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Q&A: Feminist author Caroline Criado-Perez talks about the sometimes-deadly lack of data on the female body

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Note: This Q&A first published in Mississippi Today’s InformHer newsletter. Subscribe to our free women and girls newsletter to read stories like this monthly.

Caroline Criado-Perez, a feminist author and public speaker living in London, talked about her latest book, “Invisible Women,” last week at Lemuria Books in Jackson. 

Her book, published in 2019, explores the gender data gap. From frustrating examples of a freezing office or a shelf out of reach, to deadly examples of an undiagnosed heart attack or crashing a car whose safety features don’t account for women’s measurements, Criado-Perez’s book is full of the real-world consequences of a world built without women in mind.

While the lack of research on the female body is an age-old problem, she argues, it becomes all the more pressing with the emergence of artificial intelligence and the increasing reliance on “Big Data.”

Criado-Perez is working on a new book about the reproductive journey of women, and how little science knows about it. She says she plans to use Mississippi as a case study. She sat down for an interview with Mississippi Today.

Editor’s note: This Q&A has been edited for length and clarity.

Mississippi Today: Tell us about the arc of your career and how you got to the point where you were writing your book “Invisible Women.”

Caroline Criado-Perez: Yeah so that’s a question with a very long answer. Really the story of me writing this book is the story of me becoming a feminist. I didn’t grow up as a feminist. I would say I was sort of anti-feminist – I was really quite misogynistic. And I think that was a very normal thing for young women in the ‘90s. I didn’t really identify with women and I just thought, you know, we’re all equal now and everyone should just stop complaining.

And it wasn’t until I went to university – I went as a mature student, I was 25 I think – and it was the first time I had to read any feminist analysis. And I had to read this book called Feminism and Linguistic Theory, which introduced me to the idea of the “generic masculine,” so, using “he” gender-neutrally or “man” gender-neutrally. The author of this book pointed to research that showed that when people hear these words or read these words, they think of men. And that completely blew my mind because it made me realize that I was picturing a man and I was incredibly shocked that I never noticed that, as a woman, that I’m just picturing men all the time.

That really kick-started the whole process for me because having had that realization, I started noticing it in other areas, where we act like we’re speaking gender-neutrally and we’re actually talking about men. So, after my first degree I went and studied feminist and behavioral economics and that is where I sort of discovered the whole economy is built around this mythical man – even though we speak about it being objective like a science. And there were various other bits and pieces I was doing that made me notice it in other areas and then finally I came across it in health, and that was when I was writing my first book. And that was when I started reading some research, the very early stages of my understanding of how much health and our knowledge of the human body is actually knowledge of the male body. That we’re not as good at diagnosing heart attacks in women as in men, and women are 50% more likely to be misdiagnosed if they have a heart attack. And more than anything I just couldn’t believe that this wasn’t on the front page of every newspaper, why did people not know this, why was everyone not talking about this – women are more likely to die if you have a heart attack: what?! And this is because we haven’t researched female bodies?

So that is how it ended up being a book. Essentially because I had all these things going around in my head and I felt like I was going crazy, that everyone was just blithely acting like we were speaking gender-neutrally when I knew we were talking about men. And just the fact that it was a huge, systematic issue, I knew that it wasn’t going to be an article – it had to be a book. Because it was just in everything.

MT: I’m interested in this term you use near the beginning of your book, “absent presence.” What is the experience of being defined by an absence, a negative space, a silence?

CP: I mean, I suppose for someone who recognizes the negative space, it’s intensely frustrating to know that there are all these gaps and all these silences that, as a society, we just skip over and we don’t notice that they’re there.

This is why I start the book with the Simone de Beauvoir quotation about representation being the work of men, and how they describe the world from their own point of view – which they confuse with the absolute truth. I f—–g love that quote so much. Because I feel like it sums up my book in a quotation because it’s not about these men having deliberately described the world and excluded women from it. They think that’s really what it is like. They think they’re really talking about the real world and they don’t see these absent presences, this silent figure of the woman.

But as a woman, you’re constantly knocking up against it, against the ways in which the world has not been designed for you. And having done the research I’ve done, I now experience the world in quite a different way than I did before, and it’s not a more comfortable way – it’s a much more uncomfortable way, because I’m constantly frustrated.

And of course, when it comes to health care it’s something that one thinks about a lot – you know, has this drug been tested in my body, is this the correct dosage for me, do they know how this drug interacts, and what if I’m on contraception, have they actually done any research? And nine times out of 10, no, they haven’t. Or they don’t know how the menstrual cycle might interact with it.

So it’s intensely frustrating and sometimes frightening, I think, to then just experience the world in which, for the most part, we are still speaking gender-neutrally when we’re talking about men.

MT: You talk about how this is an age-old problem – we live in a world made by men with men in mind. Can you tell us why, in a world that increasingly relies on “Big Data,” it matters so much more? How it becomes deadly, even?

CP: Yeah, so I mean, the gap in data for women is already deadly, if you’re thinking anywhere from car design to health care, but the real danger is becoming exponential, because of the introduction of AI into every single part of our world. And the problem with developing AI using bad data, biased data, is that machine learning is not like a human, in that it doesn’t simply reflect our biases back at us – it amplifies them.

I’ve read so many papers since “Invisible Women” came out where researchers will be like, “we’ve developed this AI and it performs better than a radiologist at detecting lung cancer” or “can predict heart attacks five years before they happen,” and then when you look at the paper, not only are the datasets incredibly male-biased, so you’ve got that bias already baked in, but also, they’re not even thinking about sex.

One paper I’m thinking about that came out shortly after “Invisible Women” was published was about predicting heart attacks. And there are sex-specific risk factors. So, if you’re going to be predicting heart attacks in men versus women, you don’t want to have, as this paper did, something like a 70% male dataset, but you even more don’t want to have that data all mixed up together. Because that’s not going to work for men or women. And yet, there was absolutely no mention of sex in the paper. So, that is frightening. Because the problem with that is it could make the situation worse.

When I find AI exciting is when researchers are using AI to address problems that we aren’t addressing otherwise. So, for example, one woman I spoke to was developing AI to detect victims of domestic violence via injury patterns, potentially years in advance of them ultimately having to be taken to a shelter or something. Because of course victims don’t necessarily report, and it’s not something that we’re investing a lot of money in in health care – because there’s not a lot of money in it and doctors don’t necessarily have the time to do the sort of questioning of a victim, et cetera. So there is exciting potential for AI. But if we’re just using it to do what we’re already doing but faster, that’s where the massive pitfalls are.

MT: As a health reporter, I’m interested in the subject of endocrine-disrupting chemicals you bring up in your book. We know that these chemicals are in everything, but they’re especially pervasive in feminine products, such as toiletries and makeup – and even menstrual products that women put inside their bodies. And as you know, not only are they more common in female products – they’re also worse for women, because of how they mimic and disrupt women’s hormones. How do we begin to address the issue? How can data help?

CP: The first thing that needs to change is obviously labeling – that’s a huge one, that people have the right to know what is actually in these products. That is one of the things that makes me most frustrated. I mean, as you can imagine, since writing the book I am scanning product ingredients all the time. If there’s anything that says “fragrance” I’m like “nope, that’s out, not using that.” And it’s amazing how many products just have these random ingredients in them and they don’t have to disclose what they are. Nobody knows. Nobody knows that “fragrance” means they could put anything in there. That’s deeply frustrating.

But my answer is always going to come back to: we have to collect data on this. And that is the thing that we’re not doing. And that is just incredible to me. The problem we have is not only are there endocrine-disrupting chemicals in these products, but also, how are these affecting not only the women who use them but also the women who work with them and the women who produce them.

And, as I say in my work, it’s not just that we haven’t tested them on women – for example, absorption into female skin, which can be different, or the way that it might accumulate in a female body, because of differences in fat in the body – but also the way in which women encounter them. Because it tends not to be in discrete “now I’m going to be exposed to this chemical, and tomorrow to that chemical.” We’re exposed to a cocktail of chemicals, and that’s not how they’re tested. So the way they’re tested is in itself biased against the way women are exposed to them, as well as the fact that we aren’t even testing them on women anyways.

And I feel that this really ties into this attitude that somehow the female workplace is this cozy, safe place, that women are never exposed to any form of danger. Because historically, the sort of headline-grabbing dangerous jobs have been done by men. By the way, because they were high-paying and women were barred from doing them, but let’s not let that get that in the way of the story that “women are lazy and they don’t want to do scary, difficult jobs.” But the female-dominated jobs that are low-paid, we simply have not been measuring how dangerous they are – from the perspective of exposure to chemicals.

MT: So, it seems like the call to action of this book is to begin filling in some of these gaps in data. But if we think of the modern world as being made up of data, then the idea of collecting all this new data can feel almost like building a new world – and that might be intimidating to some. What would you say to people who feel overwhelmed by this imperative?

CP: Well, there’s no getting around the fact that it is a huge job, and it is intimidating. And if you tried to do it all, you would be overwhelmed. But nobody could possibly fix this on their own. It’s like saying “you – go fix patriarchy.” It’s not how it works. Everybody has their own area that they can address. And so, people who work in research can collect sex disaggregated data. That’s a really great thing that people who work in research can do. People who work in HR, there’s a lot that they can do when it comes to looking at how their companies consider diversity, for example, in decision making.

People who have children, there’s so much that they can do to address how the future generation even notices that the “default male” operates. Like, if you look at kids’ TV, kids’ books, it’s “default male” all over the place – all the characters are male and if there’s a female character, her characteristic is that she’s female. I’m not saying that you’re going to be able to protect kids from that, but have a conversation with them. And I wish that had happened to me when I was little, that someone had taken the time to point out “isn’t it weird that in the real world, there’s all these women, and in your stories, it’s all boys?” I think that that’s a really powerful thing and I actually think that that’s something that everyone can do is have these conversations and notice when the “default male” is in operation – because I think that that really is half the battle.

If you think about the car crash stuff, that we have historically used an average male car crash test dummy, as if that’s representative of humans overall – when you say it like that, it obviously sounds ridiculous. But we’re so used to using the male body as the human body that people don’t even notice that it’s happening. As soon as you tell people “by the way, cars have not been tested to be safe for an average female body,” they understandably get really freaked out and start demanding change from car manufacturers – which is something very cool that’s happening in America at the moment. So, a really big part of it is just spreading the word and making the changes you can make.

MT: So, we’re talking about the gap in data around the female body and how that plays out in the health care system. One of the things I’ve noticed is that when people bring up this gap and try to address it – and particularly when talking about the menstrual cycle and how it interacts with medicine or what have you – that people tend to think of it as “woo-woo” or “mystical.” I think the fact that talking about something as fundamental as the menstrual cycle is met with such disbelief sheds light on just how uncommon it is to talk about the female body. Has that been your experience? Why is that?

CP: Right. That’s just sexism. It’s like, “oh, that has to do with ladies.” So, you’re reminding me of this report that came out, and again it was after “Invisible Women” was published, and it was about women and asthma. And there were all these testimonials from women who said “I went to the doctor and told them I feel like I get asthma flare-ups in relation to my menstrual cycle, I can tell where in my menstrual cycle I am, based on my flare-ups.” And the doctors were like “that’s just nonsense, you’re making it up” – because women can’t possibly know what’s going on with our bodies. Anyways, it transpires that actually, yes it is. It is hormonally-linked.

So that is something that, hashtag-not-all-doctors, but that they will say because there is this idea that lingers on somehow, in these people who are trained in science, that women are somehow just hysterical and should be less believed than men. But, I mean, that’s just misogyny.

MT: So you’re writing a new book. Tell us about how it relates to health care and how you’re using Mississippi as a case study.

CP: Yeah, so the book is about a woman’s reproductive journey from the beginning of whether or not she’s going to have children and going through things like pregnancy and how little we know about, firstly, how to treat a pregnant woman for anything, because we don’t do any research on women, let alone pregnant women. And then, how little we know about reproduction, so things like miscarriage and the disorders of pregnancy we know very little about, and of course that ties into abortion.

So that’s the area I’m wanting to focus on while I’m in Mississippi – for the obvious reason of Dobbs, and also my husband is from Mississippi, and also I had a miscarriage in January last year when we were last here, which was briefly scary, particularly as a British person, being here and thinking “if this goes wrong, am I going to be able to get the care I need?”

So I’m just really interested in understanding what it is actually like for a woman whose pregnancy goes wrong in Mississippi right now. Because I know there are these exceptions, but also, they’re never used. So, the focus for that chapter is I want to look at what happens to women who need an abortion and legally, supposedly, can get one, but actually, can’t get one. And then the rest of the book is looking at fertility and infertility through to the menopause.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

On this day in 1961

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mississippitoday.org – Jerry Mitchell – 2024-11-22 07:00:00

Nov. 22, 1961

Credit: Courtesy: Georgia Tourism & Travel

Five Black students, made up of NAACP Youth Council members and two SNCC volunteers from Albany State College, were arrested after entering the white waiting room of the Trailways station in Albany, Georgia. 

The council members bonded out of jail, but the SNCC volunteers, Bertha Gober and Blanton Hall declined bail and “chose to remain in jail over the holidays to dramatize their demand for justice,” according to SNCC Digital Gateway. The president of Albany State College expelled them. 

Gober became one of SNCC’s Freedom Singers and wrote the song, “We’ll Never Turn Back,” after the 1961 killing of Herbert Lee in Mississippi. The tune became SNCC’s anthem. 

After her release from jail, Gober joined other students, and police arrested her and other demonstrators. Back in the same jail, she sang to the police chief and mayor to open the cells, “I hear God’s children praying in jail, ‘Freedom, freedom, freedom.’” 

Albany State suspended another student, Bernice Reagon, after she joined SNCC. She poured herself into the civil rights movement and later formed the Grammy-nominated a cappella group Sweet Honey in the Rock to educate and empower the audience and community. 

“When I opened my mouth and began to sing, there was a force and power within myself I had never heard before,” a power she said she did not know she had. 

Other members of the Freedom Singers included Cordell Reagon, Bernice Johnson, Dorothy Vallis, Rutha Harris, Bernard Lafayette and Charles Neblett. On the third anniversary of the sit-in movement in 1963, they performed at Carnegie Hall. 

“This is a singing movement,” SNCC leader James Forman told a reporter. “The songs help. Without them, it would be ugly.” 

Today, the Albany Civil Rights Institute houses exhibits on these protesters, Martin Luther King Jr. and others who joined the Albany Movement.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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IHL deletes the word ‘diversity’ from its policies

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mississippitoday.org – Molly Minta – 2024-11-21 14:32:00

The governing board of Mississippi’s public universities voted Thursday to delete the word “diversity” from several policies, including a requirement that the board evaluate university presidents on campus diversity outcomes.

Though the Legislature has not passed a bill targeting diversity, equity and inclusion initiatives in higher education, the Institutions of Higher Learning Board of Trustees approved the changes “in order to ensure continued compliance with state and federal law,” according to the board book

The move comes on the heels of the re-election of former President Donald Trump and after several universities in Mississippi have renamed their diversity offices. Earlier this year, the IHL board approved changes to the University of Southern Mississippi’s mission and vision statements that removed the words “diverse” and “inclusiveness.”

In an email, John Sewell, IHL’s communications director, did not respond to several questions about the policy changes but wrote that the board’s goal was to “reinforce our commitment to ensuring students have access to the best education possible, supported by world-class faculty and staff.”

“The end goal is to support all students, and to make sure they graduate fully prepared to enter the workforce, hopefully in Mississippi,” Sewell added.

On Thursday, trustees approved the changes without discussion after a first reading by Harold Pizzetta, the associate commissioner for legal affairs and risk management. But Sewell wrote in an email that the board discussed the policy amendments in open session two months ago during its retreat in Meridian, more than an hour away from the board’s normal meeting location in Jackson.

IHL often uses these retreats, which unlike its regular board meetings aren’t livestreamed and are rarely attended by members of the public outside of the occasional reporter, to discuss potentially controversial policy changes.

Last year, the board had a spirited discussion about a policy change that would have increased its oversight of off-campus programs during its retreat at the White House Hotel in Biloxi. In 2022, during a retreat that also took place in Meridian, trustees discussed changing the board’s tenure policies. At both retreats, a Mississippi Today reporter was the only member of the public to witness the discussions.

The changes to IHL’s diversity policy echo a shift, particularly at colleges and universities in conservative states, from concepts like diversity in favor of “access” and “opportunity.” In higher education, the term “diversity, equity and inclusion” has traditionally referred to a range of efforts to comply with civil rights laws and foster a sense of on-campus belonging among minority populations.

But in recent years, conservative politicians have contended that DEI programs are wasteful spending and racist. A bill to ban state funding for DEI in Mississippi died earlier this year, but at least 10 other states have passed laws seeking to end or restrict such initiatives at state agencies, including publicly funded universities, according to ABC News.

In Mississippi, the word “diversity” first appeared in IHL’s policies in 1998. The diversity statement was adopted in 2005 and amended in 2013. 

The board’s vote on Thursday turned the diversity statement, which was deleted in its entirety, into a “statement on higher education access and success” according to the board book. 

“One of the strengths of Mississippi is the diversity of its people,” the diversity statement read. “This diversity enriches higher education and contributes to the capacity that our students develop for living in a multicultural and interdependent world.”

Significantly, the diversity statement required the IHL board to evaluate the university presidents and the higher learning commissioner on diversity outcomes. 

The statement also included system-wide goals — some of which it is unclear if the board has achieved — to increase the enrollment and graduation rates of minority students, employ more underrepresented faculty, staff and administrators, and increase the use of minority-owned contractors and vendors. 

Sewell did not respond to questions about if IHL has met those goals or if the board will continue to evaluate presidents on diversity outcomes.

In the new policy, those requirements were replaced with two paragraphs about the importance of respectful dialogue on campus and access to higher education for all Mississippians. 

“We encourage all members of the academic community to engage in respectful, meaningful discourse with the aim of promoting critical thinking in the pursuit of knowledge, a deeper understanding of the human condition, and the development of character,” the new policy reads. “All students should be supported in their educational journey through programming and services designed to have a positive effect on their individual academic performance, retention, and graduation.” 

Also excised was a policy that listed common characteristics of universities in Mississippi, including “a commitment to ethnic and gender diversity,” among others. Another policy on institutional scholarships was also edited to remove a clause that required such programs to “promote diversity.” 

“IHL is committed to higher education access and success among all populations to assist the state of Mississippi in meeting its enrollment and degree completion goals, as well as building a highly-skilled workforce,” the institutional scholarship policy now reads. 

The board also approved a change that requires the universities to review their institutional mission statements on an annual basis.

A policy on “planning principles” will continue to include the word “diverse,” and a policy that states the presidential search advisory committees will “be representative in terms of diversity” was left unchanged.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Closed St. Dominic’s mental health beds to reopen in December under new management

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mississippitoday.org – Gwen Dilworth – 2024-11-21 13:54:00

The shuttered St. Dominic’s mental health unit will reopen under the management of a for-profit, Texas-based company next month. 

Oceans Behavioral Hospital Jackson, a 77-bed facility, will provide inpatient behavioral health services to adults and seniors and add intensive outpatient treatment services next year. 

“Jackson continuously ranks as one of the cities for our company that shows one of the greatest needs in terms of behavioral health,” Oceans Healthcare CEO Stuart Archer told Mississippi Today at a ribbon cutting ceremony at its location on St. Dominic’s campus Thursday. “…There’s been an outcry for high quality care.” 

St. Dominic’s 83-bed mental health unit closed suddenly in June 2023, citing “substantial financial challenges.”

Merit Health Central, which operates a 71-bed psychiatric health hospital unit in Jackson, sued Oceans in March, arguing that the new hospital violated the law by using a workaround to avoid a State Health Department requirement that the hospital spend at least 17% of its gross patient revenue on indigent and charity care.

Without a required threshold for this care, Merit Health Central will shoulder the burden of treating more non-paying patients, the hospital in South Jackson argued. 

The suit, which also names St. Dominic’s Hospital and the Mississippi Department of Health as defendants, awaits a ruling from Hinds County Chancery Court Judge Tametrice Hodges-Linzey next year. 

The complaint does not bar Oceans from moving forward with its plans to reopen, said Archer.

A hallway inside Oceans Behavioral Hospital in Jackson, Miss., is seen on Thursday, Nov. 21, 2024, during the facility’s grand opening. Credit: Eric Shelton/Mississippi Today

Oceans operates two other mental health facilities in Mississippi and over 30 other locations in Louisiana, Oklahoma and Texas. 

“Oceans is very important to the Coast, to Tupelo, and it’s important right here in this building. It’s part of the state of Mississippi’s response to making sure people receive adequate mental health care in Mississippi,” said Lt. Governor Delbert Hosemann at the Nov. 21 ribbon cutting.

Some community leaders have been critical of the facility. 

“Oceans plans to duplicate existing services available to insured patients while ignoring the underserved and indigent population in need,” wrote Hinds County Sheriff Tyree Jones in an Oct. 1 letter provided to Mississippi Today by Merit Health. 

Massachusetts-based Webster Equity Partners, a private-equity firm with a number of investments in health care, bought Oceans in 2022. St. Dominic’s is owned by Louisiana-based Catholic nonprofit Franciscan Missionaries of Our Lady Health System.

Oceans first filed a “certificate of need” application to reopen the St. Dominic’s mental health unit in October 2023. 

Mississippi’s certificate of need law requires medical facilities to receive approval from the state before opening a new health care center to demonstrate there is a need for its services. 

The Department of Health approved the application under the condition that the hospital spend at least 17% of its patient revenue on free or low-cost medical care for low-income individuals – far more than the two percent it proposed. 

Stuart Archer, CEO of Oceans Healthcare, speaks during the grand opening of Oceans Behavioral Hospital in Jackson, Miss., on Thursday, Nov. 21, 2024. Credit: Eric Shelton/Mississippi Today

Oceans projected in its application that the hospital’s profit would equal $2.6 million in its third year, and it would spend $341,103 on charity care.

Merit Health contested the conditional approval, arguing that because its mental health unit provides 22% charity care, Oceans providing less would have a “significant adverse effect” on Merit by diverting more patients without insurance or unable to pay for care to its beds. 

Oceans and St. Dominic’s also opposed the state’s charity care condition, arguing that 17% was an unreasonable figure. 

But before a public hearing could be held on the matter, Oceans and St. Dominic’s filed for a “change of ownership,” bypassing the certificate of need process entirely. The state approved the application 11 days later

Merit Health Central then sued Oceans, St. Dominic and the State Department of Health, seeking to nullify the change of ownership. 

“The (change of ownership) filing and DOH approval … are nothing more than an ‘end run’ around CON law,” wrote Merit Health in the complaint. 

Oceans, St. Dominic’s and the Mississippi Department of Health have filed motions to dismiss the case. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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