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[–] 12 points 1 month ago (8 children)

Oh geeze, I'm not an expert in this stuff. I'm writing a novel about a PhD-level biologist (who becomes a shapeshifter) and ended up doing loads of research about biology... stuff in order to make the way he modifies people a bit more believable (so many stories are so full of hand waving these days it drives me nuts!).

One of the things I ended up researching was sexual dimorphism in various species including humans and wow what a rabbit hole that is! I have in my notes all sorts of things (differences) that most people have no clue about:

  • Women have different livers. Specifically, estrogen/testosterone turns on/off epigenetic pathways that make their livers behave a bit differently. So if a woman receives a liver transplant from a man or vice versa, it'll be a while before it starts behaving "on brand" haha.
  • Women's hearts are bigger/stronger/thicker but most people know that (necessary for pumping blood for more than one!)
  • Women's internal organs can move around a lot more than men's. They're not fixed in place like with men. Along these lines, women's tailbones can move a little bit (men's might as well be hard stone). This was important research because my shapeshifter character gets requests to give people tails and I needed to know if that was even possible and, come to find out, much simpler to give women tails than men! Haha
  • The tendency for women's brains to form more cross-hemisphere connections VS men's tendency to form front-to-back connections is actually a very funny part of the story (it's a comedy). Anyone that reads that part (and doesn't understand what it means yet) is going to be thinking, "holy shit that makes so much sense!" Hahaha
  • Women can perceive textures men cannot. The reasons why aren't complicated: Thinner skin, smaller fingers means greater nerve density and sensitivity. This was the research that had me looking into nerve pathways and why women are just generally more sensitive than men. Besides what I already mentioned, women store fat completely differently than men. Essentially, men and women have completely different flesh. Men cross-link fat cells making them much more "solid" whereas women stack their fat cells on top of each other like little pillows... This is why they're softer than men.
  • Now combine the flesh knowledge with the T-cell nervous response and the fact that stacked fat cells (and the vasculature that goes with that) together and you end up with this: Women bruise much easier than men. Bruising results in a cytokine (swelling) response... Which amplifies pain in the affected region. Having more lifelong exposure to cytokine in various joints that are constantly being used/bumped, it makes sense to me that women would be more susceptible to inflammation-related pain disorders such as rheumatoid arthritis. Which impacts women at two to three times the rate of men!

Hopefully that explains what I think I understand about the differences that lead up to women experiencing pain differently/more intensely.

...and that's just scratching the surface of all the differences! People think men and women "are basically the same, just with a few physical differences" but it's more like this: Men and women experience the world completely differently from each other.

Women physically see things differently than men (they see colors in greater resolution), they feel the world differently from men, and they have 50% more olfactory bulb neurons than men which means they have much more sensitive noses (especially to certain compounds like sulfur and scents like lavender have a vastly enhanced effect!).

Women live in a different world than men. We need to stop pretending we're the same and start accounting for it in medical studies!

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  • [–] 5 points 1 month ago* (3 children)

    While this comment is very well written, I believe the reason you're not getting a lot of upvotes compared to the other guy is because you didn't cite a paper, which was the original request.

    This sent me on an hour-long scour of a variety of papers, and it ended with me finding one titled "Sexual dimorphism in a neuronal mechanism of spinal hyperexcitability across rodent and human models of pathological pain" by Dedek et al.

    In this paper, they take spinal samples from deceased humans and mice and compared sex differences after they doused them in BDNF. They found that the pathway responsible for uptaking BDNF was only active in male samples.

    I think you're extrapolating a little if you're saying, based on this, that men solely use this pathway for pain and women don't, but then again, I can't tell what paper you're looking at because you never posted it.

    TL;DR: what you're saying about BDNF might be true, but please post sources when making specific claims like that, especially when asked :3

    PS your book sounds really interesting

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  • [–] 6 points 1 month ago* (last edited 1 month ago) (2 children)

    Doh! You're right. I had to dig deep into my old notes about this and here's the papers:

    Edit: Almost forgot the studies showing female (mammals) switch to the male pathway during pregnancy:

    ...and this study indicates that humans have the same genes associated with this sexual dimorphism:

    https://pmc.ncbi.nlm.nih.gov/articles/PMC10169414/?hl=en-US

    Since it's highly unethical to test pain pathways in humans, we have to rely on the mouse studies and extrapolate from there. The RNA testing shows we have the exact same genes as mice for pain expression, so the evidence lines up that men and women are using these different pathways for pain.

    I didn't just use "magical thinking" like I've of the other commenters suggested 🤷

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  • [–] 5 points 1 month ago (1 child)

    Okay, let's go through these:

    https://doi.org/10.1038/nn.4053 Yep, it shows that male mice are able to recover from induced mechanical hypersensitivity, while female mice were not. They hypothesised that this is due to the female mice getting around this by using adaptive immune cells, meaning this pathway still had the mechanical hypersensitivity, despite the original incision being healed. It is to be noted that, in the absence of adaptive immune cells, female mice did seem to use the standard glial-dependent pain pathway. While this does show that female mice may recover from neuronal injury poorly, it doesn't show that female mice experience more pain than male mice at a baseline. Similarly, this wasn't done in humans and thus comparison becomes very hearsay, although it is to be noted that these mice have very similar neural structures to humans and that human research in this area is usually very sparse.

    https://doi.org/10.7554/elife.69056 Very interesting study. Weirdly, by showing female mice inhibiting microglia-induced pain hypersensitivity with T-cells, it would imply that female mice have the capacity to reduce pain more so than male mice.

    I unfortunately don't have time to go over the others, but from those two it wouldn't be without reason you could say that women likely use different pathways to signal pain compared to men, althoughyou can't say that with anywhere close to certainty, as this wasn't done in humans, nor was that the point of the papers. In a sci-fi context it'd make perfect sense to present these findings as absolute in a JoJo sort of way, but I'd warn not to present these as factual as you did in the original comment. In a book, a disclaimer at the start would honestly let you run loose in what you say on these topics, and open the gates as to what you could get away with.

    TL;DR the people handwaving these findings are wrong, but you shouldn't take these studies as absolute in a human context

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  • [–] 3 points 1 month ago*

    Sure!

    Disclaimer: This LitRPG comedy about a shapeshifter is a work of fiction. 😇👍

    Possibly interesting: The following placebo-controlled clinical trials were for drugs that inhibited the microglial pathways (via p38 MAPK inhibitors and minocycline). They all failed:

    There's a problem with all of them: They failed to disaggregate results based on sex, which is exactly the problem I was talking about when I said "(we) need to account for (sex in medical studies)" earlier. This leads me to believe that these pain medications could have been useful for men, but probably not for women if the mouse studies indicating different pain pathways for each sex apply to humans.

    There's a whole article about this: https://doi.org/10.3389/fneur.2025.1730291

    Historically, research has assumed a largely “sex-neutral” model of pain. Yet mounting evidence demonstrates that men and women differ substantially in pain perception, processing, and response to treatment (7–9). These differences span the entire biopsychosocial spectrum, including neural circuitry, immune function, hormonal regulation, genetics, and social context (10). Understanding these distinctions is critical, as failure to account for sex as a biological variable risks overlooking mechanisms unique to half of the population and may lead to suboptimal or even harmful therapeutic approaches.

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  • [–] 1 point 1 month ago (2 children)
  • [–] 3 points 1 month ago (1 child)

    It'll be a while. I'm going to use it as the poster child for a new web novel publishing site I'm building.

    I've already got much of the code written for the site, but I had to stop because I was thinking, "I should really write a story using all these features first so I know what works and what doesn't."

    ...and that's the phase I'm currently at.

    I have a draft written for the first two acts, so it won't be forever but probably at least six months out.

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