Women make up about half of the United States population, but current standards and systems in healthcare tell a different story. Biases persist in diagnosis and treatment, and reproductive healthcare is lacking on a global scale. While some of these inequalities are obvious, many are also hidden within the systems and providers that we should be able to trust. Awareness is only the first step to addressing the gap in care, and systemic change is necessary for healthcare equity to be achieved.

Female health conditions and physiology are chronically underrepresented in research, data collection, and clinical trials — both historically and currently.

Female health conditions and physiology are chronically underrepresented in research, data collection, and clinical trials — both historically and currently.

The leading cause of death for women in the United States is heart disease, yet only 4.5% of coronary artery disease research funding is focused on women. Approximately 1 in 10 women in the US suffer from polycystic ovarian syndrome (PCOS); however, it is significantly underfunded compared to other disorders of similar prevalence and morbidity. These examples are two of many in a chronic pattern of inequality and underrepresentation in the US healthcare system. 

In 1993, the NIH Revitalization Act mandated that clinical trials include women to receive federal funding. This was a critical mandate, but a significant amount of foundational clinical research was conducted before this date. As a result, information related to disease progression, diagnosis, and pathophysiology is primarily derived from male-centered data, yet is generalized to women. For example, early research on cardiovascular disease was conducted primarily in men, leading to diagnostic criteria based on typical male symptoms such as chest pain. Women are more likely to experience more subtle signs, such as shortness of breath, nausea, and fatigue, so they are often misdiagnosed or diagnosed late, resulting in worse outcomes overall. Similarly, past studies on pain and medication dosage primarily included men, so women are commonly overmedicated, undermedicated, or subjected to increased adverse effects.

Female underrepresentation in research extends beyond human participants, with biases in animal trials and testing even before clinical trials are initiated. Male mice are often favored in research because female hormone cycles are more variable, and scientists worry about the effect on their results. However, it is important to understand the interaction of the female hormone cycle with disease and treatment. Health conditions and medications often affect females and males differently due to basic physiological variation. For example, sleep apnea has been predominantly studied in men and male mice, who present with snoring and daytime sleepiness. Women present with insomnia, fatigue, and headaches, and thus are significantly underdiagnosed . The lack of inclusion of female participants in animal and clinical trials has resulted in diagnostic standards and treatment plans based on male physiology, resulting in poor health outcomes for women.

In combination with inherent prejudice in data and research, healthcare providers often treat women differently, either knowingly or not, due to a lack of education on female-specific healthcare topics. Immune conditions like lupus and multiple sclerosis disproportionately affect women , yet training often does not emphasize early detection in females. Many doctors misdiagnose such disorders because of biases in training, and pain and symptoms are often dismissed or minimized . Symptoms such as fatigue and brain fog that accompany autoimmune disorders are often chalked up to depression or anxiety, and chronic pain is rarely taken adequately seriously. Studies have also shown that women’s pain typically isn’t treated as generously with painkillers or anesthesia. This issue is particularly prevalent in reproductive healthcare, with a lack of pain management practices for procedures such as IUD insertion , and underdiagnosis of conditions such as PCOS and endometriosis due to doctors’ inability to distinguish between these disorders and typical menstrual pain. 

Reproductive healthcare, in particular, is a crucial and contentious area of care for women. The interactions of menstruation and female hormonal cycles with other health conditions are a particularly weak area in research, despite their prevalence. For example, menopause has recently been found to have implications in Alzheimer’s disease onset, and many thyroid irregularities have a direct effect on menstrual health. Considering the lack of awareness and funding, there are likely countless other connections between female menstrual cycles and health issues that have yet to be uncovered and studied.

Gender-based discrepancies in quality of care begin with subpar funding for research, treatment, and medicine. Federal funding for research and development routinely underprioritizes female-specific health conditions, which receive fractions of the federal budget severely disproportional to their prevalence and severity. For example, a study from the University of Wisconsin evaluated cancer funding relative to incidence and lethality, and found that prostate cancer ranked first, while ovarian, cervical, and uterine cancers ranked 10th, 12th, and 14th, respectively. Similarly, a 2021 analysis that examined funding relative to disease burden found that the most underfunded areas were chronic fatigue syndrome, migraines, headaches, anorexia, and endometriosis — all female-dominant conditions. Even as measures are taken to address these gaps, historically, healthcare has always taken a male lens. So, these inequities will continue to seep into the future. Reversing centuries of underprioritization, disadvantage, and inequality is a mountainous yet necessary endeavor. Incredible progress has been made in recent decades, but there is still a long way to go.

As of September 2025, the current administration of the United States has shifted away from progress in this regard, rolling back funding, protections, and projects implemented in the interest of improving healthcare for women. Initiatives such as the CDC’s Pregnancy Risk Assessment Monitoring System , the HHS’s Maternal and Child Health Bureau , and countless international women’s health programs have been hit or threatened with layoffs and cuts to funding. In April 2025, the HHS moved to terminate funding for the Women's Health Initiative (WHI), an established research program that has studied the health of postmenopausal women for decades, and produced critical findings on menopause, heart disease, cancer, and healthy aging. After backlash from scientists and politicians, the administration reversed the decision. However, the initial push to defund the WHI demonstrated the extremes to which female health programs are being threatened. These cuts, in combination with limits on reproductive freedoms and questions of contraceptive access, have put the future of women’s health at risk.

Women in the United States and across the globe are not receiving the caliber of healthcare that they deserve. Starting from the roots, the male-centered standards in healthcare need to be deconstructed and reformed, and extensive reform is necessary for the true inclusion of women in research and clinical trials. Female health conditions need to receive equal attention and funding, and inherent biases in training and treatment should be addressed. Reproductive healthcare should be taken seriously, and lawmakers should ensure wide accessibility. Women have been relying on a system designed for men for too long, and change is needed to achieve equitable healthcare in the United States.