Invisible Women: Data Bias in a World Designed for Men

We live in a world driven by data, an ocean of data that in theory should enable us to make much better decisions. Yet, to a truly frightening degree, that data leaves out half the human race--the female half.

One way is, of course, in medical studies. For a long time, women weren't included at all. Only men were included in medical studies, and it was just assumed that of course the same data, at least when adjusted for weight and height, will apply to women. Yet the reason women aren't included in studies is because women's bodies are different, and in some ways more complicated. It's bizarre that no consideration is normally given to whether this might mean that drugs and treatments might affect women differently.

Of course, they do. One of the better-known examples, now, is that women don't show the same symptoms as men when having a heart attack. Because of this, women tend to get diagnosed later, and are less likely to survive. But there are a wide range of problems resulting from the lack of female data in medical studies. Women have different proportions of fat in their bodies than men, and different proportions of the different types of muscle than men. This causes many drugs to be processed differently, and this can make those drugs less effective in women, or make different dosages than arrived at by taking data based on men and adjusting it only for weight.

But's not just medical data that's missing, and that matters. Virtual reality designs are based on men, and aren't always as effective for women. Okay, that's just games. What about homeless shelters, or disaster relief shelters, or refugee shelters? We want them to be safe, but "safe" for men isn't the same as "safe" for women. Yet typically all these shelters are designed with the assumption of "gender neutral" design is genuinely gender neutral, when in fact it simply leaves out women's safety issues.

Most unpaid work, caring for children, other family members, elderly parents, is done by women. Women to the cooking and cleaning, most of it anyway, and the amounts done by men and women hasn't changed as much as we like in the last forty years. That work is of great economic value, and society depends on it, but because it's unpaid, it's simply not counted, and it's not accounted for in making tax, pension, and other legal and economic decisions that affect women's ability to do both their caring work and their paid work--often forcing women to cut back on or drop out of paid work. Some of those decisions are the ones working women or formerly working women deal with on a daily basis in middle class lives in developed countries. Others are truly startling, like building public housing that takes no account of extended families and informal local networks that provide backup and support for women trying to both care for their families, and earn money to provide for them.

Criado-Perez recounts the impact of the lack of data, or even more infuriatingly, the impact of not using data that has been collected, in a lively, interesting, accessible, and compelling way. I personally think the most startling error caused by not talking to women, or as far as I can tell, thinking, is the rebuilding of housing following a natural disaster in Sri Lanka--without kitchens. How do you not realize that houses need kitchens? Even not bothering to talk to the women, but only the men, hardly seems like an adequate reason for doing that, but it apparently also happened elsewhere, for the same reason.

I'm not conveying at all, I think, just how engrossing this book is, how well-organized, and how informative and enlightening. Highly recommended!

I bought this audiobook at Libro.fm. ( )

The world isn’t designed for women, and we don’t even know how bad it is because we haven’t collected information about it. For example, until very recently there was no crash testing of cars using dummies with a female weight/height profile, and it’s still very limited. “[W]hen a woman is involved in a car crash, she is 47% more likely to be seriously injured, and 71% 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.” Because women are shorter, “[o]ur legs need to be closer to reach the pedals, and we need to sit more upright to see clearly over the dashboard,” but designers have defined this as the wrong position, making us “out of position” drivers. We “have less muscle on our necks and upper torso than men, which make 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.”

Women’s work is ignored, which means that, for example, transportation planning doesn’t take into account the trips that women are more likely to make and anti-poverty programs move women into places where their networks are unavailable and childcare is suddenly both necessary and impossible to find. And male violence against women is ignored, so women’s safety concerns that limit use of public transportation and public space are dismissed as flaws in female behavior, even as we now know that women in India who have to use fields to urinate, instead of bathrooms, face a much greater risk of sexual assault and that women prefer security measures at bus stops (where we otherwise have to wait alone in the dark) to cameras on buses (which transportation designers are more willing to plan for). The disregard for women’s interests interacts—when we don’t count unpaid care work, we find that moderately long hours at paid work improves men’s health but threatens women’s health—because women are actually working a ton more. Everything could use some gender analysis: what counts as a deductible work expense generally conforms to “the kinds of things men will need to claim. Uniforms and tools are in; emergency day care is out.”

Among the rage-inducing stuff, I also learned that “countries with genderless languages (such as Hungarian and Finnish) are not the most equal. Instead, that honour belongs to a third group, countries with ‘natural gender languages’ …. because men go without saying, it matters when women literally can’t get said at all.” Relatedly, “gender neutral” tenure policies that give extra time on the tenure clock for having children advantage men, who use the extra time to write: one analysis of economics departments found that they resulted in a 22% decline in women’s chances of gaining tenure at their first job, and a 19% increase for men. Instead, Perez points to the example of giving father-specific paternity leave on a use it or lose it basis, which has apparently done some good in Sweden.

Then there’s bias against women: male biology students routinely underevaluate female peers while female students can tell who’s actually good; student evaluations are biased against female professors (and nonwhite professors)—that we know this very well and keep using evaluations as part of the standards for professors demonstrates that it’s not just lack of information that’s the problem, it’s that policymakers can’t stop thinking of women as problems to be solved, deviations from the norm. Women can’t get startup funding as easily as men; when professions gain importance (like computer programmers), decisionmakers kick women out of the field. In such circumstances, the myth of meritocracy can only perpetuate itself by collapsing the is/ought distinction—Perez cites an example of a finding that “frequenting a particular Japanese manga site is a ‘solid predictor of strong coding,’” which of course is much more about free time and culture than anything else.

And it’s not just money; women pay in illness and death for these failures to see. Construction jobs have safety limits on what can be lifted, but the research and regulation in nursing lags far behind. Miners’ diseases are heavily studied, but not the chemicals used in nail salons. The Army buys ‘different boot styles for hot and cold weather, mountain and desert warfare and the rain,’ but not for women. Medicine isn’t studied in women because women’s bodies are considered too complex and variable—but it sure as hell is prescribed to us, though our pain is undertreated. One result: “the second most common adverse drug reaction in women is that the drug simply doesn’t work, even though it clearly works in men.” And note what else that failure may mean: since women aren’t sufficiently studied in drug trials, we are likely losing out on drugs that would work for women but are ruled out because phase one trials are mostly done in men. And so on.

Poverty programs that fail to think about women fail. In Syria, for example, “while the introduction of mechanisation in farming did reduce demand for male labour, freeing men up to ‘pursue better-paying opportunities outside of agriculture’, it actually increased demand ‘for women’s labour-intensive tasks such as transplanting, weeding, harvesting and processing.’” Other interventions fail “in part because women are already overworked and don’t have time to spare for educational initiatives, no matter how beneficial they may end up being,” leading innovators to blame women for failing to be sensible. Other initiatives “exclude women by requiring a minimum land size, or that the person who attends the training is the head of a farming household, or the owner of the land that is farmed.” The story of improved stoves—which could help environmental impacts and women’s health—is particularly frustrating, because their designers for decades ignored the barriers to women’s uptake and blamed women for not changing, even though the new stoves disrupted multitasking and household relationships. ( )

This is a book that once again will be ignored by those who don't want to hear it. I'm sure it has added to the authors litany of threats but it's a book that needs to be read that needs to be thought about and examined. Yes there may be errors, but honestly I want to see your proof and if you're coming at this going "well actually the number is 77% not 78% and with that error how can we trust any of it" I don't want to hear it.
There were two things that stood out for me in this book, one was the Policewoman who had breast reduction surgery to make her stab vest safe... the other is that 78% of female pianists (47% of men) have hand pain and that if they just could use the 7/8 DS keyboard that this would be drastically reduced. The reason the second anecdote stood out for me is because I had ganglion surgery at 21 and stopped doing piano exams because the Octave scales were causing pain. I had done 7 of 8 exams before the Diploma. Barely passing the last one so I decided to cut my losses.

I'm a short woman, I wear a padded piece on the seatbelt of the car because otherwise it rubs painfully. I'm also aware that front impact protection bags can kill women my size. But the fact that we're in a world where it's acceptable to ignore 50% (I've seen the numbers at 51% but let's just go broad here) of the population because it's messy to properly do the research. Ignoring the fact that body chemistry can have impact on things. The fact that a lot of tools to help detect that a person has fallen over involves phones in pockets... when most women can't carry them that way.
Read this book, no really, there may be some errors in it but overall it's a book that designers and most men need to read and then ask themselves why women aren't angrier.
I lost sleep over this book.... ( )

A depressingly eye-opening of the way that the male default has an effect in every area of life in every country, from transportation planning to medical research to the calculation of the GDP. Thoroughly researched and compellingly argued; essential.

Epigraph:
Representation of the world, like the world itself, is the work of men; they describe it from their own point of view, which they confuse with the absolute truth. -Simone de Beauvoir

...men go without saying, and women don't get said at all. (xii)

...male bias is so embedded in our psyche that even genuinely gender-neutral words are read as male. (9)

while errors overall are 'notoriously hard to kill...an error that ascribes to a man what was actually the work of a woman has more lives than a cat.' -Hertha Ayrton (17) (see: Rosalind Franklin: https://en.wikipedia.org/wiki/Rosalind_Franklin)

[Snow-clearing in Karlskoga, Sweden] They didn't deliberately set out to exclude women. They just didn't think about them. They didn't think to consider if women's needs might be different. And so this data gap was a result of not involving women in planning. (32)

[Transport planning divides data into travel for paid work and not, so all of women's unpaid care work gets subdivided into other categories; planners should take care travel as seriously as employment travel.
Zoning also has an effect on transport; more mixed-use areas would be better for women.] ...Zoning has women a male bias into the fabric of cities around the world. (39)

When planners fail to account for gender, public spaces become male spaces by default. (66)

Iceland passed the Gender Equality Act in 1976, a year after the women's strike....if Iceland's strike does anything it is surely to expose the term "working woman" as a tautology. There is no such thing as a woman who doesn't work. There is only a woman who isn't paid for her work. (70)

Women end up working in jobs below their skill level that offer them the flexibility they need - but not the pay they deserve. (75)

Why should we accept that the way men do things, the way men see themselves, is the correct way? [Promotions at Google, 108)

The gig economy is in fact often no more than a way for employers to get around basic employee rights. (132)

It's not always easy to convince someone a need exists if they don't have that need themselves. [breast pumps, 170)

"Gender affects the kinds of questions we ask...[limiting developers to one gender puts companies] in a position of myopia." (Margaret Mitchell, senior research scientist at Google, 179)

Even something as basic as advice on how to exercise to keep disease at bay is based on male-biased research. (210) When even something as simple as ice-pack application is sex-sensitive, it's clear that women should be included in sports-medicine research at the same rates as men. But they aren't. (211)

It seems that Yentl syndrome may be at play again here: it is striking that so many of the stories women tell of undiagnosed and untreated pain turn out to have physical causes that are either exclusively female diseases, or are more common in women than in men. (227)

Period pain - dysmenorrhea - affects up to 90% of women...it affects the daily life of 1 in 5 women...but despite how common it is and how bad the pain can be, there is precious little that doctors can or will do for you.
...sildenafil citrate [Viagra!] has been shown to work but further studies are needed and are unlikely (in case adverse affects turn up that would endanger the use of sidenafil in men) (229-231)

Like so many of the decisions to exclude women in the interests of simplicity, from architecture to medical research, this conclusion [Excluding unpaid services of housewives in calculating national income] could only be reached in a culture that conceives of men as the default human and women as a niche aberration. (241)

The failure to measure unpaid household services is perhaps the greatest gender data gap of all. (241)

Physical infrastructure vs. social infrastructure; early childhood education studies (249)

..the public provision of childcare services is 'strongly associated' with higher rates of women's paid employment.
We like to think that the unpaid work women do is just about individual women caring for their individual family members to their own individual benefit. It isn't. Women's unpaid work is work that society depends on, and it is work from which society as a whole benefits. (252)

US tax system, married filing jointly (259)

"It's just a feature of human psychology...to assume that our own experiences mirror those of human beings in general..." [naive realism, projection bias] Essentially, people tend to assume that our own way of thinking about or doing things is typical. (Molly Crockett, Oxford University, 270)'

Given the steady stream of abuse reports from around the world, perhaps it's time to recognize that the assumption that male staff can work in female facilities as they do in male facilities is another example of where gender neutrality turns into gender discrimination. Perhaps...no male staff should be in positions of power over vulnerable women. (refugee camps, detention centers, 304) ( )

This book does a thorough job cataloguing the various ways in which the needs of women are not met or ignored. Medicine, technology, politics, public infrastructure… there was a lot of yelling while I was reading this book. There’s an especially good line about women being simultaneously hyper-visible (when it comes to being treated as sexual objects) and invisible (when we need to count how many women use a drug or have an adverse reaction to it, or take the bus to certain locations, or whatever). This book would pair nicely with Angela Saini’s “Inferior”, which goes into detail about the medical sphere in particular.

As a side note, I’d often seen the term “gender-based analysis” being batted around, but it was only through reading this book that I really gained an understanding of its value and what sort of initiatives it could inspire. This book shows us where the deficiencies lie. Now we just need to address them. ( )