In Story 4 of my personal experiences with ideological drama in academic peer review, we learned how incompetent and biased editors and reviewers slow the review process. This then delays findings, which go against their beliefs, from being published. We also learned of the increased tendency for such delays to occur when the research in question deals with sex or gender. In the case of Story 4, the total review time for our simple survey study was 1.5 years – an unacceptable length of time for peer review. Yet, this is not the longest amount of time that one of my papers on a sex or gender issue has been under review. That honour goes to the International Journal of Human Rights.

On June 29, 2021, I submitted, to the International Journal of Human Rights, a paper that reviewed use of the phrases “male circumcision” and “female genital mutilation” in biomedical research articles. I also summarized the existing data on why parents choose to have these procedures performed on their children. I argued that because (a) parents choose these two procedures for mostly cultural or social reasons rather than medical reasons, (b) both procedures involve significant alteration of a child’s genitalia, and (c) “circumcision” is a benign medical term, whereas “mutilation” is a term loaded with value judgment, that the frequent use of the phrase “male circumcision” rather than “male genital mutilation” reflects a gender bias against males.

My paper sat under review for several months without an update. On August 6 and then again on October 22 of 2021, I emailed the editorial office asking for an update on the paper. I was provided copy and pasted responses about how the peer review process can sometimes take a while.

By the end of March 2022, I still had not heard back about my paper. So, again I emailed the editorial office. I was then informed that the journal was trying to identify reviewers for my paper, as some reviewers had declined to appraise the manuscript. The editorial office asked me if I knew of any persons who might be willing to the review paper. On April 1, I sent the assistant the names of six individuals who I thought might be willing to reviewer the paper.

On May 15, I still had not received the reviews, so I again emailed the editorial office. In emailing, I provided the names of eight other individuals who I thought might be interested to appraise my work.

On May 26, an associate editor reached out to me, confirming that the researchers I had listed originally had all turned down the opportunity to review the paper. The associate editor then said he would have a look at my most recent list of suggested reviewers, which I had sent to the office two weeks earlier.

Then, in one of the strangest coincidences in my scientific career, on June 29, 2022 – exactly one year from the day I originally submitted my paper – I received the first round of reviewer comments.

Two reviewers had appraised the manuscript. Both reviewers supported publication of the paper. They requested only relatively minor revisions. So, I addressed their minor concerns, and on September 1, 2022, I submitted a revised version of the paper to the journal.

You might think that because I had to wait one year to receive the reviewers’ comments, and because their concerns were relatively minor, that the remainder of the peer review process would be expedited. That is, within a matter of days, the editor would look at the minor edits that I made to my paper and simply accept the paper for publication there on the spot. Unfortunately, this was not the case. The editor sent the paper back out for a second round of reviews.

Six months later, on February 9, 2023, I received the second round of comments from the reviewers. Remarkably, the editor appeared to have sent the paper out to two different reviewers. I cannot be certain of this because the reviews were anonymous, but the type of feedback provided makes me think that this was the first time that the reviewers had seen the paper. For an editor in this situation to send a paper back out to review to two new reviewers is ridiculous; it is something typically not done for a paper that requires only minor revisions and for a paper in which identifying the initial reviewers was a struggle. Finding two new reviewers would help to explain why it took six months to hear back. Nevertheless, I now needed to address the minor concerns of one of the new reviewers.

On February 24, 2023, I submitted a revised of the paper to the journal. At this point, you might think for certain that they would expedite the acceptance of the paper. I had undergone two rounds of reviews with four different reviewers, all of whom agreed that the paper should be published. Up to this point, the process had taken one year and seven months. Yet, it still took the editor another month to officially accept the paper. Thus, the paper’s official acceptance date was March 23, 2023, and for anyone who might be interested to confirm this history, they can look on the title page of the published paper. Next to the abstract, they will see a note labelled “article history.” In that note, the “received” date is listed as June 20, 2021, and the “accepted” date is listed as March 28, 2023. However, though the paper was accepted on March 28, it did not appear online until April 20, 2023, which is two months shy of being two years from when I originally submitted the paper.

Over this approximate two-year period, I probably sent the journal’s editor and editorial office 20-30 emails asking for clarifications and status updates about my paper. The handling of the paper was unfair to me, and it reflected incompetence at the editorial level. It was an excruciating experience. To add to the frustrations was the fact that during the long review process, I could see the editor regularly commenting about science and politics on Twitter. This was occurring at the same time that I could see, via the publisher’s submission portal, that my paper was sitting in the editor’s inbox. Thus, he had the time to get to my paper but chose not to.

I suspect, but cannot prove, that the topic of the paper was a key reason why the editor handled the paper so poorly, why he and his associates sent it out to two different sets of reviewers, and why it took the paper so long to get the final editorial nod of approval. Throughout the review process, I wanted to call the editor out for his incompetence and inconsiderate behaviour. But I held my tongue. I knew that I had four positive reviews on my side. I also knew that given the “controversial” nature of the paper, I might struggle to find another journal that was willing to review it.

Ultimately, my patience paid off. The paper was eventually published under the title, “‘Male circumcision’ and ‘female genital mutilation’: why parents choose the procedures and the case for gender bias in medical nomenclature.” According to the journal’s website, the paper was their most read paper in 2023, with over 8,000 views, nearly three times as many views as the second most viewed paper. The editor has yet to tweet it out.

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This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit jameslnuzzo.substack.com

In Story 3 of my personal experiences with ideological drama in academic peer review, we learned how editorial safetyism, caused by a worry to publish something that might be deemed “controversial,” delays important and corrective information from being published. We also learned that this occurs when the topic being discussed has to deal with sex or gender. Story 4 is another example of the issues that exist within peer review when one attempts to say that sex differences exist, and one is unlucky enough to have a social constructionist or determinist review their paper

On April 16, 2022, we submitted a paper titled, “Sex differences in interest and willingness to participate in exercise and sports science research,” to the high-ranking exercise journal, Scandinavian Journal of Medicine and Science in Sports. Our paper summarized the results of our survey in which we asked men and women about their interest and willingness to participate in exercise and sports science research and the factors that impact this interest and willingness to participate.

After 6.5 months, on November 1, 2022, we received comments from two peer reviewers on our paper. Reviewer #1 was supportive of our paper and recommended only minor revisions. Reviewer #2 was a much different case.

Among many other critiques of paper, one of Reviewer #2’s primary concerns was our use of the word “sex” rather “gender” throughout the paper. The reviewer’s opinion was that by using the word “sex” rather than “gender,” we were not accounting for any social factors that might account for the psychological differences that we observed between the male and female survey takers. However, by using the word “sex,” we were not necessarily discounting any social influences. Instead, we had asked participants about their birth sex, and also, for most people, there is no difference between their birth sex and their gender.

Nevertheless, as there were only two reviewers, we needed to address Reviewer #2’s comments carefully. Reviewer #2 seemed to be in favour of rejecting our paper. At minimum, Reviewer #2 was using their position of power in this instance to try to bully us into using their preferred nomenclature.

However, for the sake of our work, our self-esteem, and for all other academics who conduct research in this space, we did not feel that giving into the reviewer’s demands, just for the sake getting the paper through peer review, was the right thing to do. Just as in war, appeasement does not work in the long run. Give them an inch, and they will take a mile, particularly as it pertains to language and nomenclature.

We needed to find a way to address Reviewer #2’s concern without causing them to feel unheard or causing them to overreact and reject our paper. Also, at this point, our paper had been under review for 6.5 months. We wanted to get our paper through peer review as quickly as possible, and we did not want to have to submit the paper to another journal.

One day, a solution to our problem with Reviewer #2 occurred to me: I asked myself, “Do we even need to use the words ‘sex’ or ‘gender’ in our paper? Would it be possible to remove mention of these words and not lose any scientific legitimacy?”

Sure enough, this was possible, and that is exactly what we did. We carefully reworded and restructured sentences such that instead of calling results “sex differences,” we simply referred to them as “differences between men and women.” For example, the original title of our paper was, “Sex differences in interest and willingness to participate in exercise and sports science research.” We simply changed the title to, “Men and women differ in their interest and willingness to participate in exercise and sports science research.”

I actually prefer the latter title. I think it stronger and clearer. And by not referring to “sex” or “gender,” no reader will be confused about what we believe to be the causes of the differences we observed. Identifying the causes of such differences in interest and willingness to participate in exercise research was not the point of the study. The point was simply to examine whether such differences exist.

So, two weeks after receiving the reviewers’ comments, on November 15, we submitted the revised version of our paper. Given that Reviewer #1’s feedback was minimal, and given that we found a trick to not let Reviewer #2 serve as the gender word police, we thought, given that the paper had already been under review for 6.5 months, that our resubmission would be quickly processed. This was not the case.

We did not receive the second round of reviews on our paper until April 3, 2023, nearly five months after our resubmission and nearly one year after our original submission. Moreover, during the five-month period, we repeatedly emailed the editorial office asking for status updates about our paper. In return, we received unhelpful responses from an editorial assistant who had no administrative power. We also attempted to contact the associate editor directly via his university email, but we did not receive a response. Then, we attempted to contact the chief editor of the journal. Again, no response. We even offered the editorial office a solution to the associate editor’s incompetence and unprofessional behaviour; we suggested that they simply hand our paper off to a different associate editor. That potential solution never came to fruition. 

In this second round of reviewer comments that we finally received in April, Reviewer #2 was still not happy. The reviewer made comments about the “underrepresentation” of females as participants in exercise research, and how we were not doing enough to discuss this in our paper. The reviewer also suggested that because we were not discussing such things that our results did not have much to offer. This was a ridiculous statement considering that we have been the only researchers to actually ask women (and men) about their interest in participating in such research and the factors that influence their participation, which, can be used in efforts to try to increase both male and female participation. In effect, Reviewer #2 was disappointed that we were not serving as feminist activists or as wimps who bow to the gender langue police. Moreover, the editor was on Reviewer #2’s side, which made the process even more annoying. Thus, on April 11, we once again submitted a revised version of our paper, this time including responses to both concerns of Reviewer #2 and the editor.

Then, finally, a month later, on May 15, 2023 our paper was finally accepted for publication. It appeared online later that month.

In total, the paper took 1.5 years to get through peer review. The abnormally long review time was due a combination of an incompetent editor and a social constructionist peer reviewer. For a simple survey study to take this long to get through peer review is unacceptable.

Nevertheless, the good news is that we were able to get the results published in a major journal. Moreover, in December of 2023, we published a follow-up piece in another journal. Also, we have written about our results at Reality’s Last Stand on Substack.

The review process associated with this paper was long and excruciating. Yet, remarkably, it was not the longest review that I have gone through. The longest review I have experienced is the topic of Story 5.

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This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit jameslnuzzo.substack.com

In Story 2 of my personal experiences with ideological drama in academic peer review, we learned of a peer reviewer at the journal Sports Medicine who rejected one of my papers because I presented data to support my position that volunteer self-selection bias might be a contributing factor to fewer female than male participants in certain exercise research trials. The reviewer stated “Data be damned, I know women are understudied and you will not convince me otherwise. Perceptions trump data.”

What we learned from Story 2 was that some peer reviewers are cognitively unfit for the job, and they are particularly sensitive to papers that challenge ongoing narratives about women’s issues.

With this background of unhinged feminist reviewers in mind, you might perhaps understand the hesitancy of the editor at Sports Medicine to consider a second Nuzzo submission that challenges another feminist talking point: “gender-based violence.”

This is the topic of Story 3.

In September of 2022, I led an effort , along with Deborah Powney of the University of Central Lancashire and Dr. John Barry of the Centre for Male Psychology, to challenge a commentary published in Sports Medicine that presented a one-sided story about “gender-based violence.” The authors of the commentary claimed that the entire field of exercise science has “blind spot” for this violence, by which they meant only violence against girls and women. They also stated that students of exercise science should be educated about this topic in their coursework.

We submitted a letter to the journal’s editor, summarizing evidence showing roughly equal rates of male and female victimization in terms of being victims of both intimate partner violence and violence within sports environments. We also called out the authors for not providing any evidence that exercise scientists actually have a “limited awareness” of violence data. Because of their lack of discussion on male victimization, we concluded that the actual “blind spot” resided with the authors themselves, not the entire field of exercise science.

After receiving our letter, the editor sent it out for peer review. The editor’s decision to send our letter out for review was unusual because letters to the editor are specifically addressed to the editor, and historical precedence is that letters are not sent out for peer review.

One reason letters are not typically sent out for review is that doing so contradicts one of the purposes of a letter, which is to stop or slow the propagation of inaccurate data or a misguided ideas presented in a paper. Letters often challenge results and conclusions presented in papers. Thus, to the extent that a letter expresses important concerns about a paper, the letter should be published as quickly as possible so that clinicians, researchers, policymakers, and the general public are made aware of such potential issues. Placing a letter under full review, rather than simple editorial review, hinders the full effectiveness of a letter. Moreover, letters are often short opinion pieces. Therefore, because of this purpose of letters, plus the fact that they are are typically held to a lower publication standard than full-length articles, the rate of acceptanceof letters is much higher than full-length articles.

Yet, the editor sent our letter out to three peer reviewers. When I asked the editor why he did this, his response was that the journal was now following a policy in which letters that might be deemed “controversial” would be sent out for review.

Encouragingly, about two months later, on December 6th, we were sent the comments from the three reviewers, and their feedback was largely supportive. They believed our letter should be published, and their feedback helped to improve the letter.

We submitted the revised version of our letter about one week later, on December 15th. Surprisingly, the editor sent our letter back out for review. He sent it to the same three initial reviewers. For full-length articles to be sent out for a second round of reviews or final approval is not uncommon. However, for a letter to go through a second round of reviews is unheard of. Again, this slows down a piece that should be published as quickly as possible.

We then had to wait for the three reviewers to give their final nods of approval. These nods came on January 23, 2023. But the story does not end there.

With letters, the authors of the original paper get a chance to reply to the letter that critiques their work. This is a fair and healthy academic practice. However, some journals, like Sports Medicine, abide by policies in which they publish the letter and the authors’ reply to the letter simultaneously. From a pure publishing and reader engagement standpoint, this makes sense. However, this causes further delays in getting the letter out to the public, because the opposing authors need to be given time to draft their own letter.

According to the editor, the authors’ reply was due by February 6th. As of March 11th, I had not been updated by the editor, so I asked him for a status update. He informed me that the authors’ reply was out with peer reviewers and that I could expect an update in 2-3 weeks.

“What?!” I asked myself, figuratively banging my head against the desk. “Why would the editor send the authors’ reply out for peer review? The authors are simply responding to the critiques that we presented in our letter. Of what business is it of peer reviewers to weigh in on the authors’ responses to our critiques?”

More than three weeks then went by without a word from the editor. So, on April 7th, I emailed the editor expressing my concerns with the delays. Also, as I have published full-length articles on the purpose of letters, I also shared with the editor some of my opinions on how, philosophically, I thought the way that this letter exchange was being handled was inappropriate. Namely, I pointed out, in a civilized manner, the absurdity in having the authors’ reply sent out for peer review. The editor responded professionally, saying that the delays were due to the time needed for the authors and reviewers to complete their respective tasks.

So, again, I waited.

A month went by, and I had not heard from editor. On May 12th, I emailed him once again, asking for a status update. The editor responded within a few hours, with some surprising news. The editor stated that as of a couple of days ago, he had learned that the authors elected to withdraw their reply from consideration for publication. The reason for the withdraw was not revealed to me.

Our letter was finally published online on June 13, 2023. The unfortunate thing about this process was that our letter, which was first submitted on September 29, 2022, was deemed suitable for publication back in January of 2023, which means that our letter could have been online about six months earlier than its final publication date, if not for the unnecessary safetyism associated with our critique of the authors’ narrative on “gender-based violence.”

It is hard to know what, if any, damage this unnecessary safetyism has had on the exercise science field. For example, during the six month period in which our accepted letter was hanging about unpublished, dozens or hundreds of exercise science lecturers could have read the commentary, shared it with colleagues, and then started to create educational content based on the information in the article. To the extent this occurred, this is the cost of excessive safetyism.

Nevertheless, our letter did eventually get published. And that represents a small win for reason. For a discussion about the letter and the experience with the journal, please see my recent interview with Bettina Arndt on Substack. A personalized reading of our letter has also been published here  at The Nuzzo Letter.

Support The Nuzzo Letter

If you appreciated this content, please consider supporting The Nuzzo Letter with a one-time or recurring donation. Your support is greatly appreciated. It helps me to continue to work on independent research projects and fight for more evidence-based discourse. To donate, click the DonorBox logo. In two simple steps, you can donate using ApplePay, PayPal, or another service. Thank you.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit jameslnuzzo.substack.com

In Story 1 of my personal experiences with ideological drama in academic peer review, we learned of an editorial assistant who resigned from her post because the journal she worked for decided to accept for publication my forthcoming paper on Woke medicine. This was certainly an unusual and dramatic tale, but the story I am about to share, Story 2, is my most concerning experience with peer review

In 2020, I submitted an opinion article to the high-ranking exercise journal, Sports Medicine. In the paper, I commented on the hot-button issue of female participant “underrepresentation.” In my paper, I challenged the narrative within exercise and sports science that discrimination against women is the cause of fewer female than male participants in exercise experiments.

The journal’s editor, a man who I have had many positive interactions with over the years, sent my paper to five anonymous reviewers for critique. This is about two more reviewers than is normal for exercise journals. The totality of their critiques led the editor to reject my paper from being considered for publication at the journal.

A journal rejection is not the nicest news to receive, but one does get used to them after being in research for several years. However, this rejection was particularly hard to swallow given the inability of the reviewers to understand the central arguments that I was making. But most concerningly was the feedback from Reviewer #5. In arguing for why they thought my paper should not be published, Reviewer #5 stated the following:

“Data be damned, I know women are understudied and you will not convince me otherwise. Perceptions trump data.”

This comment is, by far, the most insane comment I have received in 16 years of having my worked critiqued by peer reviewers. It is insane because the whole purpose of science, and then peer review, is to evaluate the validity of an idea based on the evidence provided. The data are the evidence. The data are intended to be the best that two people can do in putting their personal biases aside and allowing reality to do the talking. If reviewers believe that “perceptions trump data,” then there is no longer a purpose in conducting or summarizing the results from scientific experiments. Moreover, there is no reason to write up results from such experiments into a paper and have others appraise them if the results are simply to be “damned” by a reviewer who cannot put their subjective whims and emotions aside.

Given Reviewer #5’s fundamentally incoherent appraisal of my work, I appealed the review. I asked the editor to reconsider my paper based on the fact that Reviewer #5 has no business serving as a peer reviewer for a scientific journal, considering that the reviewer does not believe in the purpose and procedure of scientific investigation. In other words, my argument to the editor was that Reviewer #5 was not cognitively fit to serve as a reviewer for any paper submitted to the journal.

This was the first and only time I have ever attempted to appeal a review of one of my rejected papers. The editor considered my appeal. He requested the opinion of other editors on the matter. But in the end, my paper was still rejected.

This story shows how science can be impacted by the biases and subjective whims of ideological peer reviewers, who are activists more than they are scientists. Had an author submitted a paper claiming the opposite of my thesis, but without any supporting data, Reviewer #5 likely would have accepted it for publication. Based on the poor quality of papers published on this topic of female “underrepresentation” in exercise research trials, Reviewer #5 is likely not alone in thinking that perceptions should trump data in the review process.

Nevertheless, this story does end on a positive note. A few months after my paper was rejected by Sports Medicine, I submitted the paper to the journal Quest, albeit with a less provocative title and some more finely tuned arguments. Luckily, a different set of peer reviewers reviewed this version of the paper, and they were more appreciative of the evidence-based argument that I was making. The paper was eventually published in February  of 2021 under the title, Volunteer Bias and Female Participation in Exercise and Sports Science Research.

Support The Nuzzo Letter

If you appreciated this content, please consider supporting The Nuzzo Letter with a one-time or recurring donation. Your support is greatly appreciated. It helps me to continue to work on independent research projects and fight for more evidence-based discourse. To donate, click the DonorBox logo. In two simple steps, you can donate using ApplePay, PayPal, or another service. Thank you.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit jameslnuzzo.substack.com

Academic peer review is the process by which professors critique their colleagues’ research to determine whether the research is of sufficient quality to be published in a journal and thus made available for public consumption.

Contemporary peer review is littered with many issues. It is often slow. Some submissions might take several months to a year or more to proceed through the review process. And this is just for a single submission of a paper. Some papers will need to be submitted to multiple journals before they are finally published. By the time a study’s results appear online or in-print, the study itself is often a distant memory for the researcher.

One reason why review times are slow is because journals are inundated with submissions, and there are too few volunteer reviewers and editors to handle them. This then causes delays in getting scientific results out to the public – something that is highly problematic given that most universities and research projects are funded by taxpayers.

Peer review is also highly flawed in the sense that many papers that make it through peer review, and are published, are not necessarily credible. The reviewers may have done a poor job at appraising the study’s methods and results. Evidence of this issue in peer review comes from cheeky experiments, where researchers purposely set out to test the replicability of peer review, and find that if an already published paper is anonymised and sent back out for peer review, the paper is often rejected the second time around. This is perhaps unsurprising given that even with a single submission that involves 2-4 peer reviewers, the reviewers will often disagree about whether the paper should be accepted for publication.

Moreover, the existence of letters to the editor, which are a form of post-publication review, is also an admission that peer review is imperfect, otherwise there would be no need for a reader to comment on a paper after it has been published. Yet, thousands of critical letters are published each year. Also, each year, hundreds of already published papers are retracted because of issues with data credibility and analysis, which are realised only after publication.

A final set of factors that impacts the purity of peer review is the whims, biases, and incompetencies of the professors who review and edit papers. As an author of over 70 papers, I have been on the receiving end of many of these whims, biases, and incompetencies. Here, my aim is to provide evidence of this by sharing six stories of my personal experiences with peer review. My goal in sharing these stories is to enhance understanding of some of the problems that exist within the peer review system and to provide examples of the difficulties that researchers experience when writing papers on “controversial” topics.

Story 1: Woke resignation

The first story is the most recent and perhaps most unique and dramatic. The relevant paper has been accepted for publication and will be available online later in 2024. In the paper, I use quantitative techniques to document the rise of, what I call, Woke medicine. (“Woke” refers to a heightened awareness of supposed social injustices, which are believed to be caused by power dynamics in society.)

After receiving editor desk rejections from a couple of journals, I contacted the editor of a journal where I had previously published a “controversial” paper. I asked the editor if he would consider publishing my new paper. He indicated that he might be willing to publish the paper after it had undergone peer review. So, I submitted the paper to the editor, and after a short time, I received feedback from reviewers. I made some minor changes based on their feedback and then resubmitted the paper to the editor.

After not hearing from the editor for several days, I decided to email him to confirm that he received the revised version of my paper and that my paper was still being considered for publication by the journal. Within 20 minutes, the editor responded. He stated that he had received the revised version of the paper and that his decision was to accept the paper for publication.

I would have been happy to close my email for the evening after reading that piece of good news, but I could see that the editor’s email continued for a few more sentences. So, I kept reading.

In those sentences, the editor informed me that one of the female staff in the journal’s editorial office decided to resign because of my paper.

“What?!” I thought to myself.

I then emailed the editor back, asking for clarification. The editor revealed to me that the assistant was, herself, Woke, and that she had said that she could no longer work for the journal in good conscience if my paper was going to be being published there.

The editor did not tell me who the assistant was, but I figured it out based on the limited information available in our email exchange and based on the staff biographies on the journal’s website. The woman’s biography was filled with Woke words and concepts – most of which were included in my analysis. The editor informed me that this was not the only disagreement that he had with this staff member based on her Woke views. Although, due to cowardice, there are many losses suffered in the battle for reason within academia, here, the editor deserves credit for having a spine and not letting a Woke activist influence his editorial decision.

So, that is Story 1 of Nuzzo’s adventures in academic peer review. Stay tuned in the coming days for Story 2. And watch out for my paper on Woke medicine later this year…that is, assuming some other drama does not arise in the meantime and prevent it from being published.

Support The Nuzzo Letter

If you appreciated this content, please consider supporting The Nuzzo Letter with a one-time or recurring donation. Your support is greatly appreciated. It helps me to continue to work on independent research projects and fight for more evidence-based discourse. To donate, click the DonorBox logo. In two simple steps, you can donate using ApplePay, PayPal, or another service. Thank you.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit jameslnuzzo.substack.com

History is important. It helps to place contemporary issues in their proper context. It can help us to appreciate the things that we currently have, when those things are better than they were in the past. History can also provide the motivation or yearning for something better, when things in the moment are not as good as they could be. Either way, history informs.

Recently, while searching for information on the history of medicine, I came across a paper, published in 1959, about typhoid vaccination in the United States (U.S.). The article, which was titled “The initial effort to immunize American soldier volunteers with typhoid vaccine,” was written by Colonel W.D. Tigertt and published in the journal Military Medicine. From Tigertt’s historical review, we learn that the first typhoid vaccine in the U.S. was administered in 1904 to a select group of men who were soldiers in the U.S. Army. According to Tigertt, 50 soldiers volunteered for the study. From those 50, 13 were selected by the First Sergeant to receive the vaccine. The ranks and names of the 13 soldiers were:

Tigertt described the case reports for each soldier. From the reports, we learn that the men experienced various undesirable symptoms after receiving the vaccine. Examples included headache, malaise, diarrhea, and increased body temperature. None of the men died from the vaccine.

Reading Tigertt’s article made me think more broadly about individuals who have served as participants in early medical research. More specifically, it made me think about the claim of the exclusion of women as participants in early research.

Holding that thought in mind, I then continued my search. Eventually, I discovered a short, but fascinating piece published in the famous medical journal, JAMA, in 1928. It was an editorial titled, “Martyrs of Medicine.”

In the editorial, the author, describes the history of death from medical experimentation in the early 1900s. The author listed the names of male doctors and researchers who died as a result of acquiring the disease they were studying or who died as a result of the medical technology they were developing. These men and the causes of their deaths included:

Importantly, this list only includes the male doctors and researchers who died from medical experimentation. It does not include the names of men who, like the U.S. soldiers who received the typhoid vaccine, experienced significant undesirable symptoms from medical experiments but eventually recovered. The author of the editorial went on to list such names. They were physicians who had submitted themselves to experimentations associated with inoculation for dengue fever, influenza, measles, and scarlet fever, and their names were: “John Hunter, Hammond, Carroll, Halstead, and Henry Head.”

Men led the way as subjects in early, risky medical experiments. Recognition of this fact is important. It provides additional context for discussions on the topic of “female underrepresentation” in research studies – a topic that I have discussed previously. Putting aside the result that women often are not “underrepresented” as participants in research trials, the notion of the historical “widespread exclusion of women from clinical trials” has been conceptualized as a net negative for women, and a net positive for men. This is because sex discrimination and lack of interest in women’s health issues are assumed to be the causes of fewer female than male participants in research. However, this view does not consider that being a subject in early research might have been something that was not desired. Some research would have been risky. Men have a greater overall proclivity for risk taking than women. Moreover, when different types of risk taking are considered, participation in experiments that might cause physical or psychological harm is a type of risk that shows the largest effect size difference between men and women, with men more likely to participate in such risky experiments. Similarly, my recent survey research revealed that men, on average, are less likely than women to consider factors such as the invasiveness, discomfort, pain, and possible side effects of study procedures when deciding to participate in research. These findings suggest that male ambition and risk taking are factors that require consideration in debates about the historical representations of research participants. Finally, one might also consider that men might have, to some extent, protected women from participating in such research by submitting themselves and their male colleagues to risky procedures first.

One should also not assume that men submitting themselves and their male colleagues to risky experimentation ended in the early 1900s or is restricted to research on infectious diseases. At an academic conference, I was once told a story of well-known male exercise physiologist who used to take muscle biopsies of himself. I was also once told a story of a famous male biomechanist who used to insert sensors into his tendons to better understand their viscoelastic properties. Then, there is Professor Simon Gandevia – one of the supervisors of my PhD thesis. In 1992, Gandevia and two other male researchers in Sydney, Australia gained national media attention when they paralysed themselves as part of an experiment that explored the physiology of breathlessness. The video of this experiment is provided below.

Interestingly, the lack of appreciation for what these men have done for science and society does not appear to be restricted contemporary, feminist-minded researchers. According to the author of the 1928 editorial in JAMA, the value of such men and the importance of their work was generally not well appreciated around the time of their deaths:

“The rolls of medicine contain the names of many practicing physicians and investigators who have died as a result of voluntarily submitting themselves to disease in their search for methods to relieve suffering and to prevent death. The martyrs of medicine whose names remain buried in human neglect might be numbered in the thousands; yet the search for the unknown causes of disease goes on unremittently. Physicians and scientists in chemistry, physics, bacteriology, and toxicology expose themselves again and again to death or to lingering disease, knowing the peril but devoted to the ideals of their professions and to the pursuit of knowledge.”

The author continues:

“The prizes that the world awards for such self sacrifice and martyrdom are not great. The public has not yet learned to appreciate the type of courage that such men display. The investigative spirt that drives them is little understood by the average man.”

History is not perfect. But overcorrecting for any historical flaws with new misguided ideas neither helps to correct the past nor makes for a better future. In fact, many ideas circulating within academia today will themselves be the criticisms of history by future generations. How will people in the future look upon contemporary discussions about men, masculinity, and sex and gender? If the future is bright, it will look upon us and laugh. It will be amazed at the extent to which viruses impacted the health of the human condition. These viruses, however, are not the same types that took the lives of doctors like Allen MacFadyen and Adrian Stokes in the early 1900s. Instead, they are viruses of the mind, and they are extremely potent at breaking down objective and logical thought. Nonetheless, for a future generation to come to this realization, it means that a sequence of preceding steps must have occurred to lead them to their insights about our history. That means that what we do and say from this moment forward is important. It could be the trigger for a correction in future thought. It could be the medicine that kills the virus. And a first dose might include acknowledgment of the martyrs of medicine.

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Let’s pretend for a moment that I am your personal trainer or strength coach.

I advise you that for your Monday workouts, I want you to perform the following exercises: the arm curl, the overhead press, the hamstring curl, and the heel raise.

I then advise you that for your Thursday workouts, I want you to perform the biceps curl, the shoulder press, the knee flexion, and the calf raise.

Thus, for your Monday and Thursday workouts, I have given you eight different exercises to perform. Haven’t I?

The four exercises that I prescribed to you for your Monday workouts are identical to the ones that I prescribed to for your Thursday workouts. The arm curl is the same as the biceps curl, the overhead press is the same as the shoulder press, the hamstring curl is the same as the knee flexion, and the heel raise is the same as the calf raise.

Though it is unlikely for a given personal trainer to be that inconsistent with their own use of exercise names, research within the past 10 years has shown there is indeed a lack of consistency and cohesiveness in exercise nomenclature.

To date, three studies have documented inconsistencies in the way that exercises are named and communicated. The first study, published in 2013 found that exercises are named inconsistently within and between exercise and health professionals, including athletic trainers, personal trainers, strength and conditioning coaches, clinicians, and exercise academics. An example of a within-profession inconsistency was observed when the group of clinicians were shown a photograph of a given exercise and 39% of them called it the “bench press,” while 36% of them called it the “chest press.” Interestingly, when exercise academics were shown the same photograph, 78% of them called the exercise the “bench press” and none called it the “chest press.” This result illustrates between-profession inconsistency with how clinicians and exercise academics name exercises.

In 2017, I published a study, in which I detailed the different types of words that are used in exercise names and how they are arranged, albeit inconsistently, into naming patterns. Importantly, the exercise names that I analysed came from a strength and conditioning textbook that is commonly assigned to university students.

I found that the most common type of words in exercise names were actions words. Examples included words like “press,” “push,” “pull,” “row,” “raise,” and “curl.” Body part words, such as “shoulder,” “biceps,” and “leg,” were also common in exercise names, as were equipment words such as “bench” and “barbell.”

In 2020, I published a follow-up study in which I documented inconsistent use of exercise names across scientific articles written by different researchers. For example, authors of 68 articles used the name “calf raise,” whereas authors of 154 articles used the name “heel raise,” when referring to the same exercise.

Thus, the existing research on exercise names shows that exercises are named inconsistently within textbooks, across scientific articles, and between different healthcare professionals. And the reason that these inconsistencies are important to acknowledge and address is that such inconsistencies might reduce communication efficiency about exercise and cause confusion about exercise concepts that are discussed in educational, clinical, and public health settings.

I wish I were able to tell you that since publication of these research studies, that the issue of inconsistent exercise names has been resolved. Unfortunately, this is not the case. In fact, the inconsistencies could get worse do recent technological developments in exercise equipment that allow for a different type of strength training or resistance exercise to be performed.

At the end of 2023, we published a paper in the journal Sports Medicine, titled, “Eccentric Muscle Actions Add Complexity to an Already Inconsistent Resistance Exercise Nomenclature.” In the paper, we argue that the recent explosion of interest in eccentric resistance exercise is likely to create even more confusion about exercise names.

Some of you will be unfamiliar with eccentric strength training, so let me take a minute to explain what it is. I will use the biceps curl exercise as an example.

The biceps curl exercise, like most other exercises, can be broken down into two phases. There is the phase where you lift or curl the weight from your hip to your chest by bending your elbow. This part of the exercise is called the concentricphase. It means that your muscle lifted the weight by producing force via the shortening of muscle fibers.

The other phase of the biceps curl exercise is the eccentric phase, where you lower the weight from your chest back down to your hip. During the eccentric phase, your muscle is still producing force as it works against gravity pulling the weight down.

People typically do not think much about the lowering or eccentric phase of an exercise. One reason for this is because this phase of the exercise is easier to perform. If you are holding a 15-pound dumbbell in your hand and perform as many biceps curl repetitions as you possibly can, the point at which you “fail” during the exercise is when you can no longer lift or curl the weight up – that is, you can no longer complete the concentric phase of the exercise. Yet, if given the opportunity, you could keep lowering the same dumbbell many more times. The reason that you can keep lowering the 15-pound dumbbell more than you can keep lifting the same dumbbell, is that our muscles are about 40% stronger during eccentric muscle actions than concentric muscle actions.

Understanding this feature of human biology and motor control, inventors have created exercise machines, such as flywheel devices and connected adaptive resistance exercise (CARE) machines, in which higher levels of resistance can be provided in the eccentric than concentric phase. These advancements in technology are exciting because eccentric exercise is known to provide a potent stimulus for increasing muscle strength, and this new equipment makes completion of eccentric exercise more feasible in different exercise settings.

Nevertheless, in our recent paper, we present the case that the proliferation of eccentric resistance exercise is likely to add further confusion to an already inconsistent resistance exercise nomenclature. The reason for this is because most exercise names include an action word, and action words almost always describe the action that occurs in the concentric phase of the exercise.

For example, some of the most common action words in exercise names are “push,” “press,” “row,” “pull,” “curl,” and “raise.” All of these words describe the action performed in the concentric phase. Consequently, when using new technologies that can eliminate the concentric phase of the exercise and allow for only eccentric muscle actions under resistance, it is unclear what to call such exercises. For example, what should we call the exercise I described earlier if only the eccentric phase is performed under resistance? Should it be called the eccentric biceps curl, even though the curl movement is never performed?

Unfortunately, the field of exercise science does not have a solution to such issues in nomenclature. The purpose of our paper was to simply point out that most exercises are named based on their concentric actions and that we need to consider how the proliferation of eccentric exercise might further complicate how exercises are named and communicated. I have previously suggested that the creation of a taxonomy of exercise names, supplemented with guidelines for naming exercises, could help to resolve issues of inconsistent exercise nomenclature. Resolving such inconsistencies might then facilitate communication and understanding of resistance exercise in educational, clinical, and research settings.

This year, we will be analysing results from a large survey study in which we assessed how people name exercises. From this information, we might be able to work toward making recommendations for how exercises can be named more consistently.

And perhaps you can contribute to this discussion. The next time you are at the gym and take a pair of dumbbells and push them toward the ceiling, ask yourself, “Should this exercise be called the overhead press or the shoulder press? And why?”

I look forward to hearing the results of your personal analysis.

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On January 9th of this year, the Coalition to Create a White House Council on Boys and Men, headed by Dr. Warren Farrell, published an open letter addressed to the President and First Lady of the United States, calling for more attention to boys’ and men’s health issues. The letter is available online and also displayed below. As a member of the Coalition, and one of the architects and co-authors of the letter, I thought I would read it aloud here.

Related Content at The Nuzzo Letter

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A news report on January 13th revealed that the Australia Football League, or AFL, is implementing a new policy where player body weights will no longer be listed in the official season guide.

This may come as a surprise to many of you who closely follow sports and know that body weight is a descriptive metric of players that has been reported for many years in various sports. So, why the change?

According to the report, the AFL has deemed that body weight is private information and inappropriate for publication. No other details on the decision were provided in the report. One commentator referred to the decision as “soft,” but this explanation begs the question – where is the softness coming from?

I want to explore the topic in more depth because I believe the decision of de-listing player body weights could be linked to the increased involvement of women in the AFL. And if this link is true, I believe it should be acknowledged and understood.

The AFL consists of both a men’s league and a women’s league. If we look at examples of male and female player profiles from the AFL’s website, as shown below, we can see that there is one metric missing from the female player profiles that is present in the male player profiles. That metric is body weight. Keep in mind that the policy of delisting body weight is currently aimed at the printed season guide, not the players’ online profiles, though I suspect the policy will eventually also apply to online profiles.

This lack of reporting of body weights in the online profiles of women’s AFL players likely pre-dates January of this year and is interesting for a couple of reasons.

First, it reinforces a stereotype about women that they do not want their body weights made public because they are more sensitive or self-conscious of their weight than are men. This stereotype is of course a reality, as various studies have shown that women have lower body esteem and satisfaction than men, and women tend to underreport their body weights, whereas men tend to overreport their body weights.

The second reason that the lack of reporting of female player body weights is interesting is because it suggests a sort of special accommodation for female AFL players. What I mean by this is that for many years, with regard to women’s sports participation, we have been told that women can do anything that men can do and that they can experience anything that men can experience. Yet, in this example, it seems that the female athletes do not want the same experience as the male athletes, and they do not want to give to the fans who pay their salaries the same information that the male players have historically given to their fans. This type of occupational manoeuvring parallels that of women who want the same jobs or salaries of men, so long as they do not have to experience the same sort of occupational risk or critique that men experience.

At this point, you might be thinking to yourself, “But Nuzzo, the whole point of getting rid of male body weights is to allow for men to receive the same accommodation or treatment that has been granted to the female players.”

This line of thinking, however, is problematic. It implies that men and women have the same interests and that what is done in the women’s league should serve as the gold standard for the men’s league. It implies that male and female players have similar views toward their body weights and whether they want their body weights to be public knowledge. But do male and female players really have the same views when it comes to public knowledge of their body metrics? I doubt it. I did not see a survey of male AFL players asking them whether they wanted their body weights de-listed. If given the option to answer such a question, I suspect most male AFL players would either say that they do not care if their body weight is public knowledge or that they prefer that it be public knowledge.

For some men, their body weight, or other body metrics, could serve as a source of pride or accomplishment. For example, a male player who adds a couple of kilograms of muscle mass in the off-season due to his dedication to rigorous training might be proud that he achieved an increase in body weight, and he may want his fans and competitors to know about this achievement. Or a player who punches above his weight might take pride in the fact that even though his overall stature is small, he can still mix it up with the big boys. He might want adolescent male footy players who are small in stature to know that small guys can play in the big show too.

I believe the decision to no longer list male body weights was likely caused by a sort of spill over effect from the women’s league combined with an influence from increased numbers of female staff within the AFL, who themselves have likely been influenced by the disproportionate number female professors who write papers on topics such as “weight stigma,” “weight bias,” “fat stigma,” “fat shaming,” and “body shaming.” Put more succinctly, the softness is the result of the feminization of the AFL. And this feminization appears to be associated with a lack of understanding of sex differences in psychology and an underappreciation of and desire to understand the male sporting experience. For many male athletes, having their body weights made public will not be a big deal, particularly as they are some of the most physical fit individuals in the world.

Moreover, to the extent that the women’s league or female staff have influenced the men’s league on this decision, one can then start to see the legitimacy of concerns about women entering into historically male spaces. Most men probably do not care one way or another if there is a women’s AFL league, so long as the women’s league does not negatively impact upon the men’s league. Delisting body weights is unlikely to impact game play, or the number of fans who show up for games, though it will make game announcers’ ability to describe players and their interactions on the field more difficult. Instead, the worry is that this type of decision might be just one of a thousand tiny feminine scratches that gradually chip away at the overall male sporting experience.

And a final question remains – if body weight will be delisted from player profiles, then why would body height also not be delisted? The answer to this question is that body height is not a metric that women – whether in academia, the corporate boardroom, or on the playing field – are so sensitive about. Female players are likely more concerned about their body weight being made public knowledge than their body height, because the shape and weight of a woman’s bodyis a key attribute that men consider when judging whether they find a woman physically attractive. Men, particularly in western countries, are most physically attracted to women who are thin or fit. In contrast, body height is a physical attribute that women place a high value on when selecting a mate. Women like tall men. Consequently, as we live in a world that accommodates to the sensitivities and preferences of women, the body metric often used by men to judge female attractiveness and reproductive value is removed from player profiles, whereas the body metric often used by women to judge the mating value of a man remains.

This is gynocentrism.

Oh, and by the way, if you happen to go to an AFL game this year, and buy a copy of the season guide, make sure to hold onto it for a while. Because, given current societal trends, it could be the last time you see another very sensitive metric listed: player age.

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Our letter:

“Women and men report unequal interest in participating in exercise research”

Their reply:

“Reply to Nuzzo and Deaner: “Investigator bias” is a potent influence on the underrepresentation of women research participants in biomedical research”

Their paper:

“Underrepresentation of women in exercise science and physiology research is associated with authorship gender”

Our survey study:

“Men and women differ in their interest and willingness to participate in exercise and sports science research”

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