Invisible Women: Data Bias in a World Designed for Men by Caroline Criado Perez

I heard Caroline Criado Perez on 99% Invisible a while ago and put her book on my reading list, but it slowly sank further and further down the list until I realized that now was as good a time to read it as any. Her book Invisible Women: Data Bias in a World Designed for Men examines how much research is done without input from women or even taking women's experiences into account and how that leaves much of the world designed poorly for more than half of the world.  

Let's start with the cover. It's simply a work of art. On my library copy, it is nearly impossible to see the stick figure women unless the book is directly in light and tilted away from the person holding the book. Since Perez's whole thesis is basically that a lot of research fails to account for sex and gender in data collection, women's voices and issues are largely ignored, this cover's illustration is about as brilliant as it gets.

It's crazily researched and every claim that she makes is footnoted with studies, polls, or researchers to support it.  It's accessible to read, not jargon-y or dense.  Perez is snarky and I think this is a super important piece of work for everyone to read. 

The book is divided into six parts, so I'll describe the rough outline of each and then I'll wax on and on about how true all of it is.

Part I: Daily Life

This is a couple of chapters about how the world was designed for the default man, presumably a married working man.  It starts with an anecdote about a town in Sweden that had to go through all of its policies and reevaluate them with a gender-equality lens. One official joked that at least the "gender-people" could keep their noses out of snow plowing.  But it turns out that they didn't.  

Men mostly commute in cars, so main streets were plowed first. Women generally walked or took public transit, but they were generally doing non-paid work, so cleaning side streets and streets to public transit was less prioritized. But it turns out that this was a problem because a lot of women were getting hurt in slip and falls and when the town switched what was getting cleared first, those injuries went down and the town started to save money.  

This section covers all sort of scenarios like that.  Women have complicated travel plans - they do a lot of "trip chaining," in which they run multiple errands at once, but men don't generally do that. I rarely leave the house for one errand - last week I went into my workplace and on the way there I stopped at the dentist to buy some of my prescription toothpaste and on the way home I stopped for gas and at the library.  Because of their complicated "trip chaining," it's hard to study women's travel, so researchers just don't. 

There's also the fact that women are scared in public places. They're scared to use public restrooms that are shared with men. They're scared to have to travel to restrooms that aren't lighted publicly.  They're scared to be alone in streets at night. It impacts women's mobility and access to city services.  And men don't understand because even the men who care don't see it.

"The invisibility of the threatening behavior women face in public is compounded by the reality that men don't do this to women who are accompanied by other men - who are in case also much less likely to experience this kind of behavior. A recent Brazilian survey found that two-thirds of women had been victims of sexual harassment and violence while in transit, half of them on public transportation.  The proportion among men was 18%. So men who didn't do it and didn't experience it simply didn't know it was going on. And they all too often dismissed women who told them about it with an airy 'Well I've never seen it.'" (page 55)

The thing I want to point out with this book is that it's very readable. It's infuriating and it's tough to stomach at times, but Perez's dry humor comes out and there are many times when I laughed at her asides.  Huge thumbs up.

Part II: The Workplace

You know, this is a lot of the usual to start. AC is set for men to be comfortable in suits, not women in dresses.  Women make less than men.  Women get promoted to tenure less in academia.  Women who are aggressive or ambitious are labeled as "bitches" or "uppity." Women who do care and housework, unpaid labor, are not counted in GDP or respected in most circles and even women who work do most of the unpaid labor and so can't stay at work for long hours or overtime.

But the last couple of chapters in this section deal with the dangers in the workplace. "Over the past hundred years workplaces have, on the whole, got considerably safer...But there is a caveat to this good news story. While serious injuries at work have been decreasing for men, there is evidence that they have been increasing among women" and this rise is "linked to the gender data gap: with occupational research traditionally having been focused on male-dominated industries, our knowledge of how to prevent injuries in women is patchy to say the least" (page 114).  From RNAs lifting patients improperly to work-related cancers to issues with fit with construction equipment to improperly fitting PPE that was designed to fit men's bodies, the workplace is dangerous for many women, particularly at low-skilled and low-wage jobs.

These chapters are brilliantly written, with statistics and studies linked to in the footnotes, but also with interviews with women who have suffered because of poor workplace design.  The anecdotes illustrate her data and more importantly, illustrate the lack of data about how these design flaws injury and kill women.

Part III: Design

Things are designed for men. I frequently have to call my husband over to get something from our kitchen cabinets or I have to haul out a stepstool (arrow pointing at it) that we have placed in the kitchen for just this purpose. Who on Earth thought it was a good idea to have a cabinet over the fridge?  You know the one I'm talking about.  Thusly.

Anyway, this part of the book is about how most things are designed with men in mind.  Keyboards on pianos are designed for an average man's hand, which means it's beyond the scope of most women and a fair number of men.  Smart phones have grown in size to fit a man's hand, which means women have to hold them with both hands and these phones certainly don't fit in jokes that are pockets of most women's clothes.  Voice recognition software regularly doesn't recognize female voices because it was trained using men's voices.  Seatbelts dig into women's breasts so that many women wear them incorrectly. But who knows how because crash test dummies are all designed to replicate men in the car.  

When people try to change things, say suggest a company that makes a better breast pump or makes pelvic floor training more accessible, and female owners are told their products are "disgusting."

I found this all very compelling, but nothing aggravated me as much as the next section.

Part IV: Going to the Doctor

Right before our state went on lockdown, I hurt my thumb. The doctor saw me, barely looked at it, said it was sprained, and told me it would be better in six to eight weeks. Well, as those weeks passed, the pandemic began in earnest, I finally was able to get an x-ray and it turns out that it was really broken. It healed badly, but the doctor didn't recommend physical therapy and when I called about it anyway, they weren't taking new patients (because, COVID?) and it never was treated and now the thumb on my  dominant hand doesn't have full range of motion.  

This is how women are treated in  health care.  

Most research studies still don't include women because "the male body is medicine itself (page 196).  Sex differences can be substantial. "Researchers have found sex differences in every tissue and organ system in the human body" (198), there are differences in the mechanical workings of the heart, differences in lung capacity, differences in hormones, in biomarkers for autism, how cells dies during strokes, how drugs metabolize, how proteins work, the aging of blood vessels, and the list goes on and on (198-199), but women are still excluded from most clinical trials because it complicates things.

Issues that primarily effect women are ignored as non-priorities, including deaths in childbirth, IBS, PMS, and period pain. Women are misdiagnosed and poor treated unless symptoms or diseases conform to those of men.  Women die because of this.  Women live longer than men, but don't have longer years of active living. Women are being let down by the medical profession and it's all because men are the default.  

"Instead of believing women when they say they're in pain, we tend to label them as mad. And who can  blame us? Bitches be crazy, as Plato famously said. Women are hysterical (hystera is the Greek word for womb), crazy (if I had a pound for every time a man questioned my sanity in response to my saying anything vaguely feminist on Twitter I would be able to give up work for life), irrational and overemotional." (225)

Part V: Public Life

These couple of chapters are probably the weakest in the book. Women don't make as much as men and unpaid labor isn't part of GDP.  Female politicians are straight fucked because we don't like our women ambitious and knowledgeable. Lots of talk about how Hilary Clinton was "unlikeable." It's a problem because even women internalize these things as normal.

Part VI: When It Goes Wrong

Women are hardest hit in disasters, post-disasters, and never asked for their input on how to prevent deaths or how to recover.  Everyone makes excuses about it, but women in war-torn or disaster-recovering countries are at a greater risk of mortality, violence, and poverty than men.  

I think everyone should read this book. Yes, it's infuriating, but it's also sharp and enlightening.  Please read it and report back to me about what your favorite quote is.