Gender health gap: Bias and inequity putting women at risk, warn experts

By Ilayda Cakirtekin

ISTANBUL (AA) – As global debates around gender equality gain momentum, experts warn that one divide remains stubbornly overlooked – the growing gap in how women’s health is understood, treated and researched.

Despite medical advances, and despite living longer lives, women continue to face misdiagnoses, delayed treatment and dismissive medical encounters. The effect, experts say, is a decades-old disparity that persists across specialties, symptoms and life stages.

A World Economic Forum (WEF) report this year said that although women live five years longer than men, they spend 25% more of their lives in poor health or with some degree of disability, largely due to systemic blind spots in modern medicine.

The WEF pointed to chronic under-research, underfunding and underrepresentation of women in medicine – shortcomings with “far-reaching implications” for diagnosis and outcomes.

Speaking to Anadolu, health inequality researcher Magdalena Eitenberger and Lancaster University anatomy lecturer Benedicta Quaye Mensah said the data reflects widespread patterns rooted in bias and a healthcare system historically designed around men.

“There is still a really large gap in everyday experience that women have in clinical practice. They’re struggling to be believed about their symptoms. They’re struggling to fight stereotypes, taboos and stigmas,” Eitenberger explained.

For instance, symptoms of chronic pain and migraines, which both disproportionately affect women, were routinely dismissed for decades, she noted.

“There weren’t any real breakthroughs in managing symptoms or decreasing pain for things such as migraines, but also for other chronic pain conditions that women suffer from more often,” Eitenberger said.

Quaye Mensah highlighted cardiovascular disease – the leading cause of death among women worldwide – as a major example of inequity.

Women often present with symptoms like nausea, fatigue or back pain rather than chest pain, which is typical in men. This pattern of underdiagnosis is known as Yentl syndrome, named after the 1983 Barbra Streisand film about a woman forced to pose as a man to access opportunities.

“Women’s symptoms are more likely to be misattributed to anxiety, indigestion or stress, leading to delayed diagnosis and treatment,” Quaye Mensah said.

She added that even when women present with the same risks or disease severity, they are “less likely to receive guideline-recommended interventions” and more likely to receive “less aggressive” care than men.

“Overall, these gaps contribute to higher mortality and morbidity rates for women with cardiovascular disease,” she said.

Similar gaps exist in mental health. Although women are more likely to be diagnosed with depression, anxiety and eating disorders amid stressors such as pregnancy, caregiving or domestic violence, their symptoms are often dismissed as emotional or hormonal rather than recognized as clinical conditions, she added.

Medication safety is another striking divide. Since 2000, adverse drug reactions in the US have been reported 52% more often in women, according to the WEF, with medicines being three-and-a-half times more likely to be withdrawn due to safety risks in women.

At the same time, only 5% of available medications have been adequately tested and monitored with safety information for use during pregnancy and breastfeeding.

“Every woman who goes through pregnancy has these nine months where it’s really unclear what type of medication she can take, what is safe,” Eitenberger said. “It’s a long time if someone has several children. It’s a long time in your life where you’re expected to suffer through anything that you have.”

- Healthcare systems built around ‘default male’ model

A major driver of the health gap, both experts said, is the persistent underrepresentation of women in medical research.

Only 7% of healthcare research focuses on conditions specific to women, according to the WEF.

Historically, not only was medicine dominated by men, but women were excluded from clinical trials out of concern for fetal safety or because fluctuating hormones were deemed too complex.

“As a result, healthcare systems were built around a ‘default male’ model in areas such as anatomy, pharmacology and even diagnostic criteria,” Quaye Mensah explained.

The standard dosages, side effect profiles and treatment protocols used today are “often based on male physiology,” she added, despite anatomical and physiological differences.

“These differences can influence how diseases present, how medications are absorbed and processed and what side effects may occur,” she explained.

Although awareness has grown in recent years, she warned that “unconscious bias and structural inequalities” continue to affect the quality of care based on gender.

“Real change requires overhauling research practices and ingrained clinical habits, which does not happen overnight,” she said. “While awareness is a vital first step, turning that into sustained action and policy change is the ongoing challenge.”

Both experts noted that women’s pain or health concerns may be dismissed or attributed to psychological causes more readily than men’s.

“Everyone loses because mental health is underdiagnosed in men and physical diagnoses are underdiagnosed in women,” Eitenberger said.

Gendered health norms and stereotypes also harm men, she added, who are often expected not to show emotions, contributing to widespread underdiagnosis of mental health issues and higher suicide rates.

- Closing gap could boost global economy by over $1T

According to the WEF, narrowing the gender health gap could add at least $1 trillion to the global economy every year by 2040.

“Poor health among working-age women reduces productivity and increases public healthcare costs,” Quaye Mensah said.

The underdiagnosis and mismanagement of women’s health concerns often lead to more chronic illness, more medical leave and long-term barriers to workforce participation – all of which reinforce the gender pay gap.

Quaye Mensah stressed that the gender health gap is not only a clinical issue but also a social and economic one, affecting the well-being of families and communities.

“Reproductive and maternal health is another critical area. Conditions like endometriosis or polycystic ovary syndrome (PCOS), which are notoriously under-researched and frequently dismissed, can impact fertility and family planning,” she added.

Delays in diagnosis can force women to make life-altering decisions without adequate information or support, she said, while also placing emotional and financial strain on couples trying to start a family.

- In the age of AI, where is the gap headed?

Asked about AI and digital health, Eitenberger pointed to what she called a “huge impasse.”

“In a utopian world, having AI in place and having good health technologies in place could lead to more tailored diagnostics, better drug responses, better preventative strategies,” she said.

However, she warned that these technologies risk widening the gap globally by amplifying existing biases, as many models are trained on old datasets.

Already, a key driver of the healthcare gap is that much of the medical data still comes from past decades, when women were even more underrepresented in clinical research, and current studies continue to build on that legacy.

“AI and healthcare (technologies) do also hold the very real danger of just amplifying issues that are already there in the data,” Eitenberger said.

- What about solutions?

Eitenberger said closing the gap requires safeguarding recent gains while pushing for gender-responsive healthcare “both in research and in clinical practice.”

Quaye Mensah emphasized shifting research priorities and integrating gender-sensitive training into medical education and clinical guidelines.

“Without structural change, the gap will keep repeating itself,” she said.

Eitenberger agreed, adding that translating new research into practice remains slow.

Translating research into practice is “really important,” she said, urging more effective knowledge dissemination throughout the healthcare system.

“The trickle-down effect is not as quick as it could be,” she said.