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Invisible Women - the "idiosyncratic" female colon

Invisible Women
Invisible Women - the "idiosyncratic" female colon
By Caroline Criado Perez • Issue #52 • View online

Hello GFPs!
This week I have been mainly eating cake (because it was my birthday) and declaring war on bindweed (also because it was my bindweed I mean birthday it’s possible I have spent too much time thinking about bindweed). Here is a picture of me after several hours in the trenches
Unfortunately I didn’t think to take a pic of my mortal enemy Mr Bindweed (it’s definitely a Reference Man) so you’ll have to take my word for it that he came off worse
Unfortunately I didn’t think to take a pic of my mortal enemy Mr Bindweed (it’s definitely a Reference Man) so you’ll have to take my word for it that he came off worse
In other news, this week I’ll be trying something new…which is always a bit nerve-wracking…
As you may have noticed, I launched a membership option two newsletters ago. At the moment it’s mainly just a way for those of you who want to, to financially support the work that goes into this newsletter, as well as an investment in its future as I figure out ways to develop it (and expand our reach as a community).
I’m so grateful to the many of you who have already signed up, and I wanted to do something for our growing community, so I’m going to host an instagram live q&a on Tuesday 22nd June at 12:30pm BST. I know not everyone is on instagram, but if you don’t have an account don’t worry, I will be experimenting with various different platforms to figure out the best way of doing things like this. This is just experiment #1 – remember we are still in our beta launch phase and I welcome all feedback for future events!
Members will be able to submit questions from today until midnight on Sunday 20th June (you’ll receive a separate email about this), so if you aren’t a member right now but want to submit a question, you still have time to join! You can ask about the GFP community, about the newsletter, about the book, about Poppy, about anything! And, of course, everyone can watch.
RIGHT, that’s enough of that, let’s get on to what you’re really here for ✊
Gender data gap of the week
WELL, GFPs, THE PLOT THICKENS.
As many of you will remember, last week we revisited the issue of pain-relief during gynae procedures that many women find painful. You may also remember that I quoted a couple of GFPs who compared the standard of care for gynae procedures with colonoscopies.
Here’s a sum-up of the situation as we knew it last week:
I wonder what on earth could be behind this discrepancy 🤔
I wonder what on earth could be behind this discrepancy 🤔
only taken me 2 years to get my first karadashian gif in despite literally referencing them in my bio. in my defence, i have actually never watched the show 😬
only taken me 2 years to get my first karadashian gif in despite literally referencing them in my bio. in my defence, i have actually never watched the show 😬
But, GFPs, it gets a lot worse than comparable procedures men also have to go through getting pain relief as standard where women have to just scream and bear it. Because, it turns out colonoscopies DON’T EVEN WORK PROPERLY FOR WOMEN
Following on from the newsletter, GFP Elizabeth got in touch:
Elizabeth McWilliams
@CCriadoPerez Pre-colonoscopy they told me most people have no problem with a colonoscopy. After returning home with my piece of paper saying ‘incomplete’ I looked up the stats on incomplete colonoscopy. Turns out the 2nd biggest risk factor for it after older age is being female.
WHICH REMINDED ME, I had actually briefly covered this in Invisible Women:
Women have a higher risk than men of developing right- sided colon cancer, which often develops more aggressively, but the faecal blood test commonly used to detect colon cancer is less sensitive in women than in men. Meanwhile, because women have on average a longer and narrower colon than men, colonoscopies in women may be incomplete. (IW, 220-221)
Meanwhile, there was this on my instagram:
A VERY GOOD QUESTION.
A VERY GOOD QUESTION.
I had a look around in the literature to see what I could find, but while there are loads of explanations for why colonoscopies may be incomplete which mostly boil down to either practitioner error or patient error, ahem I mean being old or a woman which is basically the same thing let’s face it 🤪, I didn’t find much by way of acknowledgement that the problem may be the scope itself except for a brief mention in this 2007 paper:
In some cases, particularly in women, many endoscopists find that use of a thinner endoscope, such as a pediatric colonoscope, can be advantageous. This endoscope is particularly helpful for navigating the female sigmoid colon; however, the endoscope’s ‘floppiness’ can sometimes become a hindrance toward the end of the procedure when trying to navigate those final centimeters to the cecum. Some endoscopes have a variable stiffness mechanism that is useful in cases where a more rigid endoscope is needed. When this is not available, some endoscopists achieve a similar increased stiffness by placing a biopsy forcep down the endoscope, then opening and applying tension on it.
ie: all that was available at the time of this article were sub-optimal workarounds. For the colon found in the bodies of half the world.
It did, however refer to a range of technologies that were at the time under development, including one prototype of a “variable stiffness colonoscope that tapers from the adult diameter to the pediatric diameter of 11.3 mm at 25 cm” that was specifically designed to cope with “the idiosyncrasies [hmmm] of the female sigmoid colon” Anyway, “This device is intended to be a compromise between the adult colonoscope and the thinner pediatric colonoscope often helpful in female colons.”
Which sounds great! My idiosyncratic non-standard colon is overjoyed!
But has this ever been rolled out? Well, it’s not clear, although the continuing high rates of incomplete colonoscopy in females would suggest that at the very least it is not standard. And then there’s this 2021 review which states that “sex-specific CRC screening guidelines and tools are not available.” Double hmmm.
Meanwhile in men…
Philippa Hammond
@CCriadoPerez And prostate biopsies are something only men experience - under general anaesthetic.

The vile assumption that women have to put up with pain is rife. https://t.co/e2Jk0iIFrS
ANYWAY! That is not actually this week’s gender data gap of the week, which on reflection maybe belonged in Default male of the week…oh well!
It’s this, which was submitted by GFP Inma:
For those of you who don’t speak Spanish, this is a call for participants in a vaccine trial for HIV. Hurrah!
It’s open to “HIV negative men and transgender people aged 18 to 60 who have sex with men and/or transgender people”. Wait, what? And I say wait what on several counts.
Let’s start with the obvious question: what on earth do they mean by “transgender people” as if they are an amorphous blob? Do they mean trans women? Trans men? Are they going to be receiving hormonal treatment? Are hormonal levels going to be part of the study? Which it OBVIOUSLY needs to be since we know that hormones do interact with treatments (something that we didn’t bother looking into for the COVID vaccines because obviously). And to be clear, it’s great that trans people are included in this research: we are woefully low on disaggregated data for trans people. But this is just sloppy research practice and it p*ss3s me off.
Next up, let’s address the obvious omission: HIV negative women aged 18 to 60 who have sex with men and/or transgender people.
I mean, it’s not like women make up more than half of those living with HIV worldwide is it? It’s not like AIDS-related illnesses remain the leading cause of death for women aged between 15 and 49, or that young women are twice as likely to acquire HIV as their male peers, amirite? It’s also not like young women (aged 15-24), or adolescent girls (aged 10-19) [this stats in particular kills me] account for a disproportionate number of new HIV infections.
In the worst-affected countries of Sub-Saharan Africa, “80% of new HIV infections among adolescents are among girls, who are up to eight times more likely to be living with HIV than adolescent boys. It is estimated that around 50 adolescent girls die every day from AIDS-related illnesses.”
I’m sorry for presenting such blunt and appalling statistics, but they felt necessary in the face of YET ANOTHER TRIAL FOR HIV THAT IGNORES WOMEN.
And this is before we get to the point that vaccines may be particularly important for women as a way to avoid contracting HIV. Why? Because of this:
The traditional advice of using condoms to avoid HIV infection is simply not practicable for many women who lack the social power to insist on their use. This also goes for Ebola, which can remain present in semen for up to six months. And although a gel has been developed to address this problem, it fails to account for the practice of ‘dry sex’ in certain parts of sub-Saharan Africa. A gel which also acts as a lubricant will not be acceptable in areas where women de-lubricate their vaginas with herbs in order to indicate that they are chaste. (IW, p.223)
Vulnerable GIRLS who are being coerced into unsafe sex are perhaps the population MOST in need of a vaccine. But apparently they are not important enough to include in a vaccine trial. GFPs, I try not to get too angry in tone when I’m writing this newsletter, but honestly I just can’t with this. I am RAGING.
Default male of the week
ARGH! I am still angry! Have a cute red-bellied lemur to cheer you up!
Except OH NO! 😭 As sharp-eyed GFPs will have noted, it is only the *male* that has a red belly 😭. The female belly is white.
MUST REFERENCE MAN RUIN EVERY D4MN THING???
Yes, yes he must. However! Don’t despair, my dear GFPs, because this cute whiteorred-bellied lemur (whed-bellied lemur??) was sent in by GFP Kate, who took this poster as an opportunity to PROSELYTIZE 🙌
Today I had a great chat with a younger woman about this sign (see bottom information box):
I was delighted to tell her about your book and works when she expressed frustration that so many creatures are named for male characteristics only (in species that are not capable of parthenogenesis and have equal population sexes) when others are named after their (also mostly male) finders.
Excellent work, GFP Kate. GFPs and white-bellied lemurs everywhere salute you! ✊
Actually designed for women of the week
So, as some of you may remember, a few weeks back product of the week (hmm maybe that should be the name for this section?!) was running shoes from Altra. These proved quite popular (apparently quite a few GFPs are also default female runners). You may also remember GFP Rose from a couple of newsletters later….
I promise I am not sponsored by Altra although at this rate maybe I should be, because this week I got ANOTHER message from GFP Rose…
erm well I have received several comments like this….
so uh, MAAAAYYYBEEE….sorry love you byeeee!
IN MY ALTRAS, NATCH
IN MY ALTRAS, NATCH
Anyway, yet again this is a section that opens with a section that is not in fact the focus of the section, BECAUSE, *this week’s* prize for designing product that actually accounts for women’s bodies goes to…BRIDGEDALE! For recognising that female feet are not just small men’s feet and designing their socks accordingly.
Wait, what? Didn’t you already do Bridgedale, you ask? Well, yes I did mention them before…
but that was before I had a) tried them out on a run and b) spoken to them about their design. Both of which I have now done. And I can report the following:
It all started when Bridgedale actually listened to women (imagine!) which then kicked off.. brace yourselves…a DATA COLLECTION PROCESS
keep it together, ron
keep it together, ron
“Initial findings,” Bridgedale told me, “showed that 85% of people thought outdoor designs and ranges were male based and 98% would buy female specific socks.” And, “unlike other brands we don’t just shrink and pink,” they continued, clearly knowing the way to my heard, “we went back to the drawing board and engineered women’s socks that:
  • Have a smaller size range than men’s styles e.g Men’s size Small is shoe sizes 3 – 5.5, women’s size small is shoe sizes 3 – 4.5
  • Focus on narrower women’s feet, whilst allowing for those who may require a bit more room.
  • Make stitching at the toes less bulky.
  • Adds elastic around the instep and ankle to stop the sock slipping, allowing for a close and supportive fit.
  • Reinforces the heel and toe.”
Oh, and yes, I can confirm that following my run in them last week it’s a GFP stamp of approval from me* ✊
*now I actually want a GFP stamp
And finally! Can anyone help a GFP out??
Women fixing it of the week
One of the questions readers of Invisible Women ask me most often is, “how do we fix this?” Which, since my readers are the BEST, usually means, “what can I personally do to fix this?” And my answer to that question never really feels very satisfying, because the reality is that a lot of what is needed involves high-level decision-making, regulation, and, more often than not, financial investment.
For GFPs without that kind of power and money, or alternatively the kind of time that as all good readers of Invisible Women know is often lacking from women’s lives (see IW pp…well, pretty much all of it – male GFPs, this is your moment to shine! 😘) it’s harder to recommend things you can do that won’t take over your lives.
So I loved getting this from GFP Naomi, who wrote to tell me about her one woman mission to address the default male in her daughters’ school readers:
Naomi clearly knows the way to my heart 😍
Naomi clearly knows the way to my heart 😍
Now, this approach of changing default male to female when reading books to children has been mentioned to me by several GFPs in the past and NATURALLY I love it, but Naomi is taking things ONE STEP FURTHER:
Yes they could, Naomi, yes they could.
Yes they could, Naomi, yes they could.
Anyway, I am very much looking forward to hearing back from Naomi on her campaign; in the meantime she has asked me to ask YOU what your children’s school readers are like.
Now, being able to directly hook GFPs up for exactly this kind of thing is one of my plans for the membership option, but I haven’t figured out exactly how to do that yet, so in the meantime you will all just have to send your data to me so I can pass it on! (and maybe share it in a future newsletter too) Incidentally, if anyone DOES have any ideas for how/where to set up a members forum-type-thing or where we can discuss and share data and whatnot, please do get in touch! I REALLY want to do this.
Homework of the week
By contrast I was *very* disappointed to receive this email from GFP Hannah:
I was particularly disappointed to get Hannah’s email because I know for a fact that Levi’s are perfectly capable of including proper pockets in their women’s jeans and I know that because because I now *only* only buy Levi’s 501s purely because they have MASSIVE pockets of the kind I have literally never experienced in women’s clothes before. I had naively assumed all Levi’s were so well endowed….
But not so. Check out Hannah’s pics:
Anyway, as Hannah said, she emailed Levi’s, but she got a very disappointing reply, NOTHING like my Sweaty Betty reply, where they didn’t address her complaint at all, just gave her directions for how to return the product. Which is not what we want, is it!
No, as our YouGov survey found, EIGHTY PER CENT of women want pockets in their trousers, and let me assure you, Levi’s and in fact all clothes manufacturers, we don’t want pockets because we think they look pretty, we want pockets SO WE CAN PUT THINGS IN THEM WHICH IS LITERALLY RHWY POCKETS EXIST IN THE FIRST PLACE. And by things I mean things adult women in the 21st century actually carry around, not thimbles and a single pound coin if you’re lucky.
So, GFPs, are we going to take this pocket-teasing lying down? No we are not! So what next?
Well I tried very hard to find the right person at Levi’s to speak to about this, but it’s almost like Levi’s doesn’t want a horde of angry pocket-starved GFPs getting in touch??? In fact they don’t even advertise a customer service email address which I find DISTINCTLY SUSPECT, but no one has ever accused me of not being up for a challenge
I did find out that the global head of design is a woman called Karyn Hillman who I am confident is a GFP in the making, if only there were a way to contact her. And THIS is where GFPs come in 💪
I would love to see Levi’s become the first major brand (that I’m aware of) to ensure ALL their jeans come with great and glorious pockets that are big enough to fit a smartphone in. And we know they can, cf the 501 range. There are nearly 20,000 of us. I refuse to believe not a single GFP either works for Levi’s or knows someone who knows someone who does. Do you? Get in touch! I think this could be an easy win for everyone. (again, this is exactly the kind of thing I eventually want to turn the members scheme towards)
IN THE MEANTIME, however, I think it’s worth also showing them the strength of feeling on this so I am proud to announce…drum-roll please, the first GFP mass mailing of 2021!
Click here to let Levi’s know what you think of their insult to pockets and indeed GFPs everywhere.
WE WANT POCKETS! ✊
Poppy pic of the week
How dare you go out without me HOW VERY DARE YOU
How dare you go out without me HOW VERY DARE YOU
(yes the windows do need painting 😬)
RIGHT! That’s it! Until next time, my dear GFPs! And don’t forget, you can now support the work I do for this newsletter by becoming a member!
Love you, byeee! xoxoxo
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Caroline Criado Perez

Keeping up with the gender data gap (and whatever else takes my fancy). Like the Kardashians, but with more feminist rage. Plus, toilet queue of the week.

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