Book Review: Invisible Women

This year, after watching this video, I have been encouraged to try and return to the heights of my preteen reading capacity (probably not possible with the rate I devoured YA novels) to expand my exposure to novels and books beyond the confines of my academic course. Whilst over summer I focused more on fiction (particularly recommend 'We Need to Talk about Kevin'), this month I treated myself to a (hardback!) book called 'Invisible Women' by Caroline Criado Perez, and whilst a lot of the book felt infuriating, many of the insights felt ever relevant and the solutions proposed optimistically straightforward.
Split into 6 sections, this book proved to be eminently accessible and even though economic understanding is present throughout, this is not a barrier for those intimidated at the thought of an 'economics book' as such. Whilst as I got towards the end of the book and came across sections I was more familiar with such as GDP calculation I found myself skimming, there was plenty of content I had not encountered before which felt more engaging. Perhaps then this book is best suited to an introductory investigation of key topics.
Whilst many of us have seen articles lamenting design flaws such as smartphone size and VR headsets, topics which Perez does discuss, what held most impact for me within this book were instances of planning, policy and research that failed to include the perspective of women and consequently held gendered consequences. Below I will include a couple of examples
Medical Research
This section in the book was probably where 80% of my outraged scoffs were aimed. Perez takes the reader through an academic and practical minefield for women. Referring back to her introductory remarks about the male default, Perez criticises assumptions made within medicinal teaching and care that the male body is the neutral norm whilst the only sex specific differences between men and women occur within reproductive systems. A lot of the reticence to examine sex differences relates to the 'messiness' of hormones commonly present within female bodies that complicate studies and warp results- the solution? Just exclude women from the study to get a neat conclusion and move on. In fact, sex difference exists within 'every tissue and organ system in the body', there are differences down to our cells, inevitably producing differential reactions to 'standard' treatments and diagnosis. Perez looks at the example of heart attacks to illustrate the dangers of such an approach. A 2014 review if the FDA database of CRT-D devices used to treat heart attacks found that only 20% of the participants in trials were women with individual studies having such negligible numbers of women that dis-aggregating results by sex found no major difference. When the results were combined however, it is revealed that women needed such devices at a lower threshold of symptoms than men. A shame then that medical guidelines releasing doctors to recommend this treatment relate to male averages then. If such devices were given to women at their lower threshold, Perez states that this would see a "76% reduction in heart failure or death and a 76% reduction in death alone" from having this pacemaker implanted. This implies that the gendered data gap is causing preventable deaths.
Moreover, Perez discusses 'Yentl syndrom', describing the instances when women are misdiagnosed and not believed unless their symptoms conform to the presentation of symptoms according to the male standard. Again referencing heart attacks, it becomes apparent that despite the fact that women and men often exhibit different symptoms that indicate an individual is having a heart attack, the male standard is used to measure a patient against, leading to many women being turned away or misdiagnosed. This is fatal!
Transport Funding
Whilst the title of the first chapter 'can snow clearing be sexist?' got a look of amusement from the man sat next to me on the bus, I am sure he might be even more surprised to find out that in fact, yes it can. Perez discusses the way that city planners can unknowingly and without any malice disadvantage women in the allocation of funding to different projects and schemes. In most countries, women tend to rely most heavily on public transport and walking. This is due to the fact that women tend to be more likely to have to make 'trip chains' running smaller errands and making multiple short journeys throughout the day. Walking and public transport lends itself to this. Men on the other hand, are more likely to drive, with a journey in and out of their workplace often covering their daily travel. So in Sweden when city officials of Karlskoga dedicated their efforts to clearing the roads rather than pedestrian walkways this was largely catered to one type of travel. Interestingly, this was actually costing Sweden, a lot, in healthcare during the winter months. The equivalent of £3.2 million was the cost of pedestrian falls in a single winter season! This sum was about twice the cost of road maintenance in winter- it made sense to adjust policy to cover broader winter safety measures and since changes has been introduced, considerable savings have been made.
This is just one of many seemingly innocuous policy choices unwittingly perpetuating a male bias, often entirely unintentional, unpacked in ‘invisible women’. Certainly the extent of impact policy at the city planning level was quite astonishing to me.

Whilst by the end of the book I felt that a certain argument was being copy pasted a lot with new examples, the very fact that there are so many instances where the argument applied should in itself give pause for thought. Overall I found the book to be packed with studies and statistics alongside enraging points that felt increasingly urgent. 

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