The journal that published a paper claiming that attractive women were more likely to develop endometriosis has finally retracted the article, more than a month after the authors called for the move.
The article, “Attractiveness of women with rectovaginal endometriosis: a case-control study,” appeared in September 2012 in Fertility and Sterility, an official publication of the American Society for Reproductive Medicine. Over the years, it had been the subject of criticism.
In early August, the authors of the paper, from Italy, called for the retraction of the work. But that didn’t happen until now.
Per the retraction notice, which is undated — as has become common for Elsevier journals that overwrite their original HTML pages — but seems to have appeared within the last few days:
This article has been retracted at the request of the Authors.
The entire group of investigators contributing to this study requests to withdraw this article. We conducted the study in good faith and according to correct methodology. We believe that our findings have been partly misinterpreted, but at the same time realize that the article may have caused distress to some people. Women’s respect is a priority for us and we are extremely sorry for the discontent the publication originated>.
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Of all the things to study they chose to invest time and energy in this? Still, discontent has no bearing on the validity of their conclusions. I’m not sure what value the knowledge would impart whatever the conclusions. In my considerable experience I have never observed that endometriosis had any effect on a woman’s attractiveness. However, dysmenorrhea can have a deleterious effect on a woman’s agreeableness. This might be perceived as less attractive. But this perception ranks alongside the discontentment, having little relevance.
The value the knowledge imparts is stated on page 6 of the retracted paper (still downloadable as a pdf) or on page 13 of the original paper that includes the original tables:
“ The biological significance of beauty has generally been interpreted in terms of sexual selection associated with presumed health advantages (29, 31, 32). Attractive subjects have more chances of being selected by potential mates because they are subliminally identified as carriers of the best gene pool. In the case of females, attractiveness can also act as a cue for fertility and reproductive potential (21, 33). In fact, esthetic perception is influenced by
sexual hormones (29). Women with higher estrogen levels have more feminine, attractive, and healthy looking faces than those with lower levels (24, 29). Because female attractiveness could be the expression of higher estrogen levels (24, 28, 33), it cannot be excluded that a stimulating endocrine environment might favor the development of aggressive and infiltrating endometriotic lesions, particularly in the most feminine subjects.”
Whether this hypothesis withstands further scrutiny is another matter. However, if the results are sound, this would be a reasonable hypothesis to put forward for further discussion in an evolutionary biology setting and would therefore have value.
Incidentally, since the authors used females for assessing the attractiveness of females in the context of sexual selection for reproductive success (“being selected by potential mates”), they have compromised their results- this assessment of attractiveness can be made only by potential mates (males). The inclusion of females for making the assessment could have skewed the results either way to be more significant or less significant.
If this article had focused on something less subjective and heteronormative than attractiveness and displayed insight into the cultural baggage this type of term carries it would be easier to take it seriously.
I see the study was “Supported by a research grant from the University of Milan School of Medicine (FIRST number 12-01-
5068118-00067”. Endometriosis is a debilitating condition that is under-diagnosed. The funding for that study could have been put to use actually helping women, for instance, than assessing the participants’ attractiveness.
I am concerned that the study was awarded funding in the first place and I am also disappointed that the researchers seem not to understand (as evidenced in their equivocal apology) why the study met with such hostility.
I agree and am even more disturbed that there is no mention of the ethical issues involved. The authors explicitly stated that participants were NOT informed about being rated for attractiveness. As far as I can establish, participants were NEVER informed – even after data collection had occurred – which means they could never given fully informed consent to participate in the study. While I appreciate that there are some instances where deception is required prior to data collection, such studies are often required to provide full disclosure to participants after data collection has occurred, and to give participants the option to revoke consent based on the new information. This study did neither.
You’re concerned it has this cultural baggage rather than your cultural baggage?
The study sounds dubious because they had only four people doing the evaluating, which is an insignificant sample size. But I’m more concerned that the article was retracted for the wrong reasons (because people got mad) than I am by its poor methodology.
The notes for Table 4 describe how the ratings were used:
“A score was calculated as the mean of the judgments of four independent observers (two females and two males), who independently gave a score of 5 (very attractive), 4 (rather attractive), 3 (averagely attractive), 2 (not very attractive), and 1 (not at all attractive).”
Further, the mean scores were collapsed into three categories for reporting in Table 4 (Very attractive or rather attractive; Averagely attractive; Not very attractive or not at all attractive).
It’s worth noting that NONE of the cited studies on measuring attractiveness support this approach to analysis. None used a 5-point scale (the closest is one study that used a 7-point scale) and none used a mean of multiple attractiveness ratings in subsequent analysis. There’s no justification for collapsing the 5 categories into 3.
It’s disappointing that this manuscript passed peer review.
It is very likely that the goal of the study was different. This might be a post hoc analysis of data that they collected but did not confirm their hypothesis. I wonder what that hypothesis was.
It seems to me also interesting of the present cultural situation that the “hostility” seems to have taken 7 years to bubble up…
Actually no, the study used two male and two female evaluators. From the text: “Two male and one female evaluator remained the same throughout the study period, whereas the fourth female evaluator changed twice.”
While it may be true that attractiveness is a factor in being selected by potential mates, the clinical implications of this study, conducted by investigators who treat women with endometriosis and a specialist facility for same, was never established. The authors never established the clinical relevance of attractiveness nor its implications for either initial diagnosis of endometriosis or ongoing clinical management. More disturbingly, they collected a substantial amount of information from each participant, yet deliberately withheld the “attractiveness” component of the study from them.
Another -poor- study retracted by wrong reasons.
Distress and hostility for retraction is a metric that destroys Science.
Actually if ‘Women’s respect is a priority for us’ was really true then the top of the Editorial tree for the journal Fertility & Sterility might look quite a bit different…