Yale Provides Dangerous Misinformation About Alcohol to Undergrads

Yale falsely implies that gender nonconformity affects alcohol metabolization.

Image: Modified by Christina Buttons from iStock

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About the Author

Pamela Paresky is a social psychologist with a clinical background. She serves as a Senior Fellow at the Network Contagion Research Institute, and has taught at Johns Hopkins University, the University of Chicago, and the US Air Force Academy. She writes frequently for Psychology Today, and her work has appeared in a diverse array of other outlets including The Guardian, Sapir, Brookings, The Boston Globe and the New York Times. Her project, Habits of a Free Mind: Psychology for Democracy and The Good Life provides tools for engaging across lines of difference without feeling traumatized and without dehumanizing others.

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Despite clearly understanding how alcohol affects male and female bodies, Yale University is teaching incoming students that declaring a trans identity or failing to conform to gender stereotypes could change the way alcohol affects them. “There’s not yet solid research on alcohol metabolism rates for trans and gender-nonconforming people,” their required incoming student orientation claims in a module ostensibly intended to prevent alcohol overconsumption and abuse.

One might assume that Yale is pointing to the possibility that high levels of exogenous testosterone or estrogen could change the way alcohol is metabolized. But “transgender” is “an umbrella term for people whose gender identity and/or expression is different from cultural expectations based on the sex they were assigned at birth,” according to the Human Rights Campaign (HRC). A recent Washington Post-KFF poll found that less than a third of those who identify as transgender have used hormone treatments or puberty blockers, and only about 1 in 6 have undergone any gender-related surgical treatment.

Even if Yale’s definition of “trans” requires medicalization, however, there is no current definition of “gender-nonconforming people” that involves hormones or other medical treatments.

Undoubtedly, as evidenced by placebo effects, a mind-body connection exists. But there is no reason to believe that a failure to conform to gender stereotypes or adopting a cross-sex identity and pronouns can change a body’s amount, type, or activity of alcohol dehydrogenase (ADH), the enzyme responsible for metabolizing alcohol. Male bodies have “highly active (i.e., fast) forms of ADH in their stomach and their liver,” according to the Alcohol Pharmacology Education Partnership at Duke University. In fact, “ADH in the stomach of males can reduce the absorption of alcohol by 30%.” Female bodies, on the other hand, “have almost no ADH” in the stomach and “ADH in the liver of females is much less active than the ADH in the male liver.”

As a result, regardless of one’s haircut, style of clothing, preferred pronouns, other expressions of gender non-conformity, or sense of gender, “females absorb more alcohol into their bloodstream.” In other words, “for the same number of drinks, it is easier for females to become intoxicated.”

Instead of teaching Freshmen how male and female bodies, irrespective of beliefs about gender, process alcohol differently, however, Yale uses the term “cisgender” (meaning people who believe their “gender identity” is congruent with their sex) in its orientation, teaching incoming students that “cisgender women” process alcohol more slowly than “cisgender men…even when adjusted for weight and size.” Yet regarding the rate at which alcohol metabolizes in the male and female bodies of people who identify as “trans” or “gender-nonconforming,” Yale claims there’s “not yet solid research.”

This is irresponsible and dangerous—particularly for female students. 

To begin with, this confuses students about the distinctions between body and mind, between “intersex” (disorders of sex development) and “transgender,” and between the meaning of sex (male/female) and current conceptions of gender. Furthermore, trans-identified students deserve accurate information about how alcohol affects their bodies. If Yale is concerned about whether cross-sex hormones or other medications affect the metabolization of alcohol, it should instruct students to obtain accurate information from their doctors about how alcohol interacts with their medications. But this would be wise regardless of whether those medications are gender related.

Perhaps Yale is implicitly acknowledging the high rate of mental illness among those who identify as trans. Mental illness puts people at greater risk of alcohol abuse. It also increases the likelihood of taking psychopharmacological medications, many of which could negatively interact with alcohol. However, those interactions are well-researched and widely known, and those who identify as trans are not the only students who would be affected.

On the other hand, given the dearth of research on medical transition, much is unknown about how cross-sex hormones affect the body. Perhaps males who take exogenous estrogen metabolize alcohol less well than those who don’t and females who take high levels of testosterone improve their alcohol tolerance. But the “dangerous interactions when alcohol and other drugs are mixed together” are mentioned immediately before the module on “gender.” And an earlier part of the orientation warns, “there’s no way to speed up the metabolization of alcohol.”

So when claiming “there’s not yet solid research on alcohol metabolism rates for trans and gender-nonconforming people,” Yale is not talking about the effects of medications. And the only students Yale puts at risk are female trans-identified and gender non-conforming students who come to believe that their non-female identity might mean that they process alcohol more like males do. (If male students were to behave as though their gender identification means they metabolize alcohol more like females, it would put them at a lower risk.)

For their health and safety, unmedicated incoming female students who fail to conform to gender stereotypes or who identify as trans or non-binary should not be given the impression that their female bodies might metabolize alcohol differently from other female bodies. All female students should understand why their bodies react differently to alcohol than male bodies do. If Yale thinks it’s important to teach accurate and cautionary information about alcohol metabolism to female students who don’t identify as trans and who are not “gender-nonconforming,” why is it not equally important for females who do identify that way to learn the same accurate and cautionary information?

Going drink-for-drink with male students can be dangerous for every female body irrespective of gender-identification. It might even be something that females who identify as trans-men are more likely to attempt. They deserve to know that they will become intoxicated more quickly than their male counterparts, regardless of how they conceive of their gender.

Misinformation about how alcohol affects the body is just one example of the problem with conflating biology and ideology. At one hospital, a trans-identified female whose paperwork only referred to the patient as a “man” was misdiagnosed as obese rather than pregnant, resulting in a stillborn baby. “While it’s true that exogenous sex hormones result in profound (and largely unstudied) physiological changes,” says Corinna Cohn, who underwent “sex-reassignment surgery” in 1994, “there is no rationale for how an individual’s sense of gender would result in any real-world effects that would differentiate them from other members of their sex.”

In a module about an empirical, biological process, Yale uses and expects students to accept unempirical, unscientific concepts, misleading vulnerable students about how alcohol affects their bodies. But there is another, separate issue with Yale’s orientation. The word “cisgender” is not a biological term—it’s an ideological one. It was added to the popular lexicon less than ten years ago and its use implies that all human beings, even those who are comfortable with their sexed bodies, have a “gender identity.” This is not a belief shared by all incoming Yale students, and many of those referred to as “cisgender” firmly reject the label.

For a school that has become exquisitely sensitive to how people self-identify, and expects its students and faculty to use preferred references regarding gender, there is one group to which Yale does not appear to afford the same respect.

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