I strongly recommend Invisible Women: Data Bias in a World Designed for Men to half the people of the world – the male half. Women may not need to read this book as much because they are, unfortunately, living it.

The main idea of Invisible Women is that our male-dominated world suffers from a massive data gap that renders women invisible and causes women incalculable harm and suffering.

The author, Caroline Criado Perez, is a British writer, broadcaster, and feminist campaigner educated at Oxford University and the London School of Economics. She received the Human Rights Campaigner of the Year award in 2013 from Liberty, a British human rights organization, and an OBE from Queen Elizabeth in 2015.

Invisible Women
By Caroline Criado Perez
Abrams Press, New York, 2019

The Gender Data Gap

Perez presents a mountain of evidence drawn from all over the world that women are invisible in two distinct ways.

First, women are absent from data. Women have always been absent from history of course; most of history is a bunch of stories about men, usually killing other men. But more important today, we don’t collect data specifically about women. From urban planning to drug trials to product design we either don’t include women in the data we collect, or we don’t disaggregate data about women from data about men. This means we are missing information about the characteristics, behaviors and needs of women.  

Second, women are underrepresented at decision-making tables in virtually all sectors of society. So important decisions about things like urban planning, drug treatments, or product design are not informed by women’s ideas, experiences, and perspectives.

This two-fold data gap exists, Perez argues, because the default human is male.

When we say “human”, most of the time we mean “men.” The default human body is male. The default customer, the default user, the default driver, the default patient, the default voter — they’re all male.

The default perspective is male too. And the male perspective is seen as objective and universal, “while the female experience – that of half the global population, after all – is seen as, well, niche.” [p. 12]

The data gap harms women in innumerable ways. Perez says these harms fall into three categories. First, we don’t account for women’s bodies when we design products, services, cities, … anything. We don’t consider women’s bodies when we design office air conditioning systems for men wearing suits, or prescribe drugs that don’t work for women or don’t work as well for women as they do for men.

Second, we don’t design our world to protect women from male violence. We don’t design public toilets, public transportation systems, parks, parking garages or even refugee camps to be safe for women. We also don’t collect nearly enough data about violence against women. Often there’s no place for women to report the violence or harassment they’ve experienced. And when women do report, they’re often not believed, or they’re shamed, or blamed while the males who perpetrate this violence are usually not prosecuted or punished.

Lastly the unpaid care work done mostly by women all over the world – child care and elder care – is invisible. It’s literally not accounted for; it’s not counted as part of GDP in any country and doesn’t count towards public pension plans. As Perez points out, the term “working woman” is 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.” [p. 70] 

As a result:

“Failing to collect data on women and their lives means that we continue to naturalise sex and gender discrimination — while at the same time somehow not seeing any of this discrimination. Or really, we don’t see it because we naturalise it — it is too obvious, too commonplace, too much just the way things are to bother commenting on. It’s the irony of being a woman: at once hyper-visible when it comes to being treated as the subservient sex class, and invisible when it counts – when it comes to being counted.” [p. 314]

Over the course of the book, Perez explores how women are not counted and not consulted in many different sectors of our society. It adds up to a dismal and infuriating picture. I’ll highlight just a couple of examples.

Automobile safety tests are done using crash test dummies that simulate a human body. A male human body. Perez notes that, even today, anatomically correct female crash test dummies are not widely used by car manufacturers. We really have no idea whether women are protected by car safety features, let alone pregnant women. We don’t collect the data from car crashes either. It’s usually just assumed that the driver is male, so accident statistics often do not provide sex-disaggregated data about the injuries sustained by crash victims.

On a less life-threatening but still serious topic, Perez describes how female pianists are more likely to suffer musculoskeletal injuries than male players. That’s because piano keyboards are designed for men who typically have wider handspans than women. Women must stretch their hands and fingers, sometimes to the point of injury, to play pianos that were not designed for them.

The Health Care Gap

Maybe this is my own male ignorance showing, but I think the most disturbing parts of the book relate to women’s health care.

To begin with, Perez details how women have different risk factors, present different symptoms, and require different treatments than men for many medical conditions including heart attacks, tuberculosis, autism, and chronic pain. Too often, these differences are not recognized by doctors (who are overwhelmingly male) because the default patient is male. So women are frequently misdiagnosed, or not diagnosed at all. Instead, women are told they are being emotional or hysterical, or that their problems are all in their heads. In other words, women are not believed, and worse yet are blamed for their medical conditions because they don’t fit the “normal” (male) patient profile.  

Women are not properly represented in drug trials. Too often, Perez tells us, drug trials either do not include enough women, or the data is not sex-disaggregated. So we don’t learn how drugs might affect women differently, or whether women might require different dosages. And drugs that do not perform well on men are simply abandoned without ever testing whether they might be effective for women – potentially huge and tragic missed opportunities.

Apparently, these shoddy practices persist. Invisible Women was published just before the COVID-19 pandemic, but I found this note, Sex-disaggregated data in COVID-19 vaccine trials, in the March 5, 2021 edition of the British medical journal The Lancet. As the title suggests, the authors call for sex-disaggregated analysis of COVID-19 vaccine trials but:

“According to an evaluation in preprint of nearly 2500 COVID-19-related studies, less than 5% of investigators had pre-planned for sex-disaggregated data analysis in their studies.”

In sum:

“The evidence that women are being let down by the medical establishment is overwhelming. The bodies, symptoms and diseases that affect half the world’s population are being dismissed, disbelieved and ignored. And it’s all a result of the data gap combined with the still prevalent belief, in the face of all the evidence that we do have, that men are the default humans. They are not. They are, to state the obvious, just men. And data collected on them does not, cannot, and should not, apply to women. We need a revolution in the research and the practice of medicine, and we need it yesterday. We need to train doctors to listen to women, and to recognise that their inability to diagnose a woman may not be because she is lying or being hysterical: the problem may be the gender data gaps in their knowledge. It’s time to stop dismissing women, and start saving them.” [p. 234-5]

Unsolicited Feedback

Invisible Women won the Financial Times Business Book of the Year in 2019. The award is well-deserved. The book is meticulously researched with examples and studies from around the world. There are over 70 pages of end notes.

Perez writes with clarity and passion mixed with frequent delightful sarcasm:

“Since the Australian Army reduced the required stride length for women from thirty inches to twenty-eight inches, pelvic stress fractures in women have fallen in number. And as an added bonus, not forcing women to march in time with men has not, as yet, led to the apocalypse.” [p. 123]

Perez notes at many places in the book that the default male is a white male, and she draws attention to the drastic disparities faced by women of color, especially in the United States. But on the whole, she does not deeply analyze questions about race. For example, her call for sex-disaggregated research data applies equally to race-disaggregated data, but she does not raise this point. And many of the systemic obstacles to gender equality are also obstacles to racial equality, such as the lack of representation in decision making and policy formulation. But again, she does not explore this topic.

Another omission is that Invisible Women does not talk about non-binary or transgender people at all. If anything, there is even less data about these groups than there is about cis-gendered women. Some discussion of the violence and discrimination they experience would strengthen Perez’s argument even more.

For a male reader, this one anyway, Invisible Women is an eye-opening, sometimes shocking, and thoroughly disheartening book. Yes, we’ve made some progress in some parts of the world towards greater equality and fairness for women. But we have so much farther to go, so much more work to do.

Perez doesn’t hesitate to call out misogyny when she sees it, especially in politics, but she doesn’t blame men for the data gap. This is partly because men have been the default human for so long we don’t even think about it. But reading through the tales of sheer boneheaded thoughtlessness described in the book, it’s hard to escape the conclusion that many of us deserve to be blamed.  By now we should know better. We should be doing better.

It starts with collecting the data and listening to women.

Guys, please read this book.