Invisible Bodies: Gender Bias in Healthcare
For decades, medical research has operated on a quiet assumption: that the male body is the default. From clinical trials to mental health studies, men have long been the standard subjects, while women, with their hormonal "complexities," were excluded in the name of scientific clarity. Women's bodies have often been seen as just smaller versions of men's bodies. Hence, insights into many conditions and the drugs used to treat them have usually been extrapolated from male data and applied to women. But this exclusion has come at a cost. When we look at medical issues, including cardiovascular, reproductive, and mental health, where conditions like depression and anxiety affect women at significantly higher rates, the lack of gender-specific data has led to blind spots in diagnosis, treatment, and understanding. So what happens when half the population is left out of the data, and how does that gap ripple into real-world care?
A 2022 study found that across 1,433 U.S.-based clinical trials for drugs and medical devices between 2016 and 2019, on average, only 41% were women. This trend was seen even in areas like cardiovascular disease and cancer. In cardiovascular disease, symptoms in women can present differently than in men. So, research into heart disease being primarily based on male patients can contribute to women receiving less accurate diagnoses and treatments tailored to their unique needs.
The disparity was even more pronounced in psychiatry: although women make up 60% of those affected by psychiatric disorders, they accounted for just 42% of participants in related clinical trials. Generally, women are more likely to be diagnosed with depression and anxiety, but healthcare professionals may hastily diagnose these conditions instead of evaluating their symptoms more thoroughly. For instance, doctors who fail to recognize the typical signs of a heart attack in women might misinterpret them as anxiety instead. Because heart attacks are a medical emergency, this kind of misdiagnosis can delay treatment and, in some cases, lead to preventable death.
The stigma around female reproductive health remains an ongoing barrier to proper care. A general lack of understanding of the menstrual cycle — a natural and essential biological process — often leads doctors to dismiss severe pelvic pain as routine cramps, recommending over-the-counter painkillers. Some doctors may ignore the severity of pain entirely and refuse to provide women with pain medication. In many cases, patients who later received more thorough evaluations were diagnosed with severe conditions like endometriosis, ovarian cysts, or even cancer. Moreover, many women, especially women of color, low-income women, or disabled women, report mistreatment and dismissal during pregnancy and delivery. Almost half (45%) of women held back from asking questions or sharing concerns during their maternity care, showing their distrust in the system that was meant to but failed to assist them.
Body size is another primary and often overlapping source of bias in healthcare. While weight bias can affect anyone, research shows that women are disproportionately impacted. Healthcare providers frequently attribute symptoms in women with larger bodies to weight alone, advising weight loss instead of investigating other potential causes. This bias also contributes to lower rates of preventative care, such as gynecological exams and breast cancer screenings, among people with higher body mass indexes (BMIs).
Along with the exclusion of women, there is also a growing realization of the erasure and mistreatment of intersex, transgender, and non-binary individuals in both research and clinical practice. This lack of inclusion compounds existing disparities and further limits our understanding of how different bodies experience illness, pain, and care. From biased clinical trials to everyday misdiagnoses, these gaps compromise the care received by women and gender-diverse people alike. For many, this leads to ineffective treatment and to lasting distrust in a system that was never built with them in mind.
Encouragingly, progress is underway. The National Institutes of Health's (NIH) 2015 policy on Sex as a Biological Variable (SABV) now requires researchers to consider sex in designing, analyzing, and reporting biomedical studies — a step toward more inclusive and accurate science.
"Within the last 10 years, there has been major progress on sex-informed research," says Dr. Hadine Joffe, a professor of psychiatry in women's health at Harvard Medical School. "But it's a mixed story because there's still such a long way to go."
Bridging this gap will require more than policy shifts. It demands a transformation in how we value bodies, knowledge, and care. A truly equitable healthcare system must center those historically excluded not as afterthoughts but as essential participants in the science that shapes their lives.
References:
Author links open overlay panelAlexandra Z. Sosinsky a b c et al. (2022) Enrollment of female participants in United States drug and device phase 1–3 clinical trials between 2016 and 2019, Contemporary Clinical Trials. Available at: https://www.sciencedirect.com/science/article/abs/pii/S1551714422000441 (Accessed: 29 June 2025).
Alberga, A.S. et al. (2019) Weight bias and Health Care Utilization: A scoping review, Primary health care research & development. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6650789/ (Accessed: 29 June 2025).
Colino, S. (2024) Does the gender gap in medical research still exist?, Time. Available at: https://time.com/7171341/gender-gap-medical-research/ (Accessed: 29 June 2025).
Freeman, A. et al. (2017) Inclusion of sex and Gender in Biomedical Research: Survey of Clinical Research proposed at the University of Pennsylvania, Biology of sex differences. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5480171/ (Accessed: 29 June 2025).
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Many women report mistreatment during pregnancy and delivery (no date) Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/vitalsigns/respectful-maternity-care/index.html (Accessed: 29 June 2025).
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Sattler, K.M. et al. (2018) Gender differences in the relationship of weight-based stigmatisation with motivation to exercise and physical activity in overweight individuals, Health psychology open. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5846936/ (Accessed: 29 June 2025).
About the author:
Eema-E-Zahra Shah is currently doing her A Levels in Islamabad, Pakistan. Her past experiences have mostly revolved around social justice and creative communications. She's worked as Content Lead with Mahwari Justice, a period equity NGO in Pakistan, and Director Operations at the Happy Little Family Foundation, an orphan development group. Eema was HR Manager at Shanakht, a welfare-focused NGO, an intern at Al Bayaan Schools, and a writer at iFeminist, DearAsianYouth Karachi, API Impact, GoodForYouth Pakistan, and Sadaa. She is also researching at a biomedical engineering lab.
