Historically, medicine has centered on the male body, leaving women underrepresented in clinical research and underserved in practice. The resulting gender bias has created a gap in evidence-based care that disproportionately affects women's health outcomes. Nurses, as advocates and primary care providers, have a responsibility to recognize this disparity and push for systemic changes that prioritize individualized, sex-specific care.
The Consequences of Exclusion from Clinical Research
Many women face skepticism when reporting symptoms, especially nonspecific ones like fatigue, chronic pain, or mood changes. Instead of thorough diagnostic workups, they are often labeled with psychological or vague diagnoses such as fibromyalgia or depression. This experience reflects not only individual provider bias but a historical legacy of research conducted primarily on men. Until the early 1990s, women were routinely excluded from most clinical trials, and when included, studies rarely analyzed sex-based outcomes (Institute of Medicine Committee on the Ethical and Legal Issues Relating to the Inclusion of Women in Clinical Studies et al., 1999; Regensteiner et al., 2023).
Because of this exclusion, crucial information on disease prevention, diagnosis, and treatment in women has been limited. Conditions such as cardiovascular disease, autoimmune disorders, and drug metabolism are still poorly understood in female patients. These information deficits have real consequences, leading to misdiagnoses, inappropriate treatments, and poorer survival outcomes (Institute of Medicine Committee on the Ethical and Legal Issues Relating to the Inclusion of Women in Clinical Studies et al., 1999).
Structural Barriers and Delayed Care for Women
Beyond research disparities, structural and socioeconomic factors also contribute to gender inequities in healthcare access. According to Deloitte's 2024 Health Care Consumer Survey, women are 35% more likely than men to delay or skip medical care due to affordability, transportation issues, or past negative experiences with healthcare providers (Gebreyes et al., 2024). These missed appointments can result in preventable disease progression, late diagnoses, and worsened outcomes.
The survey also revealed that nearly one in three women forgo preventive screenings or mental health care due to cost. Additionally, women face longer wait times and often have more appointments than men, compounding the barriers to accessing timely care (Gebreyes et al., 2024). These inequities leave women more vulnerable to chronic illness and financial hardship, particularly given the gender wage gap and higher out-of-pocket healthcare costs.
Equality vs. Equity in Women's Health
While equality implies that everyone receives the same care, equity recognizes that different populations have different needs. Providing the same treatment to both men and women does not account for the biological, hormonal, and social differences that affect how diseases manifest and progress. For example, many drugs are still dosed based on male pharmacokinetics, resulting in higher rates of adverse effects in women (Institute of Medicine Committee on the Ethical and Legal Issues Relating to the Inclusion of Women in Clinical Studies et al., 1999; Regensteiner et al., 2023).
Deloitte's findings emphasize that the healthcare system must transition from equality to equity, redesigning systems to address specific needs rather than applying a one-size-fits-all approach. Equitable design acknowledges and addresses historical and structural disadvantages while aiming to close the gender health gap (Gebreyes et al., 2024).
The Nurses' Role in Advancing Equitable Care
Nurses are uniquely positioned to address gender disparities at the bedside and within broader health systems. As the most consistent point of patient contact, nurses are trained to provide holistic and individualized care. Validating women's concerns, advocating for thorough assessments, and recognizing sex-specific symptoms are critical components of nursing care.
Moreover, nurses play a key role in education and policy advocacy. They can influence curricular reforms that emphasize the importance of sex-specific research and encourage interdisciplinary collaboration that prioritizes health equity. By staying informed about evolving research and guidelines, nurses can help bridge the evidence gap and advocate for female-inclusive healthcare strategies (Regensteiner et al., 2023).
Moving Toward Individualized, Evidence-Based Nursing Practice
To reduce health disparities, nurses must promote and implement evidence-based practices that recognize gender differences in disease risk, presentation, and treatment response. This includes ensuring female participation in research, interpreting sex-disaggregated data, and applying clinical judgment that considers both biology and lived experience.
Individualized nursing care should extend beyond clinical symptoms to incorporate socioeconomic, cultural, and psychological dimensions that affect women's access to care. By championing a model of care that is responsive, inclusive, and informed, nurses can help transform healthcare into a system that truly supports womens well-being across the lifespan.
Conclusion: The Path Forward for Women's Health Equity
Despite advances, the healthcare system continues to underserve women due to entrenched gender bias, gaps in research, and systemic barriers. The consequences are profoundhigher rates of misdiagnosis, delayed treatment, and poorer outcomes for women. As frontline advocates and caregivers, nurses must lead the effort to address these inequities.
Through advocacy, education, and evidence-based practice, nurses can elevate the standard of care for women. Embracing equity over equality, promoting individualized assessments, and supporting inclusive research are essential steps in building a fairer, more effective healthcare system for all.
References:
Gebreyes, K., Radin, J., Dhar, A., Bhatt, J., Gerhardt, W., & Korenda, L. (2024, September 10).What's causing US women to skip or delay medical care?Deloitte Center for Health Solutions.https://www.deloitte.com/us/en/insights/industry/health-care/why-women-skip-or-delay-health-care.html
Institute of Medicine (US) Committee on the Ethical and Legal Issues Relating to the Inclusion of Women in Clinical Studies; Mastroianni, A. C., Faden, R., Federman, D., and editors. (1999). Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies: Volume 2: Workshop and Commissioned Papers. Washington (DC): National Academies Press (US). Health Consequences of Exclusion or Underrepresentation of Women in Clinical Studies (I): https://www.ncbi.nlm.nih.gov/books/NBK236583/
Regensteiner, J. G., McNeil, M., Faubion, S. S., Bairey-Merz, C. N., Gulati, M., Joffe, H., Redberg, R. F., Rosen, S. E., Reusch, J. E., & Klein, W. (2025). Barriers and solutions in women's health research and clinical care: a call to action. Lancet regional health. Americas, 44, 101037. https://doi.org/10.1016/j.lana.2025.101037
About the Author:
Margaret Roe is a dedicated Bachelor of Science in Nursing student at Methodist University, graduating in April 2026. A former board-certified cardiac sonographer and current Medical ICU nurse extern, she is passionate about critical care and plans to pursue advanced practice as a CRNA. She was also recognized as an undergraduate finalist in the CEUfast Scholarship program, highlighting her academic excellence and commitment to nursing. Guided by her Christian faith and supported by her wonderful husband, an active-duty soldier, Margaret brings compassion, resilience, and a calling to serve others through nursing.
Margaret is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely those of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
If you want to learn more about CEUfast's Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.
