Campbell's “staying alive” theory (SAT) argues human females produce stronger self-protective reactions to aggressive threats because self-protection has higher fitness value for females. The SAT's core assumption is that female and male humans are under such distinct evolutionary pressures that selection structures females' bodies and minds producing “unique” adaptations relative to males. The target article takes myriad patterns (behavioral, physiological, social, cultural) in human females and aligns them as a unit emerging from an expanded version of the SAT. Human females and males do respond in overlapping but different distributions to threats, pathogens, and related health challenges, but why this is the case is extremely complex and influenced by multiple and diverse social, historical, biological, and contextual variables.

There are patterned differences between males and females in many species. For example, most mammalian females live longer than males and there are a number of processes that affect female longevity including sex chromosome heterogamy/homogamy and telomere length (Xirocostas, Everingham, & Moles, Reference Xirocostas, Everingham and Moles2020) and diversity and complexity in female life histories and behavior (e.g., Cooke, Reference Cooke2022; Morbeck, Galloway, & Zihlman, Reference Morbeck, Galloway and Zihlman1996). However, this article seeks not to complexify understandings of human behavioral variation, but to simplify them. And therein lies my first critique. Benenson et al.'s core assertion, and the assumptions of the SAT, rest heavily on the classic arguments by Bateman, Trivers, Hamilton, and others, about the relative costs of reproduction and their effects on parental investment and life histories. While these assumptions about evolutionary “costs” of being female and male remain common in biology textbooks, there are serious challenges to their precision and universality. Bateman's thesis, and work, is flawed and the realities of measuring and assessing relative costs of investment in reproduction and the implications/consequences for male and female behavior are complex (Drea, Reference Drea2005; Gowaty, Kim, & Anderson, Reference Gowaty, Kim and Anderson2012; Tang-Martinez & Ryder, Reference Tang-Martinez and Ryder2005). This complexity of patterns is especially true for humans (Borgerhoff-Mulder, Reference Borgerhoff-Mulder2004) given our complex neurobiologies (Eliot, Ahmed, Khan, & Patel, Reference Eliot, Ahmed, Khan and Patel2021), and distinctive sex/gender (Hyde, Bigler, Joel, Tate, & van Anders, Reference Hyde, Bigler, Joel, Tate and van Anders2018), life history (Sear, Reference Sear2020), and morphological (Dunsworth, Reference Dunsworth2020) processes. Specifically, parental investment in humans is more complex than the authors of this article acknowledge, and the potential evolutionary implication of this reality is not taken into account in their assessments. While noting complexity in human reproductive processes the authors' still frame their argument around assumptions of costs/benefits arising from a nuclear family/two-adult-plus-offspring core reproductive unit, which is not the basal form of residence, social organization, or childcare in humans (Gettler, Reference Gettler2016; Rosenberg, Reference Rosenberg2021; Sear, Reference Sear2021). They do acknowledge “grandmothering” and “cooperative care,” but emphasize that females do most childcare in contemporary societies, and leave it at that. However, these assessments (from the HRAF and contemporary forager/horticulturalist groups) might not reflect the range and structures of human evolutionary, and contemporary, processes related to reproduction and energetic investments and their integration into the broader range of human social behavior (Borgerhoff-Mulder & Rauch, Reference Borgerhoff-Mulder and Rauch2009; Fuentes, Reference Fuentes2016; Fuentes & Wiessner, Reference Fuentes and Wiessner2016; Spikins, Reference Spikins2015). There are other, equally valid, modes of explanation for human social organization and behavioral processes not solely grounded in assumptions of radically different evolutionary trajectories for females and males. The bottom line is that given current understandings of human evolution, physiology, and behavior one should question, and unpack, the basal framework of the SAT more extensively before building an entire thesis on it.

My secondary critique involves the evidence offered in support of the authors' argument. For example, the causes of mortality in Figure 2 are all prevalent with substantive impact primarily in the recent evolutionary moment (post-last demographic transition and post-industrial revolution). The WHO data suggest that on average females die later or less from certain diseases, but to understand morbidity and mortality of cancers or cardiovascular disease (CVD) or hepatitis A solely, or even primarily, as the outcome of evolved differences between male and female biology is to elide decades of research and scholarship on the myriad interconnecting social, economic, historical, and biological processes at play (Krieger, Reference Krieger2020). Similarly, coronavirus disease-2019 (COVID-19) is a particularly bad example as social structures and inequities are central in structuring outcomes of morbidity/mortality in pandemics/syndemics (Gravlee, Reference Gravlee2020). Patterns of race, sex/gender, geography, region, and so on mortality from COVID are not the best locale to investigate female/male biological differences. Obviously, biological factors related to reproduction can be involved, but their relative contributions to the patterns and processes of the outcomes in the face of the societal/structural determinants of health are often relatively small, and often nonlinear. I do not have the space to engage the psychological and social behavior differences the authors review (e.g., smiling, politeness, sadness, anger, avoidance of confrontation, etc.). But, to see these as direct outcomes, and measures, of selection for behavioral differences in females and males due to differential patterns of reproductive investment is to ignore vast amounts of social scientific and ethnographic data/analyses on why/how humans smile, get mad, avoid specific kinds of social contexts, and so on. Of course, evolutionary histories affect these behaviors, but it stretches credulity to assume gender/sex differences in these behaviors are best represented as specific outcomes of targeted selection.

The authors are not ignorant of these critiques. In sections 7.2 and 7.3 they acknowledge complexity and state “we cannot specify which characteristics of sex/gender relate to self-protection.” But if this is the case, isn't that all the more reason to avoid simple and strictly targeted selection models such as the SAT? It is likely that many of the processes highlighted, including aspects of SAT, are at play in contemporary humans. But to compartmentalize them as a unit and focus on only one selection model, as if its explanatory power is more meaningful, is to oversimplify and misrepresent the dynamics of the human processes being explored. In sum, to treat the complexity of human response to threats as an explicit, sexually dimorphic package being driven by a relatively simple selection hypothesis, the SAT, is not reflective of the immense body of knowledge regarding health, sex/gender, reproduction, and behavior in Homo sapiens.