My dear GFPs, welcome, if you can believe it, to the 50th edition of the Invisible Women newsletter! First off, I want to thank you all so much for joining me in this sometimes infuriating project of documenting and ultimately, hopefully, closing the gender data gap.And second, I want to share with you an important announcement: over the lifetime of this newsletter many of you have very kindly asked if you can contribute financially to this newsletter. I've held off doing that as I wanted to keep this open to everyone: closing the data gap is going to take an awful lot of people and putting this information behind a paywall does not serve that goal.But I have come to a point with this project where it just isn't sustainable to keep producing this newsletter in my spare time -- I can't reliably give it the time and attention it deserves and needs each week. AND, I want to do more with this amazing community we are creating. And to do that I am going to need your help. So as of this week, if you want to become a paying member of the Invisible Women community, you can! For more details, read on, GFP, read on!

In my very first edition of this newsletter back in August of 2019 I wrote about how the growing movement of women (and a heartening number of men) all fired up about closing the gender data gap had made me feel less angry and less alone.

There are a few questions that I've been asked repeatedly in the six months since Invisible Women came out. "What was the worst example of the gender data gap you came across?" is a common favourite. "How do we get men to read it / are any men reading it?" is another. But probably the most common one is, "How are you not furious ALL THE TIME?" 

I'll get to the other two questions, but to answer the final question first: it's because of all of you. Don't get me wrong, I'm still furious a lot of the time, but I spent three years writing the book in a state of permanent rage, with no outlet. I felt alone and isolated with this explosive knowledge. I knew that what I was writing was important -- too often life or death important. But I also knew that there was a chance I wouldn't be believed. After all, I'm not a scientist. And I'm a woman. A woman writing about sex and gender. I knew -- and my research confirmed this -- that all this meant I was up against some in-built assumptions that would make me a far less credible witness than, say, a white male psychology professor to just pluck one example out of nowhere.

And that knowledge, that permanent anxiety, on top of the facts I was uncovering, that I wouldn't be able to do those facts justice, made me furious. All the time.

But then the book came out. And there you all were. An army of very visible women (and yes some men). And not only did you tell me that the world suddenly made sense to you, that you felt seen. You started sharing your own stories. You started telling them to me, to other people, to strangers in queues for the toilet. 

And I stopped being so angry. I stopped feeling so powerless, alone at the top of my mountain of gaps. I felt like I was witnessing the birth of a movement.

But I also started feeling a bit anxious again. Here I was, in the privileged position of being sent personal stories, research papers, engineering solutions, concrete changes that were being implemented as a result of someone having read *my* book. Plus more toilet queues than I knew what to do with. And I knew that these were all important. That something needed to be done with them. But what?

This newsletter was my answer to that question and I've been writing it on and off ever since, joined by an increasing number of simply awe-inspiring people.

The responses I get after every edition are always so wonderful. So many of you so kindly get in touch just to tell me how much you enjoy the newsletter and obviously these emails always make my day. Others get in touch to share traumas they have experienced that relate to something I have written about that week, and knowing the newsletter has made you feel less alone, or has made you realise that what happened to you wasn't your fault, never fails to humble me. Still others get in touch to share their expertise on a topic, or to share examples of gender data gaps they have come across, or to share papers and articles they think I will find interesting -- which I always do!

I also am regularly contacted by readers who have been inspired by the book and/or the newsletter to create something of their own -- an activist group, a company, a product -- that will close a data gap or correct a male bias, and of course these are some of my favourite emails to get, because this is exactly why I wrote Invisible Women: I wanted things to change. I wanted people to know what I knew, and then be inspired to go away and fix something in their area of expertise. These people are sometimes getting in touch just to thank me for inspiring them, but they also often get in touch for advice or to ask if I have any contacts I can share with them.

I feel, when I read these emails, more than ever, that this is a movement, whose power could be unstoppable. The only thing stopping us from fully unleashing that power is that at the moment it's all mediated through me, one person who is doing this in her spare time. Invisible Women could be so much more.

So, deep breath, this is where I ask you if you'd like to take one further step on this journey you've been on with me. I want to do far more with this project than I am currently able to do. I want to be able to track what is going on in the world of gendered data gaps and default male biases much more closely. I want to track where we are going right and where we are going wrong. And I want to really turn this into a movement. I want to be able to connect people -- I want to be able to connect you. Because closing the gender data gap was never going to be the work of one person: it was always going to have to be a movement. And the more emails I get from you the more I think: WE NEED TO BE CONNECTED. All of us.

And so, here is the plan, such as it is. If you don't want anything to change, nothing will. This email will remain free and keep coming for as long as you keep subscribing. However, as of this week I am offering you the option to become a paid member (NB: this link only works if you're clicking it in your own inbox. If you're looking at this online, click here to become a member).

What I want to create is a space where GFPs can meet and discuss ideas, plans, experiences. I want to build a proper community around this newsletter. This already happens to a certain extent on my instagram and twitter...

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Like this but MORE SO![/caption]

...but I want to make it easier so more of it happens!

This community-building will take various forms, from twitter spaces, to occasional book reviews (and maybe discussions!), to extra monthly newsletter round-ups, along with opportunities to ask me questions and advice. There are also other ideas I have up my sleeve as soon as the tools to offer them are available. And, of course, you will also be helping to support the newsletter for GFPs who can't afford to become paying members

Since I haven't got everything figured out yet, I'm going to start this off at £3 a month. Paid membership at this stage is an opportunity to support this project, to get in on the ground floor of what we are building, and help to shape this movement. See this as the beta launch. And if you sign up now, you will stay at this lower price for the first year once we go fully live. The first 20 GFPs to sign up will also receive a signed copy of my first book, Do It Like A Woman, while the first 500 GFPs to sign up will receive a special edition GFP bookmark -- sneak preview here:

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If you're one of the first 500 I will get in touch to find out your address and you'll receive your goody(ies) in the post within a couple of weeks.

Like when I first started this newsletter, I feel slightly terrified. But I also feel excited! I think this could be the start of something really amazing and I hope you want to join me! 💪 (I'm always worried that's a default male bicep 😫)

Now, let's get on with the show!

PS: a few people got in touch last week worried we were doing work in our garden and disturbing baby bird nests and I promise we aren't! The photos were taken from a distance with a zoom and all the work currently going on is very much indoors -- there's only so much upheaval one GFP can take!

Gender data gap of the week

I was really interested to come across this article in The Times this week reporting that "mildly elevated blood pressure" at the age of 41 doubles the risk of a woman having a heart attack in women. It does not, the article continued, "significantly raise the risk in men."

From the article:

The study investigated whether mildly elevated blood pressure — readings between 130 to 139mmHg over 80 to 89mmHg — was a stronger risk factor for heart attacks in women than in men. Blood pressure was measured in 6,381 women and 5,948 men in Norway, when they were aged 41. Heart attacks were recorded during the next 16 years.

This particularly caught my eye because as regular GFPs will recall from a few newsletters ago, we recently discovered that the healthy blood pressure threshold we have been using forever of 120/80 is in fact the healthy blood pressure threshold for men, and that the healthy blood pressure threshold for women should in fact be 110/80. Which suggests to me that it's not so much that women are more likely to have a heart attack if their blood pressure is only mildly elevated, as that what we think of as "mildly elevated" is based on male data. This matters, because as GFPs know, elevated blood pressure is associated with heart attack, stroke, and death. So we really need to get these thresholds right.

The article also made me think of a diagnostic AI that I saw being breathlessly reported all over the UK news media back in September 2019 as predicting gender neutral heart attacks five years before they happen.

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They even got a lady having a gender neutral heart attack to illustrate it[/caption]

The trouble was, when I looked into the research paper itself, the heart attacks it was likely to be able to predict were far from gender neutral. The data on which the AI was trained was heavily male dominated. The paper provided hardly any sex disaggregated data. And it made zero mention of sex differences in risk factors that we do know, like diabetes and smoking, both of which are higher risk factors for women. And while at the time we didn't have the data on sex differences in healthy blood pressure thresholds, we did know that "elevated blood pressure is more directly linked to cardiovascular mortality in women than in men." (Invisible Women, p.210).

The more I look into medical AI the more concerned I get about its impact on women's health. There is little to no evidence that the researchers designing these algorithms are accounting for the sex differences we do know about let alone the many we haven't yet discovered. And bear in mind: algorithms don't merely replicate our biases, they amplify them. And by a significant amount.

In Invisible Women I reported on the findings of a study that trained an algorithm on a commonly used dataset. In this dataset, pictures of cooking were over 33% more likely to involved women than men...

...but algorithms trained on this dataset connected pictures of kitchens with women 68% of the time. The paper also found that the higher the original bias, the stronger the amplification effect, which perhaps explains how the algorithm came to label a photo of a portly balding man standing in front of a stove as female. Kitchen > male pattern baldness. 

It's not that I'm anti-algorithm. Far from it. I think there is a lot that AI could be doing to help us correct our biases, for example by analysing datasets for bias. But that is not what we're currently doing. What we are currently mainly doing is blithely training algorithms on data riddled with gaps and biases, and then letting them make unaccountable decisions.

Meanwhile, as I also reported in Invisible Women, despite the elevated risk for women from high blood pressure, the standard medical advice on how to handle high blood pressure is biased towards men:

If you run a general search for whether resistance training is good for reducing heart disease, you’ll come across a series of papers warning against resistance training if you have high blood pressure. This is in large part because of the concerns that it doesn’t have as beneficial an effect on lowering blood pressure as aerobic exercise, and also because it causes an increase in artery stiffness.

Which is all true. In men. Who, as ever, form the majority of research participants. The research that has been done on women suggests that this advice is not gender-neutral. A 2008 paper, for example, found that not only does resistance training lower blood pressure to a greater extent in women, women don’t suffer from the same increase in artery stiffness. And this matters, because as women get older, their blood pressure gets higher compared to men of the same age, and elevated blood pressure is more directly linked to cardiovascular mortality in women than in men. In fact, the risk of death from coronary artery disease for women is twice that for men for every 20 mm Hg increase in blood pressure above normal levels [which we now know is in fact only normal for men]. It also matters because commonly used antihypertensive drugs have been shown to be less beneficial in lowering blood pressure in women than in men.

So to sum up: for women, the blood-pressure drugs (developed using male subjects) don’t work as effectively, but resistance training just might do the trick. Except we haven’t known that because all the studies have been done on men.  

In conclusion, it might be an idea to get some sex disaggregated data before we literally code today's inquality into the future.

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Default male of the week

First up, an update on last week's default male of the week, from GFP Kirsten, who wrote in to alert me to a survey specifically about the helpfulness of the diagram that popped up for her when she scrolled down to the bottom of the NHS catheter page. Naturally I went and had a look myself and sure enough, up it popped:

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OK says the survey, did you find what you were looking for?

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No, not really, says I.

Oh dear, says the survey :( but did you notice the great diagram?

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Well, yes, now you come to mention it, I did notice something of the kind, Mr Survey (oh come on the survey is definitely default male)

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Top marks for you! says the survey [it didn't say that, but it should have so we'll pretend it did], did you like it?????

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Well, no, since you ask. Not at all, tbh.

Oh no! says the survey, very sad face! Why not????

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Well you did ask.[/caption]

Survey very very sad :(:(:(

GFPs should feel free to head over to the page and fill in the survey for themselves. GFPs with p3n1$e$ [sorry, I don't find the word offensive but I've met a few spam filters who do] who probably do find the survey helpful are also free to fill in the survey although you should ALSO feel free to point out that if you WERE a p3*1$-free GFP you might find it less than informative....😃

ANYWAY, moving SWIFTLY on to this week’s discovery that, drum-roll please, NOT ALL HUMAN REMAINS ARE MALE.

Egyptian mummy thought to be a male priest actually a pregnant woman, researchers find - ABC News — www.abc.net.au Polish researchers examining an ancient Egyptian mummy that they expected to be a male priest are surprised when X-rays and computer tests reveal instead it was a woman who was seven months pregnant.

INORITE!!! I particularly enjoyed this from the research paper:

The interpretation of the mummy's sex as a male was established by radiological examinations in the 1990s (Urbanik et al., 2001). But, the current research proves that the sex of the mummy is undoubtably female [...] The sex of the individual as female was confirmed by the presence of the fetus, breasts, and female genitalia visible on the CT images. 

Now look I'm no radiology expert, but CT scans have been around since the 1970s and there hasn't been some massive advance since the 1990s that means CT scans today are more capable of showing us a female pelvis than they were back in the 1990s. Still, it's not the first time a female pelvis hasn't been able to trump the mighty power of Reference Man, as GFPs may remember from the introduction to Invisible Women:

Even human bones are not exempt from male-unless-otherwise-indicated thinking. We might think of human skeletons as being objectively either male or female and therefore exempt from male-default thinking. We would be wrong. For over a hundred years, a tenth-century Viking skeleton known as the ‘Birka warrior’ had – despite possessing an apparently female pelvis – been assumed to be male because it was buried alongside a full set of weapons and two sacrificed horses. These grave contents indicated that the occupant had been a warrior – and warrior meant male (archaeologists put the numerous references to female fighters in Viking lore down to ‘mythical embellishments’). But although weapons apparently trump the pelvis when it comes to sex, they don’t trump DNA and in 2017 testing confirmed that these bones did indeed belong to a woman.

The argument didn’t, however, end there. It just shifted. The bones might have been mixed up; there might be other reasons a female body was buried with these items. Naysaying scholars might have a point on both counts (although based on the layout of the grave contents the original authors dismiss these criticisms). But the resistance is nevertheless revealing, particularly since male skeletons in similar circumstances ‘are not questioned in the same way’. Indeed, when archaeologists dig up grave sites, they nearly always find more males, which, as noted anthropologist Phillip Walker drily noted in a 1995 book chapter on sexing skulls, is ‘not consistent with what we know about the sex ratios of extant human populations’. And given Viking women could own property, could inherit and could become powerful merchants, is it so impossible that they could have fought too?

After all, these are far from the only female warrior bones that have been discovered. ‘Battle-scarred skeletons of multiple women have been found across the Eurasian steppes from Bulgaria to Mongolia’ wrote Natalie Haynes in the Guardian. For people such as the ancient Scythians, who fought on horseback with bows and arrows, there was no innate male warrior advantage, and DNA testing of skeletons buried with weapons in more than 1,000 Scythian burial mounds from Ukraine to Central Asia have revealed that up to 37% of Scythian women and girls were active warriors.

More on the unprecedented news from archaeologists that women existed prior to the last 50 years or so as we get it.

Women fixing it of the week

Well, GFPs, this one is obviously very dear to my heart. And when I say heart I mean teeny tiny bladder.

Long-time GFPs will remember that back in the before times when we were still allowed to go out and be around other people there was a section in this newsletter called "Toilet Queue of the Week" (or, when I was feeling particularly sassy, #TQOTW), which was populated by pictures GFPs sent me of themselves, well, standing in a queue for the toilet.

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I confidently expect this section to be making a glorious/tedious comeback any time soon...OR DO I.

Enter PEEQUAL: a urinal for women.

WHAAAAAATTTT????

Peequal came about as a result of the usual story: women getting fed up. Those two women were Hazel and Amber, who first decided to tackle the ladies loo queue while working at festivals.

In our breaks we had to choose between going to the loo or getting food -- the queue for the women’s toilets were just too long. We want a solution to our own problem!

At the time they were Master's students at Bristol University, Amber studying Anthropology with Innovation and Hazel studying Physics with Innovation.

We chose to tackle this issue in our Master’s research project and the design developed from feedback when testing with users, prototyping and constant iteration. The enthusiasm and encouragement from women confirmed the necessity of this project. 

But how, you ask, does a woman use a urinal? Over to Amber and Hazel:

After stepping into the urinal’s structure, a user would squat over the ‘pedestal’ to pee. This is an adaptation of a squat toilet but with increased comfort and privacy. We designed it this way as our research showed that 80% of women already squat over the toilet as well as people wanting touch-free facilities since COVID began. 

PEEQUAL is 6x more time efficient to use than a lockable toilet, cutting queues and generating events money. Taking Reading festival as an example we would generate an extra 1.5 million from the efficiency of our urinals alone. 

It is a touch-free and open-air, 10x more sanitary than a portable toilet, a COVID-friendly product, perfectly placed to help in post-pandemic recovery. 

It's also flat pack, 6x more compact in transport. Using the Reading festival as an example again, we would save them 70 artic lorries. Not only does this save festivals money it reduces their environmental impact. 

PEEQUAL can be configured in three different ways, easily adapting to various environments. The area can also become an additional safe space for women at events. 

PEEQUAL is made from 100% recycled material and is 100% recyclable, manufactured in the UK. Our Manufacturers can directly recycle the units into new, closing the loop completely.

Comparing the environmental impact to portable toilets PEEQUAL produces ninety eight percent less C02 emissions.

Well I'm sold. How, I'd like to know, can a GFP try out this wondrous product?

We are currently testing our prototype at events that are running this year. We aim to get feedback from users and iterate the design to ensure it is something women actually want and will use. We will be testing at Bristol Comedy Garden from the 2nd-6th June 2021, then at Valley fest on the 30th July. We are very grateful for these opportunities and encourage anyone who may have similar opportunities to reach out to us and get involved!

We are looking for more events willing to help us test the prototype this year before renting out our final product to events in 2022.

Well you heard them, GFPs, if you run an event, or know someone who runs an event, get on it! Let's put a stop to #TQOTW for good!

In the meantime, though, GFPs should feel free to follow this excellent example I was reminded off while scanning through my #TQOTW archives...

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Designed for women's bodies of the week

Before we get into this week's product that has actually been designed with women in mind I have an update from GFP Rose who bought a pair of Altras following my signposting of them a few newsletters ago:

"Love the Altras, a lot," she messaged. Obviously I pushed her for details and she replied "THEY FIT MY FEET," before relenting and explaining: "for years I couldn’t understand why even my beloved fell shoes felt loose on my heels. I tried inserts, tying my laces differently, thicker socks. Just assumed I had weird feet. No, I have women’s feet."

So there you have it. Women's feet: not just small men's feet. Who knew? Pass it on. And maybe buy a pair of Altras when you next come to replacing your running shoes.

I loved getting that update from Rose and would love to hear from other GFPs about how they've got on with any of the products that have made it into this section. And as ever, also don’t forget to let me know if you come across a company that is specifically designing for women!

Anyway, THIS week, the slot goes to Osprey, who have been designing backpacks actually designed around women's bodies for 25 years now.

According to the Osprey website, their woman-specific design incorporates: narrower shoulder width (because as every good GFP knows but apparently the car industry can't get their head around, women have less muscle mass around their shoulders); ergonomically shaped harness, shorter torso length; and a specially designed hip belt.

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This all sounded great, but I wanted to know a bit more so I got in touch with Osprey to ask them a few questions, like, what exactly is an ergonomically designed harness?

Firstly, the width of the base of the neck. Generally males have a slightly wider base of the neck, due to the natural growth of the upper trapezius muscle, so a slightly wider harness yoke is specified. The second area is the broadness and depth of the shoulder muscles – generally these are larger on males and as such the harness is slightly longer to accommodate this wrap. Finally, female-specific harnesses are curved to avoid running directly over the breasts and therefore are shaped to run down the side of the chest and body.

Oh my, Osprey 😍 now tell me about that hip belt 😍😍😍

Generally, the outside of male hips are perpendicular to the floor. Therefore, male hipbelts wrap almost exactly horizontally from the lumbar outwards to the hipbelt buckle. This ensures even padding from the top of the hips through to the bottom of the hipbelt pad.

Female hips tend to angle inwards, usually being wider around the iliac crest and narrower at the waist. The hipbelts, therefore, are shaped more conically, slightly wider at the bottom and narrower at the top, when attached to the body. The hipbelt shaping reflects the general hip shape and helps to prevent pressure points.

I think the case has been made here. Not only for these backpacks, but if Osprey has been doing it for 25 years that kind of suggests that maybe, just maybe, there is also a business case for designing for the female half of the world??? But what would I know, being only a female.

Anyway, if you're in the market for a new backpack and decide to get an Osprey, let me know how you get on!

Poppy pic of the week

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Blep![/caption]

Phew! That's it! Here's that link again if you fancy becoming a member.

Until next time my dear GFPs...xoxoxo