Jeanne Theuret
Jeanne Theuret is the co-founder of Sorella, a French network of health centers dedicated to women. A graduate of Harvard Law School (LL.M. ’09), she practiced as a corporate lawyer for more than ten years at the American law firm Cleary Gottlieb Steen & Hamilton LLP.
“We cannot all succeed when half of us are held back.”1 This observation by Nobel Peace Prize laureate Malala Yousafzai resonates powerfully, particularly in the realm of health. It is a well-established fact that men and women differ physiologically, whether in their genetic makeup, anatomy, biology or hormonal systems. Yet for decades, these multifaceted differences were largely ignored in medicine, biomedical research, clinical trials, but also in diagnostics and treatments. Medical knowledge has long been constructed around the male body as the norm, with significant consequences for public health and macroeconomic outcomes. Addressing inequalities in women’s health necessarily requires better recognition and integration of these physiological differences.
Women’s Health: The Blind Spot of Modern Medicine
Although women tend to live longer than men, they spend on average 25% more time in poor health.2 Numerous studies and statistical analyses show that failures in the prevention and treatment of diseases affecting women lead to high levels of delayed care and increased mortality.
In France, 200 women die every day from cardiovascular disease. Although long perceived as predominantly affecting men, cardiovascular disease is in fact the leading cause of death among women in France, surpassing even cancer. One statistic alone captures this reality: in cases of heart attack, women in France experience a 30-minute delay in treatment compared to men.3 This delay can be attributed to multiple factors: the less frequent presentation of so-called typical symptoms,4 the delay between symptom onset and seeking medical attention, errors in referral,5 and the time lag between initial contact and treatment administration.6 Moreover, women are significantly less likely to receive the recommended post-infarction treatments and have more limited access to rehabilitation. As a result, the in-hospital mortality rate following a heart attack is 9.6% for women compared to 3.9% for men. Sex appears to be an independent predictor of mortality, on par with age and diabetes.7 And although the gender gap in cardiovascular risk factors is narrowing, this is mainly due to a deterioration in health behaviors among women, such as rising smoking rates.8 This situation is observed consistently in various countries and notably in the United States.9
Barriers to timely and accurate diagnosis. Beyond cardiovascular disease, growing evidence points to systematic disparities in diagnostic practices between men and women, affecting both the measurement of prevalence and the management of female-specific diseases. A twenty-one-year study in Denmark found that women were diagnosed later than men in over 700 conditions: for cancers, diagnoses occurred on average 2.5 years later; for diabetes, the delay was up to 4.5 years.10 In the United States, less than half of women suffering from endometriosis have a formally documented diagnosis. This is primarily due to diagnostic delays averaging seven to ten years.
Differential efficacy of treatments. Treatments themselves often perform differently depending on the patient’s sex. For example, the standard treatment for asthma—bronchodilator and corticosteroid inhalers—has been shown to be 20% less effective in women than in men.11 Women are often the neglected members of the family when it comes to their own health. Thus, 81% of women take better care of the health of those close to them than their own, and 34% of women have reported postponing or canceling a women’s health consultation (related to screenings, maternal health, obstetrics, or gynecology).12-13
Numerous Structural Factors
Research and clinical trials are primarily based on the male body. Historically, men have both led and developed public health policies, as well as constituted the primary subjects of studies in medicine and biomedical research.13 Animal models used in preclinical studies have predominantly been male. Questions related to biological differences between the sexes have rarely been studied or documented, with the assumption—now recognized as incorrect—that there were few significant differences in the functioning of organs and systems between men and women, apart from reproduction.14
Women were long underrepresented in clinical trials, largely due to two health scandals in the 1950s and 60s: Thalidomide, a sedative for nausea prescribed during pregnancy that caused severe birth defects, and Diethylstilbestrol (known as Distilbène), a synthetic estrogen intended to prevent miscarriages, which led to genital abnormalities and cancers in daughters exposed in utero. In 1977, following these scandals, the U.S. Food and Drug Administration recommended excluding women of childbearing age from clinical trials to protect any potential fetus.15 Although well-intentioned, this measure proved excessive and had negative implications for women’s health. It was not until the 1990s that these restrictions were lifted, and new guidelines gradually implemented. According to the international registry of clinical trials, female participation across all phases and pathologies increased from 35% in 1995 to 58% in 2018. However, for some conditions, the persistence of inadequate female representation is still criticized, particularly in trials related to heart failure, certain cancers, depression, and pain.16 This underrepresentation has had profound implications for the understanding of diseases in women, the development of appropriate treatment protocols, and the increased risk of adverse effects or suboptimal therapeutic responses.
To this day, most published studies do not break down their results by sex. This lack of disaggregated data directly limits the understanding of the specific needs and conditions affecting women, which in turn affects the quality of care they receive and continues to hinder innovation and investment in women’s health.
Limited access to care and recognition of symptoms. Women are more likely to encounter barriers in accessing care, experience delays in diagnosis, and/or receive suboptimal treatments. Healthcare costs and insurance premiums have historically been higher for women. American women, for example, spend an average of $135 more per year than men.17 Research indicates that, upon accessing healthcare, a growing body of evidence suggests a gender bias in pain assessment, wherein women’s pain is often under-examined and subsequently under-treated, resulting in adverse clinical and psychological outcomes. Disparities are also evident within the female population: in the United States, Black women are 2.6 times more likely than white non-Hispanic women to die from pregnancy-related complications, and 60% more likely to die from cervical cancer.18
Chronic underinvestment. Despite the high prevalence of female-specific illnesses, women’s health remains chronically underfunded. This leads to a cycle of inadequate scientific production, limited data, poor understanding of conditions, and weak investment incentives.
How to Address These Inequalities?
Improving women’s health represents a major challenge, both in terms of public health, by reducing the time women spend in poor health, and in terms of economic opportunity. Closing the gender health gap could boost the global economy by at least $1 trillion per year by 2040.19 Additionally, the femtech market, which encompasses all innovations dedicated to improving women’s health, could reach $135 billion by 2030.20
Achieving the goal of improved women’s health necessitates increased investment in women-centered research across the entire research and development pipeline. This is crucial to address existing gaps in the understanding of conditions specific to women, which are currently understudied and poorly diagnosed, as well as diseases affecting both sexes differently. Furthermore, the systematic collection, analysis, and publication of sex- and gender-specific data is indispensable. It is also essential to improve access to women-specific healthcare across all areas, from prevention to treatment, to create incentives for investment in innovation in women’s health, and to develop new financing models.
These efforts involve both public policies and economic actors. The latter, in fact, have a determining role to play, with an approach involving multi-sectoral stakeholders. Primarily, this includes companies, notably by collaborating with health insurers to broaden coverage to health issues beyond fertility and maternity, such as screenings, rehabilitation therapies, mental health services, and menopause-related treatments. Companies’ contribution to this endeavor would help attract and retain talent, while also contributing to their health and productivity. Employers can also explore ways to make healthcare services more accessible, for example by allowing flexible work schedules, providing on-site health services, or subsidized childcare.21 Insurers, for their part, could help reduce gender inequalities in healthcare by addressing disparities in cost, access, and experience.
Naturally, healthcare providers are central to the solution and could improve care for women, for example by tailoring care and treatment plans to their specific needs to personalize and optimize the quality of care. Improving the patient experience is also essential: implementing systematic mechanisms for collecting feedback would ensure respectful treatment and create conditions for healthcare professionals to actively listen to patients and inform them about their health.22 Thus, according to one study, among the 2.3 million women who die prematurely from cancer each year, 1.5 million deaths could be avoided through primary prevention or early detection strategies.23
Foundations and associations also play a key role in establishing initiatives to raise awareness, anticipate, and act, such as the Agir pour le cœur des femmes endowment fund in France, created by Professor Claire Mounier-Vehier and Thierry Drilhon.
Thus, economic actors are called upon to extend public policies in women’s health, based on an essential political choice to reduce inequalities. The current international context in various regions of the world creates significant uncertainties regarding the possibility of pursuing and implementing such political choices and objectives. How can sex-disaggregated data be presented when an administration prohibits the use of certain words like “women,” “underrepresentation,” “female” in publications or materials (including school curricula)? How can health investments be funded during periods of budget cuts and unwarranted layoffs in key administrative sectors? How can equal access to care be ensured when the most fundamental rights are withdrawn from women and vulnerable populations? It is time to recognize the stakes, the systemic and contemporary obstacles, and to be courageous in our choices and actions, in the name of half of humanity.
1. Malala Yousafzai, Speech at the United Nations Youth Assembly, 12 July 2013. Quotation: “We cannot all succeed when half of us are held back.”
2. World Economic Forum and McKinsey Health Institute, “Closing the Women’s Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies”, Insight Report, 17 January 2024.
3. French National Academy of Medicine, “L’inégalité de prise en charge de l’infarctus du myocarde chez les femmes en France”, 14 January 2025.
4. M. Potterat et al., “Les femmes, oubliées de la recherche clinique”, Revue Médicale Suisse, (no 487), 23 September 2015, p. 1733.
5. In the United States, 20% of women who call emergency services end up going to the emergency room or to their primary care physician because their call did not lead to any follow-up or action.
6. French National Academy of Medicine, supra note 3.
7. Id.
8. Bulletin Épidémiologique Hebdomadaire (BEH), “Épidémiologie des maladies cardiovasculaires en France”, Santé Publique France, Hors Série, 4 March 2025, p. 81.
9. French National Academy of Medicine, supra note 3.
10. World Economic Forum and McKinsey Health Institute, supra note 2.
11. Id.
12. Fondation Agir pour le Cœur des Femmes, “Les maladies cardio-vasculaires chez les femmes”, Infographic, consulted in April 2025;
13. Deloitte, “What’s Causing US Women to Delay Medical Care?”, 10 September 2024.
14. For example, regarding cancer: Ophira Ginsburg et al., “Women, Power, and Cancer: A Lancet Commission”, The Lancet, vol. 402, (no. 10417), 26 September 2023, pp. 2113–2166.
15. World Economic Forum and McKinsey Health Institute, supra note 2.
16. These recommendations applied to Phase I trials, which verify the safety of drugs, and Phase II trials, which estimate the effective dose. However, women could be included in Phase III clinical trials if the drug demonstrated a favorable benefit/risk assessment.
17. Haut Conseil à l’Égalité entre les Femmes et les Hommes, “Prendre en compte le sexe et le genre pour mieux soigner : un enjeu de santé publique”, Report no. 2020-11-04 Santé 45, 4 November 2020.
18. World Economic Forum and McKinsey Health Institute, supra note 2.
19. World Economic Forum and McKinsey Health Institute, “Blueprint to Close the Women’s Health Gap: How to Improve Lives and Economies for All”, 2024.
20. World Economic Forum and McKinsey Health Institute, supra note 2.
21. Femtech France and Wavestone, “Baromètre 2024 Femtech France”, 16 July 2024.
22. Deloitte, supra note 13.
23. Id.
24. Ophira Ginsburg et al., supra note 14.