The Biologically Vulnerable Boy: Framing Sex Differences in Childhood Infectious Disease Mortality

Abstract

Demographers have noticed longer adult female life expectancies and higher rates of male infant mortality in Europe as early as the seventeenth and eighteenth centuries. During the Western demographic and epidemiologic transition of the late nineteenth and early twentieth centuries, infant and childhood mortality rates became increasingly male-skewed. I examine the changing awareness and understanding of sex differentials in childhood infectious disease mortality and the discourse surrounding them in the medical and epidemiological literature, with particular focus on discussions surrounding diphtheria. I identify the emergence of the concept of males as the weaker sex (the “biological hypothesis”) and the framing of boys as biologically vulnerable, and argue that these are products of this historical period, linked not only to observed epidemiological patterns but also to changing ideas of children and childhood and the shift in science and medicine toward the laboratory as the source of knowledge.