No More Overlooking that Our World Ignores Women.

Minorities often suffer repression.  We easily recognize it when it is active and brutal, but subtle oppression is much more difficult to recognize. 

Unfortunately, our culture and our science is riddled with it.  In her book, Invisible Women – Data Bias in a World Designed for Men, Caroline Criado Perez highlights sexism inherent in our laws, our product designs, public policy, and most insidious of all, medicine.

I am not her target audience and I admit that I found some of her language choices and blanket stereotyping of men to be as crude and clumsy as the stereotyping she points out.  However, I am a faithful husband to my wife, a devoted son to my mother, and a father who wants nothing best for his daughters.  Thus, the well cited research and examples of sexism were powerful and shocking.

At least to me.  My wife said she already knew most of the examples that I brought up to her.  I’ll list a few of the examples that shocked me and we’ll see if you already knew them.

However, first, a quick overview and summary of the book.  Invisible Women only contains 321 pages of content followed by 69 pages of citations to back up the examples and statistics cited in the book.  This is not a casual opinion piece.  While the writing style can be a bit academic, I highly recommend this book to any woman or to anyone who loves a woman.  As a caring human being, I want everyone to start a dialog that will help women and make the world a better place for us all in the long run.

Now for the examples that infuriated me the most.  Let’s start with something simple.  Children’s entertainment.

In the United States of America, 50.8% of the 2010 US Census self-reported as female.  Yet in an analysis of G-rated films released between 1990 and 2005, only 28% of speaking roles went to female characters and only 17% of the people in the crowd scenes! 

In a more recent study, less than 30% of almost all characters in movies rated G, PG or PG-13 released between 1990-2009 are female.  While there is a small upward trend to 32.6% of the characters strictly for G-rated movies released between 2006-2009, this meager improvement is not impressive.

Lack of representation still doesn’t necessarily mean oppression.  How about forgetting that women exist?

Take policies designed to promote agriculture.  A 2012 Gates Foundation report analyzed the gap between the low adoption rate of high-yield crops in developing countries versus the high interest shown by farmers in surveys.  Apparently in field testing, the survey was given primarily to men despite the fact that women also play a significant role in farming.  Women typically prepare the land and weed the crops and high-yield crops required additional prep time and weeding.  The high-yield crops also took longer to cook, so where was the extra time going to come from to make the high-yield crops work?  Why didn’t anyone ask the women?

How about automobile safety?  In a car crash, women are 71% more likely to be moderately injured, 47% more likely to be seriously injured, and 17% more likely to die – even when controlled for height, weight, and other factors.  Why?  First, women tend to be shorter and sit further forward in the car when driving.  Second, women’s neck muscles are generally not as developed making them more susceptible to whiplash.  Third, car seats tend to be too firm for lighter people (women generally weigh less) and throw women forward with too much firmness.

Why don’t car companies have ways to compensate?  They don’t have to.  In fact, they don’t bother to test their cars for the safety of women at all.  In the US, the standard dummy is 1.77 meters tall (five feet eight inches) and 76 kg in weight (~168 pounds), and the ‘female’ dummy, not even required until 2011, is simply a scaled-down version of the male dummy!  There is no changing of anatomy to account for simple anatomical differences such as different weight distribution, lower bone density, or different vertebra spacing.  Most testing also sticks to men as the drivers with women primarily tested as passengers in the cards.  Let’s not even start to consider how these tests fail to account for common variances in size, pregnancy, or driving position!

Car companies don’t do the tests because they know they will fail.  The 2011 Toyota Sienna was given a four-star safety rating, but tests of the female crash test dummy in the passenger seat only reached a two-star safety rating because of a 20-40% risk of being killed or seriously injured in a 35 mph collision!  Of course, this it should not be just women that are up in arms.  Anyone who is not the 50% male should be complaining!  Anyone over 5’10” tall or under 5’6” tall, or anyone over 180 lbs. or under 140 lbs. is not tested in normal safety crash tests.

People use averages because they are easy.  However, it’s time to stop pretending that averages mean everything.  We need to work harder to reflect the reality of our world.  Businesses and governments need to recognize and involve women much more.

The most important target for improvement may be medicine.  Medical school anatomy textbooks treat male anatomy as the default anatomy and female anatomy as variants from normal. 

Menstrual cycles involve many complex chemical reactions, so pharmaceutical researchers don’t like to deal with it.  Most testing upon animals has been done primarily upon male mice.  Even for drugs intended for women!  A 2014 paper noted that only 44% of the studies of female-prevalent diseases mentioned the sex of the animal used in the research and of those, only 12% used female animals.  In other words, about 5% of the studies specifically attempted to study female animals for female diseases.

Does gender matter in drugs?  A 2007 study found that 54% of studies that involve animals of different genders show sex-dependent drug effects.  In other words, drugs usually don’t work the same on women as they do for men!  Side effects often derail the adoption of drugs, but we only reveal the side effects upon men and optimize the drugs to minimize male issues. 

Sadly, many advances that could protect women simply have been missed.  A 2016 research study found that women’s cells exposed to Estrogen fight off viruses that a male cell could not.  Even in clinical drug trials involving humans, the majority of subjects remain male.

Of course, drugs are not the only part of medicine with a bias.  Women possess different symptoms than men when experiencing cardiac arrest, yet doctors rarely will receive training on the differences.  In a 2014 review of a type of pacemaker, CRT-D, it was found that women with an electrical wave of 130-149 milliseconds enjoyed a 76% reduction in heart failure or death using the pacemaker.  However, the guidelines for the device were based upon the primarily male population and a minimum 150 millisecond electrical wave was determined to be the lowest rate at which someone could benefit from the device!

I would hope that these medical biases are not intentional and that doctors do not simply want women to die.  However, now that we know about the biases, we need to work on systems, policies, and procedures to unwind the biases from our world.  It won’t just be women that benefit.  Anyone that isn’t the dead-center average will eventually benefit from a more nuanced and sophisticated approach that reflects our world more accurately.