On the left bank of the Seine, in the southwestern suburbs of Paris, lies the beautiful city of Sevres, famous for its delicate porcelain and for housing the International Bureau of Weights and Measures, which precisely defines the units for measuring time (seconds), temperature (kelvins), length (metres) or mass (kilograms). These are universal references for studying objects or phenomena of nature. However, for the study of the human body, a less scientific standard has traditionally been used: men.
The male body has been the reference system under which inventions have been designed, diseases have been studied or doses of medicines have been established. This is the starting point for British writer Caroline Criado Pérez in her book Invisible Women: Exposing Data Bias in a World Designed for Men, in which she describes in detail how the world is designed around the average man. It is the reference, in short, that must represent humanity in all its heterogeneous, changing and colourful glory. And it is a reference that ignores, from the outset, half the world’s population: women.
This work has been the latest winner of the Royal Society’s Science Book Prize, whose jury noted that “every page is full of facts and data that support her fundamental contention that in a world built for and by men gender data gaps, biases and blind spots are everywhere.” Here are some of them:
Automobile design and safety systems
Researchers at the University of Virginia published a study in 2011 in which they analysed 45,445 victims of traffic accidents over 11 years. Their conclusion was clear: women are 47% more likely than men to suffer serious injuries in an accident, even when both groups wear seat belts. A few months ago, they published another study on head-on crashes and, in this case, the probability was 73%. Women also lead a darker ranking: according to the U.S. Department of Transportation, they are 17% more likely to die in these accidents.
For road safety researchers, this disturbing data has to do with the design of cars. The shape of car seats, the position of headrests or the sitting position of passengers are designed with non-female bodies in mind: women have less muscle in the neck and upper torso, and are shorter and lighter than the average man.
The same goes for safety systems. Crash-test dummies —used in impact tests— were introduced in the 1950s based on 50th percentile male bodies: about 1.77 metres in height and about 76 kg in weight. Although the inclusion of female dummies has been requested for decades, they were not used in the United States until just eight years ago. In Europe, Astrid Linder, director of road safety research at the Swedish National Institute for Road and Transport Research, presented a study in 2018 that analysed the requirements that these tests have to meet: none requires the use of anthropometrically-correct dummies based on the female body. Moreover, in several tests, such as the seat belt test, it is specified that the 50th percentile male dummy must be used.
There is one statutory test that does require a 5th percentile female dummy (only 5% of women will be shorter than this dummy), but it is only tested in the passenger seat. Linder, with more than 20 years of experience in road safety research, has developed EvaRID, the first and only “real” female dummy, which currently exists only as a prototype.
The old debate about temperature in the office
The formula for determining the standard office temperature was developed in the 1960s around the metabolic resting rate of the average man. But researchers at the University of Maastricht recently found that the metabolic rate for young adult women doing light office work is significantly lower than the standard values for men doing the same activity. In fact, the formula can overestimate the female metabolic rate by as much as 35 percent, meaning that current offices are on average five degrees cooler for women.
Personal protective equipment for police and workers
Differences in a woman’s chest, hips, and thighs can affect the fit of safety harnesses or bulletproof vests. A 2017 report from the British National Trade Union Centre revealed that the problem of poorly adjusted personal protective equipment was particularly acute in the emergency services, where 95% of women said their equipment hampered their work, and that body armour, anti-stab vests and high-visibility clothing were inadequate for their bodies.
The same applies to respiratory protective equipment against dust or chemicals and to safety goggles, designed exclusively for male faces.
Discrimination in medical research
In this area, gender disparities are especially dangerous. For decades women have been excluded from research (and clinical trials) on some of the diseases they suffer from the most, such as breast or uterine cancer.
What’s more, if you are a woman and have knee pain, you are less likely to be prescribed a prosthesis; if you have heart failure, it will take longer to get an electrocardiogram; and if you are over 50 and fall seriously ill, you are less likely to receive potentially life-saving interventions.
The case of heart attacks is especially worrying because of a vital issue: the symptoms in women are different from those of men. According to a 2000 study published in The New England Journal of Medicine, women are seven times more likely than men to be misdiagnosed and discharged while having a heart attack. But even if they are diagnosed early, their survival is more problematic. In a clinical trial published in the October issue of the Journal of the American College of Cardiology, the presence of a blood protein (troponin) that is secreted when the heart muscle is damaged was analysed, but with specific thresholds for men and women. Although this greatly improved the diagnosis, women were found to be half as likely as men to receive the recommended treatments for heart attack.