The questions come at me rapid-fire from the back of the car. “Why do we have to go to school today?” my kids ask. That one’s to be expected. Then come the questions about differences between girls and boys, anatomical and otherwise. “Why do we do this, but they do that” sorts of questions.
It is a reminder that these young minds are natural scientists, exploring the world through a series of “whys.” As a physician-scientist, my days mirror this same process: asking questions, seeking patterns and solving puzzles. Each “why” I encounter in my clinic as a maternal and fetal medicine specialist — Why does this heart medication not work for women? Why are there disparities in maternal health? Why is the placenta stuck at delivery? — has profound implications for public health. When these questions are addressed with curiosity, care and evidence, they have the potential to transform individual lives and the health of entire communities.
Women’s health matters. It touches every part of society. When we invest in understanding and improving the unique health needs of women — and in this context I refer both to those who are biologically female and those who identify as women — there is a ripple effect that uplifts families, workplaces and future generations. Women’s health is not an esoteric, niche interest; it is the foundation of a thriving, equitable society. Just like those questions from my kids in the back seat, the “whys” in women’s health are urgent, real and worthy of every ounce of our scientific and clinical attention.
But despite their being half of the world’s 8.2 billion people, the health needs of women remain underserved, held back by archaic biases in research and systematic exclusion from basic, pre-clinical and clinical trials. Yet, focused research on women’s health — from the unique physiological processes of pregnancy, contraception and menopause to gynecological cancers and diseases that disproportionately impact women — has implications far beyond individual outcomes. When women’s health is prioritized in medical research, the benefits extend far beyond to offer insights and innovations that enrich health care for all, strengthen health systems and, ultimately, elevate the quality of life globally.
It is unfortunate that historically, this has not been the case. Medical research was built around the “male norm,” and the male body has been the default laboratory for exploration. This has created critical gaps in knowledge about how sex differences influence aging, disease and physiology.
But slowly, there has been a shift that prioritizes sex as a key variable in health. Institutions like the National Institutes of Health (NIH) now mandate the inclusion of women in clinical trials and analyses that explore sex-based differences. This push has led to such crucial — and fundamentally basic — findings as how women and men can experience cardiovascular disease and heart attacks differently. Studies on osteoporosis, a condition with a higher prevalence in women, have deepened our understanding of bone density and degeneration in both men and women. Research in women’s health has spurred advancements in screening and treatment protocols for cervical cancer that are now translatable to broader populations, recognizing the different risk factors and metabolic changes that men also can face. Other examples include differing drug metabolism rates, which has led to adjusted dosing recommendations for medications like antidepressants, enhancing safety.
By embracing sex as a critical biological variable, research becomes more personalized based on the unique physiological differences among people. It is not one-size-fits-all.
One of the biggest misunderstandings in women’s health research has been the belief that it is merely focused on reproductive health while overlooking the broader health implications and experiences of women across their lifespan. I say this as a reproductive biologist and pregnancy researcher. By moving beyond reproduction, researchers are redefining women’s health as “whole health.” This shift recognizes that women’s health isn’t just about reproductive function, but also involves a host of interconnected physiological systems that deserve study in their own right. Striving to serve the distinct needs of women is beneficial to understanding broader health and disease patterns across the sexes.
Menstruation and menopause research, for example, has linked hormonal changes with bone-density loss and cardiovascular health, informing preventive strategies for aging populations of both sexes. Chronic conditions such as autoimmune diseases and Alzheimer’s, which disproportionately affect women, are receiving greater attention. This shift promises gender-sensitive treatments while uncovering biological pathways relevant to all patients.
Mental health research, too, benefits from a gender-inclusive approach. Conditions such as depression and anxiety are more commonly diagnosed in women, in part due to hormonal influences that occur during puberty, menstruation, pregnancy and menopause. As researchers dive into these factors, they are uncovering how mental health disorders can be managed through hormone modulation. Findings from these studies are informing new treatments that benefit all people, acknowledging the roles that sex and hormones play in mental health.
While progress has been made toward achieving gender parity in medical research, work still remains to ensure that research represents the diverse patients we serve and the communities we live in. Achieving this requires more than surface-level efforts; it demands increased funding, belief in the significance of this work and targeted policy initiatives to prioritize gender-specific research, especially in historically underfunded areas such as pregnancy, autoimmune diseases, chronic pain conditions and mental health. It is imperative that sex and gender be treated as critical variables in all fields of health research, not just in studies focused on so-called “female-specific” conditions.
By embracing sex as a critical biological variable, research becomes more personalized based on the unique physiological differences among people. It is not one-size-fits-all.
Creating a research environment that genuinely prioritizes women’s health is not just ethically sound; it is a scientific imperative that leads to improved outcomes for all populations. The progress thus far offers a hopeful path forward, signaling the possibility of a health care system that recognizes women not as an afterthought, but as integral to the understanding of human health and disease. By continuing to foster inclusivity and equity in research, we can build a future where medical science serves all communities with the respect, precision and care they deserve.
Women’s health matters not only because women matter, but because society thrives when all its members are supported with the care and knowledge they need to live well. So, whether in a lab, a clinic or from the back seat of the car on the way to school, the questions we ask and pursue have the power to change the world. And that, perhaps, is the most compelling “why” of all.
Dr. Yalda Afshar is an assistant professor-in-residence of obstetrics and gynecology in the Division of Maternal-Fetal Medicine. Her clinical and research interests include high-risk pregnancy, prenatal ultrasound, genetic testing and congenital heart disease affecting either the mother or fetus.
