Closing The Gender Gap In Medicine Starts With Listening

Despite dramatic advances in diagnostics and therapeutics over the last half-century, medicine still falls short for half the population. Women continue to face systemic disparities in care delivery, outcomes, and research representation. The problem begins upstream in clinical research, where female participation has historically been lower, even as multi-stakeholder efforts expand inclusion. Downstream, in everyday care, women are often treated using protocols, dosing regimens, and safety assumptions derived primarily from male data. Progress is strongest when biopharma, academia, regulators, educators, and health systems move together.

Clinical trial underrepresentation has been well documented for decades, yet progress remains slow. A global analysis of nearly 300 trials revealed that women accounted for just 41% of participants overall, even in conditions where they carry the majority of the disease burden. In early-phase, industry-sponsored studies, the foundation on which safety profiles are built, women comprised fewer than 30% of participants. These patterns stem in part from outdated exclusionary policies dating back to the 1970s and 1980s, which discouraged female enrollment due to concerns about pregnancy risk. Though those policies have been rescinded, the legacy lingers in research culture and design.

The imbalance is not uniform. In oncology, for example, the disconnect is especially striking. Women represent 77% of new thyroid cancer cases, but until recently, they comprised only 51% of participants in thyroid cancer trials. In cardiovascular research, where heart disease remains the leading cause of death in women, decades of male-dominant studies shaped diagnostic criteria and therapeutic guidelines that often miss atypical presentations in female patients.

These gaps have real-world consequences. Women have historically reported 1.5 to 2 times more adverse drug reactions (ADRs) than men. Differences in body composition, enzymatic activity, and drug clearance mean that a standard “average” dose may overshoot therapeutic needs, raising toxicity risk. Sex-aware dosing is an evolving science, and sponsors, clinicians, and regulators are incorporating emerging evidence into labels and practice where appropriate, as seen with zolpidem, where regulatory labeling later recommended a lower starting dose for women after reports of next-morning impairment.

Why listening matters

If evidence gaps create risk, listening is the tool clinicians already possess to mitigate it. Shared decision-making (SDM), in which providers integrate clinical data with patient values and preferences, is proven to improve satisfaction, reduce decisional conflict, and strengthen adherence. In menopause care, for example, SDM interventions have been shown to improve understanding of non-hormonal therapy options and empower women to choose treatments aligned with their needs and risk profiles. Embedding SDM alongside industry-independent education and clear patient communication turns emerging science into practical, individualized care.

Listening also requires rethinking how information is presented. Too often, continuing education defaults to guidelines and general principles without highlighting sex-specific differences. Providers report difficulty finding consolidated resources on how sex influences pharmacokinetics, risk-benefit profiles, and comorbidities. Without that knowledge, listening to a patient’s concerns about side effects or treatment trade-offs can feel anecdotal rather than evidence-based.

When clinicians are equipped with tools that translate emerging research into bedside practice, concise literature reviews, dosing checklists that flag sex-based metabolism differences, or CME sessions that integrate patient voices, listening becomes actionable. It shifts from empathetic rhetoric to informed, collaborative decision-making. Partnerships that include biopharma medical affairs (for non-promotional data sharing), academic educators, and patient groups can accelerate this translation responsibly.

Four practical steps to close the gap:

1. Make sex-disaggregated evidence the default.

Clinical committees that review formularies, pathways, or device purchases should require documentation of sex-specific efficacy and safety outcomes. Where data are missing, those gaps should be named explicitly and monitored. Transparency forces accountability.

2. Elevate shared decision-making to a clinical skill.

Incorporating decision aids, question prompts, and care-team huddles can normalize SDM in routine encounters. In areas like menopause, cardiovascular prevention, and chronic pain, where evidence is evolving and patient values matter deeply, these conversations improve both trust and outcomes.

3. Build patient feedback loops.

Patient advisory councils and post-visit surveys that focus specifically on women’s experiences can surface barriers that are often invisible to clinicians. Closing the loop—by reporting back what was learned and what changes were made, reinforces trust and signals that women’s input drives improvement.

4. Prioritize education that centers women’s health.

Professional education should expand beyond textbook summaries. Case-based sessions on under-discussed issues, such as insomnia in aging women, non-hormonal menopause therapies, or sex differences in cardiovascular risk, give providers tangible takeaways. When patient perspectives are integrated into these sessions, education becomes more relevant and aligned with real-world needs.

The role of medical education and implementation science

Education is where change scales. For many clinicians, busy practices leave little time to parse research nuances or track evolving sex-based evidence. Medical education providers play a critical role in curating and synthesizing information, presenting it in ways clinicians can immediately apply. Programs that pair multidisciplinary expertise with patient narratives have proven especially powerful.

It is important to emphasize that educational efforts are not about promoting a particular product or intervention. They are about equipping providers with a sharper lens that acknowledges biological and experiential differences and integrates them into care. Whether the topic is cardiovascular risk in women, the nuances of hormone therapy, or sleep disruption in midlife, evidence-based education designed with women in mind benefits the entire healthcare system.

Listening changes outcomes

The gender gap in medicine is not inevitable. It reflects choices made in research design, policy, and practice that can be unmade. By demanding sex-disaggregated evidence, adjusting prescribing habits, embedding shared decision-making, and investing in education that centers women’s experiences, we can create meaningful change today. We can do so through partnership, without casting blame, by aligning incentives and sharing data to accelerate what works.

Listening is the thread that connects all of these actions: listening to research that highlights disparities, listening to colleagues who push for equity in practice, and above all, listening to women, whose experiences too often reveal what the data missed. When clinicians are trained and resourced to listen well, and when the system values their ability to act on what they hear, women receive safer, more personalized, and more equitable care. That’s how collaboration turns “women’s health” from a niche category into a universal standard.