Research Questions About the Two Sexes

In his 1869 book on The Subjection of Women, the economist and political philosopher John Stuart Mill wrote that he had “repudiated the notion of its being yet certainly known that there is any natural difference at all in the average strength or direction of the mental capacities of the two sexes, much less what that difference is.” Whatever the differences, the political implications should still be what Mill thought.

An article in The Economist suggests that perhaps women make for better physicians than men. It cites a number of recent medical studies concluding that female doctors have better medical outcomes in terms of patient survival and hospital readmissions (“Do Women Make Better Doctors than Men? Research Suggests Yes,” August 7, 2024). The data comprised hundreds of thousands of medical records in Canada and the United States. The Economist notes that they were retrospective studies, which are less reliable than the controlled-randomized sort. It could be, for example, that women doctors covered by the studies were, for whatever reason, assigned the least serious cases, which would be controlled in a study that randomly assigned doctors to patients.

But why is it important to know whether women or men are better physicians? The question looks strange, except perhaps for hospitals, clinics, and medical groups who, if discrimination were legally allowed, would be interested in hiring the most efficient doctors—pushing the salaries of women doctors above their less efficient male counterparts’. Since sex discrimination is illegal in hiring (we would now say “gender discrimination,” which has the advantage of avoiding a culturally hated three-letter word, but I’ll stick with Mill’s terminology), there must be another reason why the question has become a research agenda.

In a free society, whether males or females are better doctors would have no philosophical or political implications, regardless of genetic or social causes. (Once the hypothesized difference in productivity has been priced into salaries, it would have little business interest either as the prices would provide sufficient information.) The question would be no more important than whether left-handed or right-handed doctors are better.

Now, it does seem rather obvious, doesn’t it, that women are genetically more empathetic and caring than men. The Economist suggests that information on the relative competence of men and women as physicians would help male doctors change what they don’t do right. But then, one would think that the same sort of study for other social groups—say, white doctors vs. black doctors or left-handed doctors vs. right-handed ones—would be as useful. Why is that not the case? Certainly, such studies further reinforce the cage of group identities, but this should not be an objection for our group-loving intellectual establishment, except for the fact that some groups are more loved than others.

I agree, of course, that whatever research question somebody wants to investigate is his own business, although there is an issue as to whether the researcher should force others to finance his research. I have discussed this issue in a few previous EconLog posts–for example, about how spurious scholarly journals are helped by government financing of higher education. Freedom of research is the only way to know, as best as possible, that no important question has been neglected.

Given the zeitgeist of our time, we may wonder if the studies on the relative efficiency of male and female doctors would have been published if they had found that male doctors are better. Or perhaps such studies were buried by professional and academic journals? Imagine the headline in the press, “A Government-Subsidized Study Claims that Men Are Better Doctors than Women”! Mrs. Grundy (whose opinions have moved along with the times) would turn in her grave. In this area like in others, a free market in ideas is essential to the search for truth.

Let’s return to John Stuart Mill and how he justified the formal freedom of women to compete with men in all occupations, a more enlightened approach than the coercive one we are now used to. In The Subjection of Women, as I previously wrote on this blog, Mill argued that the emancipation of women would benefit everybody in society (or, should we say, would satisfy general rules beneficial to everybody) by allowing each person to contribute to the activities in which he or she perform best. Mill viewed discrimination against women as either harmful or superfluous. It was harmful if it prevented women from competing and proving themselves better than, or as good as, their male counterparts. It was superfluous if women could not or would not compete in certain jobs or tasks–garbage collectors, say. Mill saw no reason to prevent women, especially with discriminatory laws, from competing in any field of activity, but no reason for the government to help them either. What’s important is the formal liberty to compete, whatever the result is, whoever proves better at responding to market preferences.

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Those who have struggled with DALL-E will understand my frustration. The image was supposed to show male and female doctors on each side of a wall. But the bot did not understand. For more than an hour (for example), I tried to have him replace the woman standing up on the men’s side with a male doctor, or at least replace the head of the woman with the head of a man. I tried to teach the robot the secrets of life and the basics of anatomy. I finally gave up. Here is the image, in all its robotic imperfection.

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