Invisible Women - Has Much Changed?
I vividly remember the moment it struck me how deeply engrained gender disparity is within healthcare and the society we live in. I was an A&E nurse who had just learned the ECG (Electrocardiogram, a widely used diagnostic tool for checking electrical activity of the heart) machines we use were pre-set to think all patients were 40-year-old males. It blew my mind.
Women are half the population, how are we this obscure other, considered not the norm? How can we be assured that we are providing appropriate and safe care to women, if we’re using references designed with men in mind?
The “atypical” women
Inspired, I went on to write a gender inequality essay on female ACS (acute coronary syndrome). “Typical” presentations of ACS align with the profile that is reported most commonly by men – chest pain, breathlessness, critiqued as originating from an image of a man clutching his chest. “Atypical” ACS is attributed to symptoms more commonly reported by women, the nature of the pain being sharp and having different characteristics than what is classically thought of as cardiac pain. Labelling gendered presentations as typical and atypical seems problematic, when we’re talking about equally major representatives of the population.
Reading the book “Invisible Women” by Caroline Criado Perez was both a fascinating and bleak read. Gender disparity interwoven into every crevice of society and the structure it’s built upon. From healthcare, to roadworks, to terminology we all commonly use – who else is guilty of calling a group of people of both genders “guys”. Male is the default.
Under-researched, underrepresented
The book also discusses the distinct lack of women represented in clinical trials, trials that form the foundation blocks for evidence-based care. The Guardian published an article highlighting that while the UK is thought to be a hub for pioneering research, women are significantly underrepresented in trials, with male only studies being twice as common as female only.
As healthcare professionals, we commit to acting in our patient’s best interests and using evidence-based care to underpin our clinical practice. The foundation is not equal. As women, we know we are not an abstract concept, “atypical”.
Invisible women was published in 2019, the data and statistics in it preceding this time. Has much changed since then?
Gregory, A. (2025). ‘Concerning’ lack of female-only medical trials in UK, say health experts. [online] the Guardian. Available at: https://www.theguardian.com/society/2025/may/07/concerning-lack-of-female-only-medical-trials-in-uk-say-health-experts.
NICE EXCELLENCE. (2021). Acute coronary syndromes | Treatment summary | BNF content published by NICE. Retrieved 16 May 2025, from https://bnf.nice.org.uk/treatment-summary/acute-coronary-syndromes.html
Preciado, S., Sharp, A., Sun, B., Baecker, A., Wu, Y., & Lee, M. et al. (2021). Evaluating Sex Disparities in the Emergency Department Management of Patients With Suspected Acute Coronary Syndrome. Annals Of Emergency Medicine, 77(4), 416-424. doi: 10.1016/j.annemergmed.2020.10.022
Safdar, B., & D'Onofrio, G. (2016). Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department. The Yale journal of biology and medicine, 89(2), 227–238.