The full title is Invisible: How Young Women With Serious Health Issues Navigate Work, Relationships, and the Pressure to Seem Just Fine. It’s a mouthful, and the post title has a character limit for search engines, hence the abbreviation.
First, some summary statements. This is an incredibly information-dense book. The depth and quality of research (and Hirsch’s ability to insert citations conversationally) impressed me. It is written in an engaging style that keeps you reading. Here’s an evil confession—I read a lot of nonfiction, but usually crave a story so badly that I put nonfiction books down midway, read a novel, then pick them back up. You could liken reading nonfiction to eating your vegetables, except that I happen to love vegetables. While reading this book, I did not eye my night table stack with longing, I was here now, reading this book. That is rare enough for me that I declare Ms. Hirsch’s writing style to be a standout. This book is inclusive—Hirsch states early that by women and men she means people who identify as female or male, and when that’s not the case, she specifies “cisgender.” She shows how inclusive language need not be cumbersome. Overall, this book seems almost ahead of its time, “woke” in a way that doesn’t seem forced or labored.
The book covers many aspects of life with serious health issues, and my first concern was why did she compartmentalize young women when serious health issues strike all of us, regardless of age or gender, and we have many work and social difficulties in common. She addressed that right out of the gate with the well-supported statement that misogyny in health care is rampant, and younger women often suffer the most from it. Also, young women are beginning their careers and making choices about lifestyle and family planning. When health issues strike at this stage of life, it influences the trajectory of a woman’s whole life. Older women often must reinvent themselves when their lives change abruptly and there are lots of books about that; Hirsch had the good sense to compartmentalize her broad topic to a segment that was underrepresented. There are not lots of books about young women in this position; perhaps because so much of the drama they go through is hidden.
Why do young women hide their health issues? There are lots of reasons, and Hirsch covers them chapter by chapter. In the workplace, employers expect to accommodate the problems of older workers. Not so much with young ones. They are expected to be competitive, enthusiastic, ready for anything. Mallory the intern isn’t supposed to struggle with lupus or Crohn’s disease, that’s Dolores in accounting. Young women are competing with fit young people. They try to work the same long hours and not show any visible signs that they are more challenged than their peers, or else their careers may never launch.
One point Hirsch made is so important to me that I’m doing a separate, intersectional post on it next week. She said that the biggest challenge young women with health problems face is the necessity to go to work on a schedule, under supervision, when so many would be better off telecommuting or working on flex time. That’s a big, meaty topic and I’ve seen it addressed so seldom that I shouted out loud while reading—the validation was that big a rush. Stay tuned for more on this next week!
Young adulthood is also the time when women are deciding what they want from life—marriage? Children? Hirsch is quick to disclaim that not all women want a partner or children, and her discussion of the many women who do is not heteronormative (operating from a point of view in which straight and coupled is a default assumption). She even gives a nod to social scientist Dr. Bella DePaulo, whose research shows that some of us are “single at heart” and live our best lives as single people.
For women who do want a partner and/or children, health issues can be a barrier. Illness and disability are not perceived as sexy, and there is pressure to appear desirable. Hirsch coins the word “deathyness” to describe the jarring aura of vulnerability in a body that is supposed to be “hot.” In one story, Hirsch herself was on an elevator shortly after hip surgery, and a young man asked her why she was on crutches. When she explained about her hip surgery, he looked at her distastefully and said, “You should tell people it’s your knee.” Because, he implied, hip problems are for old people and a young woman with a bad hip is a turnoff.
The health care industry is a barrier for young women, as they find it hard to find doctors who believe them or take them seriously enough to diagnose their issues. Young women have gone years without help, even died, because no one considered that they might actually have a serious condition. They’re written off as hypochondriacs or being overly dramatic. When they are diagnosed, it’s often shocking because their age makes the diagnosis unexpected, and there is very little bedside manner involved in delivering the news. Stereotypes make it harder for women, especially women of color, to be taken seriously. Hirsch tells of black women who were not listened to because their doctors believed them to have a high pain tolerance and assumed they were attention-seeking. Hirsch also shows how health care research is biased toward white male sample pools, and women and people of color are left out. In one powerful sentence, she quotes Alondra Nelson, Dean of Social Sciences at Columbia University, “In our culture, a group of Latinx women is seen as too specific to be generalized to all humans, whereas we see a group of white males as the gold standard.”
This book’s message is delivered with the stories of real people. Some of those stories are hard to read, but not hard for me to believe. I could have furnished lots of the anecdotes for this book. In the final chapter, Hirsch says “…many of the women I’ve met have made me realize that disability is largely about the world’s failure to make space for you.”
I feel like I’ve delivered one of those movie trailers where you feel as if you’ve already seen the movie when it’s done, but this book is worth a committed read, even if you’re an older person with serious health issues like me. It’s made me aware of the unique challenges faced by younger women in the same situation while validating my own issues.
If any of the points made in the book resonate with you, feel free to comment below.