Episode 62

Invisible Women: Data Bias in a World Designed For Men

Published on: 23rd November, 2021

Amy: Welcome to Breaking Down Patriarchy! I remember several years ago one of my friends pointed out the fact that women had to bring jackets to church in the middle of the summer because it was always so freezing. I had grown up my whole life with my teeth chattering in church buildings, but had never thought about it. My friend said, “well, of course. Men wear suits - pants, long sleeves, jackets, socks and shoes to church. And the church leaders (always exclusively men) are the ones who show up to their meetings at the church in the mornings and set the thermostats. They’re not being mean; they just don’t realize that half the people in here have to wear dresses.” I thought of that conversation when I read the preface to Caroline Criado Perez’s book, Invisible Women: Data Bias in a World Designed For Men, which we’ll be discussing today. She says that the gender data gap is composed of missing information, or “silences,” in all kinds of scenarios: 

“These silences, these gaps, have consequences. They impact women’s lives every day. The impact can be relatively minor. Shivering in offices set to a male temperature norm, for example, or struggling to reach a top shelf set at a male height norm. Irritating, certainly. Unjust, undoubtedly. But not life-threatening. Not like crashing in a car whose safety measures don’t account for women’s measurements. Not like having your heart attack go undiagnosed because your symptoms are deemed ‘atypical’ For these women, the consequences of living in a world built around male data can be deadly.” 


She goes on to say that this is not malicious or deliberate on the part of men, but is an understandable blind spot. However, this “non-thinking” about women has a serious impact just the same, and this modus operandi must change… but before I get ahead of myself I want to welcome my reading partner to the program, Barbie Hada Harper. Hi, Barbie!


Barbie: Hi Amy! So great to be here with you.


Amy: (Tell how we know each other, invite you to share your bio)


Barbie:

  • born and raised by my parents in Mission Viejo, CA - only girl w/3 brothers
  • dad is Japanese-American, born as his parents migrated back to their CA home after being imprisoned in the Japanese internment camps of WWII / mom is Caucasian; being bi-racial has informed my life experience 
  • raised a member of Church of JC of LDS –– great values and examples but church itself is highly patriarchal - this aspect has been challenging for me at times
  • As a child, by default socialized more as a boy in some ways with 3 brothers –– confident achiever––student body president, valedictorian, voted “most likely to succeed.” Even then I planned on being a stay-at-home mom. In my teens, I began to sense that my ambition made some men uncomfortable: 1) Remember a boy I dated said he was concerned about how I’d do as a mom since I was so ambitious. 2) I once shared with a man at church (a doctor) that I was interested in medical school; he counseled me to not go to medical school b/c it callouses women’s nurturing qualities. 
  • Fast forward––undergrad at BYU in Fitness and Wellness Management, served 18-mo. volunteer mission. When I met my husband (Idaho farm boy), I cancelled all plans to pursue masters. Felt it was more noble and practical to support his education and career over any dreams of mine. 
  • We have 4 children, ages 7-15. I’ve stayed at home most of the time, doing some freelance editing and PR on the side, and I’m currently studying holistic health, nutrition, and detoxification with the goal to become a practitioner. Also love art and design. 
  • Motherhood IS noble, but I also believe in the importance of fatherhood, and my husband has felt an increasing amount of grief over the heavy burden that it’s been for him to be the sole provider. When I heard stat that Iceland men and women equally contribute to home incomes, and concurrently, Iceland has the lowest suicide rate for adult males, this hit home for me!
  • If we did it over again, my husband and I would allow ourselves to creatively explore a more egalitarian balance within our marriage while still prioritizing the raising of our children in love.  


Amy: And what interested you in the project?


Barbie: (1.5 min)

  • Ever since known, respected depth of intellect and heart. “Dear Mormon Man” piece resonated with me deeply. So I dove into this podcast. I believe this work is part of an ongoing awakening. It’s a privilege to take a small part in this conversation. 
  • I believe life gives us all trauma (some are micro traumas that we might not even recognize as trauma) and one of our tasks in life is to identify that trauma and do the inner work needed to heal. Takes time, searching, vulnerability - part of my healing has come through the education and community this podcast has provided me! SO THANK YOU AMY.
  • Want to echo what you’ve said in past episodes, disclaimer that I have remarkably GOOD men in my life. Some of my favorite people on this earth happen to be men and boys. I don’t see myself as a victim of men––patriarchal system facilitates a sort of self deception for both women and men. 


Amy

Let’s get to know the author of the book we’re discussing today.


Caroline Criado Perez was born in Brazil in 1984, the daughter of an Argentinian-born businessman and an English registered nurse who worked with Doctors Without Borders. The family lived in several countries during her childhood, including Spain, Portugal, Taiwan, and the UK. She also attended boarding school in the Netherlands. 


Criado Perez studied History at a university in London, but then discontinued her studies. She loved opera and for a time, she wanted to become an opera singer, and she worked various jobs in order to pay for singing lessons.

Criado Perez worked in digital marketing for some years, then studied for an English Literature A-level, and gained a place to study English Language and Literature at Oxford University as a mature student. (That was inspiring for me.) She graduated from Oxford in 2012. She became a feminist through studying language and gender in a book by Deborah Cameron discussing gender's relationship to pronouns (and she mentions this in her book).  

She also studied Gender Studies at the London School of Economics, and some of her notable campaigns include getting a female historical figure on Bank of England banknotes; getting Twitter to introduce a “report abuse” button on tweets; and getting the first statue of a woman (Millicent Fawcett) in Parliament Square.​ So she’s an impressive activist as well!

Her first book, Do it Like a Woman, was published by Portobello in 2015. Her #1 Sunday Times best-selling second book, INVISIBLE WOMEN: Exposing Data Bias in a World Designed for Men, was published in March 2019.

So let’s dig in.


Amy: Introduction: The Default Male

For me, as a “word” person, one really interesting part was this:


Anthropologist [Sally] Slocum pointed out that gender bias appeared ‘not only in the ways in which the scanty data are interpreted, but in the very language used.’ The word ‘man,’ she wrote, ‘is used in such an ambiguous fashion that it is impossible to decide whether it refers to males or to the human species in general.’ 


Numerous studies in a variety of languages over the past forty years have consistently found that what is called the ‘generic masculine’ (using words like ‘he’ in a gender-neutral way) is not in fact read generically. It is read overwhelmingly as male. 

When the generic masculine is used people are more likely to recall famous men than famous women; to estimate a profession as male-dominated; to suggest male candidates for jobs and political appointments. Women are also less likely to apply, and less likely to perform well in interviews, for jobs that are advertised using the generic masculine. 


...While the generic masculine only really clings on in the writings of pedants who still insist on using ‘he’ to mean ‘he or she,’ it has made something of a comeback in the informal usage of Americanisms such as ‘dude and ‘guys,’ and, in the UK, ‘lads’ as supposedly gender-neutral terms. (Our family is in trouble!! Erik is from SoCal and will say “dude” until the day he dies”; I say “guys” to my daughters all the time, and for some unknown reason, Sophie addresses her all-girl group of school friends as “lads”! Should we stop? Probably!)


So then she goes on to describe languages that, unlike English, gender everything. She says:


Try searching Google for ‘lawyer’ in German. It comes back “Anwalt”, which literally means male lawyer, but is also used generically as just ‘lawyer.” If you want to refer to a female lawyer specifically you would say “Anwaltin’ (incidentally, the way female terms are often, as here, modified male terms is another subtle way we position the female as a deviation from the male type -  de Beauvoir’s term, “the Other.”)


The generic masculine is also used when referring to groups of people: when the gender is unknown, or if it’s a mixed group the generic masculine is used. So a group of one hundred female teachers in Spanish would be referred to as ‘las profesoras’ - but as soon as you add a single male teacher, the group suddenly becomes ‘los profesores.’ Such is the power of the default male. (6-8)


Criado Perez describes how Viking skeletons with very obviously female pelvises were nevertheless described as men because they were buried with weapons and wealth… and it was only after DNA testing that they realized “oh wow, they really are women!!” Which reminded me of our very first episode on The Chalice and the Blade, where archaeologists studying Neolithic civilizations described carvings as spears that turned out to be plants, and the multitude of female sculptures as erotica, rather than goddess iconography. The “default male” is in all of our minds. 



Barbie: Chapter 1: Can Snow Clearing Be Sexist?

Stories of Brazilian government clearing the slums called favelas and displacing women who end up in updated complexes far from their jobs, without cars, without good public transportation, without childcare, without community they’d depended on, stuck in their homes taking care of their kids, and it was illegal to run an in-home business like a daycare to make money. Women that weren’t home with children had work commutes for 3-6 hours a day. This is planning gone wrong! These new facilities they built could have help these women feel a sense of dignity and lift these women out of poverty, if had planned for simple resources like public transit, nearby grocery stores and daycares; instead, the poor planning made a bad situation worse. What a missed opportunity.


One woman who was involved in city planning committee in Philadelphia had to keep telling the men to not put shared kitchens on the 3rd floor with no elevator. Explained to her male counterparts, “Would you want to carry all your groceries and your kids and a baby stroller up three flights of stairs?” “Ohhh.” Housing facilities obviously planned by a group of men with absolutely no understanding of women’s lives. (42-46) 


Example of solution here: cites Vienna’s public housing officials who built a new housing complex, and began by collecting sex-disaggregated data - Austria’s national statistics agency revealed that women spent double the time per day than men on unpaid work such as household chores and childcare. (44) Armed with this data, they identified that the people this housing was intended to serve was women. The planners solicited feedback from women, and they designed housing based on that feedback. 


Amy: Chapter 2: Gender Neutral With Urinals


She begins with the oh-so-relatable scenario of being at a theater with the line for the ladies’ room going out the door and all the way around the foyer, while there’s no line for the men’s room. And even reading just that, I thought YES!! That’s something that we all just live with without questioning why, or thinking that that problem could be solved.


On the face of it, it may seem fair and equitable to accord male and female public toilets the same amount of floor space - and historically, this is the way it has been done. 50/50 division of floor space has even been formalized in plumbing codes. However, if a male toilet has both cubicles and urinals, the number of people who can relieve themselves at once is far higher per square foot of floor space in the male bathroom than in the female bathroom. Suddenly equal floor space isn’t so equal.


But even if male and female toilets had an equal number of stalls, the issue would not be resolved, because women take up to 2.3 times as long as men to use the toilet. Here, I thought she was going to say “because women have to take off their pants and sit down, etc….” but it’s even more than that! She says: Women make up the majority of the elderly and disabled, two groups that will tend to need more time in the toilet. Women are also more likely to be accompanied by children, as well as disabled and older people. Then there’s the 20-25% of women of childbearing age who may be on their period at any one time, and therefore needing to change a tampon or a sanitary pad. 

Women may also in any case require more trips to the bathroom than men: pregnancy significantly reduces bladder capacity, and women are eight times more likely to suffer from urinary tract infections than men which again increases the frequency with which a toilet visit is needed. (49)


If there were more women in those building planning meetings, there’s no way we would continue to have this problem. And again, it’s not that men are doing this on purpose; it’s just that most men never have to think about it. 


-A third of the world’s population lack adequate toilet provision at all. According to the UN, one in three women lack access to safe toilets. The next few pages talk about how women all over the world don’t have access to a safe, private space to relieve themselves, and they are thus vulnerable to sexual assault. (p. 49-52) This problem is worldwide - there’s been a trend of public toilet closures in US for over 50 years. The health problems that result from this are far worse for women. Local govts do this to cut cost, however Yale did a study suggesting that installing more toilets would actually reduce costs associated with these sexual assaults.


-Sexual assault of women on public transportation all over the world - highly underreported - women take longer routes or stop riding public transit alltogether due to these dangers 


-More discussion of public spaces, which are thought of as “gender neutral” and technically all genders have equal access, but they are so male-dominated that only very traditionally masculine men feel comfortable entering. One example: weight rooms in gyms.


(Amy:Just this past week Sophie told me how much she hates her weight training class at school because she feels so uncomfortable around the boys. She very much does not want me to email the school to share the research on this, but I want to, because we can solve that issue. It reminded me of one happy example from this section where Criado Perez shares a success story:


In the mid 1990’s, research by local officials in Vienna found that from the age of 10, girls’ presence in parks and public playgrounds ' decreased significantly.’ But rather than simply shrugging their shoulders and deciding that the girls just needed to toughen up, city officials wondered if there was something wrong with the design of parks. And so they planned some pilot projects, and they started to collect data.

...It turned out that single large open spaces were the problem, because these forced girls to compete with the boys for space. (and most girls don’t like to compete with boys for space - there are various explanations for that, but we’ll just leave it at that) Originally these spaces were encased by wire fencing on all sides, with only a single entrance area - around which groups of boys would congregate. And the girls, unwilling to run the gauntlet, simply weren’t going in. Enter, stage right, Vienna’s very own Leslie Knope, Claudia Prinz-Brandenburg, with a simple proposal: more and wider entrances. And they subdivided the sport courts and the grassy areas, so that they could be occupied by smaller groups that didn’t compete with each other. ...These were all subtle changes - but they worked. A year later, ... there were more girls in the park. ...And now all new parks in Vienna are designed along the same lines. (64)


Barbie: Chapter 4: The Myth of Meritocracy


In certain enlightened arenas such as in tech and academia, it’s a popular belief that individuals receive recognition based on their merit. But, this concept of meritocracy is sadly a myth. In academia, for example, students and academics who are female are significantly less likely to receive funding, be granted meetings with professors, be offered mentoring, or even to get the job. But universities operate as if males and females are on a level playing field. Multiple studies have shown that, when female authored papers are rated under double-blind review (meaning they aren’t gender-specified), they are accepted more often or rated higher. So, there is a gendered publishing gap. When female academics are published, several studies have shown that women are systematically cited less than men: a gendered citations gap. Both of these gaps lead to a vicious cycle where fewer women progress in their careers, and around again we go. (96)


Meanwhile, a study showed that women in academia (and many other workplaces) are asked to do more undervalued work than their male colleagues, like taking notes, getting coffee, and doing the clean-up. And they generally do it b/c they are penalized as being ‘unlikeable’ if they say no. This likeability factor, in turn, affects their ability to publish. Another vicious cycle. (98)


This lack of meritocracy in academia is a problem that should concern all of us. We should care about the quality of research because it has a significant impact on government policy, on medical practice, and on occupational health legislation. Research has a direct impact on all our lives. We NEED women to be represented here.


Related to academia, I have an exercise for you: tell me the first image that comes to your mind when you picture a genius. Chances are, it’s a man. It’s OK––we all have these unconscious biases. I pictured the inventor, Thomas Edison. Who did you picture, Amy? “Brilliance bias” is in no small part a result of the data gap: female geniuses have been written out of history. Children are taught brilliance bias from an early age. Using the ‘draw a scientist’ meta-analysis, youngest school children draw roughly equal percentages of male and female scientists, averaged out across boys and girls. By the time children are 7 or 8, male scientists significantly outnumber female scientists. By age 14, children are drawing 4 times as many male scientists as female scientists. And this isn’t backed by reality. In the UK, for example, there are more female than male scientists in genetics, polymers, and microbiology. Criado-Perez suggests that our schools are teaching brilliance bias, but I am willing to be that we’re teaching it at home as well? I’ve gotten after my husband for doting on our only girl (and who can blame him?) as being “cute” and “pretty” or commenting on her outfit, but I do worry that she will learn to place deep value in her appearance if that’s what she customarily hears. So now any comment on her appearance is followed with “and you’re smart and you’re tough too.” :)



Barbie: Chapter 5: The Henry Higgins Effect


Over the past fifty years, breast-cancer rates in the industrialized world have risen significantly (my mom has had breast cancer twice and my grandmother had breast cancer so this is of personal relevance to me––but the truth is, breast cancer affects 1 in 8 women so most of us know someone who has dealt with this disease). Sadly, a failure to research female bodies, occupations and environmental toxins means that the data for exactly what is behind this rise is lacking. ‘We know everything about dust disease in miners,’ Rory O’Neill, professor of occupational and environmental policy research at the University of Stirling, tells me. ‘You can’t say the same for exposures, physical or chemical, in ‘women’s work.’ (116) 


She goes on to describe the effects of chemicals on women working in nail salons: women are smaller, have thinner skin, and higher levels of body fat where many chemicals are stored. Ironically,  the studies of chemical exposure are done on “Reference Man,” which is a Caucasian man, aged twenty-five to thirty, weighing 154 pounds. There are many nail salon workers and factory workers experiencing health problems, including cancers linked to endocrine disrupting chemicals (EDC’s), which are found in a large number of plastics, cosmetics, and cleaners. Beyond this––these workers are exposed to one set of chemicals on the job (like breathing in the toxic dust from filing acrylic nails) and then they go home and work their “second shift” at home, using toxic chemicals to clean their homes. And yet there’s hardly any data on how these chemicals affect women’s bodies, let alone how they mix. 


This is something I know from my own experience-–I have MCS (multiple chemical sensitivity) so chemicals of all kinds REALLY bother me. This condition coincides w/my autoimmune disease and certain other common genetic variants. I sincerely wish there was more awareness around these chemicals (car fumes, synthetic laundry fragrance, etc.), it causes my lungs to ache, can exacerbate autoimmune symptoms. My heart aches to think of all these women in such unhealthy work environments. 



Amy: Chapter 7: The Plough Hypothesis


Humans (by which I mean mainly women) have been cooking with three-stone fires since the Neolithic era. These are exactly what they sound like: three stones on the ground on which to balance a pot, with fuel (wood or whatever else you can gather that will burn) placed in the middle. In South Asia, 75% of families are still using biomass fuels (wood and other organic matter) for energy; in Bangladesh, the figure is as high as 90%. In sub-Saharan Africa biomass fuels are the primary source of energy used for cooking for 753 million people. That’s 80% of the population.


The trouble with traditional stoves is that they give off extremely toxic fumes. A woman cooking on a traditional stove in an unventilated room is exposed to the equivalent of more than a hundred cigarettes a day. ...globally they cause three times more deaths every year than malaria (2.9 million). ...women who cook on them are exposed to these fumes for three to seven hours a day, meaning that, worldwide, indoor air pollution is the single largest environmental risk factor for female mortality and the leading killer of children under the age of five. Indoor air pollution is also the eighth-leading contributor to the overall global disease burden, causing respiratory and cardiovascular damage, as well as increased susceptibility to infectious illnesses such as tuberculosis and lung cancer. However, as is so often the case with health problems that mainly affect women, scientists admit that ‘these adverse health effects have not been studied in an integrated and scientifically rigorous manner.’ (152)


She goes on to tell how, since the 1950’s, development agencies have tried to introduce “clean” stoves, but these organizations suck at data collection.

...they don’t generally collect data on what user needs actually are (for example, drinking-water pumping; food processing; fuel collection) before starting on their development projects. And the result of this dearth of data is that, to date, clean cook stoves have nearly all been rejected by users. ... a USAID-funded report in Bangladesh repeatedly acknowledged that all five stoves increased cooking time and required more attending. This prevented women from multitasking as they would with a traditional stove, and forced them to change the way they cooked - again increasing their workload. Nevertheless, the main and repeated recommendation of the report was to fix the women, rather than the stoves. The women needed to be educated on how great the ‘improved’ stoves were, rather than the designers needing to be educated on how not to increase women’s already 15-hour average working day. (154) There is hope from India, where the problem was addressed––designers closed the gender data gap and first consulted with the women, then designed a cheap $1 mechanism that fit within their current stoves to increase efficiency.  Ugh...again, my heart aches for these women. This was yet another reminder of the privilege I enjoy. In Mongolia where my in-laws served a mission for 4 years, the pollution is so bad there it is like you’re constantly standing in the path of a bonfire that’s blowing your direction. I cook a lot and just can’t comprehend cooking with all that smoke day in and day out. 


In another initiative in Bangladesh, the women expressed enthusiasm about the new stoves, but when their husbands got home they prohibited their wives from spending their very limited money on a new cookstove. A headline was run describing it this way: “Despite efforts for change, Bangladeshi women prefer to use pollution-causing cookstoves.” Didn’t care to find out why the women didn’t get the new stoves - blamed the women and made them sound irresponsible and backward. (155)


**Francis, Collins, scientist who refused to speak in public conferences and forums until they put women on the panel. (https://www.nytimes.com/2019/06/12/health/collins-male-science-panels.html)

I always thought this was awesome because it was a powerful act of solidarity and support, and a brave act of moral courage to stand for justice and equity and inclusion. What I missed is that it’s critical so we don’t keep making mistakes like the favelas and the wrong crops and the cook stoves.



Amy and Barbie: Chapter 9: A Sea of Dudes

Amy:

A woman gamer and author played a VR game for the first time in multiplayer mode, and was sexually assaulted by a player named BigBro442. (VR is designed to feel real, so it felt real to her). She wrote about it on her blog, and the makers of the game had a really great response.

They immediately redesigned their ‘Personal Bubble’ setting (in which other player’s hands disappear if they come close to your face) to cover the entire body and so made such groping impossible. But as they themselves noted, while they had thought ‘of the possibility of some silly person trying to block your view with their hands and ruining the game,’ they hadn’t thought of extending the fading function to the rest of the body. How, they asked, ‘could we have overlooked something so obvious”?

Fairly simply, to be honest. Henry Jackson and Jonathan Schenker are clearly well-meaning men who don’t mean to shut women out. But it’s Sergey Brin and the pregnancy parking all over again: even the best of men can’t know what it’s like to go through the world as a person with a body which some other people treat as an access-all-areas amusement arcade. This just isn’t something that Jackson and Schenker have to face on a regular basis, and therefore it really isn’t all that surprising that they missed ‘something so obvious.’ (182)



Barbie:

A Cape Town-based tech company fell into this trap when they developed an app to help community health workers monitor HIV-positive patients. The app ‘fulfilled all the usability requirements; it was easy to use, adaptable to local language’ and solved a very specific issue. More than this, the community health workers were ‘excited at the prospect of using it.’ But when the service was launched, it proved to be a flop. Despite several attempts to solve it, the problem remained a mystery until a new design team took over the project. A team that happened to have a woman in it. And this woman “took only a day to discover the problem.’ It turned out that in order to more safely travel to the townships where their patients lived, female health workers were concealing their valuables in their underwear. And the phone was too big to fit in their bras. (179)

This doesn’t mean that Apple needs to make a bra-sized phone, but there is a trend of phone theft in Cape Town, and this is one more example of how when well-meaning teams made of only men develop their solutions to problems without women’s input, they’re likely to miss really critical information. Since developing technology is an extremely expensive undertaking, wasted a lot of time and money. If only they’d consulted with the nurses beforehand.


Barbie: Chapter 10: The Drugs Don’t Work


When a woman is involved in a car crash, she is 47% more likely to be moderately injured, even when researchers control for factors such as height, weight, seat-belt usage, and crash intensity. She is also 17% more likely to die. And it’s all to do with how the car is designed - and for whom. 

Women tend to sit further forward than men when driving. This is because we are on average shorter. Our legs need to be closer to reach the pedals, and we need to sit more upright to see clearly over the dashboard. This is not, however, the ‘standard seating position.’ (I learned to drive in a giant blue diesel Suburban and I literally had to stand up to floor the gas pedal. I always laughed about that, but I think of that memory differently now! My even tinier mother was the one driving that car! Suburbans are literally designed for people who drive a bunch of kids around in the suburbs. And who does that? Women! So why are they proportioned for a 6 foot tall person??) Women are ‘out of position’ drivers. And our willful deviation from the norm means that we are at greater risk of internal injury on frontal collisions. The angle of our knees and hips as our shorter legs reach for the pedals also makes our legs more vulnerable. Essentially, we’re doing it all wrong.


Women are also at higher risk in rear-end collisions. Women have less muscle on our necks and upper torso than men, which makes us more vulnerable to whiplash (by up to three times), and car design has amplified this vulnerability. Swedish research has shown that modern seats are too firm to protect women against whiplash injuries: the seats throw women forward faster than men because the back of the seat doesn't give way for women’s on average lighter bodies. The reason this has been allowed to happen is very simple: cars have been designed using car-crash test dummies based on the ‘average’ male.  (186-187)


Crash test dummies were first introduced in the 1950’s, and for decades they were based around the fiftieth percentile male. ...In the early 1980’s, researchers argued for the inclusion of a fiftieth percentile female in regulatory tests, but this advice was ignored. It wasn’t until 2011 that the US started using a female crash-test dummy, although ...just how ‘female ‘these dummies are is questionable. 

...There is one EU regulatory test that requires what is called a fifth-percentile female dummy, which is meant to represent the female population. Only 5% of women will be shorter than this dummy. But there are a number of data gaps. For a start, this dummy is only tested in the passenger seat, so we have no data at all for how a female driver would be affected (WHAT???!!!!) ...And secondly, this female dummy is not really female. It is just a scaled-down male dummy. And… women are not scaled-down men. We have different muscle-mass distribution. We have lower bone density. There are sex differences in vertebrae spacing. ...even our body sway is different. And these differences are all crucial when it comes to injury rates in car crashes. (187-188) This was just absolute absurdity to me. How hard is it to scale a dummy accurately to represent both genders? I’ve been in a scary car accident before when our car hydroplaned and rolled. At that moment, all the safety features of your car that you took for granted suddenly mean everything to you. I’m blown away that car crash regulations are still based on such narrow data. Where is the govt in all of this? 



Amy: Chapter 11: Yentl Syndrome (Yentl is of course the character from the Barbara Streisand movie - a Jewish woman in Poland who pretends to be a man in order to get an education. The film’s premise has made its way into medical lore as ‘Yentl syndrome’, which describes the phenomenon whereby women are misdiagnosed and poorly treated unless their symptoms or diseases conform to that of men.) Later on the podcast we will be covering Elinor Cleghorn’s Unwell Women: Misdiagnosis and Myth in a Man-Made World, which talks about lots and lots of issues in the medical world, but I still want to bring this one out because it’s so important.


If I were to ask you to picture someone in the throes of a heart attack, you most likely would think of a man in his late middle age, possibly overweight, clutching at his heart in agony. That’s certainly what a Google image search offers up. You’re unlikely to think of a woman: heart disease is a male thing. But ...a recent analysis of data from 22 million people from North America, Europe, Asia and Australasia found that women from lower socio-economic backgrounds are 25% more likely to suffer a heart attack than men in the same income bracket.

Since 1989, cardiovascular disease has been the leading cause of death in US women and, following a heart attack, women are more likely to die than men.


...Perhaps the greatest contributor to the numbers of women dying following a heart attack ...is that their heart attacks are simply being missed by their doctors. Research from the UK has found that women are 50% more likely to be misdiagnosed following a heart attack (rising to almost 60% for some types of heart attack). This is partly because women don’t have the ‘Hollywood heart attack’ (chest and left arm pains). Women (particularly young women) may in fact present without any chest pain at all, but rather with stomach pain, breathlessness, nausea and fatigue. These symptoms are often referred to as ‘atypical.’ (218-219)

Anyone who thinks we don’t live in a male-centric world… imagine if the tables were turned and the vast majority of the doctors throughout the ages had always been women, and so women’s symptoms were considered “typical” and men’s symptoms are labeled “atypical.” We do have many more women doctors than we used to - over half of OBs and Pediatricians are now women. But in most fields, women are still underrepresented, and even once we get to 50/50 it will still take a long time for us to stop seeing men as primary and women as secondary.


...a heart attack is traditionally diagnosed with an angiogram, which will show where there are obstructed arteries. But women often don’t have obstructed arteries, meaning the scan won’t show any abnormalities. ...women with ‘normal angiogram have gone on to suffer a heart attack or stroke shortly after being discharged from hospital. (220)






Amy:  Barbie, what is a takeaway from the book?


Barbie


Here’s one takeaway––


For much of my life, even during tough times, I’ve tended to tough things out silently, believing there was virtue in my uncomplaining nature. As I read accounts of Invisible women’s suffering worldwide, I see with new eyes the suffering that compounds when man is the standard and women, the other half of humanity, is “the other.” I question whether my silence is actually the most noble choice. Women need to speak up if women’s needs are to be accounted for––in academia, in tech, in public policy, in civic planning, in medical research, in chemical research, and so on. So we need to find our voices. But with a caveat––


When my husband and I saw a marriage therapist to help us address some recurring challenges we’d been struggling with, she taught us that nuance matters when we communicate. She coached us on tone, word choice, sentence structure, and reflective listening skills. It was hard work, but we learned a lot, and experienced healing together. Something that dumbfounded us was that these simple yet life-changing skills were completely new to us!


In a parallel way, I don’t think women OR men have had the opportunity to learn how to have difficult conversations with composure and goodwill. Sam Harris said, “Apart from violence and other parts of coercion, all we have is conversation with which to influence one another. If we fail to have civil and productive conversations [on important matters], we will fail to do everything else of value. Conversation is our only tool for collaborating in a truly open-ended way.” 


We need men that can be vulnerable and earn trust:

“I’m sorry for my part in this.”

“I want to earn your trust.”

“I’m on your side.” 

“I want to be part of the solution.”

“Tell me about your experience.” 


We need women who can say, 

“I need a space to feel heard. Can we practice sharing our thoughts in a calm way?”

“I’m still learning how to communicate openly and calmly.” 

“I need to know that you’re on my side, and I don’t want to make you into the enemy.”

“I need to share how patriarchy has hurt me. Can you be a listening ear for me?”


We need “I’m sorry if I was overly emotional or overly critical––this is a tender topic for me.” 


I believe we can improve our ability to have difficult conversations with composure and goodwill, so we can jointly work out solutions to these injustices. 



Amy: One takeaway for me is this: 

When I have conversations with people, including on this podcast, one of the things that some people emphasize is “men and women are not the same.” I must admit I feel some defensiveness rise up in me when I hear that, because “men and women are not the same” so often has meant 

  • “Men are bigger; women are smaller.”  (True, on average; true in my life) 
  • “Men are stronger; women are weaker.” (True, on average; true in my life)
  • “Men are rational; women are emotional.” (I don’t know if that’s true or if we’re just told it’s true so that’s what we see. I also don’t know if women are more emotional, if that’s because they’re subjugated. I also don’t know why men who lose their tempers are not seen as “emotionally out of control”. I do know that my body triggers water to come out of my eyes more often than my husbands, but he feels emotions every bit as strongly as I do, and I am every bit as rational as he is)
  • “Men want to go out into the world and conquer; women want to stay home and nurture,” and
  • “Men are leaders; women are followers.” 


And on and on with the implications that come from “men and women are different.” 


At the same time, I know people who claim that men and women are exactly the same, and I don’t feel like that’s true either. 


It makes me think of that conversation I had with Maxine Hanks on whether biological sex matters or not. I will always remember Maxine talking about her two professors who were arguing, and one said “what difference does one little flap of skin make” and the other said “when I’m on the delivery table and my baby’s head is crowning, it makes a whole lot of difference to me!” 


I want to respect and honor intersex persons, and the experience of all people along the gender binary. Those lives and realities must also be acknowledged, studied, understood, and treated with care. And at the same time, I did not realize all the many, important ways that typical men’s bodies are different from typical women’s bodies, and that there are such distressing outcomes from still regarding women’s bodies and lives as secondary and marginal. 


Thank you, Barbie… etc.


Barbie: Thank you Amy.


Amy:

Next time on Breaking Down Patriarchy, we will be discussing The Moment of Lift: How Empowering Women Changes the World, by Melinda French Gates, published in 2019. My friend Becca Archibald gave me this book last Christmas, and with all the reading I’ve been doing for the podcast I left it on my shelf of “to read later” for several months… but then several other people recommended it so I picked it up and read it over the course of about three days, and then immediately ordered it for several other people. It’s an amazing book, so check it out if you can, and then join us for the discussion of Melinda French Gates’ book, The Moment of Lift: How Empowering Women Changes the World, next time on BDP.





Compost Pile


One more point in this chapter I found really interesting about language is the way we describe historical eras. She says:


We class the fourteenth to seventeenth centuries as ‘the Renaissance’ even though, as social psychologist Carol Tavris points out, … it wasn’t a renaissance for women, who were still largely excluded from intellectual and artistic life. We call the eighteenth century ‘the Enlightenment,’ even though, while it may have expanded ‘the rights of man,’ it ‘narrowed the rights of women, who were denied control of their property and earnings and barred from higher education and professional training.’ We think of ancient Greece as the cradle of democracy although the female half of the population were explicitly excluded from voting. (13)



Chapter 5: The Henry Higgins Effect

Over the past hundred years workplaces have, on the whole, got considerably safer. ...In the US, around 23,000 people (out of a workforce of 38 million) died at work in 1913. In 2016, 5,190 people died out of a workforce of 163 million. ...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.


...In her 2018 retrospective of a lifetime spent researching women’s occupational health, Karen Messing, a geneticist and professor of biological sciences at Montreal University, writes that there has still been no biomechanics research on the effects of breast size on lifting techniques associated with back pain despite the fact that engineer Angela Tate of Memorial University alerted scientists to male bias in biomechanical studies back in the 1990s. Messing also points to women’s reports of work-related musculoskeletal pain still being treated with scepticism despite accumulating reports that pain systems function differently among women and men. Meanwhile, we’ve only just noticed that nearly all pain studies have been done exclusively in male mice. (115)


...



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About the Podcast

Breaking Down Patriarchy
An Essential Texts Book Club
Breaking Down Patriarchy is a podcast for everyone! Learn about the creation of patriarchy and those who have challenged it as you listen to bookclub-style discussions of essential historical texts. Gain life-changing epiphanies and practical takeaways through these smart, relatable conversations.

About your host

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Amy Allebest

I grew up in Colorado as the oldest of 5 children, reading, writing, drawing, singing, and practicing the piano and violin. I attended Brigham Young University, where I met Erik Allebest during my first week of freshman year, studied abroad in Israel, lived in Chile for a year and a half as a missionary, and married Erik all before graduating with a degree in English. Erik and I moved around - to Colorado, Southern California, Utah, Spain, and Northern California - while Erik started and ran chess businesses for a living (primarily chess.com) and I stayed home to raise our four children. Those four kids have become brilliant, hilarious people and are our very best friends. I am a long-time trail runner, a recent CrossFitter, a lifelong reader and writer, and an almost-graduate of Stanford University's Master's of Liberal Arts program.