Helloooo GFPs! Big week at IW HQ this week as I got some real world proof of the impact Invisible Women has been having on the research world -- see this week's gender data gap for more details. I couldn't be more delighted to see researchers taking on the message of my thesis and, most importantly, acting on it by collecting sex disaggregated data -- and then analysing that data by sex. This is the first step to fixing the multitude of ways in which our world has been designed for men to the serious detriment of women's health and lives. It's an incredible win.In other news, just a quick heads-up that there will be no newsletter next Monday as this week I am travelling to five cities in four days 😱. It's all in service of the podcast whose launch date is getting ever closer 😱😱 😱So anyway, I'm pretty sure I won't have time to write up a newsletter -- I promise it will be worth it when the podcast comes out! Plus this has turned out to be a bit of a bumper edition, so plenty to keep you going for two weeks!

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Gender data gap of the week

This week saw the publication of a really important piece of research. which looked at sex differences in injury patterns, and the likelihood of getting trapped in a car, following a car crash. "This," write the study authors, "is the largest analysis to date of sex-disaggregated data for patients with trauma following an MVC [Motor Vehicle Collision]."

In fact, on some measures, it's not only the largest analysis, it may also, incredibly, be the first:

To our knowledge, no studies have considered the differences in injury patterns, entrapment status and morbidity and mortality outcomes between female and male patients. Failure to collect and analyse sex-disaggregated data is a common concern in research; while most studies present baseline demographic data by sex, far fewer report outcome data by sex or conduct sex and gender-based analysis (SGBA).

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Obama speaks for GFPs everywhere (I am choosing to believe Obama is a GFP)[/caption]

The researchers continue:

We could find no previous sex-disaggregated data, which report injury patterns for patients trapped following an MVC.

No sex disaggregated data -- fancy that!

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This information would be useful for those triaging, rescuing or treating patients. There may be additional value of sex-disaggregated data to target public health interventions and the design of safety systems such as restraint devices and airbags.

Indeed it would, and we go live now to the reaction from our friends in car manufacturing:

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Encouraging as always.

Anyway, turns out that there are sex differences in both. Women are nearly twice as likely as men to become trapped following a car crash, and there are significant sex differences in injury patterns.

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Why does this matter? Well, for a start, because "patients who are trapped have worse outcomes than those who are not trapped," so designing cars so that women are less likely to become trapped would seem to be an important public health initiative -- and let's not forget, we already know that women are 73% more likely to be seriously injured or die than a man in the same crash.

And the sex differences in injury patterns perhaps point to a reason behind women being more likely to get trapped -- and therefore, a solution. It turns out that women are significantly more likely than men to have injuries to the pelvis and to the spine, both of which could be part of why women are more likely to become trapped in the car -- I'm no doctor, but I'm fairly sure that both your pelvis and your spine are quite important to being able to move yourself.

So the question is, why are women more likely to experience these kinds of injuries? Well, it may be down to our old frenemy: the car safety tests.

As readers of Invisible Women will remember, male bodies are significantly better represented in these tests than female bodies. A brief recap:

There exist 3 dummies for frontal crash tests:

• a 95th percentile male dummy (ie only 5% of men will be larger than this dummy)

• a 50th percentile male dummy, and

• a 5th percentile female dummy.

So right off the bat, men are twice as represented as women, two dummies to our one, which totally represents sex rations in the extant human population. Added to this already substantial gendered data gap, the female dummy isn't even used in most of the tests -- and she isn't tested at all in the driver seat, because of course, women don't drive.

But, GFPs, it gets worse than that, because the so-called female dummy is in fact not a female dummy: it's a very very very very scaled down version of the male dummy. And as I believe I may have mentioned before, just once or twice over the years, women are not just small men. There are other differences, like muscle mass distribution and in spinal column flexibility. Women’s cervical vertebrae are smaller than men of equivalent head size, women's torsos are shorter than the torsos of men of equivalent height, and, of course, as per last week's newsletter, there are differences between the male and the female pelvis, with women's being wider even when controlled for height difference.

Sharp readers may already be noticing a connection here between some major bodily sex differences and the places women were found by this study to be most likely to be injured. It's almost as if testing a very small male dummy in place of an athropometrically correct female dummy doesn't actually make cars safe for actual women? But what do I know:

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GFPs, these findings are obviously awful -- but I was also delighted to read them -- not only because any sex disaggregated and analysed data hits my sweet spot, but because the study authors have explicitly cited Invisible Women as the motivation behind carrying out the research in the first place. I don't think I can express quite how gratifying this is: getting researchers to understand the importance of doing sex analysis is why I wrote the book in the first place. It's amazing to see it having exactly the impact I hoped it would.

Now the question is: what will regulators do with this information? In the EU there has been a really amazing development where legislation is being adopted that will for the first time, require new car models to include frontal impact protection “which does not disadvantage women and older people.” Naturally, the British government does not intend to adopt this new rule because Brexit, basically. Freedom [for default men]!

Default male of the week

Longtime GFPs will remember that this newsletter has been banging on about PPE that hasn't been designed for female bodies for quite some time now. For example, here, here, here, here, here, here, here, here, and perhaps most infamously and morally indefensibly here. Not to mention of course, in Invisible Women itself, pp.121-7

And so I was not surprise to see this from the Association of American Medical Colleges:

Oversized and overlooked: Women surgeons struggle to find equipment that fits | AAMC — www.aamc.org Even as women physicians gain a foothold in the male-dominated surgical specialties, they encounter other barriers.

Well, actually I was kind of surprised because while this problem is incredibly common, it's actually fairly rare to see this being acknowledged by official bodies, so, three cheers for the AAMC.

Fewer cheers, however, for manufacturers of medical equipment, from surgical tools to PPE, because they are still really struggling with the idea that female bodies exist.

Kimberly Templeton, MD, a professor of orthopedic surgery and residency director at the University of Kansas Medical Center in Kansas City, didn’t realize that the lead gowns that she had used to protect herself from radiation during procedures did not fully protect women's breasts until she was peer-reviewing a paper on the issue.

“I was the first woman who trained in [my residency] program,” says Templeton, who served as president of the American Medical Women’s Association from 2016 to 2017. “It wasn’t something anyone thought about.”

The 2016 study pointed out that women orthopedic surgeons get breast cancer at a higher rate than the general population of women in the United States and found that the radiation-blocking gowns fail to protect the upper quarter of breast tissue near the armpits.

But sure, one-size-fits-men PPE is JUST FINE

While there are sleeves designed to add to the gown for protection, they are cumbersome and can make it more challenging to perform surgery, Templeton says.

The gowns also often don’t fit bodies in the later stages of pregnancy, a major concern because radiation exposure to a fetus can cause negative health effects.

Templeton believes that manufacturers who make gowns should consult the women who wear them to develop a design that both protects the wearer and allows them to perform their job functions.

I mean, yes that would be nice.

A mid-newsletter detour

GFPs, I regret to announce that I was involved with a minor twitter ruckus this week.

I do try to avoid those these days, but, well, someone sent me a tweet thread by a company called Arqaam, and...it kind of p*ssed me off.

In its twitter bio, Arqaam presents itself as providing "Informed & Ethical Data Analysis" -- but the tweet thread in question gave an uncited run-down of some of the major talking points from my book: car crash test dummies, heart attacks, urban planning. And...ok, that could be lifted from my book, but on the other hand, those talking points have taken on a life of their own and are spoken about by people who've never ever heard of me or my book so...not a smoking gun.

But the thread also linked to a blog post...and that post, also uncited, 100% was lifted from the book. I know this because not only did it go into those same talking points in more detail, it also made two rather obscure references that made it glaringly obvious that this content was lifted from Invisible Women.

The first was the reference to the female viagra study that tested how the drug interacted with alcohol on 23 men and 2 women (IW, p.207). And the second was the quote from Tom Schalk, the VP of voice technology for auto supplier ATX Group, who, instead of turning his attention to fix his voice recognition software that couldn't adequately recognise the voices of 50% of the global population, instead suggested that women could undergo "lengthy training" to fix the "many issues with women's voices." (IW, p.163). Together with the heart attacks, the car crashes, the references to trip-chaining and cities being designed around the traditional needs of the "male breadwinner," it was simply not credible that this was not plagiarised content.

So..."Informed," yes, but "Ethical"? Not so much.

Now, this is far from the first time I've been plagiarised. In fact, it happens semi-regularly to me, usually in the form of some viral social media post where someone will claim to have "just suddenly thought of how the world is designed for men" (🧐) and then go on to list most of the major examples from my book.

These annoy and upset me. Of course they do. It's incredibly frustrating to have your work stolen and presented as someone else's. Writing Invisible Women was the hardest thing I've ever done and probably will ever do. It took so much out of me mentally. It sucks to have people casually rip it off.

I often wonder if people think I just wouldn't know? That I won't recognise when you've lifted examples I spent the best part of a decade curating and present them as your own original research that you curated? Because actually this hasn't just happened in viral threads. I have seen this happen in at least one feminist book too. And, trust me, I know. I know that research intimately. I know which combinations of studies mean you've stolen my work.

I've let these examples slide, feeling it's more trouble than it's worth to make a fuss. But this one, I didn't let slide. It's one thing for someone to nick your work for a viral thread. It's quite another for a company to profit from it.

Arqaam is based in Germany -- and Invisible Women was a bestseller there for months (published as Unsichtbare Frauen). There was no way this was a coincidence -- and I wanted a citation. Bringing together all those disparate studies and stats, from all these different disciplines, to PROVE that the data gap is gendered, systemic, global, and multidisciplinary, was HARD. I deserved to be credited for doing that work.

So I tweeted them.

GFPs, I'm delighted to announce that this is a story with a happy ending. Not only did the company in question tweet to apologise (and updated their blog post to cite me at the top), the new Comms Manager at the company, Heidi, also followed up with an email.

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This was good to see, but even better was this:

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I call that a win. And so, Heidi from Arqaam, apology accepted.

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Homework

My dear GFPs, I know you love a bit of homework and have I got a corker for you this week. You may remember a while back I appeared on a panel about car safety at SXSW, organised by VERITY NOW -- a US-based coalition that's working on improving car crash safety tests.

Well, there is a real opportunity to have an impact in the US , because the US regulator (NHTSA) is requesting comments on the question of updates to 5 star safety -- these are the consumer tests, and they currently do not require a female dummy in the driver seat. When they do use a female dummy, in the passenger seat, they are using the very old scaled-down-male Hybrid III 5th percentile female dummy. This is weird because there is a more advanced 5th percentile female dummy available, the THOR 5F -- and the tests have introduced the more advanced THOR average male dummy. So why are women stuck in the 1980s?

GFPs, here is your mission, should you choose to accept it:

1) submit your comment on NHTSA's website, explaining why you want better representation for women in car safety tests. You can find loads of useful resources/info on VERITY NOW's website to help you craft your message and they've also created this useful toolkit.

2) Tweet @SecretaryPete, the US Secretary of Transportation, and ask him to tell @NHTSAgov to put the advanced female dummy in the driving seat for 5 star safety tests. If you aren'y sure what to say, VERITY NOW have put together some handy examples for you:

Example 1

#DYK women are 17% more likely to die in a vehicle crash than men? Why? NCAP tests do not require the use of female crash test dummies. @SecretaryPete we need #equality in all vehicle safety tests to protect women's lives. #VERITYNOW

Example 2

Vehicles and vehicle safety tests are designed by men, for men. Female crash test dummies are simply scaled-down versions of male dummies. This bias in design disproportionally affects women's lives. @SecretaryPete, it's time to #BreakTheBias in vehicle safety. #VERITYNOW

That's it! Go forth, my GFPs, and help literally save women's lives

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Poppy pic of the week

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That's it! Until next time, my dear GFPs....xoxoxo