“Please, don’t cry. I love you,” I whispered to my sister. She squeezed my hand as we chuckled softly at the “Mr. Maria Kuhn” misprinted on my new bracelet. Patient 7843649, Emergency Department, 12/26/19.

In a moment of solitude, I prayed. The force of the head-on collision ruptured my small intestine. I was due for a running of the bowels, or the removal of all abdominal organs to find the source of the leaking acid and blood. My mother’s sternum and tailbone were badly broken.

Hours before, my family was cruising through the Irish countryside. I muzzled the pain and fear because we were lucky it wasn’t worse only my mom and I sustained significant injuries. We would recover.

My once-punctured upper intestine has healed. My mom is better, too. A freak accident turned freak injury made me a more grateful sister, daughter and friend, all of which I am thankful for. The student in me has undergone a similar transformation. In the months after the accident, my bookish tendencies veered toward a new target: car crashes.

What I learned? It is no coincidence that only women were injured in our accident.

Even though statistically we are more careful drivers and spend fewer hours on the road, cisgender American women (whose gender identity corresponds with their birth sex) are 73 percent more likely to be seriously injured and 17 percent more likely to be killed than are cisgender American men. (These findings all pertain to people who are wearing seat belts.)

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A high percentage of these injuries are caused because antiquated testing standards leave these girls and women vulnerable. The government has known of this disparity for decades – of both the unnecessary deaths and the lack of representative female dummies that caused them.

All cars sold in the United States must pass standard safety regulations as decided by the National Highway Traffic Safety Administration. These tests are routinely conducted with two serious limitations that profoundly affect women’s safety.

First, these tests use primarily male dummies. The NHTSA’s 5-Star Safety Rating uses three crash tests with dummies – the Frontal, Side Barrier, and Side Pole crash tests. Until 2011, dummies the size of an average-height and -weight woman were completely absent from all NHTSA regulatory tests. Today, only the Side Pole test is conducted with a female driver.

Once deployed, these cars leave female drivers 13 percent, 14 percent and 24 percent more likely to be killed by Side Pole, Frontal and Side Barrier crashes, respectively. Progress requires patience, but it is too painful to consider the lives the NHTSA could have saved if the government listened to regulators when they asked to implement female dummies in the 1980s.

Second, the femalebodied dummy used is not representative of the modern American woman.

The current dummy, the Hybrid III 5F, is 4 feet 11 and 108 pounds. She was originally designed to represent the 5th percentile woman in the 1970s and is far from reflective of the average 5-foot-3, 170.5-pound woman today.

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Worse still, the Hybrid III 5F is simply a scaled-down version of the male, critically failing to account for the varying bone structure, neck anthropometry and mass distribution among cisgender women. Years of research prove the tangible effects of these variations and their impacts on skeletal integrity and resistance to force. Among the most common injuries suffered by female passengers? Intestinal puncture and sternum fracture.

Unless you are a cisgender male, your car was not designed to protect you. Not only is there no meaningful female dummy, there is no realistic child, pregnant woman nor representation for anyone who is elderly or disabled.

Dummy development costs money and time. But is there a worthier cause than a human life? The NHTSA calculates the yearly economic and societal costs of accidents to be $836 billion.

NHTSA’s 2021 budget requests $8.2 million to study dummy biomechanics and crashworthiness alone. As dummies have historically cost around $200,000 to develop, this is far more than enough to research and implement more anthropologically sound substitutes.

As the Biden administration is looking to make gender equity a priority, they should consider updating these archaic regulations. By requiring the NHTSA to begin the design process for anthropologically accurate dummies, and to use them in every crash scenario, thousands of lives can be saved. Or, at least, thousands of small intestines.

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