Changes from report parliamentary committee draft to plenary report

Gender inequalities in healthcare in the European Union remains a significant challenge despite some regulatory measures taken and official commitments to improve equality. This report examines the multifaceted reasons for the persistent gender inequalities in health and considers the entire cycle of healthcare, from clinical trials and drug development to diagnostics and treatment. The report also highlights the inequalities that exist in the treatment of gender-specific conditions, such as menopause, endometriosis etc.

Whilst the thrust of the inequalities discussed in this report concern gender inequalities as they pertain to women, many of the sources of inequality apply equally to other groups of people, such as transgender people and ethnic minority communities, and the rapporteur intends for the actions he proposes to also benefit these groups.

The rapporteur believes that, given the complex origins of the gender inequalities, policy makers must take a holistic approach to these and work closely with the medical profession and civil society. The rapporteur reiterates his support for gender mainstreaming throughout all relevant policies and the EU budget and considers this a necessary catalyst for addressing the specific sources of inequality.

Much of the inequality stems from systemic biases within the medical eco-system. Medical research and drug development have historically been male-centric. This bias ignores the fact that medical conditions may present differently in the female body and the female anatomy may react differently to drugs and treatments. These knowledge gaps are compounded by the consistent and repeated underfunding of research into women’s health and gender-specific conditions, with only 5 % of global research and development funding allocated to women’s health research in 20201.

Despite the considerable medical advances in the last 50 years and improvements to national healthcare systems, women persistently face misdiagnosis, dismissal of their symptoms, and adverse drug reactions. Often, there is simply not a known effective treatment for their condition, like in the cases of endometriosis and premenstrual dysphoric disorder (PMDD).

The inequalities women are subject to in healthcare are often mirrored and even amplified by intersectional inequality faced by other underrepresented communities, including transgender people and ethnic minority and migrant communities, as well as by geographical inequalities.

Clinical Trials

The EU Clinical Trials Regulation (EU) No 536/2014 introduced obligations designed to promote inclusivity, including the need to scientifically justify why certain groups are excluded. Nonetheless, representation of women in clinical trials remains below that of men and the disparity is particularly acute for pregnant and breastfeeding women, with less than 0.4 % of clinical trials in the EU including pregnant women2. Moreover, there are no obligations to ensure diversity in the pre-trial phase with the majority of animal testing still conducted on male species only3.

The report also highlights the lack of sex-disaggregated data which contributes to the knowledge gap in women’s health.

Diagnostics and Treatment

The historic male-centred approach to medicine has been embedded in diagnostic and treatment procedures and the lack of a gender-sensitive approach to medicine can lead to substandard and higher risk treatment for women.

For example, cardiovascular disease is the leading cause of death among women in the EU yet their symptoms present in a so-called “atypical” manner and so women are twice as likely to have heart failure misdiagnosed4. The treatment of pain and of mental health also provides stark examples of the ingrained biases in diagnostics and treatment.

The rapporteur considers it essential that Member States, in close cooperation with the medical profession and educational institutions, integrate gender-sensitive healthcare training into the medical curriculum. The rapporteur also stresses that any changes to bedside procedures should be informed by real-life patient experience.

Gender-specific conditions

Due to chronic underfunding and lack of prioritisation in research, the medical advancements for gender-specific issues are lagging and the gap is particularly pronounced for female-specific issues.

Endometriosis

Endometriosis is a chronic condition which can cause symptoms such as severe pain, heavy bleeding, and fatigue. It is estimated that endometriosis affects 10 % – 15 % of women of reproductive age5. Due to lack of understanding among medical professionals and inbuilt biases which result in the dismissal of symptoms – often as “normal period pain” – the condition takes, on average, 6 to 10 years to diagnose. This delay is systemic, not accidental.

Menopause

85 % of women experience menopause symptoms and by 2030, an estimated 1.2 billion women will be experiencing menopause globally6. Yet, access to care varies widely between countries and it is often still shrouded in social stigma. Moreover, menopause care is hindered by long waiting times, limited specialist services, and inconsistent guidelines for hormone replacement therapy (HRT). Many patients report that symptoms are dismissed as “normal ageing,” reinforcing gendered assumptions about women’s health and resilience. Furthermore, the majority of existing medical research focuses on the years of fertility and, therefore, overlooks puberty, perimenopause and menopause.

Sexual Health and Reproductive Rights

An individuals’ ability to exercise their sexual and reproductive health rights (SRHR) and their right to bodily integrity and autonomy must be guaranteed in order to achieve gender equality. As such, the rapporteur believes that the SRHR and the right to safe and legal abortion should be enshrined in the Charter of the Fundamental Rights of the European Union.

The adoption of Parliament’s response to the European Citizen’s Initiative, “My Voice, My Choice” in December 2025 was a momentous achievement, issuing a strong call on the Commission to take action. Moreover, the report sends a meaningful signal to the EU citizens that Parliament supports the rights of women and girls and will fight to ensure equality.

Funding

The rapporteur recognises that EU funding can play a significant role in encouraging far greater investment in research into gender-specific issues and addressing the inequalities in access to treatment across the Union. He is of the view that dedicated funding calls for gender-specific conditions may be necessary.

In this report, the rapporteur highlights that investing in closing the gap in sex-specific health data presents a competitive opportunity for Europe. Not only could it contribute to addressing the loss to the EU economy from sick leave for gender-specific conditions7, but could also crowd in private investment and offer a solid basis for further innovation in Europe.

As a first step, the Commission must use the forthcoming Strategy on Gender Equality (2026-2030) to reinforce and build upon the principles on women’s health set out in its 2025 Roadmap for Women’s Rights by proposing concrete measures that will prioritise and incentivise investment into gender-specific conditions.