Gender inequality in biomedicine is hurting women's health and keeping women from getting the same quality of care as men.
Honestly, I feel a bit weird even writing about this. There's this voice in my head going "this isn't really your topic to talk about." A bit of a "stay in your lane" thing. But those same internal doubts are actually what made me want to say something about it even more.
And those differences go way beyond our reproductive organs. Because of biological differences, men and women experience many diseases differently.
When you actually consider the fundamental differences between men and women (chromosomes, how genes in those chromosomes express themselves, and hormonal differences), it's really not that surprising that those same biological differences also affect how women and men respond differently to treatments and medications.
For example, women wake up faster from anesthesia, recover more slowly, and experience more side effects like headaches and nausea. Anesthesiologists have long since learned that when calculating dosage, you need to factor in the patient's sex and, for women, the phase of their menstrual cycle.
Beyond the obvious physical and physiological differences, there's also plenty of research describing how sex affects cellular metabolism. Yet despite all of this, these differences are almost never considered when prescribing medications.
A 2005 study found that between 1995 and 2000, out of 300 new drugs that hit the market — drugs that were known to have significant differences in absorption, metabolism, and excretion between sexes — none had sex-specific dosing recommendations. [2026 update: Some progress has been made. In 2013, zolpidem (Ambien) became the first drug with FDA-recommended sex-specific dosing. In January 2025, the FDA issued major new draft guidance on studying sex differences in medical products. However, sex-specific dosing remains the exception, not the rule.]
The scientific community and researchers are well aware that when new products are introduced to the general population, the results differ from lab tests. It's accepted that there's a grey area and that not all patients achieve the same outcomes.
And yet, practicing physicians are often still poorly informed about the significance of sex-based differences, or simply ignore them. This disconnect in clinical practice persists, and doctors who rely solely on existing studies (instead of treating the patient as an individual) often dismiss women's symptoms. But it's not entirely their fault either. They just don't have enough information about how many drugs actually affect women.
As a result, women are far more likely to experience unwanted (and dangerous) drug side effects.
The problem isn't that we don't know how a handful of drugs affect women. The problem is that nobody has a clue how most drugs and treatments affect women. And the reason we don't know any of this comes down to some pretty ugly skeletons in modern biomedicine's closet.
In 1977, the United States Food and Drug Administration banned women from participating in biomedical studies. The stated goal was to prevent women who could potentially become pregnant from participating in early-stage clinical trials. But in practice it was a bizarre law that also excluded women who were sexually active, using contraceptives, or homosexual. The ban was reversed in 1993, when concerns about women's health came to the fore and it was determined that such a ban "lacked respect for the autonomy and decision-making capacity of women."
Because of this ban, a massive body of medical research conducted during those 16 years simply doesn't apply to women. And unfortunately, this gender bias has stuck around, which means women continue to be underrepresented in biomedical studies.
Globally, 80% or more of clinical trial subjects are male, and that number is even higher in animal studies. The fact that the vast majority of biochemistry research is conducted only on males creates a cascade of problems across every field of medicine.
[2026 update: The "80% male" figure remains accurate for preclinical/animal studies. For human clinical trials, it has improved: women now represent ~41% of participants overall. However, women remain severely underrepresented in early-phase trials (only 22-34% female) and in cardiovascular research (~33%). In January 2025, the FDA issued new draft guidance on studying sex differences in medical products.]
Women often can't keep pace with men when recovering from illness. This doesn't mean women are somehow weaker — it means that a large portion of the drugs prescribed to women have literally never been tested on women. Again, both sexes are biologically different, but most of the time this isn't taken into account when developing drugs or supplements.
Men don't have menstrual cycles and their hormones don't fluctuate over long periods. This makes men a more homogeneous study population, which guarantees researchers that the study is simpler to conduct and its results are easier to interpret. Because of more complex physiology, the entire process is harder with women, which also makes studying them a lot more expensive.
The cyclical nature of female hormones (in 26-32 day cycles) strongly influences study results, which makes an already complicated research process even more inconvenient for researchers. Researchers want their experiments to be clean of any possible variables that could interfere with the final results. That's also why most animal studies are conducted only on male animals.
But none of this is a remotely convincing justification for continuing to exclude women from biomedicine. Because this approach doesn't just risk women's health — it limits our entire scientific understanding.
If this is standard practice in research, then in other words, most biomedical studies have been conducted by cherry-picking a convenient population sample, squeezing it through a bottleneck for statistical significance, and concluding that the results apply to everyone.
Coming back to that 1977 US law — what looks on the surface like a reasonable restriction aimed at protecting pregnant women and their fetuses is actually an ethically and medically unacceptable regulation. For two reasons: pregnant women get sick, and sick women get pregnant.
Pregnant patients also have the right to safe and effective treatment. But as long as pregnant women aren't included in clinical trials, they're essentially being denied that right.
Even though this law is no longer in effect, pregnant women are still screened out of all sorts of studies for new drugs, supplements, health products, and medical devices.
Pregnancy comes with all kinds of physiological changes — plasma volume, body weight, fat content, metabolism, hormones. So when research has only been done on men (or at best, on non-pregnant women), it's practically impossible to translate those results, or the related safety information, to pregnant women.
As a result, pregnant women are typically not allowed to use new drugs or devices. And this also means that when a pregnant woman has a health problem that needs medical intervention, her doctor often doesn't have enough information to make evidence-based recommendations.
Given the state of modern medicine, there's not a whole lot you as an individual can do about this.
The best thing you can do is take care of yourself and prevent illness before it happens.
Let me share a thought I recently posted on social media.
Interpreting the Pareto principle, you'll get 80% of your health results from the 20% simplest and most boring habits:
To a modern, educated, critical-thinking person, this might all sound a bit bland or just woo-woo nonsense. But the human body is a complex system where everything is connected.
If your physiology is broken, it affects your inner world. And if your inner world is broken, it affects your entire physiology.
I think the smartest approach is to look at your health and well-being in an integrative way. I'd seriously recommend exploring all kinds of traditional healing practices and start forming your own truth. At the end of the day, these are all just different tactics for the same outcome. Ask a lot of why's, try to figure out what the root causes of your symptoms might be, and deal with those.
Allopathic medicine won't make us healthy — healing has to come from somewhere else.
And if someone wants to change the system from the inside, I think that would be a very worthy and welcome goal.