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Racial Differences in Steroid (AAS) Use

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I’ve written on steroid use between blacks and whites last year, but it was a smaller part of an article concerning the misconceptions people have on steroids and what they do (responding to the hysteria that the media and the like discuss with their claims of “roid rage”). I cited some studies showing that blacks use more drugs than whites; that blacks are more likely to lie about drug-use than whites; and that blacks are more likely to use steroids than whites (indeed, minorities were twice as likely to use steroids compared to whites in one study). (It is also worth noting that “roid rage” is a myth; AAS use is associated with other drug use, which explains the relationship. See Lundholm et al, 2015. For further information on this matter, see the documentary Bigger, Stronger, Faster.)

Steroids are synthetic hormones—lab-made hormones that mimic the so-called “male hormone” testosterone. Though the term “steroid” is misleading; what is being discussed are androgenic anabolic steroids (AAS), since, for example, estrogen is a steroid and does not have the muscle-building and recovery properties of AAS. The term “anabolic” refers to muscle-building whereas the term “androgenic” refers to the increase in male sexual characters. AAS abuse is associated with tendon ruptures, a lower incidence of prostate hypertrophy, anxiety, depression, and a decreased libido (Bagge et al, 2017). Furthermore, the negative effects of AAS (ab)use cause cardiovascular problems, dyslipedemia—which may impact vascular functioning, ventricular arrhythmias while training, hypertension, etc. (Goldman and Basaria, 2018). Further negative effects include raised cholesterol, hair thinning, sterility, and decreased hormone levels. Croaker (2017) notes that AAS use is prevalent throughout high school and collegiate sports, though “When the desired outcome is achieved, the results are always short lived.

Individuals use steroids for myriad reasons—despite the well-known adverse effects. A few considered are: (1) to become better at sports; (2) to increase muscle mass (which then relates to increased recovery time so the individual can train more); and (3) they are administered a script by their primary care doctor because their testosterone levels are low for their age range. In any case, in this article, I will discuss (1) and (2).

Whichever way the racial differences in AAS use go, we can all agree on one thing: in young men, they most likely want to become better athletes. AAS use is associated with shorter recovery times (

How can you tell if any individual is using steroids? It’s very simple. An increase in upper-body mass, most notably the shoulders and traps. The reason for this is that there are more androgen receptors in the shoulders and so they respond better to the flood of synthetic hormone.

AAS (ab)use is pretty prevalent throughout America. For example, Blashill et al (2017) write that “Black, Hispanic, and White sexual minority boys reported misuse at approximately 25%, 20%, and 9%, respectively.” “Sexual minorities” refers to sexual identity and the sex of the sexual partner. “Whites” were those who said they were not “Hispanic” and were white; “blacks” were those who said that they were not “Hispanic” and were black; while “Hispanics” were those who identified as a “Hispanic” ethnicity while marking down another race. (Note that “white” and “black” are socialraces.)

The (ab)use of AAS particularly affects homosexual minorities. Blashill et al (2017) write:

Sexual orientation health disparities in anabolic steroid misuse disproportionally affect Black and Hispanic sexual minority adolescent boys …

Blashill et al (2017) conclude from the results of their study that the (ab)use of AAS by sexual minorities may be due to “muscularity-oriented body image concerns.” I have heard (albeit, anecdotally) that a lot of homosexuals use AAS in order to look good so they would fall under (2).

The Child Trends Data Bank writes that “There are no significant differences in use of steroids in the past 12 months when comparing whites, blacks, and Hispanics.”

roidrace

Hua and Braddock (2008: 29) write that “White males reported higher prevalence of steroid use than Black males, and sport participation served as a protective factor, but only for Black males.” They conclude that:

Specifically, our results show that sport participation served as a protective factor, but only for Black males. Sports active black male adolescents reported lower rates of steroid use than Black males who were not involved in sports.

So, it seems that sport participation is protective for blacks in regard to steroid use. However, black males lie about drug use more than white males, and so, I don’t see why we should accept the conclusions of this study. I also find it hard to believe that sport participation would be protective against AAS use. Intuitively, you would expect it to cause more AAS use.

The Journal of Ethics states that AAS (ab)use was higher in white (6.2%) and “Hispanic” students (7.2%) than black students (3.6%).

Irving et al (2002) state that 2.1% of white males 7.6 percent of black males, 6.1% of “Hispanic” males, 14.8% of Hmong males, 7.9% of “other Asian”, 3.1% of Native Americans, and 11.3% of mixed race males reported AAS use. Whereas 0.5% of white females, 4.3% of black girls, 0.9% of “Hispanic” girls, 8.9% of Hmong girls, 3% of “other Asian” girls, 4.7% of Native American girls, and 4.1% of mixed race girls used steroids. Here is table 1 from Irving et al (2002):

aasgrade

Low SES individuals were more likely to (ab)use AAS than high SES individuals in both sexes. Middle schoolers were more likely than high schoolers. (Where are they getting the AAS? Their parents? Older siblings?)

Irving et al noted that the male AAS users were least satisfied with their shoulders (we can’t all be so lucky). Fortunately for them, as noted above, the shoulders have the most androgen receptors in the body and so their shoulders will grow. However, other than not being satisfied with their shoulders, body image was not associated with AAS use in males. Female AAS users, more so than non-AAS users, were more likely to report that they used AAS to for “weight and shape.” Further, sport players were more likely than non-sport players to use AAS—as expected. In a nutshell, AAS use is associated with poor markers of physical health—most importantly because many individuals wanted to lose weight (most likely fat mass). It should be noted that those who were dissatisfied with their bodies were less knowledgable about nutrition, so to amleiorate some of this, nutrition should be taught earlier in schools.

I can’t think of any reasons why, however, Hmong males and females would be using AAS more than other ethnies. However, Irving et al (2002: 251) write:

One finding regarding the demographic characteristics of steroid users in our sample is worth noting. Steroid use was more common in non-Caucasian respondents (both male and female), with particularly high rates among Hmong participants. Initially, we were puzzled by this result and questioned its validity. However, in consultation with community informants from social service agencies that work with southeast Asian youth in the Minneapolis/St. Paul area, we were told by some informants that the “word on the street” was the Hmong youth were attempting to “bulk up” physically, by working out and using steroids. One possible explanation for this finding is that, as fairly recent immigrants (most Hmong immigrated to the U.S. in the past 20 years), Hmong youth may be “bulking up” to gain status in a culture that emphasizes physical appearance, including weight, shape, and physical strength. This interpretation is supported by anthropological research wherein exposure to western ideals of beauty and eating habits is followed by increases in weight and shape preoccupation and disordered eating practices among individuals from non-western cultures. On the other hand, it is possible that Hmong youth may have misinterpreted the question.

So if the Hmong did not misunderstand the question, it is possible, for example, that they were getting bullied (due to being new immigrants) and decided to take AAS in order to get bigger to stop the bullying.

Stilger et al (1999) note that (my emphasis):

Of the 873 high school football players participating in the study, 54 (6.3%) reported having used or currently using AAS. Caucasians represented 85% of all subjects in the survey. Nine percent were African-American while the remainder (6%) consisted of Hispanics, Asian, and other. Of the AAS users, 74% were Caucasian, 13% African American, 7% Hispanic, and 3% Asian, x2 (4,854 4) 4.203, p 4 .38. The study also indicated that minorities are twice as likely to use AAS as opposed to Caucasians. Cross tabulated results indicate that 11.2% of all minorities use/used AAS as opposed to 6.5% of all Caucasians (data not displayed).

Lastly, Green et al (2001) note that whites and blacks used AAS at the same rate, though the n = 10,850 Caucasians while for African Americans the n = 1,883.

However, unless a study notes that the participants’ blood was assayed, why should we believe the results when it’s been noted that blacks underreport and lie about drug use more than whites (Bauman and Ennett (1994)Ledgerwood et al, 2008Lu et al, 2001)?

In sum, many studies report different results. I would say that the difference is due to cultural/social differences based on where the studies were carried out. The mixed results of these studies points to one thing: AAS use is prevalent throughout school life, and since it starts so young with many people, older siblings seem to be getting it for them. Sexual minorities are more likely to use than whites and this seems to come down to body image; Hmong seem more likely to use than non-Hmong; and the racial differences seem to hold with females as well.

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