I entered graduate school in biology in 1968 when my sons were five and two, over the objections of professors who felt being a mother in itself disqualified me from doing a doctorate. My (male) supervisors fought to get me in, and I was content to be there. I could do interesting experiments and read articles on cells and DNA at the medical school library. Once in a while I strayed onto the physiology shelves, and there I stumbled across a book with the Olympic records for running and jumping. I was happy to learn that many pregnant women had competed in the Olympics, with no consequences to the fetus or, as far as I could tell, to their female organs.¹ I became curious about women’s biology, although it was far from my master’s thesis on fruit fly heredity. Occasionally an article on human sex chromosomes slid itself into the pile of articles about flies.

Still a student in 1972, I got a call from a group of professors at the Université du Québec à Montréal (UQAM) who wanted to establish courses in women’s studies. They had been able to negotiate one course, to be taught in the history department. But they were ambitious: they wanted to have several different versions of the course, one on women and economics, another on women and politics, and so on. With the help of Professor Donna Mergler, I took on the women and biology course. This was my first teaching job, rather far removed from my laboratory studies, and challenging, since I had a lot to learn about women’s biology and the students kept asking me hard questions. I looked for answers at the library, as graduate students did, but I was dismayed to find that there was little in the scientific literature that would answer the students’ questions about menopause, menstrual cramps, body shape, or environmental effects on pregnancy. I muddled along as best I could while continuing the laboratory research that would eventually get me my PhD in genetics.

When I became Dr. Messing, UQAM hired me as a professor. But, as I have described elsewhere,² I was enticed out of my laboratory by an agreement between UQAM and three Quebec trade unions that provided resources for research and teaching in occupational health (and other fields). I started to spend a lot of time with low-paid, low-prestige workers, most of them women, who struggled to get me to understand what their work involved. At the same time, one of my colleagues inveigled me onto the professors’ union executive by lying about the amount of time involved. I ended up being sent to serve on the women’s committee of my union confederation, which, in the late 1970s, was grappling with issues around equality and health protection. What was equal work? Why was women’s pay lower than men’s? Was it because of physical exertion? Then why would physicians be paid more than cleaners? Should women have to lift as much weight as men to receive equal pay? What if the weights are people who squirm and resist in daycare centres and seniors’ residences, should that count extra? Do women and men run an equal risk of health damage from any chemicals? all chemicals? Does pregnancy render women unable to work? at all jobs? Should women be working nights in factories? If not, why do they work nights in hospitals?

I started to think about how workplaces treat biological differences between women and men. Should our dreams really be limited by our bodies? Do we have to be the same as men to be equal?

People thought I should have answers to some of these questions because I understood how genes and chromosomes worked. I did know that people usually have forty-six chromosomes but that biological women and men almost always differ by a single chromosome. Women and men have twenty-two pairs of chromosomes that are grossly the same, but the twenty-third pair is different: 99 percent of people designated as women have two big X chromosomes, while 99 percent of men have one big X and one tiny Y. Knowing that didn’t help me much, though—I couldn’t find anything in the genetics literature to explain the links between having an X or Y chromosome and job segregation by sex. No one had unearthed a gene for any trait qualifying people for truck driving (most common men’s job) or being an office worker or teacher (most common women’s jobs). They still haven’t.

Some penetrating questions from hospital cleaners led me to seek training in ergonomics, a science that seeks to understand work and make it healthier. I then spent years working in partnership with union women’s committees and occupational health committees to study the work of bank tellers, primary school teachers, cleaners, and many other women.

For a few years, my department grumpily allowed me to continue teaching my biology and women course in addition to what they called my “disciplinary” courses in genetics. As if women’s biology wasn’t real biology.

One year I showed the 1977 film À notre santé (To Our Health), about the women’s self-help movement, produced by health activists in Quebec and Italy.³ I had meant to use it to discuss that movement’s view of women’s biology, since their bible, Our Bodies, Ourselves, had just come out in French as Notre corps, nous-mêmes. But the discussion got derailed. After the film, the all-female class was silent for a while, and then a tall, young woman said the film was ugly. It turned out she was referring to a couple of shots of women’s external genitals. The students spent the whole rest of the class sharing how much they hated their bodies. Everyone, all these beautiful young women, felt ugly everywhere. My reaction? It was hard for me to guide the conversation because I felt the same, except that in my eyes they were all beautiful and I was the only ugly one. Not to mention my unthinkable genitals. It was a revelation to all of us, I think, to realize that we were all ashamed, very deeply ashamed, of our bodies. And ourselves.

I think some of this shame came from a double bind about sexual aggression. There is no right way to be a young woman. As the #MeToo movement has pointed out, if we don’t smile at everyone no matter what, we are bitches, but if we do, we are sluts. I was ashamed about the boys who lied about me being “easy” when I was fourteen, too humiliated to explain myself to the adults who believed them. Ashamed when a camp director attacked me while walking in the woods when I was fifteen. When a clever law student tricked, argued, and pressured me into performing sexual services when I was sixteen, changing forever the way I felt about men’s bodies. When a Harvard lecturer responded to my question about economic theory with a farfetched analogy about my “reproductive capacity,” making the other students laugh and shutting me up in class for the next two years. Shame about the exhibitionists, the guys who grabbed at my body parts in Paris and Montreal, the young kid in Athens who took advantage of my carrying a huge, heavy box to feel my breasts. Facing the unrelenting pressure to do this, that, and the other thing. With a smile.

The shame at giving in, and at smiling, was silent. Just as I had kept quiet about the livers and gizzards, I never told anyone at all about the sexual attacks for a good fifty years, because I was sure I would be blamed. As I often blamed other women.

It took a while for me to see the connections between the shame in my biology class and what I was hearing, and not hearing, from the working women: the long silences when I asked whether the women were at ease in their previously all-male ghettos, nervous denial if I asked whether they were bothered by sexist jokes, reluctant admission that they found it hard to keep lifting patients, downplayed desperation about getting to work on time after a baby joined the family. As often as not, it was their male colleagues who were able to tell me about some of the injustices—about a bank manager who let male clerks, but not women, work with their backs to the public, about sexual harassment of women cleaners. An immigrant man in a clothing factory said it best:

Sometimes they have some problems with the machine or the production line, you know, how to manage, or they have some problems with co-workers, they compete, and some bullies. They cannot say. . . . I know some Chinese persons, some ladies feel hurt in their heart, they cannot say. They just keep silent because they cannot say.⁴

I don’t think the man was referring only to the women’s limited command of English and French.

From 1993 to 2012, our joint research effort with women’s committees in three union confederations tried to make the “hurt in their heart” visible. In fact, that is the name we gave our program: l’Invisible qui fait mal, or The Invisible That Hurts. Through our research, I have come to think that women workers need to combat our shame about our “different” bodies head-on. We need to dare to direct attention to the risks in our work, combatting all attempts to blame us for getting injured. And, above all, we need to develop ways to protect each other while we struggle together to adapt the workplace to our bodies and our lives.

I have come to believe that some of our failures to attain equality and health at work come from obstacles we haven’t been facing and don’t like to talk about—such as biological and social differences between women and men. I have seen (and been among) working women choked to silence by shame about being physically weaker, about menstruating, about needing to get to the daycare centre on time, about hot flashes, and I’ve realized that we need to think hard about the costs of our silence and talk with each other about solutions.

I have been forced to re-examine not only my personal, private experiences with aggression and shaming, but also our professional successes and failures. How does solidarity relate to ergonomic interventions in the workplace? Can it help us to improve women’s health and safety at work? Is it ridiculous to try to apply solidarity to ergonomic interventions to improve women’s work, and even to the science behind our interventions?

In the workplace, women have to deal with our bodies being considered “second bodies”—different, abnormal, inferior in size and strength. When we enter the job market, our jobs are often “second jobs”—supposedly easier, requiring fewer abilities, and worth less pay. Employers tell us that any mom who is well organized and insists on working for pay should be able to make it in to work on time every single day while keeping her “second” family role invisible. No mom could possibly believe that, but, like the immigrant workers, we “cannot say.” And our work-related health problems are accorded little importance, since they are considered imaginary (depression, anxiety), resulting from weakness (musculoskeletal disorders), weird (associated with pregnancy or menopause), or yucky (menstrual disorders). This lack of respect for women’s specific needs ends up making it nearly impossible for us to demand equality and health protection at the same time.

How to change this? Women need to name the aggression we face and hold responsible those who attack us. We need to name and combat the shame we feel when we are attacked for being women. We need to stand together to make real changes in the systems that support our attackers. Our network of powerful, beautiful feminist ergonomists is struggling to combat shame with solidarity, and I will describe our struggles and what we have learned.

I am only going to say this once, but it’s important. Men are also oppressed at work, have unrecognized work accidents and illnesses, and have to battle with unsympathetic employers and government agencies. Many (most?) men do not conform fully with gender and sex stereotypes and suffer from ill-adapted work sites. This book is about women at work because I have mainly done research on women’s jobs and because it is more often women (and gender non-conforming men) who experience a forced choice between gender equality and their health.

A friend of mine warned me early on that my book shouldn’t only talk about cis women. But I have to say that, in the unionized, low-paid workplaces where we have done our observations, trans and non-binary women have not been visible, just as gender non-conforming men have not been visible. I’m not saying there weren’t any, just that they were not visible. And my major message in the book can only be based on what I have seen and heard in the workplace. Yes, most physical, social, and psychological characteristics of women and men overlap; yes, women and men and everyone else should be able to access all jobs. But—there are areas where there is little or no overlap in physical characteristics, where many women (and a few others) are disproportionately affected by the fact that workplaces were designed for the average XY body. Not only spaces but also tools, schedules, and work teams were designed in a binary world where European, upper-class, cis men dominate. So the physical reality of most women (body shape, strengths and weaknesses, menstruation, pregnancy, menopause, double workday, likelihood of sexual assault) has been excluded. And (cis and other) women find it hard to fight for workplace adaptation, not only because of power imbalance, lack of a voice, ignorance, and sexism, but also because any request for change is seen as disqualification for the job.

As far as gender (social roles) as opposed to sex (biological differences) is concerned, my message has to do with the sexism experienced by all who identify / are identified by others as women. Women in the workplace are confined to certain jobs, tasks, movements, and behaviours and suffer the consequences.

My apologies also go to racialized and immigrant workers, because I haven’t had much opportunity to observe their work, either. Professor Stephanie Premji did her PhD work with us at the request of a union with many immigrant workers, and she has gone on to learn a lot about immigrant workers’ occupational health. I recommend her books and articles.⁵