What Is the Gender Health Gap?

Women and people with vaginas have long been trailblazers, from advocating for voting rights to demanding equal pay in the workplace. Yet, when it comes to healthcare, there's an invisible but deeply rooted inequality that persists — this is known as the gender health gap. This gap represents how the medical system has neglected women’s health needs, leading to worse outcomes for women compared to men. Whether it’s in research, diagnosis, or treatment, women continue to face challenges that can, and do, have life-altering consequences. To this day, women spend 25% more of their lives in debilitating health than men.

The legacy of neglect

Historically, the medical community has centered its research and practices around men, often treating male bodies as the default standard for healthcare. As shocking as it sounds, women were left out of clinical trials for decades, and the assumption was that women were just “small men” — and what worked for men would automatically apply to women. 

This approach ignores the fundamental biological differences between men and women, leading to misdiagnosis, inadequate treatments, and a lack of understanding of many conditions specific to women’s health.

It wasn’t until 1993 that the U.S. National Institutes of Health (NIH) made the inclusion of women in clinical trials mandatory. While this was a major step forward, medical gender bias didn’t disappear overnight. Today, the gender health gap is still glaring in many areas of medicine, profoundly affecting women’s lives and well-being. Even the NIH didn't have a research branch that studies female sexual organs beyond their role in reproduction until 2012 (ironic, considering that only 1% of pharma research and development funding goes to maternal health).

In a 2015 review, it was noted that progress in considering sex differences as a biological variable in medical research has been slow and insufficient to serve public health. In response, the NIH implemented a policy requiring medical researchers to consider both males and females in their research. This includes developing research questions, study design, data collection, results analysis, and findings reporting. If a researcher chooses to focus on only one sex, they must provide compelling reasons. 

However, despite these efforts, there is still a long way to go in addressing the historical exclusion of certain groups from medical research. While some strides have been made since 1993, particularly with the representation of white women, many groups remain under-represented, including women from non-white racial and ethnic communities. Additionally, older adults, pregnant and lactating people, people from the LGBTQIA+ community, and people with disabilities remain under-represented and even excluded from clinical research.

Why were women excluded in the first place?

Back in 1977, the Food and Drug Administration introduced a policy that suggested not including "women of childbearing potential" in Phase I and early Phase II drug trials. This recommendation was made to ensure safety, especially in light of the thalidomide tragedy in the 1950s, which led to thousands of birth defects. Even though thalidomide was never approved for use in the U.S., the incident led researchers to believe it was safest to exclude women of childbearing age from studies.

In addition to safety concerns, there were also biases about the challenges of studying women due to hormone fluctuations, which were thought to make research more complicated and costly. As a result, women weren't just overlooked but actively excluded from U.S. clinical research from 1977 to 1993. This means that much of modern medicine is based on research done exclusively on male bodies, and the consequences of this research gap are significant — sometimes even life-threatening.

The consequences of the gender health gap

The gender health gap has real and measurable effects. Women are more likely to be given the wrong diagnosis or prescribed the wrong treatment. This is because of years of biases in healthcare settings, a lack of research on women's healthcare, and not enough funding for solutions that focus on women. Here are a few examples of how medical inequality still affects women today:

• Cardiovascular disease: Heart disease is the leading cause of death for women, yet only one-third of clinical trial participants are women, and women are 50% more likely than men to receive the wrong initial diagnosis after experiencing a heart attack. Many symptoms of heart disease present differently in women, but because medical textbooks and training have traditionally focused on men’s symptoms, women are often overlooked.
• Chronic pain: Women are more likely to suffer from chronic pain conditions like fibromyalgia, yet studies show that their pain is more often dismissed or misdiagnosed as anxiety or emotional distress. A 2001 study found that women experiencing abdominal pain waited nearly 65% longer than men to receive pain relief in emergency rooms.
• Autoimmune diseases: 80% of all autoimmune disease sufferers are women, but these diseases remain under-researched and poorly understood. Women often endure long and frustrating diagnostic journeys, with some waiting up to five years or longer for an accurate diagnosis.
• Reproductive health: Conditions like polycystic ovary syndrome (PCOS) and endometriosis affect millions of women worldwide, yet they remain significantly under-researched. Women with endometriosis often wait over six years for a diagnosis, enduring excruciating pain and infertility issues in the meantime. PCOS, which affects about one in 10 women, can cause a range of symptoms from irregular periods to metabolic issues, yet treatment options are limited, and many women are dismissed or misdiagnosed before receiving proper care.
• Mental health: Women are twice as likely to experience depression as men, yet they are also more likely to have their symptoms misattributed to hormonal changes or dismissed as stress. This not only delays access to effective treatment but can exacerbate mental health conditions over time.

All this means that the women's health gap equates to 75 million years of life lost due to poor health or early death per year, according to a McKinsey Health Institute report.

The gender gap in women's health research funding

One of the key challenges in addressing the gender health gap is the significant disparity in funding for female-led healthcare companies and research focused on women’s health. Even though we're becoming more aware of the specific health needs of women, there's still not enough financial support to make real progress. This lack of investment not only slows down healthcare innovations but also hinders much-needed research into conditions that affect women more than men.

Female founders in healthcare face significant barriers when it comes to securing funding. In 2022, only 2% of all venture capital funding in the U.S. went to women-led startups — and 92% of femtech companies are founded and led by women. Even more concerning is that healthcare startups focused on women's health receive only a small fraction of the overall investment in the health sector. Even though women control around 80% of healthcare decisions in households and represent 50% of the population, their healthcare needs remain underfunded and under-researched.

This funding gap is particularly problematic because female entrepreneurs are often the ones driving innovation in areas like reproductive health, menopause management, and maternal care — areas that have historically been overlooked by male-dominated medical fields. Without adequate financial backing, these companies struggle to scale, limiting their ability to develop new products and services that could dramatically improve women’s health.

Beyond the startup world, there’s also a glaring lack of funding for clinical trials that focus on women’s health conditions. Historically, women were excluded from clinical research due to concerns over hormone fluctuations and reproductive cycles complicating results. Even today, while the inclusion of women in trials has improved, research dedicated specifically to women’s health issues remains underfunded. Half as much funding goes to female-specific conditions compared to those that mainly affect men. In 2019-2023 alone, funding for companies focused on erectile dysfunction was six times higher than that for endometriosis.

This lack of investment in clinical trials not only slows progress in finding better treatments for women’s health conditions but also contributes to continued misdiagnoses and delayed treatments. Until women’s health issues receive the same level of attention and funding as other medical research, the gender health gap will continue to persist.

Why this matters

The gender gap in funding both female-led healthcare companies and women’s health research is more than just a financial issue —it’s a public health crisis. Without proper funding, advancements in women’s health care will remain stagnant, and millions of women will continue to suffer from undiagnosed or poorly treated conditions. By closing the funding gap, we can unlock the potential for groundbreaking discoveries, life-saving treatments, and healthcare innovations that could transform women’s lives.

Investors and policymakers must recognize the importance of supporting female entrepreneurs and researchers who are tackling these critical health issues. The more we invest in women's health, the more we will improve not just women's lives but the overall health and well-being of society as a whole.

How Evvy is closing the gender health gap

It’s not all bad news, though. Awareness of the gender health gap has been growing, and our mission at Evvy is to close the gender health gap by researching and leveraging overlooked female biomarkers, starting with the vaginal microbiome. One of our key initiatives is Equal Research Day, an annual day of action to spotlight the need for more inclusive and equitable medical research for women.

Vaginal health has been historically overlooked, even though imbalances in the vaginal microbiome are connected to various conditions, from infertility to cancer.

Equal Research Day brings together researchers, clinicians, and advocates to push for change in how female health is studied, diagnosed, and treated. Through this initiative, Evvy seeks to encourage more gender-specific research and improve health outcomes for women. By focusing on better understanding the unique biology of women, Evvy aims to correct the decades of imbalance in healthcare, one study at a time.

What you can do

Closing the gender health gap will take time, but there are steps you can take to advocate for your health and better women's health outcomes:

• Educate yourself: Stay informed about health conditions that disproportionately affect women and advocate for your needs during medical appointments.
• Speak up: If you feel that your symptoms are being dismissed, don’t be afraid to seek a second opinion or ask for further tests.
• Support a women’s health initiative: Look for organizations like Women’s Health Access Matters (WHAM) and companies like Evvy, that are advocating for better women’s health research and care. By supporting these initiatives, you can help drive change.

The gender health gap is a persistent and deeply rooted issue, but with awareness and action, we can make progress. We owe it to ourselves — and future generations of women — to demand better. By championing equal research and advocating for gender-specific health solutions, we can all play a part in closing this gap for good.