partner, advertising who hypothetically one would be prepared to sleep with seems somewhat strange.
There is a rather irritating tendency in the rationalist community to interpret behaviours and preferences in terms of social positioning, as though people might not genuinely like hiking, or poetry, or playing the drums. Long Covid is real. Bisexuality is real. Baseless and generalised questioning of integrity doesn't advance the debate
I view our attraction/revoltion on a horizontal scale, and imprint an imaginary histogram atop that.
Some people are going to be very far on either edge, but most are centered. But where are the boundaries between the bands is going to be determined by nature and nurture, and with a heavy dose of culture.
Now make two plots, same sex attraction/revoltion, and opposite sex attraction/revoltion.
I think this also explains why the effect is larger with bisexual women. In many circles, bisexualism in women is much less frowned upon than in men (is this true statistically?), so the "self-reports bisexuality for attention seeking" is much more plausible with women.
Yeah, I would guess "left alignment" + "desire to be special" ("specialness deficiency"?) is a big cofounding factor. If you want to increase your "specialness score" bisexuality is an attractive option as it doesn't really *require* any behavior changes. (I think this can be subconscious - I don't think this has to be a conversation about 'lying')
I think the left alignment is a big factor, and the specialness factor is why it's a stronger effect compared to homosexuality, despite both fairly equally implying a left alignment.
A lot of women prefer men, but also don't want to get pregnant outside a stable relationship. When they find a man and form a stable relationship, they are satisfied. When they are outside a stable relationship, women are safer, and reasonably satisfying.
Here's a potential alternate interpretation of the data that occurred to me: Perhaps bisexual people are more likely to have more sex, which means they're more likely to contract STD's, which means that on average they are immunologically different to some degree and might legitimately get different physiological consequences from COVID. I don't actually believe this - I think your theory is at least as likely - but I'd be very interested in any analysis that tries to look into this.
I asked myself the same question. But if that was true then we should see homosexual men having a higher rate of long covid than heterosexual men. Instead, homosexual men have a particularly *low* rate of long covid.
That outcome argues against some comorbid STD leading to long COVID.
Androgens and their related receptors also seem linked to COVID. But I can't figure out what condition would put bisexual women, in particular, at risk.
Perhaps just like the correlation between being trans and hyper-mobile Scott wrote about, there’s a genetic link with bisexuality and autoimmunity issues.
Using the data shared by a fellow ‘commenter’ where bisexuals are considerably more likely to have relationships with the opposite sex (32%) than the same sex (5%), I think there’s an interesting possibility to consider.
It’s clear that within society there are those who are more confident/definitive about their views/experiences/ideas and those who are less.
This is maybe a commonality with sexuality and something like long covid. Having seen the way long covid was discussed in the media there’s no denying it’s considerably vague. A whole range of often common symptoms were mentioned. Therefore, when it comes to asking a given population whether they had long covid I think there’s a subsection in the population who are less likely to rule things out and perhaps going further, tend to question themselves. Maybe I do have long covid? I have had a stomach ache recently etc.
Similarly with sexuality, perhaps there’s a similar subsection of people who don’t have the conviction in describing their sexuality. Maybe they haven’t fully explored it yet and unlike others aren’t quite willing to rule things out. Bisexuality is clearly the ‘less definitive’ out of the 3 sexuality options, after all.
Did you correlate with political orientation? I'd expect that in the US, people willing to acknowledge they're bisexual are probably much more likely to be liberal than conservative/Republican/etc.; and that liberals/Democrats/etc. are probably, on average, more willing to acknowledge that they've had covid / that covid can be dangerous / etc.
Today if you are gay, you are very likely to accept it. If you grew up red tribe, you may stay red tribe while admitting it. If you grow up blue tribe you certainly will and you'll stay. But if you are bi and in the red tribe - it's a lot easier to pretend to yourself and surveys that you are hetro. If you are bi and blue tribe - you acknowledge it and stay blue tribe.
P(R|B) < P(R|G) because you can still pretend you aren't bi but won't pretend you aren't gay.
There's surely a data table that will quickly confirm or deny this theory but a quick google didn't turn it up..
This seems like the real deal to me. A blue-tribe person who is open to sex with the same sex but pair-bonds with the opposite sex is MUCH more likely to identify as bisexual than a red-tribe person in the same situation, so the identifies bi population skews heavily blue-tribe and has all of the markers of blue-tribe including "thinks X symptoms are long-covid when a red-tribe person wouldn't think that" and "cops to mental illnesses that a red-tribe person wouldn't cop to". In this admittedly evidence-free analysis, identified mental illness and long-covid are both downstream from culture, rather than identified mental illness being innate and long-covid being downstream from that.
Crucially, this doesn't suggest to me that bi/mentally ill/long-covid peeps are lying, or that straight/mentally healthy/short-covid peeps are lying, just that those two groups have different thresholds for using those terms to describe themselves, and those thresholds all correlate by culture.
This comment irked me in a way that makes me feel like maybe I'm suffering from a bad faith read of what you meant to say. It sounds to me like you're implying that there's a significant faction of conservatives/Republicans out there somewhere who are actively in denial about having had COVID, which seems grossly out of touch to me.
It makes me wonder what sort of experience you've had with conservatives/Republicans, because I know plenty of them and none seem particularly likely to be deluding themselves about their own health. If anything, they're more likely to take a responsible approach to the whole ordeal than my liberal friends.
My dad died of COVID. His widow called my uncle (on his ex-wife's side) to see if he'd gotten a memorial CD. _During that phone call_ he told her, "I don't see what everyone's so upset about. It's just the flu." He watches Fox News. I don't talk to him anymore.
I've read multiple accounts from doctors and nurses, describing how conservatives _who are dying of COVID in the hospital_ deny that they have COVID.
I'm glad you don't know conservatives like that. But you interpreted my comment correctly, and it was made from personal experience and apparently-valid multi-sourced information.
Your uncle sounds like a real piece of work, and I sympathize with your story. I had an uncle pass away recently, and it was a combination of diabetic and COVID-related complications.
Unfortunately, the way you've set up this comment is further ostracizing me from the conversation. Since I don't subscribe to the partisan perspective, it's not exactly damning to me that your uncle watched Fox News and I don't really understand why you included it...
*Wow, Fox News!? It's, like, they're the other team, right?* /s
I ran a quick Google search (<10m) trying to unearth some of these testimonials you're referring to, where bedridden hospital patients are denying their diagnosis, and couldn't find anything but headlines railing against the 'mass conservative delusion'. The search I used was "conservative denies having covid" - please feel free to link me to any sources that you have.
I've definitely encountered my share of radicals, and I'm not denying that there are some delusional folks, but the idea that they're proliferous enough to significantly impact Scott's poll would be pretty shocking to me. Especially given that the ACX audience is majority democrat.
I'm wondering if it's explained by something like how likely you are to hear symptoms and think "that's something that describes me" rather than just kinda going with the default answer unless you are forced into picking the other.
I mean, suppose you've occasionally had sexual or sexualish thoughts about someone of the same gender (Iess sure if there is a standard answer effect if homosexual). One sort of person might not think much of that unless they feel them quite strongly while another might report they are bisexual. The same kind of attitude plausibly affects how you answer long COVID questions.
I think this is the most plausible explanation I've seen: it has something to do with how we process ambiguous stimuli.
(I'd further hypothesize that this factor is different from, but positively correlated with, the "tolerance for ambiguity" dimension of trait Openness.)
I think what Peter is getting at here is something subtly different from a threshold effect, although I'm having trouble articulating the difference. I think the best way I can put it in "threshold" terms is something like "assessment of the relevance of subthreshold data."
That is, a hypothetical psychological factor behind bisexual identity couldn't really be describe as "high threshold" *or* "low threshold. A Kinsey 2-3 identifying as bisexual could be "low-threshold." A Kinsey 6 identifying as bisexual could be "high-threshold." What they have in common is not "how much information do you need to reject the default and/or accept the alternative," but something like "when you have conflicting information, do you think it's more important to indicate which side you're leaning toward, or to highlight the conflict?"
(Possible connection to the great "lumpers vs. splitters" divide.)
How this tendency presents across different survey questions is likely to vary, although I'd expect an overall tendency to avoid extreme responses on Likert scales. But on e.g. vegetarianism, I don't think anyone is looking at the question, scratching their head, and saying "well, I'm not *not* a vegetarian..." in the same way they might be for long COVID or self-diagnosed mental illness/developmental disability.
(Political affiliation would seem like the best analogue for sexuality in a structural sense, but current politics is extremely weird.)
Yeah I am straight as straight could be. So much more interested sexually in women than men, 100:1? 1000? Yet I can remember being IDK 11? Wrestling in shorts with another just on the cusp of puberty boys, and being super turned on by our smooth legs rubbing against each other.
More importantly I hadn’t had any real sexual contact/success with women at that time other than the modeling/aping 4-6 year olds do with each other.
I can see someone in a more modern environment, having that experience and living in this culture, and getting into this headspace where they convinced they are homo or bi-sexual.
But really I was just a horny boy who can be turned on by lots of things vaguely in the vicinity of having sex with a woman. And wrestling with a young boy was one of them.
I wonder if it's as simple as relationships -> more close interactions with people for longer periods -> greater attack surface for covid and other spread-between-humans things. It's obviously a gross oversimplification that bisexuals have twice as many potential partners, but...(plus this relies on an assumption that one would treat a partner with more lenience wrt covid precautions; this is maybe unwarranted)
I think you've missed something in that my first theory would be people admitting they're bisexual on a survey are _weirder_, and more marginalised (and more likely to be Blue Team politically?) - and deciding your symptoms are long covid is something that people who are already not trying to be respectable are more likely to do, and something that is much more fashionable in the Blue Team world than the Red or Grey teams, and you're more likely to need to put a name / diagnosis to it (to obtain support) if otherwise marginalised.
The symptoms of Long Covid could be any number of things, including 'nothing much' to someone who is otherwise healthy - so 'do you label your symptoms long covid' doesn't have much bearing on 'do you have physical symptoms or not'.
(I am somewhat biased on this because I believe the world is currently making a dreadful mistake ignoring long covid which will become increasingly apparent as people with it age and can no longer ignore the minor symptoms, and things which are psychosomatic tend to be ignored or dismissed by society as something you can somehow just stop experiencing)
Could also be reporting bias, same people who won't admit they're bisexual for social reasons won't admit to a potentially controversial illness (or identify what they have as it).
I like this. I’m basically elaborating on what you said but there’s a large amount of conservative, religious people who barely admit that Covid is real. Many still call it a flu. So you can’t have long Covid if acute Covid doesn’t exist either. I would wager many of those also would deny and suppress any bisexual feelings, at least in signaling to others if not also not acting upon that. And chronic illness is also frowned upon in general among the bootstraps types, as it inherently admits reliance on others may be necessary and not immoral.
Feels like you’re neglecting a possible arrow of causality in the other direction!
Imagine that there’s a relatively common personality trait, which expresses itself as a strong antipathy to stand out from one’s neighbors or be classified as a minority or exception; these people really really want to be ‘normal’, at least up to some threshold. Then, it seems obvious to me that they’d resist identifying as *either* bisexual *or* long-Covid.
This is not to exclude the other extreme- people with a very *low* threshold to identify as being part of a minority group or otherwise outside the typical human experience for their culture. Those people, in turn, would be more likely to identify as both bisexual *and* long-covidy, on the basis of minor expressions of either.
“People have a gradient for how willing they are to accept a self-identity far from their cultural center of gravity” seems like a pretty intuitive claim to me by observation. The only question is what fraction of our population tends towards either extreme; if they happen to be evenly balanced, it makes for a weird situation where overdiagnosing bisexuals exactly cancel out underdiagnosing people on the other side.
Would that explain the effect for homosexuality, though? It seems like this predicts that they would also be more long-covidy. (Not trying to argue against you, just trying to work through the logic.)
In my mental model, heteroosexuals have a confounder for homophobia, and homosexual identification is only testing for "how weird do you want to look."
In particular, being bisexual is "zanier" than being homosexual, just because being gay has more of its own established cultural identity whereas bisexuals are weird and marginal from the persepctive of both cultures.
I was thinking about that when I wrote it, and I think it works okay?
People with a strong conformity-impulse, or whatever you want to call it, will resist identifying as gay, but obligate homosexuality is not an ambiguous signal. (By definition!) In other words, anybody who experiences sexual attraction only to members of the same sex, but identifies as *straight*, is either extremely confused about what sexual attraction is, or (more likely) closeted. So here, the monotonic nature of a person's sexual attraction is set in opposition to their desire to conform to social norms.
On the other hand, if someone with a strong conformity-impulse is experiencing sexual attraction for both men and women, then sexuality no longer functions as well as a wedge against their need for conformity; they are capable building a narrative in which only opposite-sex attraction is 'real', of building habits in which they affirm and express only opposite-sex attraction, and commit to fulfilling monogamous relationships with people of the opposite sex.
As a result, I'd expect people with a strong conformity impulse to be better represented among self-identified homosexuals than self-identified bisexuals- obligate homosexuality simply gives a person fewer tools to maintain a straight self-identity.
Probably this should be said explicitly: there's an obvious political valence here, but I'm not really thinking anything Red v Blue. It's closer to the "lumpers versus splitters" dynamic you see in the sciences where some people like to classify phenomena in to a small number of broad labels, and others like to fine-tune categories in to more descriptive but narrower groups- but add in the evolutionary instinct to fit in well with the herd. Political divides would be basically downstream of that.
There are no (modern) places that I can think of where being straight is seen as odd, unusual, or 'marked', something in need of an explanation that someone with a strong conformity impulse would feel pressured to avoid.
That may indeed be the case, but 'conformity' is categorically not the same thing as 'status climbing.' At an engineering college, conformity-heavy students would tend to be engineering majors, not star football players; they do what their peers do. Being greatly lauded, like being greatly scorned, is the opposite of conformity.
I'm talking about an impulse that's coupled to, like, the fear of public speaking: an aversion to any situation where you are a particular and individual object of widespread social judgment. It's not at all unusual to dislike being on a stage, even when the audience is clapping.
Great nuance!! I feel like a lot of people (mainly a subset of cis individuals) vastly understimate the complexity of the internal experiences of sexual attraction and form an opinion based on their own assumptions.
I'm glad I found this comment after scrolling past many of the perspectives fixating on what they seem to deem as "false-positive identification as a bisexual is a social contagion". I mean I'm bi so I get it... it is confusing, at the same time I know of no quality data to quantify true/false sexual identification, yet people are using it as a basis for casual reasoning.
I'm going to stop here on before I have a brain aneurysm.
Yeah, that post probably benefits quite a bit from my own experiences as a gay man, though hopefully not in the 'trust me, I'm gay and I said so' sense. The interactions between social pressure and sexuality can be devastatingly complicated, and it's probably easier to articulate those interactions when you've had a few years in a domain where they diverge sharply from one another and you can track the lines of tension between them.
"these people really really want to be ‘normal’, at least up to some threshold. Then, it seems obvious to me that they’d resist identifying as *either* bisexual *or* long-Covid"
I seem like one of 'em.
That is, while I consider "normality" highly overrated, I was raised to think of drawing attention to whichever "abnormal" categories I might fit – especially any potentially "trendy" abnormal categories – as gauche, even sinful. Everyone's abnormal, more or less, and it's presumptuous to advertise our membership in any "abnormal" categories as if such a membership made us "special" .
I'm also a lumper rather than splitter, particularly regarding health history. Since underlying conditions adequately explain why I might have prolonged malaise after any respiratory infection, the discrete-seeming label "long COVID" just wouldn't be necessary for me to describe post-COVID malaise if I experienced it.
Scott, why the psychosomatic/physical dichotomy? All very Cartesian.
Surely there could be a mixed aetiology - a primarily physical initiating process could have a psychological or mixed perpetuating process or vice versa?
I think it's totally fair to distinguish between psychosomatic and physical. For example, someone who has leg pain because there's an observable fracture in their leg, or a tumor in their leg, or something like that, is much more physical than someone who has leg pain with no observable findings whenever they're really anxious. If that's "Cartesianism", I guess I agree with it!
Totally fair, of course. But it implies a dualism that I certainly don’t agree with and I don’t think is born out by what we know of disease (or physiology).
Yes, of course there are things that are purely physical and possibly some things that are purely psychological (though I’m not 100% sure that makes sense as a concept). The problem for me is that when we start running into things that sit across the supposed divide, we end up with “the majority of cases are physical” or “the majority of cases are psychosomatic” when I think it might be more accurate and fruitful to imagine a mixed process where the physical impacts on the psychological and vice versa; creating positive feedback and a self-perpetuating disease process.
One potential test for distinguishing in principle would be "if this person never had COVID, but thought they did, would they still have their symptoms or not?" although this isn't perfect because some people might have short-term symptoms that they then psychosomatize into longer ones.
Yup, I imagine that if anything it’s more like the latter - that some people are more susceptible to a condition that sits somewhere across the relationship between the immune system and psychology, though I’m far too ignorant about long COVID to speculate sensibly.
Anyway, the initial comment wasn’t meant as any kind of attack on a very interesting piece, I was just interested by the dichotomy. I think dividing the physical from the psychological is a useful model in understanding many illnesses but, like any model, it’s useful until it’s not. Many years ago I looked at the Postviral Fatigue/ME literature and it seemed then that we were getting stuck at a dividing line that was (in my view) largely imagined.
Everything is physical, because the brain is physics. But if physical causes of certain conditions are located and perpetuated in the nervous system, then it would make sense to have a separate category for them.
Yes, of course. But we distinguish between neurological disorders and psychological or psychiatric disorders, both are presumably occurring in the same physical space (more or less). I think having a hard distinction between physical and psychological disorders is helpful, until it isn’t. I don’t think a hard divide is supported by our understanding of neuropsychology and we know that, as well as the physical having a profound impact on the psychological, the reverse is true - psychological hardship has a marked effect on physical health.
Right, we distinguish them because for some conditions the causation is pretty much established, and for others we haven't yet managed it. But even though we don't know the precise mechanics, it still has to ground out in physics, one way or the other, which the unfortunate "physical vs psychological" dichotomy obscures. And, of course, establishing the truth is further muddled because having diseases that are just "in your head" is low status, so there's a concerted effort to have them categorized in other ways by those afflicted with them.
That’s a nice clean example you give, but I’m not sure it addresses Oliver’s point about mixed aetiology (maybe it does; like I say, I’m not sure). “Mixed aetiology” plus a rejection of a strong mind/body dichotomy certainly rings true to my own experience of long covid. I had one year plus of markedly altered taste/smell, along with fatigue and occasional waves of full body nausea culminating in uncontrollable tremors, starting in March 2020 (so before long covid was a Thing). The taste and smell part in particular make me think this was not psychosomatic; on the other hand, I found my thresholds for emotional stresses, including anxiety and depression, were drastically lowered, and some of the symptoms were undoubtedly triggered when I passed these new thresholds. Since then I’ve had two years of gradual improvement phases followed by relapses. Sometimes the relapses (and the improvement phases) appear to have an emotional trigger, sometimes a physical one. Overall, the explanation that seems to fit best is “physical damage to my nervous system, leading to a condition that often manifests as a psychological one.”
One challenge is that if leg pain is caused by a problem in the nerves or the brain, it would be much harder to identify, but still presumably physical.
I think there's a gray area between psychosomatic and physical, and that it's well-populated by people and phenomena. Here's an example: When I learned to do hypnosis one of the induction methods was to have someone stretch their arm straight out, palm up, and place a penny on their palm. Then you do hypnotic patter about how as the person becomes more and more sleepy and hypnotized, they will notice a tendency for the hand holding the penny to rotate inward. Eventually, you tell them, their hand will rotate so much, as they become more and more deliciously hypnotized, that the penny will drop, and when it does they will be fully hypnotized, and their eyes will close. When you, as hypnotist, observe their hand to rotate a little bit, you comment on it, and ask subject to "notice the little surge of relaxation that accompanies the motion." This method works really well, and was always my favorite.
But here's the thing: If you just hold your arm straight out, with palm flat, you will also notice that your hand tends to rotate inward. I think holding the palm flat involves angling the hand in a way that's a little bit effortful. As your arm tires, you hand will rotate in unless you expend conscious effort to keep it parallel to the floor. But hardly anyone knows that. So if during the induction you present the rotation as evidence of hypnosis-induced involuntary motion, most people really buy it. So then they have more belief in the process and in the hypnotist, and more willingness to turn themselves over to it. And a lot of being hypnotized is believing you are hypnotized, and giving yourself permission to think and act in certain ways because after all, you're hypnotized.
OK, so that's an example of the gray area: There's a purely physiological reason why your hand rotates. BUT if you buy the idea that the rotation of the hand *means* you're hypnotized, you in fact will develop "hypnosis syndrome," i.e. you will believe yourself to be becoming hypnotized and in fact become so.
Now think about a suggestible person who has recovered enough from covid to start back to work, ago and has read about brain fog. If you gave them a neuropsych eval you would find that their cognitive scores are unchanged from pre-covid. However, the truly are not feeling very well. They still have some muscle aches and fatigue. So the first morning they're going back to work they're not moving very fast, and they lose their car keys, and wonder whether that's because they have brain fog. The rest of the day they pay more attention to little fluctuations in attention, and notice they space out a fair amount at work. Uh oh. Etc. So their "brain fog" is the product of both a real phenom (fatigue) and a way of thinking about it.
Can anyone offering an argument along the lines of "Bisexuality is a social contagion just like long COVID, they both manifest in the people susceptible to social contagion" please at least take a stab at explaining why the effect doesn't seem to apply to gays?
Easy. Homosexuality is much less likely to be caused by social contagion than bisexuality simply because it's more of a lifestyle change. If you're a mostly heterosexual person who wants to be "queer" / special / have your own flag, it's much easier to say you're bisexual than to make the full switch.
But that seems more like conscious, hypocritical label-appropriation than "social contagion" in the sense that people usually argue transgendernesss is a "social contagion". After all, being trans is a big lifestyle change, an archetypal example of a "full switch".
Abstractly declaring yourself bi for status with no intention of romancing anybody of the same gender seems more like the cases you occasionally hear about of basically cis people declaring themselves non-binary while changing nothing about their gender presentation beyond pronouns. Which I don't think is the sort of thing people would describe as examples of trans-as-"social-contagion".
> As for trans, I’d be curious to see the numbers on “low cost” transition versus “high cost” transition. I would bet the number of people claiming to be non binary or socially transitioning far outstrips the number of people who actually take hormones or get surgery.
Probably, yes! I'm just saying that I think hypocritical "trendy" label appropriation, and "social contagion" as in "trans as an example of an adverse culture-bound syndrome like the eskimo things Scott was talking about the other week", are different enough phenomena that they should have different names altogether.
i.e. a 'transtrender' who gets social credit by declaring that they're now a "he/they" doesn't seem like they have anything much in common with a person who's suffering from dysphoria to the point of suicidality, but may only have gotten there because the idea got planted in their head and they kept 'picking' at it, while in another world, if they'd never heard of transgenderness, they might have lived happily as their original sex indefinitely. I understand the "social contagion" model of transness to usually refer to the *latter* scenario. (Hence "contagion": it's not pleasant for the people who "catch" it! Entirely the opposite of gender-hipsters who are in it because that's the way the wind is blowing, but could and would forget all about it if the climate changed.)
I'm not convinced the two are even a spectrum as opposed to two entirely different mechanisms that might lead to people claiming the same labels; the internal experiences don't seem to have much in common. But even if they *are* a spectrum, they're clearly very distant ends of that spectrum.
In this model, being both trans and gay can be described as severe cases of social contagion, whereas bi- or genderqueer/nonbinary are mild cases, not requiring onerous lifestyle changes.
People actually have orientations. It's both a social contagion and a real thing.
Looking at trans as a social contagion, you'd expect people who have been trans for decades with the full surgery and all the bells and whistles to have lower rates of "social contagion" and higher rates of "underlying medical condition." In the case of homosexuality, someone who literally only has sex with same-sex partners probably doesn't have a social contagion, cause that's pretty extreme behavior to be psychosomatic.
You'd expect homosexual-identifying people to be even less social-contagion susceptible than heterosexual-identifiers because homophobia and the social contagion are pulling in the same direction (gay people experience social pressure to identify as bisexual just like straight people do), so their ability to resist it is a stronger signal of social-contagion immunity.
This is related in my mind to the rise of right-wing white gay men. You don't see as many right-wing bisexuals, but being gay is just less of a socially-relevant identity than it used to be.
It's common to have at least some mild, passing sexual thoughts and feelings about one's own gender. People who are more susceptible to social contagion are more likely to think that is evidence that they are bisexual. It is though, not common to feel powerful sexual attraction to your own gender -- to really feel in love with a same-sex person, to enjoy porn featuring your own gender, etc. The signal is so strong that there's not a lot of room for suggestibility-induced ideas to affect your interpretation of what the signal means.
The link with anxiety and depression seems like it has a much more obvious reason—of course people with debilitating chronic illnesses are more likely to be anxious and depressed! Especially an illness where people often can’t get treatment and get accused of having it all be psychosomatic! I wouldn’t want to conclude anything from those correlations without at least checking the rates of anxiety and depression for other similar chronic conditions. (The borderline personality cases, I agree seem like they could be pretty non-trivially psychosomatic).
I also think that the trend being reversed between homosexuality and bisexuality shouldn’t just be a minor weakness of the theory, it should be a major one (given that mental illness is similar among the groups).
Have you thought about reporting bias instead? Consider two people who are Kinsey 5s, who have some small but definite amount of opposite-sex attraction. But one claims that they’re gay and one claims that they’re bi. Here it seems like the bi person just has a lower threshold for what degree of X you need to have in order to order to answer “yes” to “do you have X?” In this case, bisexuality is just acting as a proxy for how people interpret your question, even if bi people’s long COVID is just as organic as non-bi people’s.
If it were threshold reporting bias, we would expect to see it for every self-ID category. We do see it for some, like polyamory, but that's similar enough to bisexuality that I don't want to count it. Here are some others (remember, base rate is 3%, bisexual rate is 5%)
Self-identified Democrats and Republicans are both around 3%, same as people who don't have any party ID (libertarians are lower than average at 1.5%!)
Self-identified Christians are around 3%, same as people with no religion.
Self-identified vegetarians who were vegans were a little higher at 3.9%; vegetarians who weren't vegans were a little lower at 2.6%. If we combine them into one category, it's about normal.
Self-IDd rationalists were higher at 4.4%, but self-IDd EAs were barely higher, at 3.4%, and people who said they were "sort of" EAs were higher than confirmed EAs (3.5%). I think rationalists are more likely to be mentally ill and have unusual sexualities, and EAs mostly aren't.
People with MD-diagnosed psych illnesses were higher than people with self-diagnosed psych illnesses - for example, with ADHD it was 3.7% vs. 4.4%.
The fact that it holds for sexual preference categories, but not other self-IDs, suggests that the actual latent variable is something like "willingness to introspect your physical feelings and take the results seriously". Self-identifying bisexuals and heterosexuals at the same Kinsey scale differ specifically in how much attention they pay to subtle messages from their body, and how willing they are to answer survey questions based on that data. So this data is entirely consistent with the explanation that Long Covid has no psychosomatic component, but is mild enough that you can choose to ignore it iff you're the kind of person who is used to repressing weak somatic information.
The self vs. MD-diagnosed psych categories are potentially relevant, but not in an obvious way. I'd predict that Long Covid reporting rates would correlate better with somatic attentiveness questions like "if you ovulate, do you feel when an egg is released?" or (inversely) with "not sure" answers on the burping question.
I knew one person who identified as bi. He has never had sex with a man, only with women, and nonetheless identifies as bi. Of the perhaps half dozen men I've known who identify as gay, all of them exclusively have sex with men. One of them is older and was gay before it was cool and got a lifetime of discrimination for it. If my experiences are typical, then being bi is more of a statement of support for LBGT, while being gay is more of a sexual preference, and is more independent of trends. I'd guess that people who are more likely to identify with trends are likely to identify as both bi and long COVID.
Oh, and the gay guy who had faced a lifetime of discrimination became depressed in middle age. My guess is that among people who are unfashionably LBGT, discrimination causes mental illness, and among who are fashionably LBGT, the tendency to identify with trends causes both psychiatric diagnosis and LBGT.
For what it's worth, I experience attraction to men sometimes and to women frequently, and am a man, but think it's reasonably likely I'll go my life without ever having sex with a man. Trying to flirt with a guy feels socially forbidden on a gut level (grew up at a time when it wasn't particularly okay to be gay, though also not like totally not-okay), and I don't think I'd really know how besides. Meanwhile I'm stocked to the brim on cultural ideas about how to flirt with women.
I don't identify as bi because I don't identify with things generally, and besides I think that would be confusing communication when I don't particularly plan to bang any dudes. But I don't think it would be some trend-thing if I did feel the label suited me (and some people, it seems, really like labels). I am after all attracted to dudes sometimes, and if one of those dudes came and hit on me I'd probably go home with him.
I do think some people are doing trend-stuff as well, or just want labels to make them feel special (man do some people like labels). But I also think someone who says they're bi but acts straight still can be aiming to communicate a ground-truth difference in their experience from what someone straight would have, so wanted to throw this out there.
Thank you for posting this. This approximates my sentiments as a bisexual woman (although I am in a long-term relationship with a woman as one of my partners - but it's long-distance, so we haven't had the chance to be together on an intimate basis for what at this point is unfortunately years). I feel attracted to women, but they're less available. In my case, I actually even flirt with them! But it's usually not obvious to them that I'm flirting, and that's fine (I have three long-term relationships already, I don't actually need another).
One thing that I haven't seen mentioned in the comments yet: Bisexuals may want to have families. This is much easier to do with someone of the opposite sex! So (monogamous) bisexuals are probably more likely to "settle down" with someone of the opposite sex, which can look a lot like "guess they weren't bisexual?".
This duplicates my experience exactly. I suspect we are in a similar age cohort. (I was born in the 1970s.) I would call myself a firm 1 on the Kinsey scale after various stages of denial, acceptance, experimentation, ambivalence, and finally, happy marriage to a nice woman.
Interestingly, my wife's experience was very similar to mine. It seems inauthentic to claim that either of us are bisexual, but calling it "straight" doesn't make sense either.
I think a lot of people are like this, social conditioning aside. Sometimes I suspect most everyone is like this, but it's not for me to say.
OK, all you guys making smart comments: I do not understand Scott's chart. What is the leftmost of the 3 columns in each chart? The second column is NO's, the third one is YES's. What the hell is the unlabelled first one?
I'll also repeat what I dub the "most boring explanation", which is hinted at the end of this article: Covid, like any other viral disease, has a small likelihood of causing a post-viral syndrome. To the degree that Long Covid exceeds other post-viral syndromes in prevalence, it is most likely psychosomatic. And the explanation for why Covid in particular is also boring: The kind of person who tends to have psychosomatic diseases tends to latch onto something that is in current popular salience, and Covid was very salient as diseases go.
And to counter the obvious "I guess you're also one of those people who think Covid wasn't real, huh?", I'll note that "list of symptoms of post-viral syndromes" and "list of common psychosomatic symptoms" is almost a one-to-one match, which is not true for Covid, in particular the worse progressions.
And finally, I'll note a common misconception, namely that dubbing something psychosomatic is akin to calling it not real. I'll talk about something very similar that I've been told by a doctor: Almost everyone has a Tinnitus, if you concentrate on it. Just try it for a moment. It's just that something in our processing of hearing that successfully deprioritises it so strongly that we stop noticing it in day-to-day life. If something in this very low-level processing of hearing goes wrong, we lose that basic capability and develop what is usually known as a Tinnitus. Those people then need to train coping strategies where they need to consciously suppress it instead. And telling yourself that it "isn't real" is a useful and simple coping strategy, so plenty of people will latch unto it, even if it is wrong.
I think it's the same for almost all psychosomatic diseases: We all have constant low-level pain, low-level symptoms from lingering diseases, low-level brain fog, etc. Most people have an entirely unconscious processing step before anything else that successfully allows us to not notice this all the time. This processing step is damaged in people who tend towards psychosomatic illnesses. Just like for the Tinnitus, you'll have to re-train a conscious suppression instead.
Really true about the tinnitus. I have what I'm pretty sure is a moderately bad case of it, and I am almost never aware of it unless I read the word tinnitus, as I did in your post. (Thanks a shit, by they way. I suggest that you notice every time you blink for the next hour. Hey, have you blinked since you read this? How many times? Maybe you should keep count. . . .Just joking, of course.)
> Almost everyone has a Tinnitus, if you concentrate on it. Just try it for a moment.
Uh, idk if that's true, but I definitely don't. (I did in fact try it just now to make sure).
From time to time I'll get a sudden ringing that lasts a few seconds, and I experienced constant ringing for a couple days once after attending a very loud concert and standing right next to the speakers with no ear protection.
The sudden version of it in particular doesn't seem like a psychosomatic thing. It doesn't tend to accompany changes in stress level or any other kind of internal experience, although it does seem more likely to happen if I have a headache. And the stopping a few seconds later also doesn't seem to accompany anything else about my internal experience.
Another confound: covid can mess with the endocrine system. I had lingering fatigue after covid because I needed my thyroid meds adjusted. Once that was done the symptoms went away.
Is long covid more likely in people with sensitive endocrine systems? Maybe there is a hormonal aspect to both sensuality and long covid?
Will it be possible to find out if long covid is more/less present (percentually) in vaccinated group than in unvaccinated group? I've read somewhere that this long covid could be rather a vaccination side-effect.
Have read in several reliable places that vaxed people who have covid have shorter and milder cases of long covid. Here's a meta-analysis: https://www.mdpi.com/1660-4601/19/19/12422
I wanted to try putting "coronavirus with really long spike proteins" in DALL-E, but it seems like it immediate claims to be a TOS violation (Which I suppose is true if you *really* stretch the "personal health" section's definition)
I notice a few comments asking if this is true for bis, why not for lesbian's and gay men? This seems to assume there should be an equivalence, but I have read several articles and surveys that suggest differences between bi folk and l/g people. According to those articles, bis are more likely to have some form of mental illness (and also be more at risk from domestic abuse).
One possible reason for greater anxiety or depression could be less social recognition and acceptance of bisexuality, with fewer role models and absence of a decent support network.
I don't know how this would link to reported incidence of Long COVID.
Bisexual women are more at risk of domestic violence than lesbians, straight women, or men. To give one example of how discrimination can take different forms.
It may be interesting to look at how rates of mental illness have varied over time, but I doubt we have the data to compare bi people and other groups over time.
The article you link to isn't about this, but is about the rise in bi identification in young people. If that is a factor in correlation with incidence of Long Covid, we'd need to compare Scott's data for different age groups
You can't just say "X's have higher rates of A than Y's; X's have higher rates of B than Y's; A and B are sometimes correlated; therefore, there is no additional effect caused by X-ness". Especially when the correlations are different strengths, this is actually a really bad argument.
Are "very liberal" people disproportionately the victims of domestic abuse? Seems like they should be if the mechanism you're talking about is important.
I think a more natural hypothesis is that people with unusual domestic lives are more likely to have unusual domestic drama that leads to violence, and that to the extent that there is mental illness, that's a smaller contributor.
I linked to that because it addressed stigma in passages like this:
"Another weakness of the closeting story is that mainstream stigma against bisexuals was always milder than against any of the other groups. Yet it is bisexuality that has exploded."
Are bisexual women at more risk of domestic violence from male partners or female partners? Or about the same? If both partners are bisexual, does it affect the odds?
I looked at the full report, but they didn't have much on bisexuality or even orientation. There appeared to be a separate report for that, but the link was broken. :-(
I'm wondering how much of that 89.5% comes from bisexual women being more likely to have men as intimate partners, but without their data, I can't tell. (I'd be surprised if bisexual women had male partners 9/10 times, but I suppose that partly comes down to how they asked and who responded.)
Huh, never mind, I just saw Scott's latest post where he was saying that bisexual women were likely to have 10/11 male partners. So maybe the "primarily at risk from men" is entirely a result of the partner distribution, and on a per-partner basis, it simply duplicates the surprising result that women are more likely than men to abuse women in the context of a relationship.
"there is a consistent pattern of lowest rates of depression and anxiety among heterosexual people, while bisexual people exhibit higher or equivalent rates in comparison to lesbian/gay people. On the basis of empirical and theoretical literature, we propose three interrelated contributors to these disparities: experiences of sexual orientation-based discrimination, bisexual invisibility/erasure, and lack of bisexual-affirmative support."
For example, for studies looking at current binary indicators of depression they found: "Converting these proportion data into odds ratios (OR) yielded a pooled OR of 1.44 (95% CI: 1.22, 1.70; I2 = 73.3%) for the comparison of bisexual participants to lesbian/gay participants (see Figure 4) and a pooled OR of 2.38 (95% CI: 1.86, 3.05; I2 = 91.7%) for the comparison of bisexual participants to heterosexual participants (see Figure 5)."
Would it make sense if bisexual people are more marginalized or ostracized or have more trouble finding a community or something, which then causes mental stress that makes them more susceptible to physical illness? Are bisexuals more likely to get sick in general?
Or more broadly, if bisexuals have more mental illness for whatever reason than that might make them more susceptible to physical Illness. Does that count as psychosomatic?
<xantham> Perhaps this is because homosexuality, unlike the other "sexual orientations" people are inventing, isn't a social contagion.
That is: if you are a 2 on the Kinsey scale, identifying as bi-sexual is a choice (and, given the prevailing social trends, currently a popular one). If you are a 6 on the Kinsey scale, identifying as homosexual isn't a choice -- the choice is whether to lie about it.
"...I think this is a signal that a substantial percent of long COVID is psychosomatic."
It might be better to say that a substantial percent of people identifying as long COVID is psychosomatic.
It could well be that there's a real, core condition, long COVID, which is non-psychosomatic, even if many people identifying as having long COVID are doing so 'psychosomatically.'
The same thing could be true of PTSD or dissociative identity disorder or OCD etc., if there is a core real disorder, and then many people identifying as such psychosomatically or due to social contagion etc.
It's a fairly standard finding that bisexuality is associated with worse outcomes than homosexuality along virtually every dimension. I'm not sure why this is, but it shows up all the time in the research.
From this I infer that reading ACX is a bad outcome.
Since I'm making a negative claim, no amount of data will ever be enough. I can't disprove your claim unless you specify an effect size.
Scott claimed to provide data that supported your claim, but it was not statistically significant. The point estimates suggested that bisexuals had slightly worse outcomes than homosexuals (but not "virtually every dimension"), but small compared to the difference with heterosexuals. It didn't seem worth singling out. Would we be talking about long covid in bisexuals if they had slightly worse outcomes than homosexuals? It's bewildering because homosexuals cluster with heterosexuals.
Bisexuals are more psychologically disordered, and it is not clear why.
One possible interpretation is that bisexuals are the most confused about their identity, which suggests that a sense of clear identity about sexual orientation is partly protective in mental health terms, although non-heterosexuals are more distressed. It was sometimes asserted that bisexuals had “the best of both worlds” in that they had the double the number of prospective sexual partners, but even if that is the case, the result is that this is a very disturbed group.
Another possibility is that no people don't have the support networks that heterosexuals and homosexualities have. Bisexual people usually live in spaces or communities that are primarily heterosexual or homosexual; there are very few bi spaces. Both heterosexual and homosexual spaces can be quite restrictive about behaviours or discussion that don't fit those spaces. Bi people in a non-poly relationship are assumed to be lesbian, gay or straight. There are few bi characters in popular culture, and often bi characters are described as 'gay' (e.g. Brokeback Mountain). So it can be harder to make sense of your security when everyone around you is telling you that you are, or should be, lesbian gay or straight
It seems to me that you (and much of the research and activist communities) are assuming that there must be a sociological explanation and optimizing for plausibility under that constraint. But it's entirely possible (and likely, IMO) that there's some kind of biological explanation.
I haven't seen anything on here about bisexuality and age, but I'm pretty sure that for girls, at least, having crushes on other girls is pretty common when they're in their teens. When I was in middle school I and lots of the other girls had a crush on one of our gym teachers, who was very pretty but also quite butch. I personally just kept going with crushes on other women and girls up through my twenties, and as I became more sexually experienced the crushes were much erotic. However, I was also attracted to guys, and that's who I dated. Did have one delightful affair with a woman, but the feeling of a romantic bond was weaker than with a man -- sex felt sort of like an extension of our friendship. Anyhow, after my 20's crushes on women got much weaker and rarer, and now I'm just plain old straight. Point of all this is that I think my course was pretty common, and that for a lot of girls crushes on their own gender go along with their identity not beng fully formed. Once it is, other females somehow are not romantically fascinating any more. Anyhow, point of this is that it could be that bisexuality in women that continues into full adulthood is associated, at least for some people, with not having settled on an adult identity. That would explain its association with psychological disorder.
It would be good to look at rates of COVID, but unless he asked people to report how many times they had COVID, I expect that it'll be hard to find any signal there (since most groups will be well above 70% having COVID).
I wonder if there's some correlation between willingness to tell the truth about having problems on surveys and being willing to say one is bisexual., though I admit this doesn't explain why homosexuals seem to have less long COVID.
Still I think people lie in both directions, sometimes exaggerating their problems and sometimes minimizing them.
Thank you Nancy. I had given up finding a comment making this point and was just doomscrolling.
Yes, being bisexual is trendy, but so aremany other things that people really do enjoy (microbrews, fancy burgers, w/e). Sometimes people pretend for the trend, sometimes the trend is because a thing is genuinely popular.
I always hate to see comment sections cluttered up with repeat comments. Besides, by the time there are however many hundred comments it's not like my writing the one I hoped someone else made hours ago when the thread was fresh and people might read it will do anything.
I think the tendency to lie on Scott's questionnaire would be lower than on many others because people take it anonymously. Also, it's clear that this forum is accepting of gender diversity. Lots of people are out on here. But the strongest argument against Scott's results being explained by people's willingness to tell the truth about having problems is that people who acknowledged being gay did not report more Long Covid. Seems to me that anyone who thinks homosexuality is bad or a sign of mental illness is going to think the undliuted version is worse than the diluted one, bisexuality.
With inflammation having been implicated as a factor in several mental illnesses (most strongly in depression but also bipolar disorder, schizofrenia, anxiety, ptsd and autism spectrum disorders), I wonder if that could be the underlying factor that is missing, i.e., people already suffering from some level of mental illness being more sensitive to covid induced inflammation because of their already elevated inflammation.
What I see here is almost a third of your (much less numerous) female respondents are bisexual, whereas only about one in 12 of your male respondents are. I've seen this before in geek spaces, but I'm wondering if there's some kind of statistical correction that has to be made for what's obviously a case of selection bias (albeit one you have no real way of getting away from, because your fanbase is what it is).
Not sure exactly what you're referring to (I'm not the person who was picking fights with you on your blog if that's it), but I'll take it.
But as for the rest of it...Yes. That fits what I have observed. I always figured it was some kind of brain masculinization, a la Simon Baron-Cohen--I've known two, and one used to joke about her 2D/4D ratio. I guess as in your first case they could also be 'geek seekers'. One would probably fit that criterion, the other was definitely a geek herself.
N=2, and there's an obvious case of selection bias here.
I still think I'm not the person you're looking for (yeah, gratuitous Star Wars reference)--I don't know you from elsewhere and have no alts on Substack. I found you from here (I think?), thought your stuff was really cool, and was somewhat dismayed to be banned.... but hey, it's *your* blog, *you* make the rules. <shrug>
As for the rest of it, which hopefully is of some use to the readers of this blog...yes, you're correct, I think. Feminists as autistic-adjacent, conspiracy-obsessed title IX mavens who control the education system makes entirely too much sense. I think I always kind of knew that in the back of my head, but it's useful to have it stated explicitly. And an awful lot of geeks do seem to wind up with feminists, don't they? Often to their ultimate chagrin, as one might expect.
Thus, the need to drop geek culture like a hot potato, and the best way to do that is to build muscle, because even if you don't have social skills you no longer fit the classic stereotype?
LOL on the selection bias. It was a joke I told to someone else here, but yeah, it's one of the few bits of data analysis I know. Seemed relevant to the original conversation, anyway, because Scott wasn't really analyzing two analogous populations--there was a covariate in there, so to speak. But I guess that's true with any social science number crunching.
As an aside, if you think of the Apollo-Dionysos dichotomy in the arts, Artemis (as close to a feminist as you can get in ancient mythology) was Apollo's brother. But Apollo had a whole bunch of non-geeky areas like music and medicine, so it doesn't quite fit. Hephaistos is probably a better match--though they paired him with Athena, who was a defender of the patriarchy.
Another cofounder is self awareness level. I read that theres a chunk of the population that have a reduced ability at the Rey–Osterrieth complex figure test due to long covid, but otherwise have no idea that they have long covid.
That’s a good thread but it’s not what I’m getting at. Regardless of the nature of long covid, I’m saying that some people may have long covid but are unaware. And this may be throwing off the results.
Some people are certainly more kinesthetic than others. So it would be unsurprising if these people had higher rates of long covid (more likely to seek diagnosis and/or self diagnose). The missing link in my argument is whether or not it correlates with bisexuality.
Some of it depends on how you define long covid. If you think of it as symptoms similar to thosse seen in people with Chronic Fatigue or Fibromyaligia, seems like it would be hard to meet the criteria for the LC without knowing anything's wrong, since many of the symptoms have to do with how you feel: fatigue, exercise intolerance, malaise, body aches, shortness of breath. Some people working on Long Covid think of covid as a disease that damages many parts of the body, and then I guess you have Long Covid if you have some specified degree of damage, even if you feel fine. That seems to me to confuse things, though.
I'm not sure how long covid is defined at the margin. My sense of taste was screwed up for about two years and it's not quite back to where it was. This affected my quality of life but wasn't debilitating.
In particular, pork (low quality pork?) tasted really nasty. If I recall correctly, sometimes I couldn't taste much. I definitely remember that the same food could taste good, bad, or meh in the course of twelve hours. My enjoyment of capsaicin isn't quite what it was, but it's mostly back.
I suppose I'd say I had long covid if that question was by itself on a survey, but I have no idea how common this sort of thing is.
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?
There was an apparent link though between loneliness and long Covid.
So in any cohort that seems to correlate with higher LC prevalence perhaps one should investigate whether loneliness also correlates. (Maybe also look at severity of symptoms from whatever viral infection and poor physical activity per Norwegian study. One might hypothesize that a non lonely gym attending group would have less "long Covid" than a lonely sedentary cohort.)
The occasional study finds no link between Long Covid and having had Covid, but most studies do find a link. Here's an interesting one about abnormalities found in people post Covid: https://threadreaderapp.com/thread/1653047893522100224.html
Yes, aware of that. However, your comment about the Norwegian study presumed that lack of an operationalized definition of Long Covid does not make it pointless to discuss studies of what's up with people who have it, even though the way Long Covid is defined by the researcher is just one of many possible ones. If my study is of no interest because of our failure to have a well-operationalized definition of LC, then the same can be said of yours.
My immediate thought upon reading this was that, contrary to Scott's expectation, I would bet that bisexuals are quite likely to be immunologically different. Specifically, both the immune system and sexuality are potentially influenced by or correlated with levels of testosterone and estrogen.
For example, high estrogen makes people prone to more severe manifestations of all sorts of illnesses associated with an overactive immune system because estrogen causes histamine release. Testosterone, on the other hand, tends to act as a mast-cell stabilizer and suppresses the immune system. In line with this theory, homosexual men often have higher testosterone than straight men according to a few studies, which could explain their unusually low long covid rate (I remembered the association off the top of my head, but here's a small study I just found with a brief search showing "significantly higher" testosterone in homosexual men: https://ajp.psychiatryonline.org/doi/10.1176/ajp.131.1.82 )
Unfortunately for my theory, I haven't been able to find any studies on the average hormone profiles of bisexual men, and at least based on this this meta-analysis: https://link.springer.com/article/10.1007/s10508-020-01717-8 bisexual women have at best slightly higher testosterone than average, though the abstract itself says that most studies on the topic have been "small, biased, and heterogenous" and that little confidence should be placed in their findings.
A simpler explanation might be that bisexual people are more likely to be virtuous followers of what I call the 15th Commandment: Thou shall not self-deceive. In other words, the actual rate of long Covid could be identical across all sexual orientations but bisexuals are somewhat more likely to correctly perceive it and acknowledge it.
> (Why does homosexuality, which also has increased rate of many mental illnesses, show so much less of a signal than bisexuality? I don’t know, and it’s a weakness of this theory.)
One possibility is that bisexuality seems to be a fashionable suggestibility condition, not too different from some of the cases covered in the "unawareness campaigns" link. Since sexual orientation is entirely self-reported, and non-traditional sexual orientations and gender identities are treated as a prestigious high-status condition by woke academics, the most obvious hypothesis here is that a lot of self-reported bisexuals, especially among younger generations with the closest proximity to woke academics, self-report as such without ever being bisexual in practice.
And this is what we find in reality: the majority of young bisexuals only have heterosexual sex — sometimes quite a bit of it! — while still publicly wearing the badge of "bi" for its social prestige.
The one thing I'm sure of about human sexuality is that a high proportion of people are vocally and sometimes violently invested in other people's sex lives.
Now that I think about it, I've never seen anything like a survey or other science into how involved people are in other people's sex lives.
I think it is obvious -- people use complaining about Long COVID as a pick-up line. But when you keep saying something, you may actually start believing it!
Bisexual people are using this pick-up line on everyone. Heterosexuals only on people of opposite sex. Homosexuals only on people of the same sex, and only when they feel in a safe space. This is the simplest explanation that matches the known data.
Hmm. Could just be there exists some population of people who really wish they were bisexual and had long covid because it would give them credibility and a sense of belonging amongst their peer/friend group. Covid and everything related to it kinda arbitrarily became blue tribe. LGBTQ stuff is also blue tribe. Long covid and bi are both things that I could see an otherwise completely normal person convincing themselves applied to them with sufficient motivation. I wonder if you controlled for Kinsey 1s and 2s if this correlation wouldn't just disappear - people who psyched themselves into bi experimentation a few times, and are essentially psychosomatically bi. 🤔
(Not saying this is definitely the case, but gut feeling is something like "red tribe gets covid more and reports long covid less" - I looked for answers here and couldn't find anything, but I was pretty half-assed about it. It cooould be that this is a result of women leaning blue tribe, and bi people leaning blue tribe, and evidently both are more likely to report long covid where red tribe is more likely to *die*.
Just a fluke of those groups being more likely to be vaccinated and therefore survive their bouts of covid to deal with the lingering effects? Grim, but... possible? Like if there's some common mechanism through which fatal covid cases work, and long covid is just what happens when that mechanism is activated but you survive due to vaccination making your would-be fatal case manageable..? idk. )
At the risk of being a dick - about half the bisexual identifying folks I know have never had a same-sex relationship (not necessarily an indication that they aren't bisexual) and are much more motivated by having cool quirky zero effort identities than both the gay and straight people I know. In other words, I think there's some portion of bisexual folks who just collect weird identifiers for themselves.
Bisexuality is much more likely to correlate with an active sex life and therefore with more chances to get exposed to higher initial viral doses. I was saddened to see the casual attempt for a causal relationship with psychosomatic problems (what are these mechanistically?)
How do we define Long Covid, or rather, how do the survey takers here define it? I mean, if the symptoms are "“have you had any persistent symptoms including fatigue, brain fog, shortness of breath, changes to taste/smell, etc, etc, etc, since having COVID?”, I would definitely say "yes" to some of those, but I would not say "I have long covid".
Are our bisexuals going "yes, I have long covid, and here is my official medical diagnosis to back that up" or are they going "I feel like my sense of taste isn't what it used to be so yes, I have long covid"?
Do you not understand the concept of ecological biases, response biases etc? Data that isn't conducted in a population based prospective manner (participants recruited randomly before being infected), the survey results are likely to be highly biased.
See https://astralcodexten.substack.com/p/selection-bias-is-a-fact-of-life - is it likely that bisexuals would be more/less affected by response bias than monosexuals? But if for some reason you don't like my survey, you can just use the CDC survey mentioned in the Pirate Wires post.
You didn't actually mention the response rate range of the CDC survey in the comment I'm replying to, and you're being a jerk, so I'm banning you, sorry.
My first hypothesis would be a common factor of "willing to say you're X if you're, like, a little bit X" (where X could be "into the same sex" or "having long covid symptoms") especially given that homosexuality doesn't show the same pattern.
Alternate theory, bisexuality is presumably an extremely complex trait genetically that involves thousands of genes, some of those are going to be immunologically involved. In other words, hand waving wildly here, one gene generally does many things, we are unlikely to be able to separate any two complex traits, even extremely different ones like ability to fight a virus and sexuality, into roughly orthogonal gene difference vectors and, given a whole bunch of vectors, some will have much smaller angles than others and people will notice and be rather puzzled
I have no idea if this is true, but I wonder if people who identify as bisexual are more aware of or responsive to mild symptoms or stimuli, or less constrained to maintain their self-image in the face of contradictory stimuli.
In other words, Jane and Suzy both (a) occasionally think another woman is hot and (b) feel a little achy.
Jane identifies as straight and not suffering from long covid, because she writes off those experiences as not relevant, or because her self-image overrules them. Suzy takes those stimuli and updates her self-image to identify as bisexual and suffering from long covid.
(Suzy is then more likely than Jane to change her behavior based on this self-image, which reinforces her new self-image.)
Given that long covid symptoms are subtle, some people may be more likely to realize/admit they have long covid than others. Given that bisexuality is supposedly on a spectrum, the same people may be more likely to realize/admit that they are bisexual. I’ve had sleep apnea for a while, until I decided to get a mandibular advancement device and started sleeping better. My dad, who has essentially the same condition, held out much longer (he’s on CPAP now) because “I am just snoring a little bit, so what?”. Same as “I can appreciate a chiseled male body, but I have a wife and two kids, so what?” and “after having covid I get tired more easily, but so what?” If this is the case perhaps controlling by age could remove part of the effect, as I suspect this sort of attitude is less prevalent among young people.
Alternative hypothesis: monosexuality is a culture-bound mental illness, and long COVID is more prevalent than people think.
Suppose most people are 'actually' bisexual, but for cultural reasons they tend to believe they are either hetero- or homosexual. If that were the case, then the people who identify as bisexual will tend to be more introspectively perceptive, more willing to defy accepted truths, etc.
If those people are saying they experience long COVID at a greater rate, it may be because that rate is closer to the true rate, and monosexual people are under-reporting because they are less likely to be aware they have long COVID symptoms (e.g. less likely to notice their brain fog), or more likely to explain their symptoms in more socially normal/acceptable ways (e.g. allergies).
In bonobos, famously promiscuous and universally bisexual (and, not for nothing, our closest animal relative), it's thought that sex plays several roles: forming social bonds, releasing tension, reconciling after conflicts, etc. Similar reasons have been offered to explain the many human cultures in which bisexual behavior is common.
I appreciate the linked review, but it doesn't address bisexuality in bonobos. Looking at studies it cites seems to support the idea that they frequently engage in same-sex sexual contact in the wild, universally (at least among females; there is apparent disagreement about same-sex contact among males, but some sources cited approvingly support it (e.g. Kano 1992)).
And what was being "offered" was one possible explanation for an observation (because you asked why it would be), but it's the observation that supports my argument: bisexuality is the norm among a "species that reproduces sexually", and it has been common in many human cultures.
I only brought up the random primate in response to your incredulity at the idea that most members of a species that reproduces sexually could be bisexual. Since there does not appear to be any real disagreement among experts that all female bonobos and at least some males engage in same-sex sexual behavior, bonobos do seem a slam-dunk counter to that incredulity.
Similarly, I brought up the human societies only to show that monosexuality is culturally-mediated and not universal. For that purpose, "common" and "many" are not doing much work: it's sufficient that there have been multiple societies where sexual identity didn't function as it is generally imagined to function today.
Just to be clear, I don't think I've proven that my proposed explanation is the only or best way of explaining Scott's data. In my view, the words that do the most work for me are "alternative hypothesis": this too would explain the data, and it's not obviously false.
I read Scott's response to this, but I still think this hypothesis holds water. I'm a Long Covid sufferer (recently finding myself doing much better), and it took me a remarkably long time to really connect the dots around Long Covid being the cause, after having ruled out basically everything else I could think of.
>Bisexuals and heterosexuals seem much more likely to be psychologically different than >immunologically different, so I think this is a signal that a substantial percent of long COVID is >psychosomatic.
I think I need to ask for a steelman of the inverse statement here (i.e. that bisexuals are immunologically distinct from heterosexuals), before I can accept this point of reasoning.
The survey upon which all of these conclusions are based is fundamentally flawed - (asking if you “have” “long COVID” sounds more definite than just asking if you have a few lingering symptoms).
There are health professionals in 2023 who still have never heard of long COVID so it isn’t surprising that asking patients about this condition would result in dramatically lower positive responses.
Personally, I have spoken to dozens of folks during the pandemic who had “recovered” from acute COVID but still had lingering or worsening symptoms (fatigue, muscle pain, cough, breathlessness, racing heart rate, nerve pain, and many, many more) that just wouldn’t go away after months or even years. None of these individuals would have identified as “longhaulers.”
This survey is not about disease incidence by community but disease awareness amongst different communities and demographics. Thus, this conclusion that long COVID must be psychosomatic is based on faulty reasoning.
As a quick addendum, the evidence at this point is actually pretty conclusive for what causes long COVID and, spoiler alert, it is a persistent viral infection, which is why long courses of the appropriate antivirals cure the disease.
Also, "Bisexuals and heterosexuals seem much more likely to be psychologically different than immunologically different, so I think this is a signal that a substantial percent of long COVID is psychosomatic."
Really?
Given that sexuality has a material genetic / hormonal connection, it doesn't seem odd that that might correlate with relevant immunological differences.
Immunology vs psychology is also a false dichotomy. Psychological states influence immunology (e.g. see impact of chronic stress on the immune system).
We still know very little about why some people get Long Covid and others (apparently*) don't - the leap to "a big portion is psychosomatic" is a big stretch at this point.
The history of infectious disease is psychologizing and denialism, until somebody finds a biomarker and then we laugh at the quackery that once was.
(*Apparently - we don't know yet whether Covid-19 is a chronic infection for everybody like many viruses - e.g. EBV, CMV, HPV - for which only a subset manifest symptoms initially... We will see over the next few decades!)
I asked about specific symptoms on the survey. The fatigue symptom question (although not the smell/taste related symptom question) had the same pattern.
Readers of this blog are pretty educated and I've written several articles about long COVID before, so I think there's very little chance a substantial fraction of people don't know about it.
Link to study showing that long courses of appropriate antivirals cure it? If this is true the Stanford Long COVID clinic doesn't seem to know about it, they're treating some of my Long COVID patients and mostly trying general chronic fatigue medicines.
For my anxious patients in general and especially those with health anxiety, I find it very helpful to fully acknowledge the symptoms they are experiencing, and validate how unpleasant/difficult they may be. THEN to provide some reassurance of the type 'Fortunately, for most people these types of symptoms do get much better within a few months', and encourage REASONABLE self-care. Often within a few months the patients focus is elsewhere, and I can point out how those symptoms DID fade with time, reinforcing that message for future occurences.
With anxious patients who tend to somatize, I always focus on the 'living with chronic illness' model, which encourages living within a 'window' of effort/activity and self-care/rest, where the person neither seriously exacerbates their symptoms, nor underfunctions/has no life/has little enjoyment, out of fear of exacerbating them. I encourage starting to gradually increase effort/activity, while paying attention to not only how much symptoms are impacted, but also for how long. So for example, if a certain activity is highly valuable (socially, work, life management) but increases pain/fatigue/anxiety, I always ask how LONG that exacerbation was, and whether it faded on its own or required extra rest/self-care to recede. If a symptom increase lasted only a day or two, I encourage continuing to incorporate that activity/effort or level of activity/effort, but always prior to a day when the person has fewer demands on them (never no demands, always within the 'window').
My assumption is that there is no 'pure' psychosomatic illness. Vulnerabilities are real things, whether from genetic or life-experience factors.
There's been a lot of talk about whether or not long COVID is psychosomatic, but I don't think we even need to go there. My pet theory has always been that the generally accepted list of symptoms of long COVID is so long, vague, and comprehensive that, if somebody is really looking hard for long COVID in themselves, they can find something that'll match.
Fatigue? Long COVID. Chest pain? Long COVID. Insomnia, diarrhea, joint pain, rash? Long COVID. Are you headachy today because you're dehydrated and stressed, or is it COVID rearing up?
Now this still doesn't explain the bisexual/homosexual distinction. But if the mental health data are anything to go by it wouldn't be surprising to learn that bi people are more likely than the baseline to just be generally unwell, and thus more likely to say yes if given a laundry list of symptoms and asked "do you have any of these?"
Another interesting idea: The CDC page I looked at while writing this explicitly analogizes long COVID to Chronic Fatigue Syndrome. Do we have any data on whether bi people are more likely to report suffering from CFS than gay people are?
[1] is on chronic pain, not chronic fatigue. It does not cross orientation with sex, but the NHIS data is available, so you could do that. Also, you could use more years for more power. It finds gays and straights have the same rate of mild chronic pain (20%), while bisexuals are 20% higher, marginally significant. But bisexuals are young, so adjusting for age, they are 50% higher, significant. Restricting to debilitating pain, they have lower rates. Adjusting for age, again 50% higher, but not statistically significant.
[2] 15 year old survey of 2300 people in CA does not find a difference between gays and bisexuals for chronic pain. For chronic fatigue, it finds 50% higher among bisexual women than lesbians, but 2x higher among gay men then bisexuals, ie, the opposite effect.
From my casual knowledge of English, I'd say that bisexual means able to enjoy sex with both genders. Not necessarily enjoy it equally, nor to have equal numbers of partners of both sexes. What do folks here think it means?
My take on orientation is based on what I've read from homosexuals from an earlier era when they were pushed hard to have heterosexual relationships, and they did, to both their and their partner's cost.
Later in life, they had sex with someone of their own gender and found it was satisfying in a way that heterosexual sex wasn't.
I get the impression from people that this interpretation is eccentric, and I'm not sure why. Perhaps because it's something that can't be evaluated from the outside.
I don't think that entirely captures it. Send me to prison for life or vanish all women from the planet and I'm fairly confident I can enjoy sex with a man. It's a physical act and the hole still feels the same. But as long as women are available, I'm never going to choose a man.
It's more to do with what causes the arousal. Looking at a male body has never given me an erection. Looking at a female body has. I don't want to frame it as entirely visual, since obviously blind people can still have arousal and preferences aligned with secondary sex characteristics, but it's more than "can you be aroused at all by this person?" My pants give me an erection more often than other people do, but I don't have any sexual attraction to pants.
I would take bisexuality to mean something more along the lines of "can both a man and a woman sexually arouse you without touching you?"
Has anyone compiled a list of illnesses/syndromes that are disproportionately experienced by bi-sexuals as a way of creating an index for how much each health challenge is caused by psychosomatic factors?
"Bisexuals and heterosexuals seem much more likely to be psychologically different than immunologically different"
Well maybe....Is there any data to go along with that otherwise ungrounded opinion. IIRC, homosexuals (maybe only men) have differences in there brains compared with cishets....
Take it with a grain of salt, but related and potentially interesting: Kontextmaschine on Tumblr claims that he *became* bisexual as a *result* of long COVID (along with various other physical and psychological changes, including dramatically reduced anxiety.
An immunological theory which is probably not especially plausible is that bisexuals have less aggressive immune systems. For example, perhaps part of the etiology of (some) bisexual behavior relates to weaker discrimination of others' MHC (major histocompatibility complex) phenotypes. If this were the case I expect we'd see bisexuals have a higher degree of relatedness with their sexual partners, though probably no one has studied this.
There is variance in intra-individual MHC diversity, which has interesting effects on immune function; it appears that an intermediate level of diversity is better than a low or high level. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2666699/
There are also links between MHC/HLA genotypes and predisposition immune competence as well as schizophrenia (possibly mediated by an an immune/infection mechanism). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293234/
I'm having hard time nailing down how you are using 'psychosomatic' here.
It seems like there are at least four possible stages at which this result could be explained (plus any combination of those stages):
1. Group B actually experiencing perceptual symptoms more often than group A.
2. Group B noticing an individual incidence of a symptom as something notable/troubling more often than group A.
3. Group B noticing those symptoms form a pattern and mentally labeling it as 'a condition' more often than group A.
4. Group B saying that this pattern of symptoms they've noticed is long Covid on your survey more often than group A.
From the way the term is used in this post, it seems like perhaps any of these could be called 'psychosomatic', but they each point at very different mechanisms and underlying realities.
2. Who have had sex with only one gender despite opportunities to have sex with both (or at max one single instance with one gender and all others with other)
3. Who are having sex with only one gender because of being in a monogamous relation or scared due to legal/ social ramifications of sex with same gender
For group 1 , my theory is bisexuals have higher levels of hormonal fluctuations compared to straight or gay people. And hormones and immune system are linked. So they could have somewhat different immune system. I know it’s a data point of one My periods are slightly irregular and I have a screwed up immune system. I am also more attracted to men at ovulation, both at menstruation, women at other times. Haven’t suffered from Covid though.
For group 2 - psychosomatic
For group 3 - probably have higher rates of depression and stress which impact’s immune system.
Wow, literally hundreds of biomedical papers on Long Covid and you conclude based on your survey that most cases are psychosomatic? Your priors seem completely off.
The science behind psychosomatic medicine is often extremely poor, using bad definitions and wrong tests. The field is driven by highly dogmatic people with uncomfortably close ties to the insurance industry (if it's psychological, there's somehow no need to pay social security)
Most conditions classified as "(potentially) psychosomatic", such as fibromyalgia, irritable bowel syndrome, and ME/CFS have plenty of evidence of a biomedical origin that the psychosomatic crowd conveniently ignores.
The consequence of labeling diseases as psychosomatic are lack of treatment, harmful treatment, lack of research funding, and lack of social security. You might want to be a little more careful throwing that term around.
I really don't understand the tolerance for this pseudoscience in rationalist circles.
Just a note, I'm sure you've spent considerable time dealing with people who don't understand these things, but most people haven't, so your frustration and anger at people who don't have your history and knowledge comes across as confrontational and grating.
You'd probably win a lot more minds if you just used a friendlier and more educational tone, and less of a scolding and angry tone.
Some people, even people who "should know" sometimes just somehow missed out on that bit. So help us out and we can grow together.
EDIT: that linked article on mecfsskeptic.com was pretty awful. Are there any better introductions to the situation? I would be interested in a better writeup on the topic.
Thanks for the note Philo. It was indeed written in a lot of frustration. Just to be clear: my frustration is aimed at Scott, not readers. To me, this blog post feels akin to a post like "does conversion therapy work? A small survey" or "are Blacks really less intelligent?" although I admit that those are, fortunately, already widely accepted to be wrongheaded and offensive.
I have some understanding for readers being naive on this topic, but Scott is a psychiatrist and these type of views could do immense harm to his patients.
Sorry the link wasn't good. I recall reading some good articles from that blog, but I can see how this isn't a good intro link. I'll get back to you later with a better one.
Not an overview, but here's one example of exceedingly bad research. This is a criticism of the largest (multi-million) trial for "chronic fatigue syndrome" (an inaccurate term) by the biggest names in the psychosomatic field:
I feel like 'noticing you re attracted to the same sex even when you don't expect to be' and 'accepting and acting on those feelings, labeling yourself based on them, and proclaiming that label to the world' could very easily have neural correlates to 'noticing small unexpected changes to your sensorium, accepting them as an ongoing condition you're suffering, labeling that condition, and claiming that label on surveys.'
In which case, is the 'condition' the bisexual people who notice and talk about their symptoms, or the straight people who don't notice the symptoms or don't label them and talk about it?
Is it bad that as soon as I saw the title I knew where this was going?
The greater question for me is why do people with divergent sexual preferences seem to be more prone to neuroticism?
Also, if trans women frequently score higher in neuroticism, and women typically score higher in neuroticism than men, might that be suggestive that trans women are actually women? Or at least closer to being a woman than their assigned gender?
> I said that some cases of long COVID were probably psychosomatic, but the majority weren’t.
Is there a word for the phenomenon where the symptoms are real but it's because there's some psychosomatic-ish "tolerance" for them that allows them to be real? e.g. a dynamic where, if you "believe" in Long Covid (or have a tendency to medicalize things in general" you would say: "ah well, my fatigue is due to long covid, what are ya gonna do" and not work on it, whereas if you "reject" Long Covid, you'd say: "shoot, after having Covid I'm really fatigued, I am going to have to work really hard to get back to my previous level of health", and perhaps this makes a large part of the difference in survey results.
Anecdotally an older adult I knew from HS who reports his whole life on Facebook (lol) reported that he thought had Long Covid for a year and then it all went away when started running again and realized that actually he just never got his fitness back to where it was. Since then I've wondered how common this situation might be.
Perhaps some people are more prone to thinking through questions deeply and admitting a more generous possibility of uncertain things.
"Could I enjoy having sex with not only people of the sex that's more obviously attractive to me, but also people of the other sex? When I think hard about it, yeah, probably! So that means I'm bisexual."
"Did I experience a longer than expected period of any covid symptoms at all? When I think hard about it, yeah, I think so! So that means I had Long Covid."
That doesn't make those symptoms (or sexual attraction) fake, psychosomatically manifested, or a mental illness. Maybe someone else has the same possibility of enjoying sex with their less preferred sex, and had the same covid symptoms, but just isn't as inclined to notice, remember, or identify with those facts.
My hypothesis is that the excess overlap between bisexuals and long covid self-reports is that's selecting for a more inclusive manner of interpreting and answering questions.
This conclusion is so bizarre to me. In terms of predictive coding, i expect bisexuality to be indicative of a different relationship with respect to self-models (though of course all of this is flexible), and hence a slight update towards a different neuro-circuitry of sorts. And it wouldn't be weird that more lax model loops gets perturbed more easily.
Like, ok, to me it is like if you saw that depressed or ADHD people get long COVID more easily, and somehow that's an update that it is culture-bound, that would also feel like an overreach
I think you are really buying too much into this culture-bound disease idea, and i think it aligns with how we're emphasizing placebo too much in our society. Not to say that it doesn't exist (at least in a weak form) just that it is getting blown out of proportion.
Depressed and ADHD people *do* get Long COVID more easily, and that does make me update, so I'm not sure what you're trying to do with this analogy.
I agree that all of this goes through different neurocircuitry, but that fact that we're talking about neurocircuitry suggests to me that this is a nervous system problem and not an end organ problem in the lungs or immune system or whatever. My guess is it's something like "COVID makes you weak and fatigued" -> "weird neurocircuitry makes a hard update towards weakness and fatigue and refuses to update out of it" -> Long COVID. This is what I think most psychosomatic problems are, see eg my models of HPPD, anorexia, and chronic pain.
Okay, so i think what I'm confused about is your jump from "it's a nervous system problem" to "it's mostly culture-bound".
Being both bi/pan and having answered yes on the survey about having had long covid, i see long COVID more like anxiety or depression, wherein your prior do not matter as much and you just feel that "something is wrong" (that is at least my personal experience, and i only pieced the long COVID possibility months after)
Culture-bound disease can happen in that it can constrain your expectation, but i think we're over considering the impact of conscious beliefs; aliefs are much harder to change, and from what I'm seeing, are what actually matter in terms of impact on oneself
Unless you think that a majority of depression/anxiety/ADHD would not have existed if we didn't know the term, then it would be quite consistent.
What I'm still surprised by is that in your highlights on culture-bound diseases, you said
> All of this is convincing me that culture bound illness, while real, is much subtler than The Geography of Madness (or my previous views) suggested. Or maybe that the panic type (where they spread in epidemics over the course of a few days) are more culture-bound, but that the long-run normal conditions are less culture-bound than I thought.
Which to me indicated you were giving it way less credence, and a higher complexity penalty for explaining primary facts
I might be misunderstanding you, but I think I'm analogizing this to chronic pain, where one view (not universal) is that the belief that pain can be chronic contributes to a trapped prior that keeps the nervous system locked in an expectation of pain.
I know it does on the level of aliefs, but maybe one crux we are having here is that i do not expect most beliefs and campaigns to change it
Like, i was under the impression that beliefs on the conscious level do not matter much, and that the prior "i will keep experiencing pain" is born more of a continuous experience of pain than of being told so.
I will try to look into correlations between awareness campaign on chronic pain and prevalence of it
That being said if it is indeed how it works, maybe we should try to design something like the mirror trick ( https://en.m.wikipedia.org/wiki/Mirror_therapy ) for long COVID, and stop doing placebo controls of harmless therapies that seem to work in treating chronic pain?
A lot of the bisexual people I know, particularly bisexual women, seem to have chronic pain and/or autoimmune disorders of some sort. (A few weeks back I noted a similar pattern among trans people I know.) Cisgender homosexuals, on the other hand, seem to be just as healthy as cisgender heterosexuals. Possibly even more so, since both gay men and lesbians tend to be more athletic and physically fit than the average straight person - which might explain why homosexuals tend to have even lower rates of Long COVID than heterosexuals. I've long thought that gender dysphoria in trans people might be tied to more general "body mapping" issues that would strongly correlate to various health problems; the same could be true, to a lesser degree, of bisexual people.
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. Most likely, this "mix-up" would occur during early fetal development, with downstream effects on things like muscle growth and immunological functionality.
(Note that this probably wouldn't apply to "homoflexible" or "heteroflexible" individuals, who might be technically bisexual but have a very strong preference for one gender over another. Biologically speaking, I'd imagine those people are likely to be much closer to fully gay or fully straight people, respectively.)
I realize that unawareness campaigns are useful as a thought experiment, but it bothers me that there seems to be an unawareness-campaign-shaped hole in reality where an actual strategy for handling culture-bound mental illness should exist.
To be fair, I suppose "stop holding awareness campaigns" is at least a partial strategy. But if that's the best we can do then I'd prefer to see an explicit argument saying as much. Absent an explicit argument, we're mostly still stuck in a false dichotomy with "deny that culture-bound mental illness exists" on one side and "try to solve all problems with social stigma" on the other.
TBH I would kind of assume bisexual people are further right on "snowflake spectrum" (i.e. they are more inclined to publicize their internal state as a way of forming an identity)
If this is the case, they should also have a higher incidence of other psychosomatic-adjacent conditions like PCOS and chronic Lyme disease, and other mental illnesses
I realize how this makes me sound but I'm really not conservative or anything, it's just my current model of reality
I agree with bits of that but disagree with most of it, but anyway am not very invested in arguing about because it would involve of grinding over a whole bunch of things which you and anyone else already has a very particular way of looking at that will be hard to sway.
But I think it's weird to attempt to debate a point when your opening stance is so loaded with disrespect. For example if you just wanted to debate the merits of the question you wouldn't be so weirdly focused on your example being a woman in her 20s. And "everybody knows"... do they? Did you check? What if they don't? Or what if they know something that superficially matches what you said but have the exact opposite interpretation of it? It sounds like you just wanted to take the opportunity to take some snipes at a class of people that you despise.
> For further evidence, see the fact that 1/4th of Zoomers claim to be LGBTQ versus like 2% of Boomers. I don’t believe 1/4 of Zoomers are actually interested in having homosexual sex.
In my experience I think they're probably one datapoint on a monotonic trend away from recognizing sexuality or gender as rigid constructs and probably in fifty years unless some big reactionary thing happens the question "are you hetereosexual" will just mostly not make a lot of sense.
. I looked for studies of suggestibility and sexual orientation, did not find any. Took a quick look at the research on personality differences and sexual orientation. Did not have time to be picky, though, just grabbed the first studies I found (there were not many). Here's what I found:
-In one study with a huge sample from many countries, subjects took the "big 5" personality inventory, which measures traits that factor analysis suggests are the main dimensions on which personality differs. Traits are extraversion, agreeableness, openness, conscientiousness, and neuroticism. Study found that "Bisexual women stood out from lesbian and heteroseual women in Big Five trains in that they scores the highest of all 3 groups on neuroticism and disagreeable assertiveness and the lowest on agreeableness". (Study is here:https://sci-hub.ru/10.1007/s10508-007-9267-z). Neuroticism = having mood swings, being easily upset, which sounds enough like Borderline Personality Disorder for me to be curious about BPD and sexual orientation, so looked up that. Found this: "In this study, patients with BPD were over 75% more likely to report homosexual/bisexual orientation than comparison subjects with other personality disorders." Study was not large, but was done at Harvard/McLean Hosp. so probably was decently done. (It's here: Sexual Orientation and Relationship Choice in Borderline Personality Disorder over Ten Years of Prospective Follow-up. J Pers Disord. 2008 Dec; 22(6): 564–572.
doi: 10.1521/pedi.2008.22.6.564)
So all this seems to me to support the idea that something like suggestibility is a factor in women thinking of themelves as bisexual, & there's research (cited here by Scott I think) that it's also a factor in people thinking of themselves as having LC. I have more thoughts, and all this is sort of blunt and lacking in nuance, but am out of time.
Regarding Covid and related matters, wanted to let people know that beowulf888, who posts here, has been studying Covid since early on. It's not his field, but he's smart and knows how to research things. He now posts a weekly Twitter thread about covid-related events and/or whatever new things he's found or figured out. He has no ax to grind regarding covid, is only interested in figuring out what's true. Here's his latest update, which actually is mostly about covid sequelae: https://twitter.com/beowulf888/status/1653553731760459776
Would be really interesting to get these results further broken down by Kinsey scale. The suggestions of bisexuality being dependent on cultural suggestibility or tendency towards self-identification with labels seem to make much more sense lower on the Kinsey scale. At 1 or 2, sure most men will say they're straight and the ones that say they're bi would be more likely to identify with other controversial labels. By the time you reach 3 or 4 on the Kinsey scale though, it's not really something you can still be uncertain about, so at that point people are either identifying as bi or intentionally staying closeted (meaning no disrespect to those making that choice, I did the same for a long time).
So if the higher long COVID rate is driven by a greater tendency towards identifying with something controversial or suggestibility/culture-bound explanations, I would expect the long COVID percentage to drop most of the way back towards normal for Kinsey 3+.
Is there a good reason to think that the etiology of male and female bisexuality is the same? Is an increased risk of long covid weak evidence that it is?
I wonder if which strain of covid people got could be a confounding factor. One family member in college had (probably) Delta and had loss of smell/long term altered smell. The rest of us caught Omicron later and didn't have symptoms after a week or two, no changes to sense of smell. I wonder if (on average) openly bisexual people might be more social and more likely to have caught Covid earlier with a greater chance of long covid.
Well, the comments here are predictably horrible, so I'll ignore them and just throw my anecdata into the pool. 63-year-old bisexual man married to a 56-year-old bisexual woman. We regularly have sex with people of both genders (or, rather, did before Covid), so no this isn't about trendiness. Dodged Covid for 3 years, but it finally caught up with us in March. Both have physiologically unambiguous long Covid symptoms, mine mild and hers moderately severe (heart inflammation). Age is obviously a more relevant factor than sexual orientation for us, but I found the post intriguing.
Using the data shared by a fellow ‘commenter’ where bisexuals are considerably more likely to have relationships with the opposite sex (32%) than the same sex (5%), I think there’s an interesting possibility to consider.
It’s clear that within society there are those who are more confident/definitive about their views/experiences/ideas and those who are less.
This is maybe a commonality with sexuality and something like long covid. Having seen the way long covid was discussed in the media there’s no denying it’s considerably vague. A whole range of often common symptoms were mentioned. Therefore, when it comes to asking a given population whether they had long covid I think there’s a subsection in the population who are less likely to rule things out and perhaps going further, tend to question themselves. Maybe I do have long covid? I have had a stomach ache recently etc.
Similarly with sexuality, perhaps there’s a similar subsection of people who don’t have the conviction in describing their sexuality. Maybe they haven’t fully explored it yet and unlike others aren’t quite willing to rule things out. Bisexuality is clearly the ‘less definitive’ out of the 3 sexuality options, after all.
Blogger Scott Alexander does not promise he'll never make mistakes. But he says get that if he gets something significantly wrong, he will acknowledge it to help anyone trying to assess his credibility. I am cross-posting his blog because I am so outraged at what he says about Long Covid being a culture bound psychosomatic condition. I am going to provide Scott with a free service for which I normally charge lots of money. I'll prepare him a critical appraisal report that suggests he mend his ways. I'll do that by Tuesday on Substack . He might come with his friends. Rather than send me money that I could use, I invite him to cross-post my article. Then we can have a sit down, maybe toss back some beers. Scott, you're a good soul, but you have sinned. Please repent.
Granted, the boundary between organic disease psychosomatic / functional neurological disorder might be demarcated by "is it detectable by well-validated clinical-grade diagnostics (in-vitro or otherwise) or not"; which I think is pure map/territory confusion. Under this definition, long covid is indeed psychosomatic; there is no such diagnostic test currently available. However, there is a consilience of evidence pointing towards some sort of organic disease (possibly of a heterogeneous flavor) in at least a significant fraction of long covid patients. I doubt that all these biomarker findings are the fruit of indefatigable p-hacking but nevertheless, replicating the more promising findings would be nice (and essential to getting something into clinical use).
Research groups seem to favor hunting for *new* sets of exotic biomarkers (as seen by the ever-expanding lists of candidate biomarkers with good AUC in those "wtf *is* up with long covid" review articles) rather than trying to replicate existing biomarker findings or validate a more limited set of findings for clinical diagnostic use. I think this is unfortunate. There is a company claiming to do that with the Ang-1 and P-sel biomarkers summarized below, but they seem to be doing this alongside developing a novel platform ("quantum dot high performance fluorescent immunosensors for high sensitivity bio-detection and quantification to develop best-in-class low-cost rapid diagnostic assays") for point-of-care tests. Don't need high sensitivity detection and quantification to pick up on the vaporware vibes from this, and hopefully someone else tries to replicate the Ang-1 / P-sel findings, even if they can't commercialize it.
For instance, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549814/ gets **excellent** classification accuracy -- between healthy subjects, people who've been in the ICU for covid, and long-covid outpatients -- by looking at blood levels of only two proteins; Angiopoietin-1 and P-selectin (both involved in endothelial / vascular / clotting function). If you look at the figures in that paper, you can see that the levels of Ang-1 and P-sel are **off the charts** in long covid outpatients compared to healthy patients -- or even people who've been in the ICU for covid and have recovered.
https://www.medrxiv.org/content/10.1101/2022.08.09.22278592v1 is another one of those "look at a bunch of immune-related biomarkers, throw statistics at it, and find what has good predictive accuracy" studies and yep, they indeed also find some biomarkers with excellent predictive accuracy. Also, the self-reported long-covid symptoms matched up well with the biomarker findings.
Looking a bit more upstream, this study found low levels of circulating Spike protein *months after acute illness* in 60% of studied long covid patients (and none in those who recovered OK from covid): https://academic.oup.com/cid/article/76/3/e487/6686531. The "weird viral persistence" stuff also shows up in this study of IBD patients -- almost all of which previously had a covid infection, but only half of which reported long covid symptoms: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9057012/. The majority of people with SARS-CoV-2 nucleocapsid protein and SARS-CoV-2 RNA in their guts reported long covid symptoms, and people without these covid virus parts in their gut reported no long covid symptoms.
Bisexuality seems to me to be a pretty low-stakes label, relative to homosexuality at least. This leads me to believe that there's probably some meaningful overlap between 'people who choose to spend their time and energy reporting their bisexuality in polls' and 'people who spend an outsized portion of their time and energy on social signaling'.
It's actually incredibly difficult to phrase that in a way that doesn't seem - to me - to ooze contempt, which isn't what I want to broadcast. There's an obvious implication that I attribute a good deal of long COVID to social contagion, which is clearly a popular idea among other commenters. I'm not really confident about anything at this point, but if we're going to interpret this correlation as substantial then I think my take is as good as any that I've seen.
Activism is trendy, and bisexuality is currently underrepresented. Those who are concerned with representation in this case are probably more likely to be trendy. Setting aside the issue of whether or not long COVID is even real, I'd assert that it's almost indisputably trendy.
From personal experience, reading the long covid subreddits, I believe there is a Subset of "Long-Covid" patients who are just Copper deficient.
Copper deficiency can be caused by excess consumption of Zinc and Vit C, the key supplemments promoted for COVID prevention. Most people are unaware of the interaction between Zinc & Copper, and Doctors rarely check for Copper deficiency. There's research showing that Copper deficient patients take more than a year to get a proper diagnosis, as the symptoms mimic other diseases (for example Vit b12 deficiency).
I'm not sure I got anything from Covid Actual that was worse than the Jab itself, twice. Jab kicked my ass for five-plus days each time.
Given that I was working as a truck driver, trying to keep y'all in toilet paper and ramen, this was exceedingly bad.
(Yes, I understand that people who have read my comments over the decades probably think I'm making shit up, and I agree that I have had an exceedingly eclectic career path. Truck Driving was my midlife crisis career shift for a couple of years after my bout with Major, Direct Suicidal Ideation post-divorce. [The answer is still ketamine.] Yes, I eventually went back to computers.)
I feel silly commenting so late, though more so I'm happy to get into the action. I didn't feel prompted to share this initially, but on relistening to highlights of comments on this post it came to mind. Commenter Alex mentions this, and alludes to it as a preexisting view (that I wish was widely held).
I believe that a major explanatory factor of long COVID is health and fitness. Specifically, people viscerally notice a sudden decrease in exertion-capacity, on the order of hours and days, not the months or years of aging), and, without retraining to a fitness that suits their desired activity level and capacity, instead notice that the gap between desired versus current fitness level persists.
Some people may have experiences a comparable fitness drop
due to a night (or nights) of heavy drinking, or sleep deprivation (or both)—more noticeable if it affected group competitive fitness activities or defined personal challenges. Cardio-pulmonary(?)- or exertion-load (and -capacity) felt moment to moment are something I'm constantly aware of. I mentally track my fitness and mental acuity consistently and somewhat closely, as a runner and for programming, while I use VO_2 max as an indicator of general fitness, integrated over time, hard to cheat, lifespan associated, correlates with workout quality (intensity and preparation, including sleep) like an exponential moving average. This factor plus a restedness factor explains almost all of my felt physical and mental energy for long work hours or extensive physical adventuring.
I have risk factors for anemia, eating mostly-vegetarian, and when I donate blood, I'm quite consistently on the edge of donation-cutoff anemia (heme: 13.0 mg/dL whole, 13.3 mg/dL double red). Donations don't feel like quite the same fitness step-function decrease, but maybe I allow for, expect, some decrease. I should try mile times before and after future donations. (Against general advice to not exercise, I use the donations as a chance to see what suddenly decreased fitness feels like afterwards.) I'm not sure how widely shared is the experience of viscerally noticing the internals of one's body. I describe sensing spikes in blood sugar, fats, and physical effects of caffeine. And have trained endogenously noticing my heart beat, but many I talk to do not report recognizing the experiences, even prompted in close context, e.g. while eating cake together or drinking espresso shots.
I hope to hear others reports that speak for or against a fitness factor, and about the extent and form of viscerally felt capacity and exertion.
Based on what's freely available on the web...
https://journals.sagepub.com/doi/pdf/10.1177/070674371105600107
This one's from 2011, and covers 34, 653 Canadians, but we have gay men with more mood and anxiety and substance use and cluster B disorders, whereas there are more bi men with cluster A personality disorders; both are more common relative to the general public. (Cluster C is about the same, though higher than the general public; same for suicide attempts.) Schizophrenia is more common among gay, though not bi men.
For women, it basically goes bi > gay> straight for all of the disorders except schizophrenia, which is lower among lesbians.
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/rates-and-predictors-of-mental-illness-in-gay-men-lesbians-and-bisexual-men-and-women/EFCC9177FC0DF526E0279DAE050F9CDE
This study had 1239 people. Bi men were a little higher for anxiety and depression (it has scores on a scale but no breakdown) than gay men, no such effect for bi vs lesbian. Gay men were a little more likely to have used drugs.
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09210-6
This survey had 25,880 middle-aged and older people. Again bi > gay > straight for mental illness for both men and women, though again it doesn't break down, say, bipolar vs ADHD. Drug use for bi and gay men is about the same, though higher than straight men; for women it's again bi > gay > straight. Interestingly for chronic *medical* illnesses it goes gay > bi and straight for men (it's all the same for women); maybe it pays to have a woman nagging you to be healthy?
No, it was my own terrible attempted joke, long COVID in the sense of longcat.
Wait, that's actually pretty funny, but shouldn't it be stretched vertically rather than horizontally? Right now it's wide COVID.
It's lying on its side because it's tired.
Ooohhhh! LOL. I did not get the joke (or even that there was a joke) until this thread.
It's not a terrible joke, it's just very (too?) subtle. I showed it to my wife, and she giggled nervously (she knew I thought it was funny because I had just laughed, but she didn't get it). I explained the joke to her, and she thought it was clever, too.
Sibling thread about wide Covid lying on its side because tired is also gold.
I like the idea, but I think the intent would've gotten across better with some form of repetition of the middle section rather than scaling the whole thing. 🙂
"Everyone knows a woman who claimed to be bisexual in their 20s yet goes back to getting together with men or never stopped in the first place."
This comment suggests you don't know what bisexuality is. Bisexuality means someone who would be happy dating someone of either sex. Compare to eg me saying I would be happy dating either blondes or brunettes. If I then date a brunette, and then later date a blonde, this doesn't prove I was lying when I said I was okay with either.
Again, I think this is misunderstanding bisexuality.
I wouldn't adopt the "bisexual" label for social reasons because I find the idea of dating a man to be repulsive. Some men do adopt that label, then go on to date both men and women, which apparently suggests they're built differently from me. Even if they eventually get married to a woman, or continue to date some women while also dating men (which is completely consistent with their claim that they're okay with either), that doesn't change my belief that there's something there different from me going on.
If there is an element of trendiness in choosing to self-describe as bisexual, then those who do so for trendy reasons are showing they are susceptible to social influence, and I expect that might be generalised into a tendency to be more influenced by other items in the social milieu, including self-diagnosing with the disease du jour. I don't care whether they are "real' bisexuals or not, whatever that might mean, only that we are very likely to see suggestible people in greater than expected numbers among those who claim to have internet-famous conditions.
There is a difference between something being *possible*, and something being so *frequent* that it explains statistical outcomes.
It is possible that a Chinese cardiologist is a murderer? Yes, certainly.
If we look at the statistics of how many Chinese cardiologists have Long COVID, and someone says: "well, the obvious hypothesis most people ignore is that they are murderers, and perhaps being a murderer changes your probability of reporting Long COVID because..." that is a much stronger statement.
*
Also, if we are using speculation as a research method, it works both ways. You know, there are also environments where people are under social pressure to publicly identify as "heterosexual", no matter how they actually feel (or sometimes who they secretly have sex with). By coincidence, these are often the environments where people publicly doubt whether COVID actually exists, or is actually dangerous. This would explain why people identifying as "heterosexual" are more likely to deny having symptoms of Long COVID.
Do you feel convinced?
I'm not denying that some people might claim to be bisexual because it's trendy, I'm denying that "she was bisexual, but also dated men" or "she was bisexual but eventually settled down with a man" provides evidence at all that a bisexual is doing that.
Here is some data from a poll: https://news.gallup.com/poll/389555/lgbt-americans-married-same-sex-spouse-steady.aspx
> Bisexual adults are overwhelmingly likely to be married to, or living with, someone of a different sex (32%) rather than someone of the same sex (5%).
I think that's some evidence that a lot of use of this label is of the trendy nature.
I think when you say it's either no difference or only opposite sex (or only same sex) you're oversimplifying things. Probably a lot of people have both strong sex urges and preferences that can't always be satisfied. IIRC Kinsey used a 9 level scale in this area. (That's second hand, and I never checked, so don't trust it.)
I've known multiple out-and-proud confirmed lesbians, across decades (so not evidence of a recent phenomenon), who later in life partnered with and even married men. I have never inquired about this choice, but I believe it has something to do with social acceptance (and maybe something about the male temperament) making for an easier, more relaxed partnership.
I've also known nominally gay women who didn't have a problem with dick, just with what was attached to it; they would have long-term relationships with women, and casual encounters with men. That might fall under "genderqueer" these days.
I don't think any of these people were lying to themselves, or anyone else; I think our categories are insufficiently descriptive of the human experience.
It's hard to take this seriously when your disrespect for this example person is coming through so clearly. Anyway I bet in many cases this isn't done for the social value of being edgy, or whatever, so much as it is based on a newly-acquired understanding that rigid sexuality is largely made up and actual sexuality can be much more fluid than believed in adolescence (gradually discovering that you can love or be attracted to all kinds of people). It can easily be a phase of positive growth rather than an attention-seeking reaction.
I've known people who did what seemed on the surface like what you described -- a bisexual 'phase' -- but if anything the big indicator is that they are, like, *turned on* by both sexes, which is to say, it's _real_ as far as anyone who's keeping score is concerned. But what you are turned on by and what you can imagine a stable relationship of don't have to overlap.
Gore Vidal (very famously openly gay) took the position that a word like "homosexual" shouldn't be used to describe a person at all. It describes an act.
Seen this way, all of this becomes kinda ridiculous because in our interactions in the world, it's only in very specific situations where we need to be able to predict someone's sexual behavior without other context (i.e..need an identifier).
When you say "claimed to be bisexual", I see it as an accusation of lying. "Said they were bisexual" is what I consider to be neutral language.
I actually know a woman who said she was bisexual and ended up with a man. Apparently her actual orientation is tall, quiet, blond(e)s.
The pattern could mostly be a matter of odds if lesbians/bisexual women are rare compared to heterosexual men.
Another complexity is that bisexuality is a plus in some social circles and a minus in others, including some homosexual social circles. I have no idea how the two balance out.
The point is that how you label your sexuality and your behavior are two different things.
A lot of bisexual-identified people have a revealed preference for heterosexual relationships. Some straight-identified people enjoy gay sex. This suggest that the difference between straight- and bisexual-identified people isn't just that of sexual preference.
To put it more rudely for the sake of clarity: Bisexual identity, like long covid, is transmitted socially. And people more susceptible to such transmission (notably women) are more likely to have both.
Bisexuality doesn't necessarily mean 'ambivalent gender of attraction'--lots of bi people have a preference for one or the other.
Your average male Kinsey 2, and even your average male Kinsey 4, is much more likely to identify as straight, because there's a huge amount of stigma attached to male bisexuality (and fear of STDs), whereas a female Kinsey 2 or 4 is much more likely to ID as bi. Identifying as a bi man will hurt you with straight women (who are much more numerous than gay men), whereas identifying as a bi woman will...not hurt you with straight men.
Well said about the blue-red tribe distinction (the bi women I knew weren't that bad drama-wise, though I'm sure you definitely experienced what you experienced!) and I should have taken that into account when writing that.
I still think you have a response-bias issue between men and women because the blue tribe is so big. But it's likely half as large as I anticipated initially, or smaller.
Sure, I'm not saying that the only reason people identify as bi is to be trendy, obviously a lot of other factors are at play.
Given that most women exhibit a bisexual arousal pattern in formal studies, why can't we say that heterosexual female identity is transmitted socially?
A woman who identifies as bisexual is more likely to be accurately describing her physiological responses. Do we need to explain away accuracy as some kind of mental weakness?
To the contrary, increased awareness of one’s own physiology could apply across the board, all the way to spotting pathological alterations of it. So our hypothetical woman would be more likely to spot signs of long covid, even when they are subtle.
How is that different from what I said?
It’s not, I was agreeing with you
Yea I agree that you don't have to see it as a negative, especially when it's something harmless like identifying as bi.
But most of the time these illnesses cause real harm, like young women "catching" tourettes from tit-tok influencers:
https://web.archive.org/web/20221224132431/https://www.theamericanconservative.com/what-long-covid-means/
I think the blonde/brunette example is actually instructive. I think most people accept that "attractiveness" is at least somewhat culturally determined. Some cultures favor thicc butts (or whatever) and so *more* people in such a society then favor thicc butts. It's hard to differentiate between the people who would've liked thicc butts regardless of cultural impact and those who were swayed at the margin.
If attraction to same or other-sex people is similarly culturally mediated (which is Try Catholicism's suggestion), you'd still have a group of people who are intrinsically bisexual, but there would also be some number of people who would develop that attraction (or not) due to social factors. Those people would label themselves as "bisexual" while in the culture favors bisexuality, but then actually feel less/not bisexual if moved to a culture (let's call it "not college") that doesn't favor bisexuality. And those people may also be the people who are probably more likely to internalize other things (let's say, Long Covid) that are culturally favored or accepted in some way.
Are you implying that some people who say they like big butts might in fact be lying, despite their comrades not denying this preference?
Not lying - I'm suggesting actual sexual preferences are affected by cultural factors, which I think is fairly well accepted when we're talking about physical attributes within sexes.
And I was referring to "thicc" butts. I'm not sure what the research says on big butts.
I think the real test would be be to observe, if a female were to enter the room with a large hip to waist ratio and curvaceous gluteus directly in your near-field view, would you become “sprung”?
> I'm not sure what the research says on big butts.
I believe the prevailing opinion in the field can be found in the publications of Anthony L. Ray et al.
An interesting follow up would be if pet preferences do in fact correspond to owner preferences.
And also, does this preference transcend racial categories, as some have claimed, at least for sufficiently shapely and voluminous butts?
We might be able to rule this out with an experimental manipulation. Have a confederate with a slim waistline but a large amount of gluteal adipose tissue enter the room, and observe whether these claimed big-butt lovers do, in fact, get sprung.
Of course, you'd need a control condition involving someone who does not got buns.
There's a lot of rounding you can do.
I know people who have the same level of interest in homosexual encounters as I do in heterosexual encounters. They occassionally find people of the same sex attractive, and are curious enough to act on it once or twice in a lifetime, but they clearly are more interested in opposite sex encounters. This is based on conversations and self-description, NOT observing who they date.
Yet these people would say on a survey "I'm bisexual," whereas I would say on a survey "I'm homosexual" because I'd rather simplify my self-presentation and they are motivated to complexify their presentation. They emphasize the ambiguity, I hide the ambiguity.
I have honestly considered the possibility that I have long covid. I entertain the possibility with comparable frequency to how often I entertain opposite-sex attraction: maybe every few months, when I'm in a certain frame of mind. But I said "no long covid" on the survey, because I'm not interested in broadcasting my random uncertainty.
Yeah, this was my off-the-cuff theory. Maybe rounding up is correlated with rounding up, and vice versa. There's all sorts of reasons why someone might round up or down, but maybe there's signal in the noise.
It's anecdotal but it does seem to be true that more young than old women identify as bisexual. Without wanting to gatekeep their sexuality, it does strike me at least a little as an affectation (And I can freely admit that if being a bisexual man were socially encouraged, I would have experimented with it more)
If we go by prejudices many homosexual men have an outgoing personality; yet they have even less long COVID than heterosexual men. You are just trying to shove your own prejudices and believes into the discussion ... (especially considering your Boomer numbers are outright wrong and used to validate your claims, even as far back as 1948 those numbers were much higher: https://en.wikipedia.org/wiki/Kinsey_Reports#Findings https://kinseyinstitute.org/research/publications/kinsey-scale.php )
Your whole argument hinges on 'Gen Z are more likely to identify as LGBTQ because it's 'trendy'' while not considering the inverse 'Boomers are less likely to identify as LGBTQ because of stigmatization'.
These are surveys about how people identify and they will be affected by the generation one was brought up in. If a Gen Z person has had even the slightest romantic attraction towards someone of the same sex, they will be more likely to identify as bi than an Boomer with those same feelings who will explain them away.
The proof is in the pudding. You have confirmed that you are standing on your beliefs and interpreting the data the way you do. Your bias is not an "obvious conclusion" or basis for a rational conversation. Thoughtful conversation requires a mind that is willing to be changed. Is your perspective on this something that could change and if so, what might be convincing to you?
You aren't comparing like with like there. Kinsey had a scale, whereas you are trying to compare his nuanced results with an absolute number you googled somewhere. Kinsey had a scale for a reason, and research has since become even more nuanced.
Additionally Kinsey did his research at a time where talking about such things was much more of a taboo back then. If anything, it's Kinsey's numbers which are skewed.
Also: holding random numbers from various sources side by side without context makes no sense at all. The actual ratios depend heavily on the methodology used. There is way more nuance to human sexuality than the heavy labels you are trying to slap onto it. Which is why your approach is prone to fail.
And yes: there is a cultural aspect the human sexuality as well. If society doesn't scold you for exploring your true self the results will of course be very different to those of a society which freaks out at anyone who even dares talking about sex. So yes: those numbers might have changed to a degree.
I don't take issue with Gallup. I take issue with your own personal interpretation of the results of their work ...
Your claims aren't their claims. All they claim is that to a certain question to a certain panel they got a certain ratio of responses. Everything else is your (faulty) interpretation ...
Trans and homosexuality are mostly sociocultural/environmental phenomena anyway (ie. not congenital/biological). This certainly does not mean they are a choice of course, but very little evidence that anyone is born trans or homosexual (and certainly not 30% of the population). So if they are mostly sociocultural/environmental phenomena, it should be normal that with greater acceptance their incidence will increase and vice-versa.
Considering that literally each and every sexually reproducing species of animals has been observed to perform homosexual practices I don't buy the "mostly sociocultural/environmental phenomena anyway" part. It's very obviously part of the natural variance of behaviors which come with sexual reproduction, even in animals which don't really form any kind of societies. Environmental factors could play a role, but those shouldn't vary in line with social acceptance.
Considering that homosexuality isn't an ON-OFF-switch, I fully agree with your "it should be normal that with greater acceptance their incidence will increase and vice-versa"; if by "incidence" we agree to mean that people act on this preference, instead of suppressing it trying to adhere to opposing social norms, if they feel allowed to do so.
Yes, homosexuality in nature occurs opportunistically but there is no evidence of a sustained sexual preference for the opposite sex in wild animals under natural circumstances. This has only been observed in human beings and in one breed of domestic sheep. In other words, given an equal choice in natural conditions, the sexual preference in nature is for the opposite sex (which is hard to argue against from a Darwinian perspective). In overcrowded conditions, homosexuality increases (which seems pretty self-explanatory), hence environmental factors are clearly at play. And very hard to argue that in the highly socialized existence that we humans have, that the socialcultural aspect is not extremely influential as well (perhaps the most important factor).
You don’t think animals have cultures of environments?
Animals don't engage in 'homosexual practices', as they--with very few exceptions--don't engage in social nor recreational sex. Homosexual activities in animals is a deviation of aim, not a deviation of objective.
Bulling behavior in cows, isn't one cow horny for another, its a cow overcome by hormones that in the natural world would have brought a large number of bulls to engage in sex with her.
> Trans and homosexuality are mostly sociocultural/environmental phenomena anyway
What about bisexuality?
FYI, Kinsey data expands to the following numbers, rounded for convenience:
40% of men engaged in same-sex activity at some point in their lives.
30% of men engaged in same-sex activity to orgasm, at some point in their lives.
10% of men had exclusively same-sex sexual contact for a period of at least five years.
4% of men had exclusively same-sex sexual contact for their entire lifespan.
Which of these you classify as 'gay', 'bisexual', etc. is kind of dodgy, especially in the 50s. If you take this data as gospel, I don't think it's at all out of the question that a fairly large plurality of the population would adopt bisexual identity in a 'neutral' setting, though it's honestly anyone's guess what the 'zero tension' number actually is given some hypothetical perfectly-tolerant society.
I don't think social scientists take Kinsey's numbers that seriously today.
That's beyond the point. Whether those numbers were good or bad doesn't change the fact that they are MUCH closer to the numbers we find today than "Try Catholicism" claimed! So the change isn't as massive as he implied ...
If the numbers are bad, then you can't determine whether the change was massive or not.
Since there aren't any better numbers the same MUST be said for the initial claim I was contesting. Those are the numbers which exist; may they be bad or not. The other numbers were simply made-up.
Throughout this thread I repeatedly stated already that comparing those numbers without regard for methodology is stupid anyways. We agree on that account. I was merely stating that even by doing this stupid thing the outcome wouldn't be the one "Try Catholizism" claimed ...
The low numbers make sense in my mental model.
Everyone is bisexual. Like, basically everyone. There may be exceptions, but you could never prove it. In a Kinsey scale sense, the *actual* 0s and 6s, if you could read minds instead of relying on surveys or observations, is a negligible percentage of the population.
So why doesn't everyone identify as bisexual?
Well, some of it is legitimately being a Kinsy 3 vs a Kinsey 1 or 5. But on the margins, some people are dedicated to expressing the complexity of their inner personality, and in the social cache of being "queer," while others are more interested in hiding their inner complexity and avoiding the social stigma of being "queer."
Heterosexual-identifiers have two potential motivations, but homosexual-identifiers have only one potential motivation (since they're queer anyways). Hence, anyone claiming to be homosexual in a survey must be statistically less interested in flaunting their inner complexity in surveys (compared to the population as a whole)
My personal crazy theory, of many years' standing, is that I think there's (at least) two axes here - attraction and (for lack of a better word) phobia. So I think some of what gets counted as 1s and 5s are people who have no attraction but simply aren't repulsed by that type of sex. Cats being grey at night, and all that.
Having the axes be completely independent would imply the existence of heterosexual people who are phobic of heterosexual sex or the opposite sex, and the homosexual equivalent. And frankly, I think that would explain a fair bit of pathological behavior.
I’d guess a similar correlation with queer or trans identities would warrant further speculation in this direction, but the sheer number of bisexual responses to the survey suggests you might be overly dismissive here.
I don’t think most people who casually use the word demisexual consider that an identity. I think it’s more a qualifier, used especially on dating apps to signal disinterest in hookups.
The relevant point for here though is that it's not in the survey (except under "other", which is too small a number to be statistically analyzed).
I've known three people who might be said to have had Long Covid. One was an fit fell runner who suffered extreme fatigue and poor concentration for over six months. This was in 2020. She is now ok but it was very scary, and very unpleasant. Another has had what might be called LC since falling mildly ill with Covid in 2021. Symptoms include aches and pains, physical weakening, and fatigue. Not life changing but not nice and still there.
On bisexuality, I am a bi male. Few people know that: for example, my children and most of my friends don't know. I haven't had any same sex action this century and I don't expect to do so in future: nonetheless I have in the past enjoyed it and felt attraction to men. That's a report on experience which may or may not be widely shared but which in fact I suspect to be quite common. If one has settled with a life partner, advertising who hypothetically one would be prepared to sleep with seems somewhat strange.
There is a rather irritating tendency in the rationalist community to interpret behaviours and preferences in terms of social positioning, as though people might not genuinely like hiking, or poetry, or playing the drums. Long Covid is real. Bisexuality is real. Baseless and generalised questioning of integrity doesn't advance the debate
That conclusion only works if you believe it is likely that a large fraction of the people who identify as bisexual fit that description.
I view our attraction/revoltion on a horizontal scale, and imprint an imaginary histogram atop that.
Some people are going to be very far on either edge, but most are centered. But where are the boundaries between the bands is going to be determined by nature and nurture, and with a heavy dose of culture.
Now make two plots, same sex attraction/revoltion, and opposite sex attraction/revoltion.
I think this also explains why the effect is larger with bisexual women. In many circles, bisexualism in women is much less frowned upon than in men (is this true statistically?), so the "self-reports bisexuality for attention seeking" is much more plausible with women.
Yeah, I would guess "left alignment" + "desire to be special" ("specialness deficiency"?) is a big cofounding factor. If you want to increase your "specialness score" bisexuality is an attractive option as it doesn't really *require* any behavior changes. (I think this can be subconscious - I don't think this has to be a conversation about 'lying')
I think the left alignment is a big factor, and the specialness factor is why it's a stronger effect compared to homosexuality, despite both fairly equally implying a left alignment.
How about:
A lot of women prefer men, but also don't want to get pregnant outside a stable relationship. When they find a man and form a stable relationship, they are satisfied. When they are outside a stable relationship, women are safer, and reasonably satisfying.
Very interesting research!
Here's a potential alternate interpretation of the data that occurred to me: Perhaps bisexual people are more likely to have more sex, which means they're more likely to contract STD's, which means that on average they are immunologically different to some degree and might legitimately get different physiological consequences from COVID. I don't actually believe this - I think your theory is at least as likely - but I'd be very interested in any analysis that tries to look into this.
I asked myself the same question. But if that was true then we should see homosexual men having a higher rate of long covid than heterosexual men. Instead, homosexual men have a particularly *low* rate of long covid.
That outcome argues against some comorbid STD leading to long COVID.
Androgens and their related receptors also seem linked to COVID. But I can't figure out what condition would put bisexual women, in particular, at risk.
Perhaps just like the correlation between being trans and hyper-mobile Scott wrote about, there’s a genetic link with bisexuality and autoimmunity issues.
Some of us might be flexible enough to kick our own asses!
That looks pretty plausible. Is there some data about other autoimmune/ post infection problems and bisexuality?
Using the data shared by a fellow ‘commenter’ where bisexuals are considerably more likely to have relationships with the opposite sex (32%) than the same sex (5%), I think there’s an interesting possibility to consider.
It’s clear that within society there are those who are more confident/definitive about their views/experiences/ideas and those who are less.
This is maybe a commonality with sexuality and something like long covid. Having seen the way long covid was discussed in the media there’s no denying it’s considerably vague. A whole range of often common symptoms were mentioned. Therefore, when it comes to asking a given population whether they had long covid I think there’s a subsection in the population who are less likely to rule things out and perhaps going further, tend to question themselves. Maybe I do have long covid? I have had a stomach ache recently etc.
Similarly with sexuality, perhaps there’s a similar subsection of people who don’t have the conviction in describing their sexuality. Maybe they haven’t fully explored it yet and unlike others aren’t quite willing to rule things out. Bisexuality is clearly the ‘less definitive’ out of the 3 sexuality options, after all.
So good to see the use of an engaged audience for replication studies. It's really a unique community
Did you correlate with political orientation? I'd expect that in the US, people willing to acknowledge they're bisexual are probably much more likely to be liberal than conservative/Republican/etc.; and that liberals/Democrats/etc. are probably, on average, more willing to acknowledge that they've had covid / that covid can be dangerous / etc.
So why not the gays?
Today if you are gay, you are very likely to accept it. If you grew up red tribe, you may stay red tribe while admitting it. If you grow up blue tribe you certainly will and you'll stay. But if you are bi and in the red tribe - it's a lot easier to pretend to yourself and surveys that you are hetro. If you are bi and blue tribe - you acknowledge it and stay blue tribe.
P(R|B) < P(R|G) because you can still pretend you aren't bi but won't pretend you aren't gay.
There's surely a data table that will quickly confirm or deny this theory but a quick google didn't turn it up..
This seems like the real deal to me. A blue-tribe person who is open to sex with the same sex but pair-bonds with the opposite sex is MUCH more likely to identify as bisexual than a red-tribe person in the same situation, so the identifies bi population skews heavily blue-tribe and has all of the markers of blue-tribe including "thinks X symptoms are long-covid when a red-tribe person wouldn't think that" and "cops to mental illnesses that a red-tribe person wouldn't cop to". In this admittedly evidence-free analysis, identified mental illness and long-covid are both downstream from culture, rather than identified mental illness being innate and long-covid being downstream from that.
Crucially, this doesn't suggest to me that bi/mentally ill/long-covid peeps are lying, or that straight/mentally healthy/short-covid peeps are lying, just that those two groups have different thresholds for using those terms to describe themselves, and those thresholds all correlate by culture.
Precisely these sort of fine-tuned language differences make self-reported polling about anything even slightly abstract weak.
gay is harder to ignore then bi
This comment irked me in a way that makes me feel like maybe I'm suffering from a bad faith read of what you meant to say. It sounds to me like you're implying that there's a significant faction of conservatives/Republicans out there somewhere who are actively in denial about having had COVID, which seems grossly out of touch to me.
It makes me wonder what sort of experience you've had with conservatives/Republicans, because I know plenty of them and none seem particularly likely to be deluding themselves about their own health. If anything, they're more likely to take a responsible approach to the whole ordeal than my liberal friends.
My dad died of COVID. His widow called my uncle (on his ex-wife's side) to see if he'd gotten a memorial CD. _During that phone call_ he told her, "I don't see what everyone's so upset about. It's just the flu." He watches Fox News. I don't talk to him anymore.
I've read multiple accounts from doctors and nurses, describing how conservatives _who are dying of COVID in the hospital_ deny that they have COVID.
I'm glad you don't know conservatives like that. But you interpreted my comment correctly, and it was made from personal experience and apparently-valid multi-sourced information.
Your uncle sounds like a real piece of work, and I sympathize with your story. I had an uncle pass away recently, and it was a combination of diabetic and COVID-related complications.
Unfortunately, the way you've set up this comment is further ostracizing me from the conversation. Since I don't subscribe to the partisan perspective, it's not exactly damning to me that your uncle watched Fox News and I don't really understand why you included it...
*Wow, Fox News!? It's, like, they're the other team, right?* /s
I ran a quick Google search (<10m) trying to unearth some of these testimonials you're referring to, where bedridden hospital patients are denying their diagnosis, and couldn't find anything but headlines railing against the 'mass conservative delusion'. The search I used was "conservative denies having covid" - please feel free to link me to any sources that you have.
I've definitely encountered my share of radicals, and I'm not denying that there are some delusional folks, but the idea that they're proliferous enough to significantly impact Scott's poll would be pretty shocking to me. Especially given that the ACX audience is majority democrat.
Red-tribe here, have had COVID, have never denied it.
I'm wondering if it's explained by something like how likely you are to hear symptoms and think "that's something that describes me" rather than just kinda going with the default answer unless you are forced into picking the other.
I mean, suppose you've occasionally had sexual or sexualish thoughts about someone of the same gender (Iess sure if there is a standard answer effect if homosexual). One sort of person might not think much of that unless they feel them quite strongly while another might report they are bisexual. The same kind of attitude plausibly affects how you answer long COVID questions.
I think this is the most plausible explanation I've seen: it has something to do with how we process ambiguous stimuli.
(I'd further hypothesize that this factor is different from, but positively correlated with, the "tolerance for ambiguity" dimension of trait Openness.)
See my comment at https://astralcodexten.substack.com/p/replication-attempt-bisexuality-and/comment/15537215
I think what Peter is getting at here is something subtly different from a threshold effect, although I'm having trouble articulating the difference. I think the best way I can put it in "threshold" terms is something like "assessment of the relevance of subthreshold data."
That is, a hypothetical psychological factor behind bisexual identity couldn't really be describe as "high threshold" *or* "low threshold. A Kinsey 2-3 identifying as bisexual could be "low-threshold." A Kinsey 6 identifying as bisexual could be "high-threshold." What they have in common is not "how much information do you need to reject the default and/or accept the alternative," but something like "when you have conflicting information, do you think it's more important to indicate which side you're leaning toward, or to highlight the conflict?"
(Possible connection to the great "lumpers vs. splitters" divide.)
How this tendency presents across different survey questions is likely to vary, although I'd expect an overall tendency to avoid extreme responses on Likert scales. But on e.g. vegetarianism, I don't think anyone is looking at the question, scratching their head, and saying "well, I'm not *not* a vegetarian..." in the same way they might be for long COVID or self-diagnosed mental illness/developmental disability.
(Political affiliation would seem like the best analogue for sexuality in a structural sense, but current politics is extremely weird.)
Yes, that's what I'm suggesting. Thanks.
Yeah I am straight as straight could be. So much more interested sexually in women than men, 100:1? 1000? Yet I can remember being IDK 11? Wrestling in shorts with another just on the cusp of puberty boys, and being super turned on by our smooth legs rubbing against each other.
More importantly I hadn’t had any real sexual contact/success with women at that time other than the modeling/aping 4-6 year olds do with each other.
I can see someone in a more modern environment, having that experience and living in this culture, and getting into this headspace where they convinced they are homo or bi-sexual.
But really I was just a horny boy who can be turned on by lots of things vaguely in the vicinity of having sex with a woman. And wrestling with a young boy was one of them.
I wonder if it's as simple as relationships -> more close interactions with people for longer periods -> greater attack surface for covid and other spread-between-humans things. It's obviously a gross oversimplification that bisexuals have twice as many potential partners, but...(plus this relies on an assumption that one would treat a partner with more lenience wrt covid precautions; this is maybe unwarranted)
This would have to be a *very* strong effect in order to produce the observed results!
I think you've missed something in that my first theory would be people admitting they're bisexual on a survey are _weirder_, and more marginalised (and more likely to be Blue Team politically?) - and deciding your symptoms are long covid is something that people who are already not trying to be respectable are more likely to do, and something that is much more fashionable in the Blue Team world than the Red or Grey teams, and you're more likely to need to put a name / diagnosis to it (to obtain support) if otherwise marginalised.
The symptoms of Long Covid could be any number of things, including 'nothing much' to someone who is otherwise healthy - so 'do you label your symptoms long covid' doesn't have much bearing on 'do you have physical symptoms or not'.
(I am somewhat biased on this because I believe the world is currently making a dreadful mistake ignoring long covid which will become increasingly apparent as people with it age and can no longer ignore the minor symptoms, and things which are psychosomatic tend to be ignored or dismissed by society as something you can somehow just stop experiencing)
Could also be reporting bias, same people who won't admit they're bisexual for social reasons won't admit to a potentially controversial illness (or identify what they have as it).
I like this. I’m basically elaborating on what you said but there’s a large amount of conservative, religious people who barely admit that Covid is real. Many still call it a flu. So you can’t have long Covid if acute Covid doesn’t exist either. I would wager many of those also would deny and suppress any bisexual feelings, at least in signaling to others if not also not acting upon that. And chronic illness is also frowned upon in general among the bootstraps types, as it inherently admits reliance on others may be necessary and not immoral.
Feels like you’re neglecting a possible arrow of causality in the other direction!
Imagine that there’s a relatively common personality trait, which expresses itself as a strong antipathy to stand out from one’s neighbors or be classified as a minority or exception; these people really really want to be ‘normal’, at least up to some threshold. Then, it seems obvious to me that they’d resist identifying as *either* bisexual *or* long-Covid.
This is not to exclude the other extreme- people with a very *low* threshold to identify as being part of a minority group or otherwise outside the typical human experience for their culture. Those people, in turn, would be more likely to identify as both bisexual *and* long-covidy, on the basis of minor expressions of either.
“People have a gradient for how willing they are to accept a self-identity far from their cultural center of gravity” seems like a pretty intuitive claim to me by observation. The only question is what fraction of our population tends towards either extreme; if they happen to be evenly balanced, it makes for a weird situation where overdiagnosing bisexuals exactly cancel out underdiagnosing people on the other side.
Great comment IMO, just want to say it
Thanks!
Would that explain the effect for homosexuality, though? It seems like this predicts that they would also be more long-covidy. (Not trying to argue against you, just trying to work through the logic.)
In my mental model, heteroosexuals have a confounder for homophobia, and homosexual identification is only testing for "how weird do you want to look."
In particular, being bisexual is "zanier" than being homosexual, just because being gay has more of its own established cultural identity whereas bisexuals are weird and marginal from the persepctive of both cultures.
I was thinking about that when I wrote it, and I think it works okay?
People with a strong conformity-impulse, or whatever you want to call it, will resist identifying as gay, but obligate homosexuality is not an ambiguous signal. (By definition!) In other words, anybody who experiences sexual attraction only to members of the same sex, but identifies as *straight*, is either extremely confused about what sexual attraction is, or (more likely) closeted. So here, the monotonic nature of a person's sexual attraction is set in opposition to their desire to conform to social norms.
On the other hand, if someone with a strong conformity-impulse is experiencing sexual attraction for both men and women, then sexuality no longer functions as well as a wedge against their need for conformity; they are capable building a narrative in which only opposite-sex attraction is 'real', of building habits in which they affirm and express only opposite-sex attraction, and commit to fulfilling monogamous relationships with people of the opposite sex.
As a result, I'd expect people with a strong conformity impulse to be better represented among self-identified homosexuals than self-identified bisexuals- obligate homosexuality simply gives a person fewer tools to maintain a straight self-identity.
Probably this should be said explicitly: there's an obvious political valence here, but I'm not really thinking anything Red v Blue. It's closer to the "lumpers versus splitters" dynamic you see in the sciences where some people like to classify phenomena in to a small number of broad labels, and others like to fine-tune categories in to more descriptive but narrower groups- but add in the evolutionary instinct to fit in well with the herd. Political divides would be basically downstream of that.
There are no (modern) places that I can think of where being straight is seen as odd, unusual, or 'marked', something in need of an explanation that someone with a strong conformity impulse would feel pressured to avoid.
That may indeed be the case, but 'conformity' is categorically not the same thing as 'status climbing.' At an engineering college, conformity-heavy students would tend to be engineering majors, not star football players; they do what their peers do. Being greatly lauded, like being greatly scorned, is the opposite of conformity.
I'm talking about an impulse that's coupled to, like, the fear of public speaking: an aversion to any situation where you are a particular and individual object of widespread social judgment. It's not at all unusual to dislike being on a stage, even when the audience is clapping.
I do think the fact that homosexuals are not more long-covidy weighs strongly against the don't-want-to-stand-out theory.
Great nuance!! I feel like a lot of people (mainly a subset of cis individuals) vastly understimate the complexity of the internal experiences of sexual attraction and form an opinion based on their own assumptions.
I'm glad I found this comment after scrolling past many of the perspectives fixating on what they seem to deem as "false-positive identification as a bisexual is a social contagion". I mean I'm bi so I get it... it is confusing, at the same time I know of no quality data to quantify true/false sexual identification, yet people are using it as a basis for casual reasoning.
I'm going to stop here on before I have a brain aneurysm.
Yeah, that post probably benefits quite a bit from my own experiences as a gay man, though hopefully not in the 'trust me, I'm gay and I said so' sense. The interactions between social pressure and sexuality can be devastatingly complicated, and it's probably easier to articulate those interactions when you've had a few years in a domain where they diverge sharply from one another and you can track the lines of tension between them.
"these people really really want to be ‘normal’, at least up to some threshold. Then, it seems obvious to me that they’d resist identifying as *either* bisexual *or* long-Covid"
I seem like one of 'em.
That is, while I consider "normality" highly overrated, I was raised to think of drawing attention to whichever "abnormal" categories I might fit – especially any potentially "trendy" abnormal categories – as gauche, even sinful. Everyone's abnormal, more or less, and it's presumptuous to advertise our membership in any "abnormal" categories as if such a membership made us "special" .
I'm also a lumper rather than splitter, particularly regarding health history. Since underlying conditions adequately explain why I might have prolonged malaise after any respiratory infection, the discrete-seeming label "long COVID" just wouldn't be necessary for me to describe post-COVID malaise if I experienced it.
https://astralcodexten.substack.com/p/raise-your-threshold-for-accusing/comment/15575845
Scott, why the psychosomatic/physical dichotomy? All very Cartesian.
Surely there could be a mixed aetiology - a primarily physical initiating process could have a psychological or mixed perpetuating process or vice versa?
I think it's totally fair to distinguish between psychosomatic and physical. For example, someone who has leg pain because there's an observable fracture in their leg, or a tumor in their leg, or something like that, is much more physical than someone who has leg pain with no observable findings whenever they're really anxious. If that's "Cartesianism", I guess I agree with it!
Totally fair, of course. But it implies a dualism that I certainly don’t agree with and I don’t think is born out by what we know of disease (or physiology).
Yes, of course there are things that are purely physical and possibly some things that are purely psychological (though I’m not 100% sure that makes sense as a concept). The problem for me is that when we start running into things that sit across the supposed divide, we end up with “the majority of cases are physical” or “the majority of cases are psychosomatic” when I think it might be more accurate and fruitful to imagine a mixed process where the physical impacts on the psychological and vice versa; creating positive feedback and a self-perpetuating disease process.
One potential test for distinguishing in principle would be "if this person never had COVID, but thought they did, would they still have their symptoms or not?" although this isn't perfect because some people might have short-term symptoms that they then psychosomatize into longer ones.
Yup, I imagine that if anything it’s more like the latter - that some people are more susceptible to a condition that sits somewhere across the relationship between the immune system and psychology, though I’m far too ignorant about long COVID to speculate sensibly.
Anyway, the initial comment wasn’t meant as any kind of attack on a very interesting piece, I was just interested by the dichotomy. I think dividing the physical from the psychological is a useful model in understanding many illnesses but, like any model, it’s useful until it’s not. Many years ago I looked at the Postviral Fatigue/ME literature and it seemed then that we were getting stuck at a dividing line that was (in my view) largely imagined.
Norwegian study: LC not correlated with actually contracted Covid among adolescents.
Everything is physical, because the brain is physics. But if physical causes of certain conditions are located and perpetuated in the nervous system, then it would make sense to have a separate category for them.
Yes, of course. But we distinguish between neurological disorders and psychological or psychiatric disorders, both are presumably occurring in the same physical space (more or less). I think having a hard distinction between physical and psychological disorders is helpful, until it isn’t. I don’t think a hard divide is supported by our understanding of neuropsychology and we know that, as well as the physical having a profound impact on the psychological, the reverse is true - psychological hardship has a marked effect on physical health.
Right, we distinguish them because for some conditions the causation is pretty much established, and for others we haven't yet managed it. But even though we don't know the precise mechanics, it still has to ground out in physics, one way or the other, which the unfortunate "physical vs psychological" dichotomy obscures. And, of course, establishing the truth is further muddled because having diseases that are just "in your head" is low status, so there's a concerted effort to have them categorized in other ways by those afflicted with them.
That’s a nice clean example you give, but I’m not sure it addresses Oliver’s point about mixed aetiology (maybe it does; like I say, I’m not sure). “Mixed aetiology” plus a rejection of a strong mind/body dichotomy certainly rings true to my own experience of long covid. I had one year plus of markedly altered taste/smell, along with fatigue and occasional waves of full body nausea culminating in uncontrollable tremors, starting in March 2020 (so before long covid was a Thing). The taste and smell part in particular make me think this was not psychosomatic; on the other hand, I found my thresholds for emotional stresses, including anxiety and depression, were drastically lowered, and some of the symptoms were undoubtedly triggered when I passed these new thresholds. Since then I’ve had two years of gradual improvement phases followed by relapses. Sometimes the relapses (and the improvement phases) appear to have an emotional trigger, sometimes a physical one. Overall, the explanation that seems to fit best is “physical damage to my nervous system, leading to a condition that often manifests as a psychological one.”
One challenge is that if leg pain is caused by a problem in the nerves or the brain, it would be much harder to identify, but still presumably physical.
I think there's a gray area between psychosomatic and physical, and that it's well-populated by people and phenomena. Here's an example: When I learned to do hypnosis one of the induction methods was to have someone stretch their arm straight out, palm up, and place a penny on their palm. Then you do hypnotic patter about how as the person becomes more and more sleepy and hypnotized, they will notice a tendency for the hand holding the penny to rotate inward. Eventually, you tell them, their hand will rotate so much, as they become more and more deliciously hypnotized, that the penny will drop, and when it does they will be fully hypnotized, and their eyes will close. When you, as hypnotist, observe their hand to rotate a little bit, you comment on it, and ask subject to "notice the little surge of relaxation that accompanies the motion." This method works really well, and was always my favorite.
But here's the thing: If you just hold your arm straight out, with palm flat, you will also notice that your hand tends to rotate inward. I think holding the palm flat involves angling the hand in a way that's a little bit effortful. As your arm tires, you hand will rotate in unless you expend conscious effort to keep it parallel to the floor. But hardly anyone knows that. So if during the induction you present the rotation as evidence of hypnosis-induced involuntary motion, most people really buy it. So then they have more belief in the process and in the hypnotist, and more willingness to turn themselves over to it. And a lot of being hypnotized is believing you are hypnotized, and giving yourself permission to think and act in certain ways because after all, you're hypnotized.
OK, so that's an example of the gray area: There's a purely physiological reason why your hand rotates. BUT if you buy the idea that the rotation of the hand *means* you're hypnotized, you in fact will develop "hypnosis syndrome," i.e. you will believe yourself to be becoming hypnotized and in fact become so.
Now think about a suggestible person who has recovered enough from covid to start back to work, ago and has read about brain fog. If you gave them a neuropsych eval you would find that their cognitive scores are unchanged from pre-covid. However, the truly are not feeling very well. They still have some muscle aches and fatigue. So the first morning they're going back to work they're not moving very fast, and they lose their car keys, and wonder whether that's because they have brain fog. The rest of the day they pay more attention to little fluctuations in attention, and notice they space out a fair amount at work. Uh oh. Etc. So their "brain fog" is the product of both a real phenom (fatigue) and a way of thinking about it.
Can anyone offering an argument along the lines of "Bisexuality is a social contagion just like long COVID, they both manifest in the people susceptible to social contagion" please at least take a stab at explaining why the effect doesn't seem to apply to gays?
Easy. Homosexuality is much less likely to be caused by social contagion than bisexuality simply because it's more of a lifestyle change. If you're a mostly heterosexual person who wants to be "queer" / special / have your own flag, it's much easier to say you're bisexual than to make the full switch.
But that seems more like conscious, hypocritical label-appropriation than "social contagion" in the sense that people usually argue transgendernesss is a "social contagion". After all, being trans is a big lifestyle change, an archetypal example of a "full switch".
Abstractly declaring yourself bi for status with no intention of romancing anybody of the same gender seems more like the cases you occasionally hear about of basically cis people declaring themselves non-binary while changing nothing about their gender presentation beyond pronouns. Which I don't think is the sort of thing people would describe as examples of trans-as-"social-contagion".
> As for trans, I’d be curious to see the numbers on “low cost” transition versus “high cost” transition. I would bet the number of people claiming to be non binary or socially transitioning far outstrips the number of people who actually take hormones or get surgery.
Probably, yes! I'm just saying that I think hypocritical "trendy" label appropriation, and "social contagion" as in "trans as an example of an adverse culture-bound syndrome like the eskimo things Scott was talking about the other week", are different enough phenomena that they should have different names altogether.
i.e. a 'transtrender' who gets social credit by declaring that they're now a "he/they" doesn't seem like they have anything much in common with a person who's suffering from dysphoria to the point of suicidality, but may only have gotten there because the idea got planted in their head and they kept 'picking' at it, while in another world, if they'd never heard of transgenderness, they might have lived happily as their original sex indefinitely. I understand the "social contagion" model of transness to usually refer to the *latter* scenario. (Hence "contagion": it's not pleasant for the people who "catch" it! Entirely the opposite of gender-hipsters who are in it because that's the way the wind is blowing, but could and would forget all about it if the climate changed.)
I'm not convinced the two are even a spectrum as opposed to two entirely different mechanisms that might lead to people claiming the same labels; the internal experiences don't seem to have much in common. But even if they *are* a spectrum, they're clearly very distant ends of that spectrum.
But Havana syndrome seems like a high cost transition!
In this model, being both trans and gay can be described as severe cases of social contagion, whereas bi- or genderqueer/nonbinary are mild cases, not requiring onerous lifestyle changes.
People actually have orientations. It's both a social contagion and a real thing.
Looking at trans as a social contagion, you'd expect people who have been trans for decades with the full surgery and all the bells and whistles to have lower rates of "social contagion" and higher rates of "underlying medical condition." In the case of homosexuality, someone who literally only has sex with same-sex partners probably doesn't have a social contagion, cause that's pretty extreme behavior to be psychosomatic.
You'd expect homosexual-identifying people to be even less social-contagion susceptible than heterosexual-identifiers because homophobia and the social contagion are pulling in the same direction (gay people experience social pressure to identify as bisexual just like straight people do), so their ability to resist it is a stronger signal of social-contagion immunity.
This is related in my mind to the rise of right-wing white gay men. You don't see as many right-wing bisexuals, but being gay is just less of a socially-relevant identity than it used to be.
It's common to have at least some mild, passing sexual thoughts and feelings about one's own gender. People who are more susceptible to social contagion are more likely to think that is evidence that they are bisexual. It is though, not common to feel powerful sexual attraction to your own gender -- to really feel in love with a same-sex person, to enjoy porn featuring your own gender, etc. The signal is so strong that there's not a lot of room for suggestibility-induced ideas to affect your interpretation of what the signal means.
The link with anxiety and depression seems like it has a much more obvious reason—of course people with debilitating chronic illnesses are more likely to be anxious and depressed! Especially an illness where people often can’t get treatment and get accused of having it all be psychosomatic! I wouldn’t want to conclude anything from those correlations without at least checking the rates of anxiety and depression for other similar chronic conditions. (The borderline personality cases, I agree seem like they could be pretty non-trivially psychosomatic).
I also think that the trend being reversed between homosexuality and bisexuality shouldn’t just be a minor weakness of the theory, it should be a major one (given that mental illness is similar among the groups).
Have you thought about reporting bias instead? Consider two people who are Kinsey 5s, who have some small but definite amount of opposite-sex attraction. But one claims that they’re gay and one claims that they’re bi. Here it seems like the bi person just has a lower threshold for what degree of X you need to have in order to order to answer “yes” to “do you have X?” In this case, bisexuality is just acting as a proxy for how people interpret your question, even if bi people’s long COVID is just as organic as non-bi people’s.
If it were threshold reporting bias, we would expect to see it for every self-ID category. We do see it for some, like polyamory, but that's similar enough to bisexuality that I don't want to count it. Here are some others (remember, base rate is 3%, bisexual rate is 5%)
Self-identified Democrats and Republicans are both around 3%, same as people who don't have any party ID (libertarians are lower than average at 1.5%!)
Self-identified Christians are around 3%, same as people with no religion.
Self-identified vegetarians who were vegans were a little higher at 3.9%; vegetarians who weren't vegans were a little lower at 2.6%. If we combine them into one category, it's about normal.
Self-IDd rationalists were higher at 4.4%, but self-IDd EAs were barely higher, at 3.4%, and people who said they were "sort of" EAs were higher than confirmed EAs (3.5%). I think rationalists are more likely to be mentally ill and have unusual sexualities, and EAs mostly aren't.
People with MD-diagnosed psych illnesses were higher than people with self-diagnosed psych illnesses - for example, with ADHD it was 3.7% vs. 4.4%.
This makes me skeptical of threshold effects.
The fact that it holds for sexual preference categories, but not other self-IDs, suggests that the actual latent variable is something like "willingness to introspect your physical feelings and take the results seriously". Self-identifying bisexuals and heterosexuals at the same Kinsey scale differ specifically in how much attention they pay to subtle messages from their body, and how willing they are to answer survey questions based on that data. So this data is entirely consistent with the explanation that Long Covid has no psychosomatic component, but is mild enough that you can choose to ignore it iff you're the kind of person who is used to repressing weak somatic information.
The self vs. MD-diagnosed psych categories are potentially relevant, but not in an obvious way. I'd predict that Long Covid reporting rates would correlate better with somatic attentiveness questions like "if you ovulate, do you feel when an egg is released?" or (inversely) with "not sure" answers on the burping question.
I knew one person who identified as bi. He has never had sex with a man, only with women, and nonetheless identifies as bi. Of the perhaps half dozen men I've known who identify as gay, all of them exclusively have sex with men. One of them is older and was gay before it was cool and got a lifetime of discrimination for it. If my experiences are typical, then being bi is more of a statement of support for LBGT, while being gay is more of a sexual preference, and is more independent of trends. I'd guess that people who are more likely to identify with trends are likely to identify as both bi and long COVID.
Oh, and the gay guy who had faced a lifetime of discrimination became depressed in middle age. My guess is that among people who are unfashionably LBGT, discrimination causes mental illness, and among who are fashionably LBGT, the tendency to identify with trends causes both psychiatric diagnosis and LBGT.
For what it's worth, I experience attraction to men sometimes and to women frequently, and am a man, but think it's reasonably likely I'll go my life without ever having sex with a man. Trying to flirt with a guy feels socially forbidden on a gut level (grew up at a time when it wasn't particularly okay to be gay, though also not like totally not-okay), and I don't think I'd really know how besides. Meanwhile I'm stocked to the brim on cultural ideas about how to flirt with women.
I don't identify as bi because I don't identify with things generally, and besides I think that would be confusing communication when I don't particularly plan to bang any dudes. But I don't think it would be some trend-thing if I did feel the label suited me (and some people, it seems, really like labels). I am after all attracted to dudes sometimes, and if one of those dudes came and hit on me I'd probably go home with him.
I do think some people are doing trend-stuff as well, or just want labels to make them feel special (man do some people like labels). But I also think someone who says they're bi but acts straight still can be aiming to communicate a ground-truth difference in their experience from what someone straight would have, so wanted to throw this out there.
Thank you for posting this. This approximates my sentiments as a bisexual woman (although I am in a long-term relationship with a woman as one of my partners - but it's long-distance, so we haven't had the chance to be together on an intimate basis for what at this point is unfortunately years). I feel attracted to women, but they're less available. In my case, I actually even flirt with them! But it's usually not obvious to them that I'm flirting, and that's fine (I have three long-term relationships already, I don't actually need another).
One thing that I haven't seen mentioned in the comments yet: Bisexuals may want to have families. This is much easier to do with someone of the opposite sex! So (monogamous) bisexuals are probably more likely to "settle down" with someone of the opposite sex, which can look a lot like "guess they weren't bisexual?".
This duplicates my experience exactly. I suspect we are in a similar age cohort. (I was born in the 1970s.) I would call myself a firm 1 on the Kinsey scale after various stages of denial, acceptance, experimentation, ambivalence, and finally, happy marriage to a nice woman.
Interestingly, my wife's experience was very similar to mine. It seems inauthentic to claim that either of us are bisexual, but calling it "straight" doesn't make sense either.
I think a lot of people are like this, social conditioning aside. Sometimes I suspect most everyone is like this, but it's not for me to say.
Being bi means that I like women. It says nothing about whether those women like me back.
(edit: I’m a woman, to be clear)
OK, all you guys making smart comments: I do not understand Scott's chart. What is the leftmost of the 3 columns in each chart? The second column is NO's, the third one is YES's. What the hell is the unlabelled first one?
I think those were people who didn't answer.
Oh! Well, jeez, why not label it IDK or n/a or something? And did everybody but me just figure that out?
TBH I just didn't pay much attention to the chart and trusted Scott to give me the gist of it in the text.
“most will say this symptoms are mild” -> these symptoms
I'll also repeat what I dub the "most boring explanation", which is hinted at the end of this article: Covid, like any other viral disease, has a small likelihood of causing a post-viral syndrome. To the degree that Long Covid exceeds other post-viral syndromes in prevalence, it is most likely psychosomatic. And the explanation for why Covid in particular is also boring: The kind of person who tends to have psychosomatic diseases tends to latch onto something that is in current popular salience, and Covid was very salient as diseases go.
And to counter the obvious "I guess you're also one of those people who think Covid wasn't real, huh?", I'll note that "list of symptoms of post-viral syndromes" and "list of common psychosomatic symptoms" is almost a one-to-one match, which is not true for Covid, in particular the worse progressions.
And finally, I'll note a common misconception, namely that dubbing something psychosomatic is akin to calling it not real. I'll talk about something very similar that I've been told by a doctor: Almost everyone has a Tinnitus, if you concentrate on it. Just try it for a moment. It's just that something in our processing of hearing that successfully deprioritises it so strongly that we stop noticing it in day-to-day life. If something in this very low-level processing of hearing goes wrong, we lose that basic capability and develop what is usually known as a Tinnitus. Those people then need to train coping strategies where they need to consciously suppress it instead. And telling yourself that it "isn't real" is a useful and simple coping strategy, so plenty of people will latch unto it, even if it is wrong.
I think it's the same for almost all psychosomatic diseases: We all have constant low-level pain, low-level symptoms from lingering diseases, low-level brain fog, etc. Most people have an entirely unconscious processing step before anything else that successfully allows us to not notice this all the time. This processing step is damaged in people who tend towards psychosomatic illnesses. Just like for the Tinnitus, you'll have to re-train a conscious suppression instead.
Really true about the tinnitus. I have what I'm pretty sure is a moderately bad case of it, and I am almost never aware of it unless I read the word tinnitus, as I did in your post. (Thanks a shit, by they way. I suggest that you notice every time you blink for the next hour. Hey, have you blinked since you read this? How many times? Maybe you should keep count. . . .Just joking, of course.)
> Almost everyone has a Tinnitus, if you concentrate on it. Just try it for a moment.
Uh, idk if that's true, but I definitely don't. (I did in fact try it just now to make sure).
From time to time I'll get a sudden ringing that lasts a few seconds, and I experienced constant ringing for a couple days once after attending a very loud concert and standing right next to the speakers with no ear protection.
The sudden version of it in particular doesn't seem like a psychosomatic thing. It doesn't tend to accompany changes in stress level or any other kind of internal experience, although it does seem more likely to happen if I have a headache. And the stopping a few seconds later also doesn't seem to accompany anything else about my internal experience.
Another confound: covid can mess with the endocrine system. I had lingering fatigue after covid because I needed my thyroid meds adjusted. Once that was done the symptoms went away.
Is long covid more likely in people with sensitive endocrine systems? Maybe there is a hormonal aspect to both sensuality and long covid?
Maybe adding a question about vaccination status and count would add insight into this "long covid".
I had one - what analysis would you want me to do with it?
Will it be possible to find out if long covid is more/less present (percentually) in vaccinated group than in unvaccinated group? I've read somewhere that this long covid could be rather a vaccination side-effect.
See Norwegian study. LC doesn't even seem to be correlated with actually having contracted Covid.
A study that can't be replicated because almost everybody has contracted Covid by now.
Have read in several reliable places that vaxed people who have covid have shorter and milder cases of long covid. Here's a meta-analysis: https://www.mdpi.com/1660-4601/19/19/12422
What about confounder effect from liberals being more likely to fall into both categories?
Agreed
> be me
> be Scott Alexander
> have 140IQ but can't put an thumbnail on a post without it stretching and looking bad
> tfw wordcel ;(
https://i.imgur.com/JYe18rz.png
I think that's intentional. It's a long covid.
Looks like wide covid to me.
I wanted to try putting "coronavirus with really long spike proteins" in DALL-E, but it seems like it immediate claims to be a TOS violation (Which I suppose is true if you *really* stretch the "personal health" section's definition)
I notice a few comments asking if this is true for bis, why not for lesbian's and gay men? This seems to assume there should be an equivalence, but I have read several articles and surveys that suggest differences between bi folk and l/g people. According to those articles, bis are more likely to have some form of mental illness (and also be more at risk from domestic abuse).
One possible reason for greater anxiety or depression could be less social recognition and acceptance of bisexuality, with fewer role models and absence of a decent support network.
I don't know how this would link to reported incidence of Long COVID.
Historically, there has been a lot of discrimination against homosexual men. Against bisexual women? Not so much.
https://betonit.substack.com/p/lgbt-explosion
Bisexual women are more at risk of domestic violence than lesbians, straight women, or men. To give one example of how discrimination can take different forms.
It may be interesting to look at how rates of mental illness have varied over time, but I doubt we have the data to compare bi people and other groups over time.
The article you link to isn't about this, but is about the rise in bi identification in young people. If that is a factor in correlation with incidence of Long Covid, we'd need to compare Scott's data for different age groups
You can't just say "X's have higher rates of A than Y's; X's have higher rates of B than Y's; A and B are sometimes correlated; therefore, there is no additional effect caused by X-ness". Especially when the correlations are different strengths, this is actually a really bad argument.
Are "very liberal" people disproportionately the victims of domestic abuse? Seems like they should be if the mechanism you're talking about is important.
I think a more natural hypothesis is that people with unusual domestic lives are more likely to have unusual domestic drama that leads to violence, and that to the extent that there is mental illness, that's a smaller contributor.
I linked to that because it addressed stigma in passages like this:
"Another weakness of the closeting story is that mainstream stigma against bisexuals was always milder than against any of the other groups. Yet it is bisexuality that has exploded."
Are bisexual women at more risk of domestic violence from male partners or female partners? Or about the same? If both partners are bisexual, does it affect the odds?
They are primarily at risk from men. I don't know if anyone has looked at whether bi partners make any difference. This report gives the results from one survey in 2010: https://www.thetaskforce.org/bisexual-women-have-increased-risk-of-intimate-partner-violence-new-cdc-data-shows/
I looked at the full report, but they didn't have much on bisexuality or even orientation. There appeared to be a separate report for that, but the link was broken. :-(
I'm wondering how much of that 89.5% comes from bisexual women being more likely to have men as intimate partners, but without their data, I can't tell. (I'd be surprised if bisexual women had male partners 9/10 times, but I suppose that partly comes down to how they asked and who responded.)
Huh, never mind, I just saw Scott's latest post where he was saying that bisexual women were likely to have 10/11 male partners. So maybe the "primarily at risk from men" is entirely a result of the partner distribution, and on a per-partner basis, it simply duplicates the surprising result that women are more likely than men to abuse women in the context of a relationship.
Yeah, this meta-analysis of 52 studies says
"there is a consistent pattern of lowest rates of depression and anxiety among heterosexual people, while bisexual people exhibit higher or equivalent rates in comparison to lesbian/gay people. On the basis of empirical and theoretical literature, we propose three interrelated contributors to these disparities: experiences of sexual orientation-based discrimination, bisexual invisibility/erasure, and lack of bisexual-affirmative support."
https://www.tandfonline.com/doi/full/10.1080/00224499.2017.1387755
For example, for studies looking at current binary indicators of depression they found: "Converting these proportion data into odds ratios (OR) yielded a pooled OR of 1.44 (95% CI: 1.22, 1.70; I2 = 73.3%) for the comparison of bisexual participants to lesbian/gay participants (see Figure 4) and a pooled OR of 2.38 (95% CI: 1.86, 3.05; I2 = 91.7%) for the comparison of bisexual participants to heterosexual participants (see Figure 5)."
Would it make sense if bisexual people are more marginalized or ostracized or have more trouble finding a community or something, which then causes mental stress that makes them more susceptible to physical illness? Are bisexuals more likely to get sick in general?
Or more broadly, if bisexuals have more mental illness for whatever reason than that might make them more susceptible to physical Illness. Does that count as psychosomatic?
This is why I was surprised not to find the same pattern with homosexuals.
See my comment above
<xantham> Perhaps this is because homosexuality, unlike the other "sexual orientations" people are inventing, isn't a social contagion.
That is: if you are a 2 on the Kinsey scale, identifying as bi-sexual is a choice (and, given the prevailing social trends, currently a popular one). If you are a 6 on the Kinsey scale, identifying as homosexual isn't a choice -- the choice is whether to lie about it.
"...I think this is a signal that a substantial percent of long COVID is psychosomatic."
It might be better to say that a substantial percent of people identifying as long COVID is psychosomatic.
It could well be that there's a real, core condition, long COVID, which is non-psychosomatic, even if many people identifying as having long COVID are doing so 'psychosomatically.'
The same thing could be true of PTSD or dissociative identity disorder or OCD etc., if there is a core real disorder, and then many people identifying as such psychosomatically or due to social contagion etc.
It's a fairly standard finding that bisexuality is associated with worse outcomes than homosexuality along virtually every dimension. I'm not sure why this is, but it shows up all the time in the research.
From this I infer that reading ACX is a bad outcome.
It's small sample sizes, but I don't see a pattern here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040376/table/t3/
Sorry, I just saw this. Look at the confidence intervals. Because of the small sample sizes, they're far too wide to draw and meaningful conclusions.
Since I'm making a negative claim, no amount of data will ever be enough. I can't disprove your claim unless you specify an effect size.
Scott claimed to provide data that supported your claim, but it was not statistically significant. The point estimates suggested that bisexuals had slightly worse outcomes than homosexuals (but not "virtually every dimension"), but small compared to the difference with heterosexuals. It didn't seem worth singling out. Would we be talking about long covid in bisexuals if they had slightly worse outcomes than homosexuals? It's bewildering because homosexuals cluster with heterosexuals.
https://www.unz.com/jthompson/sexual-orientation-and-psychological-disorder/
Bisexuals are more psychologically disordered, and it is not clear why.
One possible interpretation is that bisexuals are the most confused about their identity, which suggests that a sense of clear identity about sexual orientation is partly protective in mental health terms, although non-heterosexuals are more distressed. It was sometimes asserted that bisexuals had “the best of both worlds” in that they had the double the number of prospective sexual partners, but even if that is the case, the result is that this is a very disturbed group.
Another possibility is that no people don't have the support networks that heterosexuals and homosexualities have. Bisexual people usually live in spaces or communities that are primarily heterosexual or homosexual; there are very few bi spaces. Both heterosexual and homosexual spaces can be quite restrictive about behaviours or discussion that don't fit those spaces. Bi people in a non-poly relationship are assumed to be lesbian, gay or straight. There are few bi characters in popular culture, and often bi characters are described as 'gay' (e.g. Brokeback Mountain). So it can be harder to make sense of your security when everyone around you is telling you that you are, or should be, lesbian gay or straight
It seems to me that you (and much of the research and activist communities) are assuming that there must be a sociological explanation and optimizing for plausibility under that constraint. But it's entirely possible (and likely, IMO) that there's some kind of biological explanation.
I haven't seen anything on here about bisexuality and age, but I'm pretty sure that for girls, at least, having crushes on other girls is pretty common when they're in their teens. When I was in middle school I and lots of the other girls had a crush on one of our gym teachers, who was very pretty but also quite butch. I personally just kept going with crushes on other women and girls up through my twenties, and as I became more sexually experienced the crushes were much erotic. However, I was also attracted to guys, and that's who I dated. Did have one delightful affair with a woman, but the feeling of a romantic bond was weaker than with a man -- sex felt sort of like an extension of our friendship. Anyhow, after my 20's crushes on women got much weaker and rarer, and now I'm just plain old straight. Point of all this is that I think my course was pretty common, and that for a lot of girls crushes on their own gender go along with their identity not beng fully formed. Once it is, other females somehow are not romantically fascinating any more. Anyhow, point of this is that it could be that bisexuality in women that continues into full adulthood is associated, at least for some people, with not having settled on an adult identity. That would explain its association with psychological disorder.
I find weird not to control for rates of COVID when studying rates of long COVID.
Norwegian study unable to find link been contracting Covid and LC among adolescents!
Although apparently correlation between loneliness and LC regardless of having contracted Covid!
It would be good to look at rates of COVID, but unless he asked people to report how many times they had COVID, I expect that it'll be hard to find any signal there (since most groups will be well above 70% having COVID).
He did ask
I wonder if there's some correlation between willingness to tell the truth about having problems on surveys and being willing to say one is bisexual., though I admit this doesn't explain why homosexuals seem to have less long COVID.
Still I think people lie in both directions, sometimes exaggerating their problems and sometimes minimizing them.
Thank you Nancy. I had given up finding a comment making this point and was just doomscrolling.
Yes, being bisexual is trendy, but so aremany other things that people really do enjoy (microbrews, fancy burgers, w/e). Sometimes people pretend for the trend, sometimes the trend is because a thing is genuinely popular.
Excuse me for asking, but why didn't you make the comment rather than doomscrolling to find someone else making it?
I always hate to see comment sections cluttered up with repeat comments. Besides, by the time there are however many hundred comments it's not like my writing the one I hoped someone else made hours ago when the thread was fresh and people might read it will do anything.
I think the tendency to lie on Scott's questionnaire would be lower than on many others because people take it anonymously. Also, it's clear that this forum is accepting of gender diversity. Lots of people are out on here. But the strongest argument against Scott's results being explained by people's willingness to tell the truth about having problems is that people who acknowledged being gay did not report more Long Covid. Seems to me that anyone who thinks homosexuality is bad or a sign of mental illness is going to think the undliuted version is worse than the diluted one, bisexuality.
Very interesting observations.
With inflammation having been implicated as a factor in several mental illnesses (most strongly in depression but also bipolar disorder, schizofrenia, anxiety, ptsd and autism spectrum disorders), I wonder if that could be the underlying factor that is missing, i.e., people already suffering from some level of mental illness being more sensitive to covid induced inflammation because of their already elevated inflammation.
What I see here is almost a third of your (much less numerous) female respondents are bisexual, whereas only about one in 12 of your male respondents are. I've seen this before in geek spaces, but I'm wondering if there's some kind of statistical correction that has to be made for what's obviously a case of selection bias (albeit one you have no real way of getting away from, because your fanbase is what it is).
Well done sir. ;-)
I still kind of wonder about the selection bias question though.
Not sure exactly what you're referring to (I'm not the person who was picking fights with you on your blog if that's it), but I'll take it.
But as for the rest of it...Yes. That fits what I have observed. I always figured it was some kind of brain masculinization, a la Simon Baron-Cohen--I've known two, and one used to joke about her 2D/4D ratio. I guess as in your first case they could also be 'geek seekers'. One would probably fit that criterion, the other was definitely a geek herself.
N=2, and there's an obvious case of selection bias here.
I still think I'm not the person you're looking for (yeah, gratuitous Star Wars reference)--I don't know you from elsewhere and have no alts on Substack. I found you from here (I think?), thought your stuff was really cool, and was somewhat dismayed to be banned.... but hey, it's *your* blog, *you* make the rules. <shrug>
As for the rest of it, which hopefully is of some use to the readers of this blog...yes, you're correct, I think. Feminists as autistic-adjacent, conspiracy-obsessed title IX mavens who control the education system makes entirely too much sense. I think I always kind of knew that in the back of my head, but it's useful to have it stated explicitly. And an awful lot of geeks do seem to wind up with feminists, don't they? Often to their ultimate chagrin, as one might expect.
Thus, the need to drop geek culture like a hot potato, and the best way to do that is to build muscle, because even if you don't have social skills you no longer fit the classic stereotype?
LOL on the selection bias. It was a joke I told to someone else here, but yeah, it's one of the few bits of data analysis I know. Seemed relevant to the original conversation, anyway, because Scott wasn't really analyzing two analogous populations--there was a covariate in there, so to speak. But I guess that's true with any social science number crunching.
As an aside, if you think of the Apollo-Dionysos dichotomy in the arts, Artemis (as close to a feminist as you can get in ancient mythology) was Apollo's brother. But Apollo had a whole bunch of non-geeky areas like music and medicine, so it doesn't quite fit. Hephaistos is probably a better match--though they paired him with Athena, who was a defender of the patriarchy.
This piece on bisexual health disparities https://assets2.hrc.org/files/assets/resources/HRC-BiHealthBrief.pdf proposes:
"While a variety of factors contribute to these disparities, research suggests that experiencing biphobia may
discourage bisexual women from accessing healthcare. A recent survey of bisexuals in the United Kingdom
found that only 33 percent of respondents felt comfortable telling their general practitioner about their
sexual orientation, and nearly half had experienced biphobia when accessing health services.
Negative experiences in healthcare settings can lead bisexual people to delay health care visits, change
healthcare providers, avoid disclosing their sexuality in subsequent interactions with providers and rely on
internet sources rather than a doctor for health information.1 A 2012 study by the Williams Institute, for
example, found that bisexual people were significantly less likely than lesbians and gay men to disclose
their sexual orientation to their medical provider. According to the study, 39 percent of bisexual men and
33 percent of bisexual women reported not disclosing their sexual orientation to any medical provider,
compared to only 13 percent of gay men and 10 percent of lesbians who chose not to disclose."
Another cofounder is self awareness level. I read that theres a chunk of the population that have a reduced ability at the Rey–Osterrieth complex figure test due to long covid, but otherwise have no idea that they have long covid.
https://www.nature.com/articles/s41380-022-01632-5
I would say those people may have brain damage from covid, rather than long covid. Here's an interesting Twitter thread that's relevant: https://threadreaderapp.com/thread/1653047893522100224.html
That’s a good thread but it’s not what I’m getting at. Regardless of the nature of long covid, I’m saying that some people may have long covid but are unaware. And this may be throwing off the results.
Some people are certainly more kinesthetic than others. So it would be unsurprising if these people had higher rates of long covid (more likely to seek diagnosis and/or self diagnose). The missing link in my argument is whether or not it correlates with bisexuality.
Some of it depends on how you define long covid. If you think of it as symptoms similar to thosse seen in people with Chronic Fatigue or Fibromyaligia, seems like it would be hard to meet the criteria for the LC without knowing anything's wrong, since many of the symptoms have to do with how you feel: fatigue, exercise intolerance, malaise, body aches, shortness of breath. Some people working on Long Covid think of covid as a disease that damages many parts of the body, and then I guess you have Long Covid if you have some specified degree of damage, even if you feel fine. That seems to me to confuse things, though.
I’d split the difference and define long covid by impairment.
Scott’s follow up today goes into some detail about noticing one’s sexuality, but doesn’t go down this path so perhaps there’s no correlation.
I'm not sure how long covid is defined at the margin. My sense of taste was screwed up for about two years and it's not quite back to where it was. This affected my quality of life but wasn't debilitating.
In particular, pork (low quality pork?) tasted really nasty. If I recall correctly, sometimes I couldn't taste much. I definitely remember that the same food could taste good, bad, or meh in the course of twelve hours. My enjoyment of capsaicin isn't quite what it was, but it's mostly back.
I suppose I'd say I had long covid if that question was by itself on a survey, but I have no idea how common this sort of thing is.
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?
There was an apparent link though between loneliness and long Covid.
So in any cohort that seems to correlate with higher LC prevalence perhaps one should investigate whether loneliness also correlates. (Maybe also look at severity of symptoms from whatever viral infection and poor physical activity per Norwegian study. One might hypothesize that a non lonely gym attending group would have less "long Covid" than a lonely sedentary cohort.)
Is SA's essay really about "replication" at all?
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802893
https://vinayprasadmdmph.substack.com/p/bombshell-new-study-on-long-covid
The occasional study finds no link between Long Covid and having had Covid, but most studies do find a link. Here's an interesting one about abnormalities found in people post Covid: https://threadreaderapp.com/thread/1653047893522100224.html
LC has not been well operationalized.
Post any infection there can be a symptomatic lengthy recuperation in some individuals.
Yes, aware of that. However, your comment about the Norwegian study presumed that lack of an operationalized definition of Long Covid does not make it pointless to discuss studies of what's up with people who have it, even though the way Long Covid is defined by the researcher is just one of many possible ones. If my study is of no interest because of our failure to have a well-operationalized definition of LC, then the same can be said of yours.
It used the WHO definition! And therefore concluded that the WHO definition was not useful!
And?
And?
My immediate thought upon reading this was that, contrary to Scott's expectation, I would bet that bisexuals are quite likely to be immunologically different. Specifically, both the immune system and sexuality are potentially influenced by or correlated with levels of testosterone and estrogen.
For example, high estrogen makes people prone to more severe manifestations of all sorts of illnesses associated with an overactive immune system because estrogen causes histamine release. Testosterone, on the other hand, tends to act as a mast-cell stabilizer and suppresses the immune system. In line with this theory, homosexual men often have higher testosterone than straight men according to a few studies, which could explain their unusually low long covid rate (I remembered the association off the top of my head, but here's a small study I just found with a brief search showing "significantly higher" testosterone in homosexual men: https://ajp.psychiatryonline.org/doi/10.1176/ajp.131.1.82 )
Unfortunately for my theory, I haven't been able to find any studies on the average hormone profiles of bisexual men, and at least based on this this meta-analysis: https://link.springer.com/article/10.1007/s10508-020-01717-8 bisexual women have at best slightly higher testosterone than average, though the abstract itself says that most studies on the topic have been "small, biased, and heterogenous" and that little confidence should be placed in their findings.
I had a similar thought in an earlier comment but you explained it so much better and in so much more detail.
A simpler explanation might be that bisexual people are more likely to be virtuous followers of what I call the 15th Commandment: Thou shall not self-deceive. In other words, the actual rate of long Covid could be identical across all sexual orientations but bisexuals are somewhat more likely to correctly perceive it and acknowledge it.
What are commandments 11-14?
Long Covid is like “consumption” in 1900, before the acid-fast stain for TB. A grab bag of conditions
> (Why does homosexuality, which also has increased rate of many mental illnesses, show so much less of a signal than bisexuality? I don’t know, and it’s a weakness of this theory.)
One possibility is that bisexuality seems to be a fashionable suggestibility condition, not too different from some of the cases covered in the "unawareness campaigns" link. Since sexual orientation is entirely self-reported, and non-traditional sexual orientations and gender identities are treated as a prestigious high-status condition by woke academics, the most obvious hypothesis here is that a lot of self-reported bisexuals, especially among younger generations with the closest proximity to woke academics, self-report as such without ever being bisexual in practice.
And this is what we find in reality: the majority of young bisexuals only have heterosexual sex — sometimes quite a bit of it! — while still publicly wearing the badge of "bi" for its social prestige.
Source data: https://www.cspicenter.com/p/born-this-way-the-rise-of-lgbt-as-a-social-and-political-identity
The one thing I'm sure of about human sexuality is that a high proportion of people are vocally and sometimes violently invested in other people's sex lives.
Now that I think about it, I've never seen anything like a survey or other science into how involved people are in other people's sex lives.
Well noted.
Another thing people were recently vocally interested in is other people's vaccination status.
I think it is obvious -- people use complaining about Long COVID as a pick-up line. But when you keep saying something, you may actually start believing it!
Bisexual people are using this pick-up line on everyone. Heterosexuals only on people of opposite sex. Homosexuals only on people of the same sex, and only when they feel in a safe space. This is the simplest explanation that matches the known data.
Hmm. Could just be there exists some population of people who really wish they were bisexual and had long covid because it would give them credibility and a sense of belonging amongst their peer/friend group. Covid and everything related to it kinda arbitrarily became blue tribe. LGBTQ stuff is also blue tribe. Long covid and bi are both things that I could see an otherwise completely normal person convincing themselves applied to them with sufficient motivation. I wonder if you controlled for Kinsey 1s and 2s if this correlation wouldn't just disappear - people who psyched themselves into bi experimentation a few times, and are essentially psychosomatically bi. 🤔
(Not saying this is definitely the case, but gut feeling is something like "red tribe gets covid more and reports long covid less" - I looked for answers here and couldn't find anything, but I was pretty half-assed about it. It cooould be that this is a result of women leaning blue tribe, and bi people leaning blue tribe, and evidently both are more likely to report long covid where red tribe is more likely to *die*.
Just a fluke of those groups being more likely to be vaccinated and therefore survive their bouts of covid to deal with the lingering effects? Grim, but... possible? Like if there's some common mechanism through which fatal covid cases work, and long covid is just what happens when that mechanism is activated but you survive due to vaccination making your would-be fatal case manageable..? idk. )
At the risk of being a dick - about half the bisexual identifying folks I know have never had a same-sex relationship (not necessarily an indication that they aren't bisexual) and are much more motivated by having cool quirky zero effort identities than both the gay and straight people I know. In other words, I think there's some portion of bisexual folks who just collect weird identifiers for themselves.
Bisexuality is much more likely to correlate with an active sex life and therefore with more chances to get exposed to higher initial viral doses. I was saddened to see the casual attempt for a causal relationship with psychosomatic problems (what are these mechanistically?)
1. Only the tiniest fraction of COVID comes from sexual partners.
2. I'm not sure bisexual women have more sexual partners than straight women, I'd want to see evidence about this (which I can't find)
3. Bisexual men do have more sexual partners than straight men, but fewer than gay men, but they have more long COVID than gay men.
I'm curious if you have access to GPT-4 with Code Interpreter and have tried to run it on this data set.
How do we define Long Covid, or rather, how do the survey takers here define it? I mean, if the symptoms are "“have you had any persistent symptoms including fatigue, brain fog, shortness of breath, changes to taste/smell, etc, etc, etc, since having COVID?”, I would definitely say "yes" to some of those, but I would not say "I have long covid".
Are our bisexuals going "yes, I have long covid, and here is my official medical diagnosis to back that up" or are they going "I feel like my sense of taste isn't what it used to be so yes, I have long covid"?
Do you not understand the concept of ecological biases, response biases etc? Data that isn't conducted in a population based prospective manner (participants recruited randomly before being infected), the survey results are likely to be highly biased.
If you think that 5-10% response rate to a pulse survey is not likely to lead to significant biases, I don't know what to say.
See https://astralcodexten.substack.com/p/selection-bias-is-a-fact-of-life - is it likely that bisexuals would be more/less affected by response bias than monosexuals? But if for some reason you don't like my survey, you can just use the CDC survey mentioned in the Pirate Wires post.
You didn't actually mention the response rate range of the CDC survey in the comment I'm replying to, and you're being a jerk, so I'm banning you, sorry.
My first hypothesis would be a common factor of "willing to say you're X if you're, like, a little bit X" (where X could be "into the same sex" or "having long covid symptoms") especially given that homosexuality doesn't show the same pattern.
Alternate theory, bisexuality is presumably an extremely complex trait genetically that involves thousands of genes, some of those are going to be immunologically involved. In other words, hand waving wildly here, one gene generally does many things, we are unlikely to be able to separate any two complex traits, even extremely different ones like ability to fight a virus and sexuality, into roughly orthogonal gene difference vectors and, given a whole bunch of vectors, some will have much smaller angles than others and people will notice and be rather puzzled
I don't get the first line of either table. The line above "Bixesual". The line with the lowest Count. Seems unlabeled. What does it mean?
I have no idea if this is true, but I wonder if people who identify as bisexual are more aware of or responsive to mild symptoms or stimuli, or less constrained to maintain their self-image in the face of contradictory stimuli.
In other words, Jane and Suzy both (a) occasionally think another woman is hot and (b) feel a little achy.
Jane identifies as straight and not suffering from long covid, because she writes off those experiences as not relevant, or because her self-image overrules them. Suzy takes those stimuli and updates her self-image to identify as bisexual and suffering from long covid.
(Suzy is then more likely than Jane to change her behavior based on this self-image, which reinforces her new self-image.)
Given that long covid symptoms are subtle, some people may be more likely to realize/admit they have long covid than others. Given that bisexuality is supposedly on a spectrum, the same people may be more likely to realize/admit that they are bisexual. I’ve had sleep apnea for a while, until I decided to get a mandibular advancement device and started sleeping better. My dad, who has essentially the same condition, held out much longer (he’s on CPAP now) because “I am just snoring a little bit, so what?”. Same as “I can appreciate a chiseled male body, but I have a wife and two kids, so what?” and “after having covid I get tired more easily, but so what?” If this is the case perhaps controlling by age could remove part of the effect, as I suspect this sort of attitude is less prevalent among young people.
Alternative hypothesis: monosexuality is a culture-bound mental illness, and long COVID is more prevalent than people think.
Suppose most people are 'actually' bisexual, but for cultural reasons they tend to believe they are either hetero- or homosexual. If that were the case, then the people who identify as bisexual will tend to be more introspectively perceptive, more willing to defy accepted truths, etc.
If those people are saying they experience long COVID at a greater rate, it may be because that rate is closer to the true rate, and monosexual people are under-reporting because they are less likely to be aware they have long COVID symptoms (e.g. less likely to notice their brain fog), or more likely to explain their symptoms in more socially normal/acceptable ways (e.g. allergies).
In bonobos, famously promiscuous and universally bisexual (and, not for nothing, our closest animal relative), it's thought that sex plays several roles: forming social bonds, releasing tension, reconciling after conflicts, etc. Similar reasons have been offered to explain the many human cultures in which bisexual behavior is common.
I appreciate the linked review, but it doesn't address bisexuality in bonobos. Looking at studies it cites seems to support the idea that they frequently engage in same-sex sexual contact in the wild, universally (at least among females; there is apparent disagreement about same-sex contact among males, but some sources cited approvingly support it (e.g. Kano 1992)).
And what was being "offered" was one possible explanation for an observation (because you asked why it would be), but it's the observation that supports my argument: bisexuality is the norm among a "species that reproduces sexually", and it has been common in many human cultures.
I only brought up the random primate in response to your incredulity at the idea that most members of a species that reproduces sexually could be bisexual. Since there does not appear to be any real disagreement among experts that all female bonobos and at least some males engage in same-sex sexual behavior, bonobos do seem a slam-dunk counter to that incredulity.
Similarly, I brought up the human societies only to show that monosexuality is culturally-mediated and not universal. For that purpose, "common" and "many" are not doing much work: it's sufficient that there have been multiple societies where sexual identity didn't function as it is generally imagined to function today.
Just to be clear, I don't think I've proven that my proposed explanation is the only or best way of explaining Scott's data. In my view, the words that do the most work for me are "alternative hypothesis": this too would explain the data, and it's not obviously false.
I read Scott's response to this, but I still think this hypothesis holds water. I'm a Long Covid sufferer (recently finding myself doing much better), and it took me a remarkably long time to really connect the dots around Long Covid being the cause, after having ruled out basically everything else I could think of.
Sounds like the opposite of Greg Cochran's view of defining illness in terms of Darwinian fitness.
>Bisexuals and heterosexuals seem much more likely to be psychologically different than >immunologically different, so I think this is a signal that a substantial percent of long COVID is >psychosomatic.
I think I need to ask for a steelman of the inverse statement here (i.e. that bisexuals are immunologically distinct from heterosexuals), before I can accept this point of reasoning.
The survey upon which all of these conclusions are based is fundamentally flawed - (asking if you “have” “long COVID” sounds more definite than just asking if you have a few lingering symptoms).
There are health professionals in 2023 who still have never heard of long COVID so it isn’t surprising that asking patients about this condition would result in dramatically lower positive responses.
Personally, I have spoken to dozens of folks during the pandemic who had “recovered” from acute COVID but still had lingering or worsening symptoms (fatigue, muscle pain, cough, breathlessness, racing heart rate, nerve pain, and many, many more) that just wouldn’t go away after months or even years. None of these individuals would have identified as “longhaulers.”
This survey is not about disease incidence by community but disease awareness amongst different communities and demographics. Thus, this conclusion that long COVID must be psychosomatic is based on faulty reasoning.
As a quick addendum, the evidence at this point is actually pretty conclusive for what causes long COVID and, spoiler alert, it is a persistent viral infection, which is why long courses of the appropriate antivirals cure the disease.
Yes.
Also, "Bisexuals and heterosexuals seem much more likely to be psychologically different than immunologically different, so I think this is a signal that a substantial percent of long COVID is psychosomatic."
Really?
Given that sexuality has a material genetic / hormonal connection, it doesn't seem odd that that might correlate with relevant immunological differences.
Immunology vs psychology is also a false dichotomy. Psychological states influence immunology (e.g. see impact of chronic stress on the immune system).
We still know very little about why some people get Long Covid and others (apparently*) don't - the leap to "a big portion is psychosomatic" is a big stretch at this point.
The history of infectious disease is psychologizing and denialism, until somebody finds a biomarker and then we laugh at the quackery that once was.
(*Apparently - we don't know yet whether Covid-19 is a chronic infection for everybody like many viruses - e.g. EBV, CMV, HPV - for which only a subset manifest symptoms initially... We will see over the next few decades!)
I asked about specific symptoms on the survey. The fatigue symptom question (although not the smell/taste related symptom question) had the same pattern.
Readers of this blog are pretty educated and I've written several articles about long COVID before, so I think there's very little chance a substantial fraction of people don't know about it.
Link to study showing that long courses of appropriate antivirals cure it? If this is true the Stanford Long COVID clinic doesn't seem to know about it, they're treating some of my Long COVID patients and mostly trying general chronic fatigue medicines.
For my anxious patients in general and especially those with health anxiety, I find it very helpful to fully acknowledge the symptoms they are experiencing, and validate how unpleasant/difficult they may be. THEN to provide some reassurance of the type 'Fortunately, for most people these types of symptoms do get much better within a few months', and encourage REASONABLE self-care. Often within a few months the patients focus is elsewhere, and I can point out how those symptoms DID fade with time, reinforcing that message for future occurences.
With anxious patients who tend to somatize, I always focus on the 'living with chronic illness' model, which encourages living within a 'window' of effort/activity and self-care/rest, where the person neither seriously exacerbates their symptoms, nor underfunctions/has no life/has little enjoyment, out of fear of exacerbating them. I encourage starting to gradually increase effort/activity, while paying attention to not only how much symptoms are impacted, but also for how long. So for example, if a certain activity is highly valuable (socially, work, life management) but increases pain/fatigue/anxiety, I always ask how LONG that exacerbation was, and whether it faded on its own or required extra rest/self-care to recede. If a symptom increase lasted only a day or two, I encourage continuing to incorporate that activity/effort or level of activity/effort, but always prior to a day when the person has fewer demands on them (never no demands, always within the 'window').
My assumption is that there is no 'pure' psychosomatic illness. Vulnerabilities are real things, whether from genetic or life-experience factors.
There's been a lot of talk about whether or not long COVID is psychosomatic, but I don't think we even need to go there. My pet theory has always been that the generally accepted list of symptoms of long COVID is so long, vague, and comprehensive that, if somebody is really looking hard for long COVID in themselves, they can find something that'll match.
Fatigue? Long COVID. Chest pain? Long COVID. Insomnia, diarrhea, joint pain, rash? Long COVID. Are you headachy today because you're dehydrated and stressed, or is it COVID rearing up?
Now this still doesn't explain the bisexual/homosexual distinction. But if the mental health data are anything to go by it wouldn't be surprising to learn that bi people are more likely than the baseline to just be generally unwell, and thus more likely to say yes if given a laundry list of symptoms and asked "do you have any of these?"
Another interesting idea: The CDC page I looked at while writing this explicitly analogizes long COVID to Chronic Fatigue Syndrome. Do we have any data on whether bi people are more likely to report suffering from CFS than gay people are?
https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
[1] is on chronic pain, not chronic fatigue. It does not cross orientation with sex, but the NHIS data is available, so you could do that. Also, you could use more years for more power. It finds gays and straights have the same rate of mild chronic pain (20%), while bisexuals are 20% higher, marginally significant. But bisexuals are young, so adjusting for age, they are 50% higher, significant. Restricting to debilitating pain, they have lower rates. Adjusting for age, again 50% higher, but not statistically significant.
[2] 15 year old survey of 2300 people in CA does not find a difference between gays and bisexuals for chronic pain. For chronic fatigue, it finds 50% higher among bisexual women than lesbians, but 2x higher among gay men then bisexuals, ie, the opposite effect.
[1] https://www.cdc.gov/mmwr/volumes/72/wr/pdfs/mm7215a1-H.pdf
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040376/table/t3/
From my casual knowledge of English, I'd say that bisexual means able to enjoy sex with both genders. Not necessarily enjoy it equally, nor to have equal numbers of partners of both sexes. What do folks here think it means?
My take on orientation is based on what I've read from homosexuals from an earlier era when they were pushed hard to have heterosexual relationships, and they did, to both their and their partner's cost.
Later in life, they had sex with someone of their own gender and found it was satisfying in a way that heterosexual sex wasn't.
I get the impression from people that this interpretation is eccentric, and I'm not sure why. Perhaps because it's something that can't be evaluated from the outside.
I don't think that entirely captures it. Send me to prison for life or vanish all women from the planet and I'm fairly confident I can enjoy sex with a man. It's a physical act and the hole still feels the same. But as long as women are available, I'm never going to choose a man.
It's more to do with what causes the arousal. Looking at a male body has never given me an erection. Looking at a female body has. I don't want to frame it as entirely visual, since obviously blind people can still have arousal and preferences aligned with secondary sex characteristics, but it's more than "can you be aroused at all by this person?" My pants give me an erection more often than other people do, but I don't have any sexual attraction to pants.
I would take bisexuality to mean something more along the lines of "can both a man and a woman sexually arouse you without touching you?"
I would assume that if women became available again, you'd prefer sex with women and actually like it better.
I agree. A diagnosis often serves to give people validation, a label of “psychosomatic” or “in the head” does the reverse.
Has anyone compiled a list of illnesses/syndromes that are disproportionately experienced by bi-sexuals as a way of creating an index for how much each health challenge is caused by psychosomatic factors?
"Bisexuals and heterosexuals seem much more likely to be psychologically different than immunologically different"
Well maybe....Is there any data to go along with that otherwise ungrounded opinion. IIRC, homosexuals (maybe only men) have differences in there brains compared with cishets....
Take it with a grain of salt, but related and potentially interesting: Kontextmaschine on Tumblr claims that he *became* bisexual as a *result* of long COVID (along with various other physical and psychological changes, including dramatically reduced anxiety.
*Screams in Alex Jones*
An immunological theory which is probably not especially plausible is that bisexuals have less aggressive immune systems. For example, perhaps part of the etiology of (some) bisexual behavior relates to weaker discrimination of others' MHC (major histocompatibility complex) phenotypes. If this were the case I expect we'd see bisexuals have a higher degree of relatedness with their sexual partners, though probably no one has studied this.
There is variance in intra-individual MHC diversity, which has interesting effects on immune function; it appears that an intermediate level of diversity is better than a low or high level. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2666699/
There are also links between MHC/HLA genotypes and predisposition immune competence as well as schizophrenia (possibly mediated by an an immune/infection mechanism). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293234/
I'm having hard time nailing down how you are using 'psychosomatic' here.
It seems like there are at least four possible stages at which this result could be explained (plus any combination of those stages):
1. Group B actually experiencing perceptual symptoms more often than group A.
2. Group B noticing an individual incidence of a symptom as something notable/troubling more often than group A.
3. Group B noticing those symptoms form a pattern and mentally labeling it as 'a condition' more often than group A.
4. Group B saying that this pattern of symptoms they've noticed is long Covid on your survey more often than group A.
From the way the term is used in this post, it seems like perhaps any of these could be called 'psychosomatic', but they each point at very different mechanisms and underlying realities.
Can we separate bisexuals into 3 groups
1. who have sex with both genders
2. Who have had sex with only one gender despite opportunities to have sex with both (or at max one single instance with one gender and all others with other)
3. Who are having sex with only one gender because of being in a monogamous relation or scared due to legal/ social ramifications of sex with same gender
For group 1 , my theory is bisexuals have higher levels of hormonal fluctuations compared to straight or gay people. And hormones and immune system are linked. So they could have somewhat different immune system. I know it’s a data point of one My periods are slightly irregular and I have a screwed up immune system. I am also more attracted to men at ovulation, both at menstruation, women at other times. Haven’t suffered from Covid though.
For group 2 - psychosomatic
For group 3 - probably have higher rates of depression and stress which impact’s immune system.
Wow, literally hundreds of biomedical papers on Long Covid and you conclude based on your survey that most cases are psychosomatic? Your priors seem completely off.
https://www.nature.com/articles/s41579-022-00846-2
You might want to reflect on the appalling history of psychiatry in psychologising serious biomedical diseases such as post-acute infection syndromes.
The science behind psychosomatic medicine is often extremely poor, using bad definitions and wrong tests. The field is driven by highly dogmatic people with uncomfortably close ties to the insurance industry (if it's psychological, there's somehow no need to pay social security)
Here's a good blog on the topic:
https://mecfsskeptic.com/history-of-psychosomatic-medicine/
Most conditions classified as "(potentially) psychosomatic", such as fibromyalgia, irritable bowel syndrome, and ME/CFS have plenty of evidence of a biomedical origin that the psychosomatic crowd conveniently ignores.
The consequence of labeling diseases as psychosomatic are lack of treatment, harmful treatment, lack of research funding, and lack of social security. You might want to be a little more careful throwing that term around.
I really don't understand the tolerance for this pseudoscience in rationalist circles.
Just a note, I'm sure you've spent considerable time dealing with people who don't understand these things, but most people haven't, so your frustration and anger at people who don't have your history and knowledge comes across as confrontational and grating.
You'd probably win a lot more minds if you just used a friendlier and more educational tone, and less of a scolding and angry tone.
Some people, even people who "should know" sometimes just somehow missed out on that bit. So help us out and we can grow together.
EDIT: that linked article on mecfsskeptic.com was pretty awful. Are there any better introductions to the situation? I would be interested in a better writeup on the topic.
Thanks for the note Philo. It was indeed written in a lot of frustration. Just to be clear: my frustration is aimed at Scott, not readers. To me, this blog post feels akin to a post like "does conversion therapy work? A small survey" or "are Blacks really less intelligent?" although I admit that those are, fortunately, already widely accepted to be wrongheaded and offensive.
I have some understanding for readers being naive on this topic, but Scott is a psychiatrist and these type of views could do immense harm to his patients.
Sorry the link wasn't good. I recall reading some good articles from that blog, but I can see how this isn't a good intro link. I'll get back to you later with a better one.
Not an introduction to psychosomatic medicine, but a rebuttal of a popular article that claimed most Long Covid is psychosomatic/functional neurological disorder: https://publicherald.org/the-new-republic-has-long-covid-all-wrong/
Not an overview, but here's one example of exceedingly bad research. This is a criticism of the largest (multi-million) trial for "chronic fatigue syndrome" (an inaccurate term) by the biggest names in the psychosomatic field:
https://virology.ws/2015/10/21/trial-by-error-i/
(Annoyingly, his interpunction got messed up somehow)
It includes practices such as changing the study protocol post-hoc to inflate the number of "recovered" patients, analyzed in this paper: https://www.tandfonline.com/doi/full/10.1080/21641846.2017.1259724
I feel like 'noticing you re attracted to the same sex even when you don't expect to be' and 'accepting and acting on those feelings, labeling yourself based on them, and proclaiming that label to the world' could very easily have neural correlates to 'noticing small unexpected changes to your sensorium, accepting them as an ongoing condition you're suffering, labeling that condition, and claiming that label on surveys.'
In which case, is the 'condition' the bisexual people who notice and talk about their symptoms, or the straight people who don't notice the symptoms or don't label them and talk about it?
Is it bad that as soon as I saw the title I knew where this was going?
The greater question for me is why do people with divergent sexual preferences seem to be more prone to neuroticism?
Also, if trans women frequently score higher in neuroticism, and women typically score higher in neuroticism than men, might that be suggestive that trans women are actually women? Or at least closer to being a woman than their assigned gender?
> I said that some cases of long COVID were probably psychosomatic, but the majority weren’t.
Is there a word for the phenomenon where the symptoms are real but it's because there's some psychosomatic-ish "tolerance" for them that allows them to be real? e.g. a dynamic where, if you "believe" in Long Covid (or have a tendency to medicalize things in general" you would say: "ah well, my fatigue is due to long covid, what are ya gonna do" and not work on it, whereas if you "reject" Long Covid, you'd say: "shoot, after having Covid I'm really fatigued, I am going to have to work really hard to get back to my previous level of health", and perhaps this makes a large part of the difference in survey results.
Anecdotally an older adult I knew from HS who reports his whole life on Facebook (lol) reported that he thought had Long Covid for a year and then it all went away when started running again and realized that actually he just never got his fitness back to where it was. Since then I've wondered how common this situation might be.
Perhaps some people are more prone to thinking through questions deeply and admitting a more generous possibility of uncertain things.
"Could I enjoy having sex with not only people of the sex that's more obviously attractive to me, but also people of the other sex? When I think hard about it, yeah, probably! So that means I'm bisexual."
"Did I experience a longer than expected period of any covid symptoms at all? When I think hard about it, yeah, I think so! So that means I had Long Covid."
That doesn't make those symptoms (or sexual attraction) fake, psychosomatically manifested, or a mental illness. Maybe someone else has the same possibility of enjoying sex with their less preferred sex, and had the same covid symptoms, but just isn't as inclined to notice, remember, or identify with those facts.
My hypothesis is that the excess overlap between bisexuals and long covid self-reports is that's selecting for a more inclusive manner of interpreting and answering questions.
This conclusion is so bizarre to me. In terms of predictive coding, i expect bisexuality to be indicative of a different relationship with respect to self-models (though of course all of this is flexible), and hence a slight update towards a different neuro-circuitry of sorts. And it wouldn't be weird that more lax model loops gets perturbed more easily.
Like, ok, to me it is like if you saw that depressed or ADHD people get long COVID more easily, and somehow that's an update that it is culture-bound, that would also feel like an overreach
I think you are really buying too much into this culture-bound disease idea, and i think it aligns with how we're emphasizing placebo too much in our society. Not to say that it doesn't exist (at least in a weak form) just that it is getting blown out of proportion.
Depressed and ADHD people *do* get Long COVID more easily, and that does make me update, so I'm not sure what you're trying to do with this analogy.
I agree that all of this goes through different neurocircuitry, but that fact that we're talking about neurocircuitry suggests to me that this is a nervous system problem and not an end organ problem in the lungs or immune system or whatever. My guess is it's something like "COVID makes you weak and fatigued" -> "weird neurocircuitry makes a hard update towards weakness and fatigue and refuses to update out of it" -> Long COVID. This is what I think most psychosomatic problems are, see eg my models of HPPD, anorexia, and chronic pain.
Okay, so i think what I'm confused about is your jump from "it's a nervous system problem" to "it's mostly culture-bound".
Being both bi/pan and having answered yes on the survey about having had long covid, i see long COVID more like anxiety or depression, wherein your prior do not matter as much and you just feel that "something is wrong" (that is at least my personal experience, and i only pieced the long COVID possibility months after)
Culture-bound disease can happen in that it can constrain your expectation, but i think we're over considering the impact of conscious beliefs; aliefs are much harder to change, and from what I'm seeing, are what actually matter in terms of impact on oneself
Unless you think that a majority of depression/anxiety/ADHD would not have existed if we didn't know the term, then it would be quite consistent.
What I'm still surprised by is that in your highlights on culture-bound diseases, you said
> All of this is convincing me that culture bound illness, while real, is much subtler than The Geography of Madness (or my previous views) suggested. Or maybe that the panic type (where they spread in epidemics over the course of a few days) are more culture-bound, but that the long-run normal conditions are less culture-bound than I thought.
Which to me indicated you were giving it way less credence, and a higher complexity penalty for explaining primary facts
I might be misunderstanding you, but I think I'm analogizing this to chronic pain, where one view (not universal) is that the belief that pain can be chronic contributes to a trapped prior that keeps the nervous system locked in an expectation of pain.
Does that actually happen?
I know it does on the level of aliefs, but maybe one crux we are having here is that i do not expect most beliefs and campaigns to change it
Like, i was under the impression that beliefs on the conscious level do not matter much, and that the prior "i will keep experiencing pain" is born more of a continuous experience of pain than of being told so.
I will try to look into correlations between awareness campaign on chronic pain and prevalence of it
That being said if it is indeed how it works, maybe we should try to design something like the mirror trick ( https://en.m.wikipedia.org/wiki/Mirror_therapy ) for long COVID, and stop doing placebo controls of harmless therapies that seem to work in treating chronic pain?
A lot of the bisexual people I know, particularly bisexual women, seem to have chronic pain and/or autoimmune disorders of some sort. (A few weeks back I noted a similar pattern among trans people I know.) Cisgender homosexuals, on the other hand, seem to be just as healthy as cisgender heterosexuals. Possibly even more so, since both gay men and lesbians tend to be more athletic and physically fit than the average straight person - which might explain why homosexuals tend to have even lower rates of Long COVID than heterosexuals. I've long thought that gender dysphoria in trans people might be tied to more general "body mapping" issues that would strongly correlate to various health problems; the same could be true, to a lesser degree, of bisexual people.
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. Most likely, this "mix-up" would occur during early fetal development, with downstream effects on things like muscle growth and immunological functionality.
(Note that this probably wouldn't apply to "homoflexible" or "heteroflexible" individuals, who might be technically bisexual but have a very strong preference for one gender over another. Biologically speaking, I'd imagine those people are likely to be much closer to fully gay or fully straight people, respectively.)
I realize that unawareness campaigns are useful as a thought experiment, but it bothers me that there seems to be an unawareness-campaign-shaped hole in reality where an actual strategy for handling culture-bound mental illness should exist.
To be fair, I suppose "stop holding awareness campaigns" is at least a partial strategy. But if that's the best we can do then I'd prefer to see an explicit argument saying as much. Absent an explicit argument, we're mostly still stuck in a false dichotomy with "deny that culture-bound mental illness exists" on one side and "try to solve all problems with social stigma" on the other.
TBH I would kind of assume bisexual people are further right on "snowflake spectrum" (i.e. they are more inclined to publicize their internal state as a way of forming an identity)
If this is the case, they should also have a higher incidence of other psychosomatic-adjacent conditions like PCOS and chronic Lyme disease, and other mental illnesses
I realize how this makes me sound but I'm really not conservative or anything, it's just my current model of reality
I agree with bits of that but disagree with most of it, but anyway am not very invested in arguing about because it would involve of grinding over a whole bunch of things which you and anyone else already has a very particular way of looking at that will be hard to sway.
But I think it's weird to attempt to debate a point when your opening stance is so loaded with disrespect. For example if you just wanted to debate the merits of the question you wouldn't be so weirdly focused on your example being a woman in her 20s. And "everybody knows"... do they? Did you check? What if they don't? Or what if they know something that superficially matches what you said but have the exact opposite interpretation of it? It sounds like you just wanted to take the opportunity to take some snipes at a class of people that you despise.
> For further evidence, see the fact that 1/4th of Zoomers claim to be LGBTQ versus like 2% of Boomers. I don’t believe 1/4 of Zoomers are actually interested in having homosexual sex.
In my experience I think they're probably one datapoint on a monotonic trend away from recognizing sexuality or gender as rigid constructs and probably in fifty years unless some big reactionary thing happens the question "are you hetereosexual" will just mostly not make a lot of sense.
Are you talking to me or to some other commenter on this thread?
Quite sure, yes. It was never actually a question for me, just something I always felt I had to hide when I was younger.
. I looked for studies of suggestibility and sexual orientation, did not find any. Took a quick look at the research on personality differences and sexual orientation. Did not have time to be picky, though, just grabbed the first studies I found (there were not many). Here's what I found:
-In one study with a huge sample from many countries, subjects took the "big 5" personality inventory, which measures traits that factor analysis suggests are the main dimensions on which personality differs. Traits are extraversion, agreeableness, openness, conscientiousness, and neuroticism. Study found that "Bisexual women stood out from lesbian and heteroseual women in Big Five trains in that they scores the highest of all 3 groups on neuroticism and disagreeable assertiveness and the lowest on agreeableness". (Study is here:https://sci-hub.ru/10.1007/s10508-007-9267-z). Neuroticism = having mood swings, being easily upset, which sounds enough like Borderline Personality Disorder for me to be curious about BPD and sexual orientation, so looked up that. Found this: "In this study, patients with BPD were over 75% more likely to report homosexual/bisexual orientation than comparison subjects with other personality disorders." Study was not large, but was done at Harvard/McLean Hosp. so probably was decently done. (It's here: Sexual Orientation and Relationship Choice in Borderline Personality Disorder over Ten Years of Prospective Follow-up. J Pers Disord. 2008 Dec; 22(6): 564–572.
doi: 10.1521/pedi.2008.22.6.564)
So all this seems to me to support the idea that something like suggestibility is a factor in women thinking of themelves as bisexual, & there's research (cited here by Scott I think) that it's also a factor in people thinking of themselves as having LC. I have more thoughts, and all this is sort of blunt and lacking in nuance, but am out of time.
I wish we knew! Oblique reference to the old Mel Brooks bit https://www.youtube.com/watch?v=w556vrpsy4w
Oh definitely someone else, whoops.
Regarding Covid and related matters, wanted to let people know that beowulf888, who posts here, has been studying Covid since early on. It's not his field, but he's smart and knows how to research things. He now posts a weekly Twitter thread about covid-related events and/or whatever new things he's found or figured out. He has no ax to grind regarding covid, is only interested in figuring out what's true. Here's his latest update, which actually is mostly about covid sequelae: https://twitter.com/beowulf888/status/1653553731760459776
Use regression with pooled sexes instead of running sex-split samples. Too small.
Load data into R, and use something like:
library(tidyverse)
d = read_csv("your data.csv")
glm(long_covid ~ sex + sexuality, data = d, family = binomial(link='logit'))
Would be really interesting to get these results further broken down by Kinsey scale. The suggestions of bisexuality being dependent on cultural suggestibility or tendency towards self-identification with labels seem to make much more sense lower on the Kinsey scale. At 1 or 2, sure most men will say they're straight and the ones that say they're bi would be more likely to identify with other controversial labels. By the time you reach 3 or 4 on the Kinsey scale though, it's not really something you can still be uncertain about, so at that point people are either identifying as bi or intentionally staying closeted (meaning no disrespect to those making that choice, I did the same for a long time).
So if the higher long COVID rate is driven by a greater tendency towards identifying with something controversial or suggestibility/culture-bound explanations, I would expect the long COVID percentage to drop most of the way back towards normal for Kinsey 3+.
Is there a good reason to think that the etiology of male and female bisexuality is the same? Is an increased risk of long covid weak evidence that it is?
I wonder if which strain of covid people got could be a confounding factor. One family member in college had (probably) Delta and had loss of smell/long term altered smell. The rest of us caught Omicron later and didn't have symptoms after a week or two, no changes to sense of smell. I wonder if (on average) openly bisexual people might be more social and more likely to have caught Covid earlier with a greater chance of long covid.
Well, the comments here are predictably horrible, so I'll ignore them and just throw my anecdata into the pool. 63-year-old bisexual man married to a 56-year-old bisexual woman. We regularly have sex with people of both genders (or, rather, did before Covid), so no this isn't about trendiness. Dodged Covid for 3 years, but it finally caught up with us in March. Both have physiologically unambiguous long Covid symptoms, mine mild and hers moderately severe (heart inflammation). Age is obviously a more relevant factor than sexual orientation for us, but I found the post intriguing.
How confident should we be that self-reported "bisexuality" means roughly the same thing in men as in women?
Using the data shared by a fellow ‘commenter’ where bisexuals are considerably more likely to have relationships with the opposite sex (32%) than the same sex (5%), I think there’s an interesting possibility to consider.
It’s clear that within society there are those who are more confident/definitive about their views/experiences/ideas and those who are less.
This is maybe a commonality with sexuality and something like long covid. Having seen the way long covid was discussed in the media there’s no denying it’s considerably vague. A whole range of often common symptoms were mentioned. Therefore, when it comes to asking a given population whether they had long covid I think there’s a subsection in the population who are less likely to rule things out and perhaps going further, tend to question themselves. Maybe I do have long covid? I have had a stomach ache recently etc.
Similarly with sexuality, perhaps there’s a similar subsection of people who don’t have the conviction in describing their sexuality. Maybe they haven’t fully explored it yet and unlike others aren’t quite willing to rule things out. Bisexuality is clearly the ‘less definitive’ out of the 3 sexuality options, after all.
Blogger Scott Alexander does not promise he'll never make mistakes. But he says get that if he gets something significantly wrong, he will acknowledge it to help anyone trying to assess his credibility. I am cross-posting his blog because I am so outraged at what he says about Long Covid being a culture bound psychosomatic condition. I am going to provide Scott with a free service for which I normally charge lots of money. I'll prepare him a critical appraisal report that suggests he mend his ways. I'll do that by Tuesday on Substack . He might come with his friends. Rather than send me money that I could use, I invite him to cross-post my article. Then we can have a sit down, maybe toss back some beers. Scott, you're a good soul, but you have sinned. Please repent.
https://jimcoyneakacoyneoftherealm.substack.com/
I am very curious what people here make of long COVID biomarker findings. Multiple groups have found multiple sets of blood biomarkers, some with very good predictive value; see Table 2 in this review article https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(23)00117-2/fulltext.
Granted, the boundary between organic disease psychosomatic / functional neurological disorder might be demarcated by "is it detectable by well-validated clinical-grade diagnostics (in-vitro or otherwise) or not"; which I think is pure map/territory confusion. Under this definition, long covid is indeed psychosomatic; there is no such diagnostic test currently available. However, there is a consilience of evidence pointing towards some sort of organic disease (possibly of a heterogeneous flavor) in at least a significant fraction of long covid patients. I doubt that all these biomarker findings are the fruit of indefatigable p-hacking but nevertheless, replicating the more promising findings would be nice (and essential to getting something into clinical use).
Research groups seem to favor hunting for *new* sets of exotic biomarkers (as seen by the ever-expanding lists of candidate biomarkers with good AUC in those "wtf *is* up with long covid" review articles) rather than trying to replicate existing biomarker findings or validate a more limited set of findings for clinical diagnostic use. I think this is unfortunate. There is a company claiming to do that with the Ang-1 and P-sel biomarkers summarized below, but they seem to be doing this alongside developing a novel platform ("quantum dot high performance fluorescent immunosensors for high sensitivity bio-detection and quantification to develop best-in-class low-cost rapid diagnostic assays") for point-of-care tests. Don't need high sensitivity detection and quantification to pick up on the vaporware vibes from this, and hopefully someone else tries to replicate the Ang-1 / P-sel findings, even if they can't commercialize it.
For instance, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549814/ gets **excellent** classification accuracy -- between healthy subjects, people who've been in the ICU for covid, and long-covid outpatients -- by looking at blood levels of only two proteins; Angiopoietin-1 and P-selectin (both involved in endothelial / vascular / clotting function). If you look at the figures in that paper, you can see that the levels of Ang-1 and P-sel are **off the charts** in long covid outpatients compared to healthy patients -- or even people who've been in the ICU for covid and have recovered.
https://www.medrxiv.org/content/10.1101/2022.08.09.22278592v1 is another one of those "look at a bunch of immune-related biomarkers, throw statistics at it, and find what has good predictive accuracy" studies and yep, they indeed also find some biomarkers with excellent predictive accuracy. Also, the self-reported long-covid symptoms matched up well with the biomarker findings.
Looking a bit more upstream, this study found low levels of circulating Spike protein *months after acute illness* in 60% of studied long covid patients (and none in those who recovered OK from covid): https://academic.oup.com/cid/article/76/3/e487/6686531. The "weird viral persistence" stuff also shows up in this study of IBD patients -- almost all of which previously had a covid infection, but only half of which reported long covid symptoms: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9057012/. The majority of people with SARS-CoV-2 nucleocapsid protein and SARS-CoV-2 RNA in their guts reported long covid symptoms, and people without these covid virus parts in their gut reported no long covid symptoms.
Bisexuality seems to me to be a pretty low-stakes label, relative to homosexuality at least. This leads me to believe that there's probably some meaningful overlap between 'people who choose to spend their time and energy reporting their bisexuality in polls' and 'people who spend an outsized portion of their time and energy on social signaling'.
It's actually incredibly difficult to phrase that in a way that doesn't seem - to me - to ooze contempt, which isn't what I want to broadcast. There's an obvious implication that I attribute a good deal of long COVID to social contagion, which is clearly a popular idea among other commenters. I'm not really confident about anything at this point, but if we're going to interpret this correlation as substantial then I think my take is as good as any that I've seen.
Activism is trendy, and bisexuality is currently underrepresented. Those who are concerned with representation in this case are probably more likely to be trendy. Setting aside the issue of whether or not long COVID is even real, I'd assert that it's almost indisputably trendy.
From personal experience, reading the long covid subreddits, I believe there is a Subset of "Long-Covid" patients who are just Copper deficient.
Copper deficiency can be caused by excess consumption of Zinc and Vit C, the key supplemments promoted for COVID prevention. Most people are unaware of the interaction between Zinc & Copper, and Doctors rarely check for Copper deficiency. There's research showing that Copper deficient patients take more than a year to get a proper diagnosis, as the symptoms mimic other diseases (for example Vit b12 deficiency).
I'm not sure I got anything from Covid Actual that was worse than the Jab itself, twice. Jab kicked my ass for five-plus days each time.
Given that I was working as a truck driver, trying to keep y'all in toilet paper and ramen, this was exceedingly bad.
(Yes, I understand that people who have read my comments over the decades probably think I'm making shit up, and I agree that I have had an exceedingly eclectic career path. Truck Driving was my midlife crisis career shift for a couple of years after my bout with Major, Direct Suicidal Ideation post-divorce. [The answer is still ketamine.] Yes, I eventually went back to computers.)
I feel silly commenting so late, though more so I'm happy to get into the action. I didn't feel prompted to share this initially, but on relistening to highlights of comments on this post it came to mind. Commenter Alex mentions this, and alludes to it as a preexisting view (that I wish was widely held).
I believe that a major explanatory factor of long COVID is health and fitness. Specifically, people viscerally notice a sudden decrease in exertion-capacity, on the order of hours and days, not the months or years of aging), and, without retraining to a fitness that suits their desired activity level and capacity, instead notice that the gap between desired versus current fitness level persists.
Some people may have experiences a comparable fitness drop
due to a night (or nights) of heavy drinking, or sleep deprivation (or both)—more noticeable if it affected group competitive fitness activities or defined personal challenges. Cardio-pulmonary(?)- or exertion-load (and -capacity) felt moment to moment are something I'm constantly aware of. I mentally track my fitness and mental acuity consistently and somewhat closely, as a runner and for programming, while I use VO_2 max as an indicator of general fitness, integrated over time, hard to cheat, lifespan associated, correlates with workout quality (intensity and preparation, including sleep) like an exponential moving average. This factor plus a restedness factor explains almost all of my felt physical and mental energy for long work hours or extensive physical adventuring.
I have risk factors for anemia, eating mostly-vegetarian, and when I donate blood, I'm quite consistently on the edge of donation-cutoff anemia (heme: 13.0 mg/dL whole, 13.3 mg/dL double red). Donations don't feel like quite the same fitness step-function decrease, but maybe I allow for, expect, some decrease. I should try mile times before and after future donations. (Against general advice to not exercise, I use the donations as a chance to see what suddenly decreased fitness feels like afterwards.) I'm not sure how widely shared is the experience of viscerally noticing the internals of one's body. I describe sensing spikes in blood sugar, fats, and physical effects of caffeine. And have trained endogenously noticing my heart beat, but many I talk to do not report recognizing the experiences, even prompted in close context, e.g. while eating cake together or drinking espresso shots.
I hope to hear others reports that speak for or against a fitness factor, and about the extent and form of viscerally felt capacity and exertion.
Clearly 0% of respondents to this thread are either bisexual or have long covid.