March 04, 2026
3 min read
Key takeaways:
- Women are underrepresented in clinical trials, creating blind spots in understanding how diseases and treatments affect them.
- Equity in funding and pay could reduce gender disparities in medicine.
International Women’s Day, dedicated to celebrating women’s social and political achievements and raising awareness of gender inequities, is observed every March 8.
In recognition of the observance, Healio spoke with Louise P. King, MD, JD, a surgeon and assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, about addressing past and present gender inequities in medical research and practice.
King, who also serves as director of reproductive bioethics at the Harvard Medical School Center for Bioethics, said she could think of “a million areas” where female representation in clinical trials falls short.
“That’s the key takeaway,” King said. “Name any [area of research], and we could do more, for women, pregnant women, children and underrepresented populations, especially minorities and people of color.”
Healio: Women have historically been underrepresented in clinical trials. What gaps in clinical research would you like to see filled and why?
King: I wish I could narrow it down to gaps, but in all the years we’ve made progress in medical research, we’ve done it with the male body as the template. There are big gaps for a variety of vulnerable populations.
Women were excluded because the fluctuations of female hormones made it difficult to normalize studies, or because of concerns about teratogenicity, which is when an abnormality occurs during a pregnancy. It made it easier to conduct studies without women in the cohort.
If I had to pick a gap, it would be wonderful to focus on common, debilitating conditions and how they affect women, including rheumatologic or cardiovascular disorders. And near and dear to my heart, endometriosis, because it’s a condition I often treat and my daughter has it.
Healio: Are there areas where we are seeing more female representation in clinical trials?
King: There has only been focus on this issue in a meaningful way for a few years now. I haven’t noticed a huge difference, but several things are coming down the pike, including efforts by the government and companies in the private sector to divert significant funds to understanding the basic pathophysiology of different diseases and how they affect women.
In the spaces I’ve mentioned, cardiovascular health, rheumatologic diseases — specifically, multiple sclerosis — and endometriosis are getting a lot of attention. We need more effort and time spent on uterine fibroids and on mental health specific to women.
Healio: What research areas in obstetrics and gynecology hold the most promise for the next few years?
King: A lot of wonderful work is being done in obstetrics around abnormal placentation, which is when the placenta grows too deeply into the muscle of the uterus. It’s also called placenta accreta or increta. I’ve also seen amazing work done in preventing premature births, eclampsia and preeclampsia.
In my space, gynecologic surgery, we’re doing a lot of work on optimizing surgical approaches, maximizing access to minimally invasive surgery.
Healio: What health inequities do you notice in your field?
King: When I prescribe medications for constipation to women, I’m always telling them not to look at the dosing on the on the bottle, because it’s dosed to the average male body, which is bigger than theirs.
Another area there’s a problem as a laparoscopic surgeon is equipment. I use equipment fitted and designed around a man’s hand. It’s too big for me, and I now have arthritis in my hands from having to work in a work area designed around someone who is bigger. Looking at the basic stuff from the lens of the other 50% of the population is so important.
Healio: If you could solve one issue related to women’s health, what would it be?
King: If I was only allowed one, it would be equal pay and equal reimbursement. I would level the playing field, both for patients and doctors.
Women’s health in general, both obstetrics and gynecologic care, is reimbursed at about two-thirds the rate of care that is specific to male procedures.
Relatedly, women in medicine, whether they be surgeons, internists or nurses, should be paid the same as men. We are typically paid about 70 cents on the dollar to comparable male surgeons. We must level the playing field, because money talks and drives outcomes. When you start looking at the overall health of different populations, it’s always directly tied to the resources they have. If we had the same amount of money coming into women’s health — for research, standard care and salaries for people in the field — that would solve a lot of problems right off the bat.
Healio: What is your message to physicians this International Women’s Day?
King: Keep it up. There’s so much burnout in medicine right now, especially in fields related to women’s health. I’m so grateful for everything that everyone does within that space. Keep up the good fight. Keep yourself in that space. Don’t leave. We’re going to make things better. We’re going to make progress, and we need you.
For more information:
Louise P. King, MD, JD, can be reached at womenshealth@healio.com.
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