I scored it as highly as I did because I was genuinely impressed by the thesis that the health of women and men is different and that women are stronger at both the beginning and end of life.
Moalem ascribes this to women having 2 XXs and men the XY chromosome. The X chromosome contains more than 1000 genes the Y about 70 largely concerned with producing sperm. The genetic difference is bigger in other species. The male drone bee has 16 chromosomes, the female with many more tasks 32.
Moalem repeats the XX;XY explanation to the point where you are bored. His exposition is poor. We are told that one of the female X chromosomes is silenced, but that women’s ability to use two XXs gives them genetic choice and flexibility, which men with one X do not have. I thought how, if one of the Xs has been silenced, can women have two XXs to rely on? Well you are told on page 108 that on the silenced chromosome 23% of gene are still active. Why didn’t he say this to begin with?

The other question I had, that if humans have 23 chromosomes and the XY difference is 23% of only one of them, why is this sufficient to make the significant difference he describes? What about the other chromosomes? This question is never addressed. He does write at the end of the book that 6,500 out of approximately 20,000 genes are used apparently differently by men and women across “45 common tissues”. If this is so, then surely the other 22 autosome chromosomes are involved in causing genetic differences in body and health ? Not discussed.
His writing wasn’t bad, but it is dumbed down (intentionally? and by him or by editors? For Americans who generally don’t read books? ) I disliked his first name familiarity. “Jordan passed away…What was it that made you think he wasn’t going to make it?” A familiarism and two euphemism in two sentences. “Rebecca was a preemie whisperer (sic)” etc
He also misses his own thread. There was an interesting description of the vaniolation/vaccination debate in the 18th century, until you think this has little to do with the male/ female difference which was meant to be the book’s subject.
He writes without any explanation that, “Your biological sex isn’t always the same as your gender.” Thereafter he refers to genetic males & females as if there are others. This is not to deny that there are those whose genetic sexual determination differs from the norm. I read, “Sex Redefined: the idea of Two Sexes is Over Simplistic” from Scientific America (2018) to educate myself. That Moalem can write without justification or a health (!) warning that gender is a separate condition presumably of volition from sexual determination without explanation really isn’t acceptable, indicative I suspect of increasing intolerance in academia and as a result of those editing works of popular science.
It was interesting that women’s B cells make antibodies that are a better fit than men’s. This explains why women suffer more when inoculated, but are more resistant to disease. As a result women suffer more from some auto-immune diseases but have greater auto-immunity against cancers. The possibility that it wasn’t just the behaviour of some males and that they are genetically more susceptible to HIV is interesting.
Moalem refers to Hemochromatoris building up iron in the body, Women suffer less as a result of mensturation and child birth resulting in blood loss and are more likely to suffer after the menopause. Men are apparently treated by bloodletting. So there was a use to the lancet after all, presumably one with greater male benefit and its medical use decided by men. In the Ukraine in 1932/3 6 to 8 million perished in forced collectivisation. Women store fat in the thighs and buttocks. Men are more muscled and require more food to Keep going, so more women survived the famine. However (I think) these two cases are not examples of Moalem’s case that it is the greater flexibility of having two XX genetic that gives advantage to women. Instead both differences follow from the inherent difference between the sexes.
For me there is a good Book to be written on the health and genetic differences between men and women. I am not sure this is it.