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Diversity and Inclusion: Breaking the Binary

The world is a colorful, diverse place, but we somehow minimize it to black and white. How did we come to divide everything and everyone into polarized opposites?

The world is a colorful, diverse place, but we somehow minimize it to black and white. While it is easy to divide everything and everyone into polarized opposites — Democrat and Republican, homosexual and heterosexual, young and old, black and white, — there is much more to be explored, acknowledged, and appreciated. By recognizing only the dominant binaries in every category, we alienate people by squeezing them out, and stealing their visibility. When people are not visible, it is less likely that they will gain the rights and freedoms they deserve as human beings.

“An individual has not started living until he can rise above the narrow confines of his individualistic concerns to the broader concerns of all humanity.”

— Martin Luther King, Jr.

The Gender Binary

The gender binary assumes that every person must be feminine or masculine, identifying as woman/girl or man/boy. This construct immediately others intersex people from the moment of birth, often leading to surgery to make a sex assignment possible. Beyond this, the gender binary applies not only to people, but to the things with which they interact. This is where we get the age-old idea that dolls and pink are for girls, and trucks and blue are for boys. It is expected that gender identity and expression matches biological sex, and behavior falls in line. This is a pipeline to gendered roles in relationships that are enforced by the media, education, religion, law, and social systems.

The Political Binary

While there is evidence of people falling outside of the defined binary, there is little room to express a political opinion that is not squarely Democratic or Republican, and we view these options as staunchly liberal or conservative. In a poll on, 91% of respondents said the two-party system in the USA is flawed. In many countries outside North America, two-party systems do not have such distinctive labelling, but independents and less dominant party options are ignored. This often creates a dynamic where people vote mindlessly, or feel like the best they can do is vote for the lesser evil. More and more, people are voting against a person, ideology, or party rather than for representation reflective of their own values. The ideological extremes don’t serve the people with more diverse views, beliefs, and visions for the future of the country. How could moderate options outside of the Republican-Democratic binary change politics and governance, and impact the way we address global issues?

The Sexual Orientation Binary

The LGBT+ community is large and diverse, but many of the people in it are not recognized by the world at large. For a long time, there was only “gay” and “straight.” In recent years, the lesbian community has become stronger and more visible, but others continue to struggle. In particular, bisexuality carries stigma as people identifying in this way are considered to be confused, indecisive, or between two worlds. It is still not a widely accepted sexual orientation, even relative to homosexuality. They are often envisioned straddling the line between heterosexuality and homosexuality because we fail to see sexual orientation and sexuality as a spectrum as suggested by the Kinsey Scale and the Klein Sexuality Grid. Biphobia is only the tip of the iceberg. People who are pansexual, asexual, questioning, queer, and many others falling outside of the binary struggle to find legitimacy, allies, and a safe way to exist. It can take them a long time to find the language to describe their sexual orientation and inclusive communities because neither of the two are generally visible or a part of mainstream conversations on sexuality.

The Binary Effect

Binaries assume that there are only two options or categories. They are the basis upon which systems are created and maintained, and require everything and everyone to fit into one of the defined categories. These are often determined based on the state of the majority, failing to consider existing moderates, or the possibility that moderates will eventually come to be. Binaries are seen as more than defaults. They ignore, deny, and other any non-compliant people, labeling them as deviants. This is in complete contravention to the values many of us claim to have: diversity, inclusion, and participation. No binary ever ends at the point of classification. This is a simplified version of the effect of binaries:

Binary ---> Normalization ---> Extremism ---> Othering

The gender binary, for example, has a domino effect in several directions. One trajectory, following the model above, can be simply plotted as:

Gender binary ---> Gender norms ---> Hypermasculinity ---> Homophobia

A Brief Explanation

The heavy influence of the gender binary on the performance of gender — dictated by gender norms — leads to hypermasculinty. At a young age, boys are told to be tough, discouraged from crying, and taught that femininity is bad, embarrassing, and synonymous with weakness. For this reason, there is a distinct separation between acceptable and unacceptable emotions. While sadness, especially accompanied by tears, is reprehensible, anger — even accompanied by violence — is commendable. Because masculinity is required and reserved for men and boys, anyone defying these rules is an outcast. Men and boys are expected to dominate women and girls, and exhibit specific behaviors, while girls are expected to be fragile and submissive, thus creating the world of heteronormativity and homophobia.

Binaries are a part of a complex system that is replicated in many areas of our lives, from gender to politics. At what point will our value for diversity and social inclusion outweigh the need to define and categorize people? There is a need for more seats at the table, and space for the people currently marginalized. Do we have more to gain from greater participation that is reflective of the population than we do from ostracizing moderates and nonconformists? It’s up to us to decide whether or not we’ll break the binaries we feed, familiarize ourselves with the spectrums that exist, and get comfortable with the discomfort that may come from making this necessary change.


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Two different experiments show hints of a 4th spatial dimension. Credit: Zilberberg Group / ETH Zürich
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Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

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