When the standard is male, women become statistical anomalies in their own lives.
Picture this: you are on a sinking boat. You reach for a life jacket and discover that in the 170 years since their invention, nobody considered that someone with breasts might ever need one. Yet for decades, safety equipment, drug trials, and diagnostic criteria were built around a default human who looked suspiciously like a 70-kilo man. Welcome to the medical research gap.
Until 1993, the United States National Institutes of Health (NIH) did not legally require women to be included in federally funded clinical research. Data gathered from men was generalised to women, as if oestrogen were a minor software update rather than an altogether different operating system.
A 2024 report by the World Economic Forum and the McKinsey Health Institute found that women spend 25 per cent more of their lives in poor health compared with men. Sexual and reproductive health makes up only about 5 per cent of women’s overall health burden, yet it dominates what little women-specific research exists.
Take endometriosis, which affects around 190 million women worldwide and about 1.5 million in the UK alone. It occurs when tissue similar to the lining of the womb grows elsewhere in the body, causing chronic pain, organ damage, and infertility. Despite its prevalence and severity, diagnosis takes an average of seven to nine years. A report by the UK All-Party Parliamentary Group on Women’s Health found that 40 per cent of women with endometriosis visited their GP ten or more times before receiving treatment. Many were told their pain was normal, exaggerated, or psychological.
Polycystic ovary syndrome, or PCOS, affects up to 1 in 10 women of reproductive age and is linked to infertility, insulin resistance,ce and increased risk of diabetes. Yet it is often reduced to irregular periods and acne, inconveniences rather than systemic disruption.
These funding patterns are not just coincidental; they reveal priorities. Between 2019 and 2023, erectile dysfunction research received roughly five times more funding than endometriosis. While one condition interferes with sex, the other can leave you fainting on the bathroom floor. Now, guess which one got the bigger check. Around $1.24 billion went to erectile dysfunction compared with just $44 million for endometriosis.
And then there was the 2013 study titled “Attractiveness of women with rectovaginal endometriosis.” Instead of funding desperately needed research into pain mechanisms or non-invasive diagnostics, researchers examined whether women with a painful pelvic disease were more attractive. It was widely criticised as ethically dubious and tone-deaf. When your pelvis feels like it’s being poked with tiny sharp knives every few seconds, it is comforting to know science is rating your cheekbones.
Meanwhile, sildenafil, best known as Viagra, has been extensively studied since the late 1990s. Erectile dysfunction affects around 19 per cent of men. Research into it significantly outpaces research into conditions such as premenstrual syndrome, which affects up to 90 per cent of women. Male pattern baldness, while surely emotionally distressing, carries no comparable physical risk, yet it has generated billions in pharmaceutical investment and a thriving transplant industry. Endometriosis research frequently depends on underfunded grants and charities.
The gap extends beyond reproductive health. Attention-Deficit Hyperactivity Disorder, or ADHD, has long been associated with hyperactive boys. Girls are more likely to present with inattentive symptoms that are quieter and easier to miss. Research shows that clinicians often overlook girls because they do not fit the disruptive stereotype. They are distracted but compliant, struggling but silent.
Autism has a similar story. Boys are diagnosed up to four times more often in childhood. The difference lies not in prevalence but in recognition. Many autistic women mask or camouflage their symptoms. Others are misdiagnosed with anxiety, depression, or personality disorders. Diagnostic tools were developed using predominantly male samples. When the standard is male, women become statistical anomalies in their own lives.
Obsessive-compulsive disorder (OCD) shows comparable patterns, with women often presenting differently and receiving later diagnoses. Underrepresentation in research shapes who is seen, who is believed, and who is dismissed.
The problem is not confined to clinics. It is embedded in infrastructure. For decades, car crash testing relied on dummy models based on the average male body. Women are more likely to be seriously injured in car crashes, partly because seatbelts and airbags were not optimised for female anatomy. Personal protective equipment often uses a standard male face shape, meaning masks and body armour fit women poorly. Office temperatures are typically calibrated to male metabolic rates.
Across Europe, women face longer diagnostic delays for cardiovascular disease, rare diseases, and chronic pain conditions. Their pain is more likely to be underestimated, a phenomenon known as pain bias. Women also experience higher rates of adverse drug reactions, in part because dosing has been calibrated to male bodies.
Underlying all of this is a persistent societal discomfort with women’s bodies. Menstruation, menopause, and pelvic pain remain taboo. When the word vagina is still whispered or avoided, it becomes harder to fund rigorous research into what affects it. Or, on the other hand, it takes over women’s identities, leaving them with little other research to explain countless other medical imbalances.
The medical research gap is not about competition between men and women. It is about accuracy and safety. When half the population is underrepresented in research, medicine becomes less precise for everyone.
Researchers are revisiting diagnostic criteria, funding bodies are acknowledging disparities, and patients are speaking out. Progress is happening, but it is slow. In the meantime, women continue to wait seven years for diagnoses, navigate misdiagnoses,s and live in systems that were not designed with them in mind.
Medicine prides itself on being evidence-based. It’s about time the evidence reflected all of us.
Sophie Gliott – Arts and Lifestyle Editor