200 Million Years of Women's History with Cat Bohannon

In October 2023, Cat Bohannon, a prominent researcher on the evolution of narrative and cognition, published her groundbreaking New York Times bestseller Eve: How the Female Body Drove 200 Million Years of Human Evolution. The book is a sweeping corrective to centuries of research that have privileged male bodies as the scientific norm. It is also a masterclass in challenging long-held assumptions. We spoke to Bohannon about why women have been "footnotes" in medical research and the adverse effects of this oversight, why "leaving your lane" takes courage (no matter what sector you work in), and the need for "dual data."

According to Bohannon, the prevalent depiction of human evolution has long relegated females to the sidelines. She remarks, "I don't think anyone who has a female body right now is surprised to hear that for a very long time, we've been a bit of a side character in the story of the evolution of humanity." Bohannon references the iconic opening scene from Stanley Kubrick’s 2001: A Space Odyssey as an example of the discrepancy: “Despite the monumental narrative, there are no babies. There are no females."

Bohannon underscores how this disparity extends into the scientific realm, noting: "The idea of what a female is doing beyond sort of temporarily being a vessel... it's been this little footnote, this little uncomfortable side thing." In essence, Bohannon's perspective calls for a paradigm shift in how we understand human evolution. By elevating the role of the female body and acknowledging the complexity and importance of sex differences, we gain a richer understanding of the collective history of the human race. "It was definitely time to correct that, especially because there's so much good research now," Bohannon urges. "We're only getting our heads around that now, as we properly study these things."

One of these things is pregnancy. "What has come up a lot in biology but is still taboo in public spaces is that there is such a thing as maternal-fetal conflict. You know we have this model of what it is to be pregnant as this wonderful, warm, cushy thing," Bohannon explains. But in fact, pregnancy involves a complex interplay between the maternal and fetal bodies, each vying for resources. This conflict, she elaborates, poses risks to both mother and child and challenges current research methods.

“The vast majority of medications on the market, even still today, have never been properly tested on female bodies…it’s just been Boy Town.”

Bohannon explains that the pervasive male bias also extends into biomedical research, emphasizing the repercussions for healthcare delivery: "The vast majority of medications on the market, even still today, have never been properly tested on female bodies—not in basic science models and rodents, up through model species or in human beings. It's just been Boy Town. It's just been studying male bodies, hoping that was sufficient." This oversight, she elaborates, has led to detrimental consequences, such as the failing to understand differing dosage requirements and metabolic profiles in female patients.

In an utterly tragic example of the real-world consequences of inadequate drug testing, Bohannon cites the case of zolpidem, commonly known as Ambien. She explains that while initially, there was a single dosage recommendation for male and female patients, in the last decade doctors concluded that women should, in fact, only take half that initial recommended dose. Why? Car crash data. "It turned out that more female patients who had taken the drug the night before got into car crashes the next morning," Bohannon explains. Since the initial recommendation was based on drug trials that only included men, it didn’t account for how women's bodies would metabolize the drug more slowly. As a result, thousands of women were unintentionally driving under the influence on their morning commutes.

"Since dosage is usually based on body weight and age, if there aren’t specific recommendations for women coming from the research, doctors have to rely on anecdotal knowledge to figure out whether or not a prescription needs to be "jimmied" for a female patient," Bohannon says. "Jimmied" prescriptions are often based on false assumptions about smaller bodies needing smaller dosages. But as Bohannon explains, that assumption is particularly problematic for certain prescription painkillers for which women in fact require higher doses in order to feel the same level as pain relief as men.

Bohannon's insights underscore that just as "shrink it and pink it" won’t cut it in product design, there is a critical need to rectify gender disparities in healthcare research. As Bohannon aptly concludes, "It's imperative that we improve our understanding of how drugs interact with the female body to provide better care for all patients."

"There are still enough loopholes... to drive entire truckloads of drugs through."

And there has been progress. Ten years ago, the National Institute for Health (NIH) launched an initiative mandating equal sex subject pools in research funded by the agency. This shift has influenced basic science, ensuring a more comprehensive understanding of sex differences in drug responses. However, Bohannon emphasizes the persistent gaps in the system, stating, "There are still enough loopholes... to drive entire truckloads of drugs through."

How did we get to the point that scientific research (as well as other fields like product development and marketing) have simply not taken half the population into account for decades? Bohannon debunks the notion of a deliberate sexist agenda: "How we got here was not a sexist cabal rubbing their hands together, saying we're going to make women's lives suck—that is not the history of science." She explains that the exclusion of females from research was primarily driven by the desire to control for the complexities of the estrous cycle and the high costs of genetic research, where the production of specific genetic lines often requires breeding animals with desired traits. "We actually got here by doing pretty good science and being good scientists," Bohannon states. But then the real-world impacts and massive consequences were overlooked for too long: "This thing that we were trying to do to simplify our science was making us do poor science."

In concluding our discussion with Bohannon, we wanted to dig into some transferable insights and talk about how her scientific work contains learnings for organizations and teams in other fields.

1. Embrace your blind spots and "leave your lane"

Bohannon reflected on the value of interdisciplinary approaches and the initial discomfort of working with experts from other fields. Recalling her experience as a PhD student at Columbia University, Bohannon acknowledges the awkwardness and vulnerability of stepping outside her comfort zone. "The biggest questions, and the most exciting questions, are usually ones that you have to be willing to be uncomfortable to dig into." Reflecting on her role as a woman in science, Bohannon observes that "women in general, of all stripes" are more used to being told to "stay in their lane." But for those who do defy these norms, Bohannon believes they are uniquely prepared for interdisciplinary exploration and to step outside traditional boundaries. "It's chutzpah," Bohannon says candidly. "But it's also just being willing to be embarrassed, being willing to be corrected, and being willing to put myself out there."

2. Commit to "dual data" and create a safe space for new perspectives to flourish

"If you're committed to a dual model in data, then you are already more than halfway there," Bohannon says. And while gathering a balanced dual model data set that accounts for biological sex differences won't keep bias from creeping into the interpretation, it does give someone else the tools they need to do better. "I think in many different fields, in many different countries, we’re starting to think more carefully about what it means that half of our planet does not have a Y chromosome," Bohannon says. She observes that many companies are becoming more conscious about incorporating users with different bodies and different lived experiences into their design process. "I am fully in support of our deciders being more diverse and more representative of the world as it actually is. If women are deciders, if people of color are deciders, then maybe we get to decide differently," Bohannon says.

But Bohannon also acknowledges that part of the shift toward new research models is generational. There continues to be resistance to change within scientific institutions, particularly among older generations of scientists who hold significant decision-making power, including grant funding. Bohannon suggests that making it safer for scientists to change their perspectives and support those who are challenging existing norms is a crucial step toward addressing bias in scientific data. As Bohannon puts it, "How do we hold space for people who are having to say yes to something that's hard to say yes to in ways that you might not anticipate?"

3. Keep a long-term view of change

"I am fundamentally a hopeful person," Bohannon answers resolutely when asked how technology can improve or worsen data gaps. "I look to the future and I think it could very well get better. That's not to discount the horrific suffering so many people are going through now and will again in the future. But no, I am hopeful." Bohannon emphasizes the importance of balancing anxieties about new technologies with proactive social efforts to address predictable suffering. To Bohannon, it is a question of scale and timing.  "We were always terrified of technology," she reminds us. "We were terrified of novels. We were convinced that the simple romantic novel would corrupt all female readers in the 1800s, and that it was going to be the death of all culture." As we know now, it wasn't the end of civilization. And so, Bohannon urges us to differentiate short-term problems from long-term possibilities. As Bohannon concludes: "You're not going to feel motivated to change the world if you think the world cannot be changed."

Cat Bohannon is a speaker, author of the New York Times-bestseller Eve, and researcher with a Ph.D. from Columbia University in the evolution of narrative and cognition. A true interdisciplinarian, Bohannon also has an MFA in poetry and nonfiction. In eye-opening talks, Bohannon speaks about why modern medicine, neurobiology, evolutionary biology, and feminism are all undermined when we focus primarily on the male body.

To book Cat Bohannon for a speaking engagement, click here.