What They Call Care

They call it care, but for centuries, medicine has failed to treat women with the same urgency, respect, or curiosity granted to men. The result? Generations of women misdiagnosed, dismissed, and neglected — not by accident, but by design.

In the U.S., women weren’t even required to be included in clinical research trials until 1993, when the NIH Revitalization Act was signed into law. Before that, clinical studies excluded women, especially those of “childbearing potential” — resulting in dosage guidelines, disease models, and treatments tailored to cisgender men. The consequences still echo through modern medicine.

And when women do seek help, they’re more likely to be dismissed, gaslit, or under-treated — especially if they are women of color, trans women, or those with chronic or invisible illnesses.

Doctors Aren’t Being Trained — and Women Pay the Price

Despite how common conditions like menopause, PCOS, and endometriosis are, medical students receive as little as one hour of formal instruction on menopause during their training (Johns Hopkins, 2023). One hour — for a life stage that affects more than half the population. Most report feeling completely unprepared to treat it. That lack of training doesn’t end in school. It echoes through every exam room, every misdiagnosis, every dismissive shrug.

Endometriosis affects 1 in 10 women, yet the average time to diagnosis is still 7 to 10 years — nearly a decade of being told the pain is “normal.” PCOS, one of the most common endocrine disorders in the world, affects roughly 1 in 5 women, disrupting everything from fertility to metabolism to mental health. Still, there’s no standardized treatment protocol. No universal screening. Just a shrug, a birth control pill, or worse — blame.

Too often, women are gaslit by the very systems meant to help them. Told their pain is imagined. Their fatigue is laziness. Their weight gain is a personal failure. Their mood swings are “just stress.”

By the time someone finally listens, years may have passed — along with jobs, relationships, opportunities, and quality of life.
The physical toll is measurable. The emotional and financial damage, incalculable.

This isn’t a gap in training. It’s a systemic failure.
A direct result of a medical system designed around a male baseline — where anything outside that default is ignored, underfunded, or treated as an afterthought.

Pain Is a Punchline — Until It’s Fatal

A study published in *Academic Emergency Medicine* found that women wait an average of 16 minutes longer than men to receive pain medication in emergency rooms — despite reporting the same symptoms. And what they receive isn’t equal either. Women are more likely to be prescribed sedatives, while men are more likely to receive opioids.

This isn’t just a difference in treatment. It’s a difference in belief — in whose pain is seen as real, and whose is seen as emotional.

This disparity becomes dangerous fast. Heart attacks, for example, often present differently in women, with symptoms like fatigue, nausea, or shortness of breath instead of the stereotypical “chest-clutching” pain. But emergency protocols were written for male-pattern heart attacks — meaning women are less likely to be diagnosed accurately, admitted, or even believed. According to *Harvard Health* (2020), emergency physicians still struggle to recognize these signs, costing lives that could have been saved with better training and better listening.

And this isn’t limited to cisgender women.

These aren’t isolated incidents or rare exceptions. They are symptoms of a medical system that still treats the straight, white, male body as the default — and everyone else as inconvenient data points.
Until that changes, “equal care” will remain a myth.

The Hormone Gap

From puberty to menopause, women are told their hormones make them “irrational.” Emotional. Hysterical. Too unpredictable to trust — even with decisions about their own bodies.
But the real irrationality lies in the medical system’s refusal to study, understand, or prepare for the very hormones that govern half the population’s health.

**PMDD (Premenstrual Dysphoric Disorder)** is a severe, debilitating hormonal condition that affects 5–8% of women, often leading to intense mood shifts, depression, and suicidal ideation. And yet, many doctors still confuse it with PMS or dismiss it as “just stress.” It wasn’t even recognized in the *DSM* until 2013.

**Perimenopause**, which can last up to a decade before menopause officially begins, causes drastic hormonal shifts that affect sleep, cognition, mood, metabolism, and cardiovascular health. But the average GP receives less than four hours of instruction on menopause — and even less on perimenopause, if it’s mentioned at all. As a result, many women are misdiagnosed with anxiety, depression, or simply told to “wait it out.”

**PCOS, endometriosis, PMDD, PM(E), thyroid disorders, hormone-induced migraines, adrenal fatigue** — all are real, disruptive conditions that disproportionately impact women, yet remain underfunded, under-researched, and under-taught.
Women who report these symptoms are often told they’re exaggerating, or handed antidepressants as a one-size-fits-all “solution.”

Most medical curricula still treat hormonal health like a footnote.
But these aren’t niche issues. Hormones regulate everything from fertility to bone density to brain function. Ignoring them doesn’t just result in inconvenience — it results in delayed diagnoses, years of suffering, and preventable health crises.

This isn’t just oversight. It’s institutional neglect.

Until hormone health is taken seriously in research, policy, and education, millions of women will continue to suffer in silence — not because of their hormones, but because of what the system refuses to see.

Reproductive Control Disguised as Care

The history of women’s healthcare is riddled with control disguised as “protection.”
From forced sterilizations of Indigenous and Black women (which occurred well into the 1970s and beyond), to coerced hysterectomies in ICE detention centers as recently as 2020.

Now, with the overturning of *Roe v. Wade*, some doctors face prison time for performing life-saving procedures.

Meanwhile, crisis pregnancy centers masquerade as medical clinics, misleading patients with ideological propaganda — and no qualified staff.

Mental Health Still Stuck in the 19th Century

Women are nearly twice as likely to be diagnosed with depression — yet still less likely to be taken seriously when they seek mental health support. They’re prescribed antidepressants at higher rates, but their symptoms are often dismissed as hormonal, exaggerated, or attention-seeking.

ADHD and autism are chronically underdiagnosed in women and girls because diagnostic criteria were developed around how these conditions typically present in boys.
Boys are more likely to show externalized symptoms — hyperactivity, impulsivity, and disruptive behavior — which match textbook descriptions.

But girls often internalize symptoms: daydreaming, social masking, anxiety, and perfectionism. As a result, many are missed, misdiagnosed, or labeled as “shy,” “lazy,” or “emotional.”

Studies show girls with ADHD are often diagnosed years later than boys — if they’re diagnosed at all. Autistic girls frequently go unnoticed until adulthood, when the strain of constant masking leads to burnout, breakdowns, or misdiagnoses like BPD or generalized anxiety.

And when women do speak up, they’re often labeled “hysterical,” “dramatic,” or “noncompliant.”
These aren’t new words.
They’re inherited from a long tradition of institutional control, where female distress was pathologized — and inconvenient truths were locked behind clinic doors.

It’s Not Just Neglect. It’s Policy.

This isn’t just about individual doctors failing their patients.
It’s about a system that was never built with women in mind — and still isn’t.

Medical standards, diagnostic criteria, and treatment guidelines were designed around the “default male.”
That default shapes everything: who gets included in clinical trials, whose symptoms are considered “typical,” what conditions are prioritized for research funding, and whose pain is believed.

When policies are written around one type of body, everyone else is expected to adapt — or suffer.
Women are expected to present their symptoms like men do. To react to medications like men do. To live in bodies that were never accounted for in the first place.

Until research, regulation, and medical education center all bodies — not just the ones historically deemed “standard” — healthcare will remain unequal by design.
Not broken. Not misguided.
**Designed** that way. Built to ignore, dismiss, and exclude.

And that means true reform requires more than better bedside manner.
It requires burning the blueprint — and building something that starts, finally, with us.