Tackling Medical Misogyny and Systemic Bias in Women’s Health

The relaunched women’s health strategy in England aims to address long-standing disparities in care, but experts warn that without confronting the deep-rooted influences of ethnicity, culture, and unequal access, progress will remain superficial.

Health Secretary Wes Streeting unveiled the updated strategy on 14 April 2026, acknowledging persistent failures in how women’s health concerns are heard and acted upon within the NHS. The plan responds to widespread reports of delayed diagnoses, prolonged waiting times for gynaecological care, and experiences of medical gaslighting — particularly among women from minority ethnic backgrounds.

Vanessa Haye, a public health advocate and commentator on health equity, welcomed the strategy’s relaunch but urged caution. “Ethnicity, culture and access continue to shape who is believed, how quickly, and with what outcome,” she said, emphasizing that naming problems is not the same as dismantling the systems that produce them.

One stark illustration of systemic delay is the gynaecology referral queue, which, if patients waited in person, would stretch over 191 miles — a figure cited by the Royal College of Obstetricians and Gynaecologists (RCOG) to highlight the extraordinary backlog in specialist care. This delay disproportionately affects conditions such as endometriosis, fibroids, and pelvic pain, which already take an average of seven to ten years to diagnose in the UK.

Research from the National Institute for Health and Care Research (NIHR) shows that Black and South Asian women are more likely to have their symptoms dismissed or misattributed, leading to later presentation and poorer outcomes. A 2024 study published in The Lancet Regional Health – Europe found that Black women in the UK were 40% less likely to be referred for urgent gynaecological investigation than white women presenting with identical symptoms.

Cultural factors also play a significant role. In some communities, stigma around menstrual health, reproductive issues, or mental wellbeing discourages women from seeking help early. Language barriers and lack of culturally competent care further widen the gap between need and access, particularly in urban areas with high ethnic diversity.

The strategy includes commitments to reduce waiting times, improve training on unconscious bias for healthcare staff, and expand community-based outreach. However, critics argue that without measurable targets tied to equity — such as reducing disparities in referral rates or diagnosis timelines by ethnicity — these efforts may fail to close the gap.

Dr. Anika Patel, a consultant gynaecologist at Guy’s and St Thomas’ NHS Foundation Trust, noted that while staff training is essential, it must be paired with structural change. “You can’t train your way out of a system that doesn’t prioritize women’s pain — especially when that pain belongs to a Black or brown woman,” she said in an interview with The Guardian on 19 April 2026.

Patient advocacy groups, including Endometriosis UK and Wellbeing of Women, have called for the strategy to be backed by ring-fenced funding and independent oversight. They point to previous initiatives that lacked accountability and were quietly deprioritized when funding shifted.

The Department of Health and Social Care stated that the strategy will be reviewed annually, with progress measured against key performance indicators including referral times, patient-reported experience measures (PREMs), and reduction in avoidable complications. Whether these metrics will adequately capture disparities across ethnic and cultural lines remains to be seen.

For now, the relaunch represents a recognition of failure — but not yet a remedy. As Haye warned, unless the strategy confronts how identity shapes credibility in clinical settings, it risks treating symptoms while leaving the disease of inequality untouched.